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https://www.readbyqxmd.com/read/29441350/perioperative-goal-directed-therapy-using-invasive-uncalibrated-pulse-contour-analysis
#1
Bernd Saugel, Daniel A Reuter
"Perioperative goal-directed therapy" (PGDT) aims at an optimization of basic and advanced global hemodynamic variables to maintain adequate oxygen delivery to the end-organs. PGDT protocols help to titrate fluids, vasopressors, or inotropes to hemodynamic target values. There is considerable evidence that PGDT can improve patient outcome in high-risk patients if both fluids and inotropes are administered to target hemodynamic variables reflecting blood flow. Despite this evidence, PGDT strategies aiming at an optimization of blood flow seem to be not well implemented in routine clinical care...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29436001/effects-of-pulsatile-blood-flow-on-oxygenator-performance
#2
Lotte Schraven, Andreas Kaesler, Christian Flege, Rüdger Kopp, Thomas Schmitz-Rode, Ulrich Steinseifer, Jutta Arens
Extracorporeal membrane oxygenation (ECMO) is mainly used for the therapy of acute respiratory distress syndrome and chronic obstructive lung disease. In the last years, the development of these systems underwent huge steps in optimization, but there are still problems with thrombus formation, clogging, and thus insufficient gas exchange. One idea of ECMO optimization is a pulsatile blood flow through the oxygenator, but this is still a controversy discussion. Analyzing available publications, it was not possible to identify a general statement about the effect of pulsatile blood flow on the gas exchange performance...
February 13, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29432140/noise-exposure-from-high-flow-nasal-cannula-oxygen-therapy-a-bench-study-on-noise-reduction
#3
Takamitsu Kubo, Hiroaki Nakajima, Ryo Shimoda, Tatsuya Seo, Yurie Kanno, Toshikazu Kondo, Sunao Tamai
BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy produces noise at a level such that patients often complain. However, the noise level has not been measured digitally. METHODS: We evaluated 3 types of HFNCs without filters and 2 types with filters attached for noise reduction. Optiflow (with and without a filter), MaxVenturi (with and without a filter) and AIRVO2 (without a filter only) were positioned at the center of a hospital room. We measured the noise levels at the distance of 1 m from the equipment at various total flows (30, 40, 50, 60 L/min) and F IO 2 (0...
February 6, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29431543/high-flow-nasal-oxygen-therapy-utilization-7-year-experience-at-a-community-teaching-hospital
#4
Mihaela S Stefan, Patrick Eckert, Bogdan Tiru, Jennifer Friderici, Peter K Lindenauer, Jay S Steingrub
OBJECTIVE: To examine the use of high flow nasal cannula oxygen therapy (HFNC) between 2008 and 2014 in patients 18 years or older at a community teaching hospital. METHODS: Yearly utilization rates of HFNC, noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV) were calculated among admissions with a set of cardiopulmonary diagnoses (heart failure, COPD, asthma or pneumonia). RESULTS: Among the 41,711 admissions with at least one of the above cardiopulmonary condition, HFNC was utilized in 1,128 or 27...
February 15, 2018: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29419538/percutaneous-mechanical-circulation-support-combined-with-extracorporeal-membrane-oxygenation-oxyrvad-in-secondary-right-heart-failure
#5
Philipp M Lepper, Sabrina I Hörsch, Frederik Seiler, Annegret Kamp, Sören L Becker, Christian Lensch, Lars O Conzelmann, Hendrik Haake, Ralf M Muellenbach, Robert Bals, Markus Kredel, Frank Langer, Heinrike Wilkens, Franziska C Trudzinski
Right heart failure (RHF) because of pulmonary hypertension (PH) is a frequently encountered clinical problem with high mortality. The last resort, if pharmacological therapy fails, is mechanical circulatory support. There is a lack of percutaneous systems to support the right ventricle (RV). Venoarterial extracorporeal membrane oxygenation is widely used as a bailout in acute RHF in non-left ventricular assist device patients. Venoarterial extracorporeal membrane oxygenation does not unload the left ventricle and may cause failure of the left ventricle if used for a longer period of time...
