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ventilation randomized controlled trial

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https://www.readbyqxmd.com/read/28444078/expiratory-rib-cage-compression-in-mechanically-ventilated-adults-systematic-review-with-meta-analysis
#1
Lúcia Faria Borges, Mateus Sasso Saraiva, Marcos Ariel Sasso Saraiva, Fabrício Edler Macagnan, Adriana Kessler
Objective: To review the literature on the effects of expiratory rib cage compression on ventilatory mechanics, airway clearance, and oxygen and hemodynamic indices in mechanically ventilated adults. Methods: Systematic review with meta-analysis of randomized clinical trials in the databases MEDLINE (via PubMed), EMBASE, Cochrane CENTRAL, PEDro, and LILACS. Studies on adult patients hospitalized in intensive care units and under mechanical ventilation that analyzed the effects of expiratory rib cage compression with respect to a control group (without expiratory rib cage compression) and evaluated the outcomes static and dynamic compliance, sputum volume, systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, peripheral oxygen saturation, and ratio of arterial oxygen partial pressure to fraction of inspired oxygen were included...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28441237/noninvasive-ventilation-in-acute-hypoxemic-nonhypercapnic-respiratory-failure-a-systematic-review-and-meta-analysis
#2
Xiu-Ping Xu, Xin-Chang Zhang, Shu-Ling Hu, Jing-Yuan Xu, Jian-Feng Xie, Song-Qiao Liu, Ling Liu, Ying-Zi Huang, Feng-Mei Guo, Yi Yang, Hai-Bo Qiu
OBJECTIVE: To evaluate the effectiveness of noninvasive ventilation in patients with acute hypoxemic nonhypercapnic respiratory failure unrelated to exacerbation of chronic obstructive pulmonary disease and cardiogenic pulmonary edema. DATA SOURCES: PubMed, EMBASE, Cochrane library, Web of Science, and bibliographies of articles were retrieved inception until June 2016. STUDY SELECTION: Randomized controlled trials comparing application of noninvasive ventilation with standard oxygen therapy in adults with acute hypoxemic nonhypercapnic respiratory failure were included...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28437539/safety-and-efficacy-of-antiviral-therapy-for-prevention-of-cytomegalovirus-reactivation-in-immunocompetent-critically-ill-patients-a-randomized-clinical-trial
#3
Nicholas J Cowley, Andrew Owen, Sarah C Shiels, Joanne Millar, Rebecca Woolley, Natalie Ives, Husam Osman, Paul Moss, Julian F Bion
Importance: Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in body fluids such as blood) can occur in up to one-third of these individuals during episodes of critical illness. Objective: To determine whether antiviral therapy is safe and effective for preventing CMV reactivation in a general population of critically ill patients. Design, Setting, and Participants: A single-center, open-label, randomized, controlled clinical trial recruited 124 CMV-seropositive patients undergoing mechanical ventilation for at least 24 hours in the intensive care unit between January 1, 2012, and January 31, 2014...
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28429603/effect-of-high-flow-nasal-cannula-oxygen-therapy-versus-conventional-oxygen-therapy-and-noninvasive-ventilation-on-reintubation-rate-in-adult-patients-after-extubation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#4
Hua-Wei Huang, Xiu-Mei Sun, Zhong-Hua Shi, Guang-Qiang Chen, Lu Chen, Jan O Friedrich, Jian-Xin Zhou
PURPOSE: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the effect of high-flow nasal cannula (HFNC) on reintubation in adult patients. PROCEDURES: Ovid Medline, Embase, and Cochrane Database of Systematic Reviews were searched up to November 1, 2016, for RCTs comparing HFNC versus conventional oxygen therapy (COT) or noninvasive ventilation (NIV) in adult patients after extubation. The primary outcome was reintubation rate, and the secondary outcomes included complications, tolerance and comfort, time to reintubation, length of stay, and mortality...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28413460/early-application-of-low-dose-glucocorticoid-improves-acute-respiratory-distress-syndrome-a-meta-analysis-of-randomized-controlled-trials
#5
Zhi-Gang Yang, Xiao-Li Lei, Xiao-Liang Li
Previous clinical trials have investigated the effect of glucocorticoid therapy in acute respiratory distress syndrome (ARDS), with controversial results, particularly with regard to the early administration of low dose glucocorticoid. The present meta-analysis aimed to assess whether the application of glucocorticoid was able to reduce mortality in patients with ARDS. A literature search was performed using online databases, including MEDLINE, Embase, Cochrane and CNKI regardless of whether the studies were published in English or Chinese...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28412111/apneic-oxygen-insufflation-decreases-the-incidence-of-hypoxemia-during-one-lung-ventilation-in-open-and-thoracoscopic-pulmonary-lobectomy-a-randomized-controlled-trial
#6
Dae Myung Jung, Hyun Joo Ahn, Sin-Ho Jung, Mikyung Yang, Jie Ae Kim, Su Min Shin, Suyong Jeon
OBJECTIVE: Hypoxemia is common during one-lung ventilation (OLV) for thoracic surgery. When hypoxemia occurs, surgery is interrupted for rescue ventilation. Apneic oxygen insufflation (AOI), which provides O2 without applying pressure, may prevent hypoxemia and does not interrupt surgery. The aim of this study was to determine the effectiveness of the AOI technique for preventing hypoxemia during OLV in thoracic surgery. METHODS: Patients undergoing open or thoracoscopic pulmonary lobectomy from September to December 2015 were included...