February 6, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29409542/to-eat-or-to-breathe-the-answer-is-both-nutritional-management-during-noninvasive-ventilation
#6
EDITORIAL
Pierre Singer, Sornwichate Rattanachaiwong
Treating respiratory distress is a priority when managing critically ill patients. Non-invasive ventilation (NIV) is increasingly used as a tool to prevent endotracheal intubation. Providing oral or enteral nutritional support during NIV may be perceived as unsafe because of the possible risk of aspiration so that these patients are frequently denied adequate caloric and protein intake. Newly available therapies, such as high-flow nasal oxygen (HFNO) may allow for more appropriate oral feeding.
February 6, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29397127/high-flow-nasal-oxygen-therapy-in-intensive-care-and-anaesthesia
#7
REVIEW
T Renda, A Corrado, G Iskandar, G Pelaia, K Abdalla, P Navalesi
Oxygen therapy is first-line treatment for hypoxaemic acute respiratory failure (ARF). High-flow nasal oxygen therapy (HFNO) represents an alternative to conventional oxygen therapy. HFNO provides humidified, titrated oxygen therapy matching or even exceeding the patients' inspiratory demand. The application of HFNO is becoming widespread in Intensive Care Units (ICUs), favoured by increasing evidence based on numerous studies supporting its efficacy. The mechanisms of action and physiological effects of HFNO are not yet fully understood...
January 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29392846/high-flow-nasal-cannulae-oxygen-therapy-in-acute-moderate-hypercapnic-respiratory-failure
#8
Myoung Kyu Lee, Jaehwa Choi, Bonil Park, Bumjoon Kim, Seok Jeong Lee, Sang-Ha Kim, Suk Joong Yong, Eun Hee Choi, Won-Yeon Lee
INTRODUCTION: Severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a significant event that results in substantial mortality. OBJECTIVES: We evaluated the effectiveness of the high flow nasal cannulae (HFNC) therapy in severe AECOPD with moderate hypercapnic acute respiratory failure (ARF) compared to non-invasive ventilation (NIV). METHODS: The prospective observational trial was performed to compare the effectiveness between the HFNC and NIV in severe AECOPD with moderate hypercapnic ARF...
February 2, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29372630/what-can-we-apply-to-manage-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-acute-respiratory-failure
#9
REVIEW
Deog Kyeom Kim, Jungsil Lee, Ju Hee Park, Kwang Ha Yoo
Acute exacerbation(s) of chronic obstructive pulmonary disease (AECOPD) tend to be critical and debilitating events leading to poorer outcomes in relation to chronic obstructive pulmonary disease (COPD) treatment modalities, and contribute to a higher and earlier mortality rate in COPD patients. Besides pro-active preventative measures intended to obviate acquisition of AECOPD, early recovery from severe AECOPD is an important issue in determining the long-term prognosis of patients diagnosed with COPD. Updated GOLD guidelines and recently published American Thoracic Society/European Respiratory Society clinical recommendations emphasize the importance of use of pharmacologic treatment including bronchodilators, systemic steroids and/or antibiotics...
January 24, 2018: Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29359072/efficacy-and-safety-of-using-high-flow-nasal-oxygenation-in-patients-undergoing-rapid-sequence-intubation
#10
Santi Maurizio Raineri, Andrea Cortegiani, Giuseppe Accurso, Claudia Procaccianti, Filippo Vitale, Sabrina Caruso, Antonino Giarratano, Cesare Gregoretti
Objective: To assess the efficacy and safety of high-flow nasal oxygen (HFNO) therapy in patients undergoing rapid sequence intubation (RSI) for emergency abdominal surgery. Methods: HFNO of 60 L.min-1 at an inspiratory oxygen fraction of 1 was delivered 4 min before laryngoscopy and maintained until the patient was intubated, and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. Transcutaneous oxygenation (SpO2), heart rate and non-invasive mean arterial pressure were monitored at baseline (T0), after 4 min on HFNO (T1) and at the time of laryngoscopy (T2) and endotracheal intubation (ETI) (T3)...
December 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29355381/detection-of-microembolic-signals-in-the-common-carotid-artery-using-doppler-sonography-in-the-porcine-model-of-acute-heart-failure-treated-by-veno-arterial-extracorporeal-membrane-oxygenation
#11
D Janák, P Hála, M Mlček, M Popková, S Lacko, J Kudlička, O Kittnar
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is a method used for the treatment most severe cases of decompensated heart failure. The purpose of this study was to evaluate the risk of the formation of microembolisms during VA-ECMO-based therapy. Heart failure was induced with simultaneous detection of microembolisms and the measurement of blood flow rate in the common carotid artery (CCA) without VA-ECMO (0 l/min) and at the VA-ECMO blood flow rate of 1, 2, 3 and 4 l/min. If embolisms for VA-ECMO 0 l/min and the individual regimes for VA-ECMO 1, 2, 3, 4 l/min are compared, a higher VA-ECMO flow rate is accompanied by a higher number of microembolisms...
December 30, 2017: Physiological Research
https://www.readbyqxmd.com/read/29354672/impact-of-heated-humidified-high-flow-air-via-nasal-cannula-on-respiratory-effort-in-patients-with-chronic-obstructive-pulmonary-disease
#12
Charles W Atwood, Sharon Camhi, Kathryn C Little, Colleen Paul, Hobart Schweikert, Nicholas J Macmillan, Thomas L Miller
Background: High flow nasal cannula therapy (HFNC) has been widely adopted for respiratory distress, and evidence suggests that purging dead space of the upper airway improves gas fractions in the lung. This study tests the hypothesis that HFNC with room air could be as effective as low flow oxygen in chronic obstructive pulmonary disease (COPD). Methods: Thirty-two COPD patients prescribed 1 - 2 L/min of oxygen were studied. The conditions tested consisted of a control (CTRL; no therapy), then in random order HFNC and prescribed low flow oxygen (LFO)...
August 15, 2017: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29350596/enhancement-of-antitumor-activity-by-using-5-ala-mediated-sonodynamic-therapy-to-induce-apoptosis-in-malignant-gliomas-significance-of-high-intensity-focused-ultrasound-on-5-ala-sdt-in-a-mouse-glioma-model
#13
Satoshi Suehiro, Takanori Ohnishi, Daisuke Yamashita, Shohei Kohno, Akihiro Inoue, Masahiro Nishikawa, Shiro Ohue, Junya Tanaka, Takeharu Kunieda
OBJECTIVE High invasiveness of malignant gliomas frequently causes early local recurrence of the tumor, resulting in extremely poor outcome. To control such recurrence, novel therapies targeted toward infiltrating glioma cells around the tumor border are required. Here, the authors investigated the antitumor activity of sonodynamic therapy (SDT) combined with a sonosensitizer, 5-aminolevulinic acid (5-ALA), on malignant gliomas to explore the possibility for clinical use of 5-ALA-mediated SDT (5-ALA-SDT). METHODS In vitro cytotoxicity of 5-ALA-SDT was evaluated in U87 and U251 glioma cells and in U251Oct-3/4 glioma stemlike cells...
January 19, 2018: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29343034/-a-study-on-the-effects-and-safety-of-sequential-humidified-high-flow-nasal-cannula-oxygenation-therapy-on-the-copd-patients-after-extubation
#14
J C Zhang, F X Wu, L L Meng, C Y Zeng, Y Q Lu
Objective: To investigate and compare the effect and safety of nasal high-flow oxygen therapy (HFNCO) and noninvasive ventilation (NIV) therapy after extubation in patients with chronic obstructive pulmonary disease (COPD). Methods: All COPD patients subjected to mechanical ventilation in the Emergency Intensive Unit of the First Affiliated Hospital of Zhejiang University during January 2015 to June 2016 were included in the study. The patients were divided into two groups after extubation and HFNCO and NIV were adopted on each group respectively...