March 10, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28410087/racial-and-ethnic-disparities-in-parental-refusal-of-consent-in-a-large-multisite-pediatric-critical-care-clinical-trial
#7
Joanne E Natale, Ruth Lebet, Jill G Joseph, Christine Ulysse, Judith Ascenzi, David Wypij, Martha A Q Curley
OBJECTIVE: To evaluate whether race or ethnicity was independently associated with parental refusal of consent for their child's participation in a multisite pediatric critical care clinical trial. STUDY DESIGN: We performed a secondary analyses of data from Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE), a 31-center cluster randomized trial of sedation management in critically ill children with acute respiratory failure supported on mechanical ventilation...
May 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28409851/response-to-a-combination-of-oxygen-and-a-hypnotic-as-treatment-for-obstructive-sleep-apnoea-is-predicted-by-a-patient-s-therapeutic-cpap-requirement
#8
Shane A Landry, Simon A Joosten, Scott A Sands, David P White, Atul Malhotra, Andrew Wellman, Garun S Hamilton, Bradley A Edwards
BACKGROUND AND OBJECTIVE: Upper airway collapsibility predicts the response to several non-continuous positive airway pressure (CPAP) interventions for obstructive sleep apnoea (OSA). Measures of upper airway collapsibility cannot be easily performed in a clinical context; however, a patient's therapeutic CPAP requirement may serve as a surrogate measure of collapsibility. The present work aimed to compare the predictive use of CPAP level with detailed physiological measures of collapsibility...
April 13, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28407831/-a-meta-analysis-of-the-efficacy-of-high-frequency-oscillatory-ventilation-versus-conventional-mechanical-ventilation-for-treating-pediatric-acute-respiratory-distress-syndrome
#9
Jun-Ying Qiao, Yuan-Zhe Li, He-Yi Wang, Shuai-Dan Zhang
OBJECTIVE: To systematically assess the clinical efficacy of high-frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) for treating pediatric acute respiratory distress syndrome (ARDS). METHODS: Data from randomized controlled trials comparing HFOV and CMV in the treatment of pediatric ARDS published before July 2016 were collected from the Cochrane Library, PubMed, Medline, CNKI, and Wanfang Data. Literature screening, data extraction, and quality assessment were performed by two independent reviewers according to the inclusion and exclusion criteria...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28406862/a-randomized-controlled-trial-of-corticosteroids-in-pediatric-septic-shock-a-pilot-feasibility-study
#10
Kusum Menon, Dayre McNally, Katharine O'Hearn, Anand Acharya, Hector R Wong, Margaret Lawson, Tim Ramsay, Lauralyn McIntyre, Elaine Gilfoyle, Marisa Tucci, David Wensley, Ronald Gottesman, Gavin Morrison, Karen Choong
OBJECTIVE: To determine the feasibility of conducting a randomized controlled trial of corticosteroids in pediatric septic shock. DESIGN: Randomized, double-blind, placebo controlled trial. SETTING: Seven tertiary level PICUs in Canada. PATIENTS: Children newborn to 17 years old inclusive with suspected septic shock. INTERVENTION: Administration of IV hydrocortisone versus placebo until hemodynamic stability is achieved or for a maximum of 7 days...
April 12, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28406814/pilot-feasibility-study-of-therapeutic-hypothermia-for-moderate-to-severe-acute-respiratory-distress-syndrome
#11
Donald F Slack, Douglas S Corwin, Nirav G Shah, Carl B Shanholtz, Avelino C Verceles, Giora Netzer, Kevin M Jones, Clayton H Brown, Michael L Terrin, Jeffrey D Hasday
OBJECTIVES: Prior studies suggest hypothermia may be beneficial in acute respiratory distress syndrome, but cooling causes shivering and increases metabolism. The objective of this study was to assess the feasibility of performing a randomized clinical trial of hypothermia in patients with acute respiratory distress syndrome receiving treatment with neuromuscular blockade because they cannot shiver. DESIGN: Retrospective study and pilot, prospective, open-label, feasibility study...
April 12, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28403395/individual-patient-data-analysis-of-tidal-volumes-used-in-three-large-randomized-control-trials-involving-patients-with-acute-respiratory-distress-syndrome
#12
J Poole, C McDowell, R Lall, G Perkins, D McAuley, F Gao, D Young
Background.: The acute respiratory distress syndrome (ARDS) is a condition with a high mortality and morbidity. Mechanical ventilation prevents immediate mortality but may further damage patients' lungs. Low tidal volume lung-protective strategies have been shown to increase survival by reducing this iatrogenic damage. Current guidelines recommend tidal volumes of 6-8 ml kg -1 of predicted body weight. We used data from three large randomized controlled trials of treatments for ARDS to determine compliance with these recommendations...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28402093/extracorporeal-co2-removal-ecco2r-in-critically-ill-patients-a-systematic-review
#13
Fabio S Taccone, Maximilian V Malfertheiner, Fiorenza Ferrari, Matteo DI Nardo, Justyna Swol, Lars M Broman, Leen Vercaemst, Nicholas Barrett, Federico Pappalardo, Jan Belohlavek, Thomas Mueller, Roberto Lorusso, Mirko Belliato
INTRODUCTION: The use of extracorporeal CO2 removal (ECCO2R) is increasingly employed in critically ill patients. However, the clinical evidence supporting its efficacy remains currently poor. EVIDENCE ACQUISITION: A systematic review using MEDLINE via PubMed was performed to identify eligible studies (until 30th September 2016). The amount of CO2 reduction, the effect on the duration of mechanical ventilation and weaning, the impact on patients' outcome and the occurrence of complications were evaluated...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28395175/oxygen-and-oxidative-stress-in-the-perinatal-period
#14
REVIEW
Isabel Torres-Cuevas, Anna Parra-Llorca, Angel Sánchez-Illana, Antonio Nuñez-Ramiro, Julia Kuligowski, Consuelo Cháfer-Pericás, María Cernada, Justo Escobar, Máximo Vento
Fetal life evolves in a hypoxic environment. Changes in the oxygen content in utero caused by conditions such as pre-eclampsia or type I diabetes or by oxygen supplementation to the mother lead to increased free radical production and correlate with perinatal outcomes. In the fetal-to-neonatal transition asphyxia is characterized by intermittent periods of hypoxia ischemia that may evolve to hypoxic ischemic encephalopathy associated with neurocognitive, motor, and neurosensorial impairment. Free radicals generated upon reoxygenation may notably increase brain damage...
March 12, 2017: Redox Biology
https://www.readbyqxmd.com/read/28393258/intermittent-noninvasive-ventilation-after-extubation-in-patients-with-chronic-respiratory-disorders-a-multicenter-randomized-controlled-trial-vhyper
#15
Frédéric Vargas, Marc Clavel, Pascale Sanchez-Verlan, Sylvain Garnier, Alexandre Boyer, Hoang-Nam Bui, Benjamin Clouzeau, Charline Sazio, Aissa Kerchache, Olivier Guisset, Antoine Benard, Julien Asselineau, Bernard Gauche, Didier Gruson, Stein Silva, Philippe Vignon, Gilles Hilbert
PURPOSE: Early noninvasive ventilation (NIV) after extubation decreases the risk of respiratory failure and lowers 90-day mortality in patients with hypercapnia. Patients with chronic respiratory disease are at risk of extubation failure. Therefore, it could be useful to determine the role of NIV with a discontinuous approach, not limited to patients with hypercapnia. We assessed the efficacy of early NIV in decreasing respiratory failure after extubation in patients with chronic respiratory disorders...