January 9, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29331328/pilot-clinical-trial-of-high-flow-oxygen-therapy-in-children-with-asthma-in-the-emergency-service
#15
Yolanda Ballestero, Jimena De Pedro, Nancy Portillo, Otilia Martinez-Mugica, Eunate Arana-Arri, Javier Benito
OBJECTIVES: To assess the efficacy of high-flow nasal cannula (HFNC) oxygen therapy and safety in children with asthma and moderate respiratory failure in the emergency department (ED). STUDY DESIGN: This was a prospective randomized pilot trial of children (aged 1-14 years) presenting to a tertiary academic pediatric ED with moderate-to-severe asthma exacerbations between September 2012 and December 2015. Patients with a pulmonary score (PS) ≥6 or oxygen saturation <94% with a face mask despite initial treatment (salbutamol/ipratropium bromide and corticosteroids) were randomized to HFNC or to conventional oxygen therapy...
January 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29326765/pneumocephalus-following-combined-spinal-epidural-anaesthesia-for-total-knee-arthroplasty-a-case-report
#16
Y W Chew, V K Suppan, S R Ashutosh, M M Tew, J H Jimmy-Tan
The authors describe a case of pneumocephalus following epidural anaesthesia for total knee arthroplasty. Multiple attempts in locating the epidural space for the anaesthesia and the use of loss of resistance to air (LORA) technique were identified as the source of air entry. Supportive management was given including high flow oxygenation therapy and spontaneous reabsorption of air was noted five days after surgery. The presence of pneumocephalus should be kept in mind if patient develops neurological complications postoperatively following epidural anaesthesia...
November 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29315036/high-flow-nasal-oxygen-therapy
#17
Keir Pickard, Steve Harris
No abstract text is available yet for this article.
January 2, 2018: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29283682/domiciliary-high-flow-nasal-cannula-oxygen-therapy-for-stable-hypercapnic-copd-patients-a-multicenter-randomized-crossover-trial
#18
Kazuma Nagata, Takashi Kikuchi, Takeo Horie, Akira Shiraki, Takamasa Kitajima, Toru Kadowaki, Fumiaki Tokioka, Naohiko Chohnabayashi, Akira Watanabe, Susumu Sato, Keisuke Tomii
RATIONALE: A growing evidence base suggests a benefit of using high-flow nasal cannula oxygen therapy (HFNC) in the acute setting. However, the clinical benefit of domiciliary use of HFNC in patients with chronic hypercapnic respiratory failure due to chronic obstructive pulmonary disease (COPD) remains unclear. OBJECTIVES: To evaluate the efficacy and safety of HFNC use in stable COPD patients. METHODS: This was a multicenter, randomized crossover trial comparing HFNC plus long-term oxygen therapy (HFNC/LTOT) with LTOT-only in 32 adults with stable hypercapnic COPD...
December 28, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29275345/preoxygenation-with-non-invasive-ventilation-versus-high-flow-nasal-cannula-oxygen-therapy-for-intubation-of-patients-with-acute-hypoxaemic-respiratory-failure-in-icu-the-prospective-randomised-controlled-florali-2-study-protocol
#19
Jean-Pierre Frat, Jean-Damien Ricard, Rémi Coudroy, René Robert, Stéphanie Ragot, Arnaud W Thille
INTRODUCTION: Endotracheal intubation in intensive care unit (ICU) is a procedure at high risk of life-threatening complications. Among them, severe oxygen desaturation, usually defined as a drop of pulse oxymetry (SpO2) below 80%, is the most common. Preoxygenation enables delaying oxygen desaturation occurring during apnea induced by anaesthetic drugs. Data suggest that non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) oxygen therapy could further increase PaO2 before intubation procedure and prevent oxygen desaturation episodes as compared with standard oxygen...
December 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29250178/toll-like-receptor-9-in-hypoxic-nasopharyngeal-carcinoma-cells-and-its-correlation-with-cell-proliferation-and-apoptosis
#20
Feng Zhang, Deli Wang, Fasheng Chen
The purpose of this study was to investigate the correlation between the expression of Toll-like receptor-9 (TLR-9) and cell proliferation and apoptosis in hypoxic nasopharyngeal carcinoma cells. Human nasopharyngeal carcinoma cell line HNE-1 (EBV positive) and CNE-1 (EBV negative) were used. Cells were divided into normal control group, hypoxia group and hyperoxia group. Hypoxic conditions were 5% CO2 and 0.01% partial pressure of oxygen, hyperoxia conditions were 5% CO2 and 10% partial pressure of oxygen...
December 2017: Oncology Letters
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