April 9, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28392369/compression-to-ventilation-ratio-and-incidence-of-rearrest-a-secondary-analysis-of-the-roc-ccc-trial
#16
David D Salcido, Robert H Schmicker, Jason E Buick, Sheldon Cheskes, Brian Grunau, Peter Kudenchuk, Brian Leroux, Stephanie Zellner, Dana Zive, Tom P Aufderheide, Allison C Koller, Heather Herren, Jack Nuttall, Matthew L Sundermann, James J Menegazzi
BACKGROUND: Previous work has demonstrated that when out-of-hospital cardiac arrest (OHCA) patients achieve return of spontaneous circulation (ROSC), but subsequently have another cardiac arrest prior to hospital arrival (rearrest), the probability of survival to hospital discharge is significantly decreased. Additionally, few modifiable factors for rearrest are known. We sought to examine the association between rearrest and compression-to-ventilation ratio during cardiopulmonary resuscitation (CPR) and to confirm the association between rearrest and outcomes...
April 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28372953/noninvasive-positive-pressure-ventilation-in-the-immediate-post-bariatric-surgery-care-of-patients-with-obstructive-sleep-apnea-a-systematic-review
#17
REVIEW
Solomon Tong, Jonathan Gower, Austin Morgan, Kyle Gadbois, Gordon Wisbach
BACKGROUND: Obstructive sleep apnea is common in morbidly obese patients, and noninvasive positive pressure ventilation (NIPPV) is the standard treatment. Postoperatively, NIPPV is highly effective in preventing hypoxia and apneic episodes; however, the concern of gastric distention leading to increased risk of an anastomotic dehiscence limits universal acceptance. OBJECTIVE: To perform a systematic review of the literature to determine if the use of NIPPV during immediate post-bariatric surgery care is safe...
February 20, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28359172/efficacy-of-a-new-device-to-optimize-positive-pressure-ventilation-via-face-mask-in-edentulous-patients-a-randomized-trial
#18
Maria C Niño, Andres Pauwels, Fernando Raffan, Enrique Arango, David J Romero, Daniel Benitez
BACKGROUND: Mask ventilation is routinely performed during anesthesia. Under some circumstances, it might be difficult to perform, such as in edentulous patients, due to inadequate mask seal. We developed a new device called NIPARA and studied its use For ventilation optimization in edentulous patients. METHODS: This randomized controlled trial included edentulous adults who had no other predictors of difficult airway, scheduled to undergo general anesthesia. Patients were assigned either to the NIPARA device group or to the control group (oral airway only)...
April 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28355359/oxidative-stress-and-immune-system-analysis-after-cycle-ergometer-use-in-critical-patients
#19
Eduardo Eriko Tenório de França, Luana Carneiro Ribeiro, Gabriela Gomes Lamenha, Isabela Kalline Fidelix Magalhães, Thainá de Gomes Figueiredo, Marthley José Correia Costa, Ubiracé Fernando Elihimas, Bárbara Luana Feitosa, Maria do Amparo Andrade, Marco Aurélio Valois Correia, Francimar Ferrari Ramos, Célia Maria Machado Barbosa de Castro
OBJECTIVE: The passive cycle ergometer aims to prevent hypotrophy and improve muscle strength, with a consequent reduction in hospitalization time in the intensive care unit and functional improvement. However, its effects on oxidative stress and immune system parameters remain unknown. The aim of this study is to analyze the effects of a passive cycle ergometer on the immune system and oxidative stress in critical patients. METHODS: This paper describes a randomized controlled trial in a sample of 19 patients of both genders who were on mechanical ventilation and hospitalized in the intensive care unit of the Hospital Agamenom Magalhães...
March 2017: Clinics
https://www.readbyqxmd.com/read/28350645/the-use-of-bowel-protocols-in-critically-ill-adult-patients-a-systematic-review-and-meta-analysis
#20
Simon J W Oczkowski, Erick H Duan, Amy Groen, Dawn Warren, Deborah J Cook
OBJECTIVE: Constipation is common among critically ill patients and has been associated with adverse patient outcomes. Many ICUs have developed bowel protocols to treat constipation; however, their effect on clinical outcomes remains uncertain. We conducted a systematic review to determine the impact of bowel protocols in critically ill adults. DATA SOURCES: We searched MEDLINE, Embase, CINAHL, CENTRAL, ISRCTN, ClinicalTrials.gov, and conference abstracts until January 2016...
March 27, 2017: Critical Care Medicine
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