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https://www.readbyqxmd.com/read/29789999/assessing-the-correct-inflation-of-the-endotracheal-tube-cuff-a-larger-pilot-balloon-increases-the-sensitivity-of-the-finger-pressure-technique-but-it-remains-poorly-reliable-in-clinical-practice
#1
Antonio Pisano, Luigi Verniero, Nicola Galdieri, Antonio Corcione
The pilot balloon palpation (or 'finger-pressure') method is still widely used to assess the endotracheal tube cuff inflation, despite consistent evidence of its poor sensitivity in recognizing cuff overinflation. It was recently speculated that this may be related to the lower wall tension (due to the smaller radius) of the pilot balloon as compared with the cuff, according to Laplace's law. To verify this hypothesis and, secondarily, to assess whether the use of a 'large' pilot balloon (identical to the cuff) increases the reliability of this technique, 62 anesthetists (41 experienced anesthesiologists and 21 residents) were asked to estimate the pressure of a cuff inflated to 88 mmHg into a simulated trachea by feeling both a usual and a modified 'large' pilot balloon...
May 22, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29785504/impact-of-a-vap-bundle-in-belgian-intensive-care-units
#2
Laurent Jadot, Luc Huyghens, Annick De Jaeger, Marc Bourgeois, Dominique Biarent, Adeline Higuet, Koen de Decker, Margot Vander Laenen, Baudewijn Oosterlynck, Patrick Ferdinande, Pascal Reper, Serge Brimioulle, Sophie Van Cromphaut, Stéphane Clement De Clety, Thierry Sottiaux, Pierre Damas
BACKGROUND: In order to decrease the incidence of ventilator-associated pneumonia (VAP) in Belgium, a national campaign for implementing a VAP bundle involving assessment of sedation, cuff pressure control, oral care with chlorhexidine and semirecumbent position, was launched in 2011-2012. This report will document the impact of this campaign. METHODS: On 1 day, once a year from 2010 till 2016, except in 2012, Belgian ICUs were questioned about their ventilated patients...
May 21, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29781581/brain-correlates-of-continuous-pain-in-rheumatoid-arthritis-as-measured-by-pulsed-arterial-spin-labeling
#3
Yvonne C Lee, Alexander Fine, Ekaterina Protsenko, Elena Massarotti, Robert R Edwards, Ishtiaq Mawla, Vitaly Napadow, Marco L Loggia
OBJECTIVE: Central nervous system pathways involving pain modulation shape the pain experience in patients with chronic pain. Our objectives were to understand the mechanisms underlying pain in rheumatoid arthritis (RA) and identify brain signals that may serve as imaging markers for developing targeted treatments for RA pain. METHODS: Subjects with RA and matched controls underwent functional magnetic resonance imaging, using pulsed arterial spin labeling (pASL)...
May 21, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29777951/experimental-referred-pain-extends-towards-previously-injured-location-an-explorative-study
#4
Thorvaldur Skuli Palsson, Shellie A Boudreau, Hans Jørgen Krebs, Thomas Graven-Nielsen
Facilitated pain mechanisms have been demonstrated in musculoskeletal pain but it is unclear whether a recent painful injury leaves the pain system sensitized. Pain characteristics were assessed in individuals who recently recovered from ankle pain (recovered pain group; n=25) and sex-matched controls (n=25) in response to tonic-pressure pain and saline-induced pain applied at the shin muscle. Pain intensity and pain referral patterns were recorded bilaterally after the painful muscle stimulus. Pressure pain thresholds (PPTs) were measured at the lower legs and shoulder...
May 16, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29774738/volume-and-not-pressure-controlled-inflation-of-supraglottic-device-cuff-may-compromise-patient-safety
#5
Berthold Moser, Heinz R Bruppacher
No abstract text is available yet for this article.
May 15, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29765893/successful-management-of-acquired-tracheomalacia-of-patients-with-amyotrophic-lateral-sclerosis-a-report-of-three-cases
#6
Jung Hyun Yang, Tae Wan Kim, Byeong Ju Lee, Jin A Yoon, Myung Jun Shin, Yong Beom Shin
Tracheomalacia is characterized by weakness of the tracheal walls and supporting cartilage. It results in dynamic compression of the airway, where the cross-sectional area of the trachea is reduced by expiratory compression. Acquired tracheomalacia results from complications associated with the use of endotracheal or tracheostomy tubes. In this report, we present three cases of patients with amyotrophic lateral sclerosis (ALS) successfully treated for tracheomalacia, including one case where the patient underwent surgery for combined tracheoesophageal fistula...
April 2018: Annals of Rehabilitation Medicine
https://www.readbyqxmd.com/read/29756700/use-of-ultrasonography-as-a-noninvasive-decisive-tool-to-determine-the-accurate-endotracheal-tube-size-in-anesthetized-children
#7
Gulnur Gollu, A Onat Bermede, Farid Khanmammadov, Ufuk Ates, Sinan Genc, Ozlem Selvi Can, Suat Fitoz, Zekeriyya Alanoglu, Aydin Yagmurlu
BACKGROUND: It is hard to determine the appropriate size and correct tracheal position of endotracheal tube (ETT) in children. The aim of this study is to determine tracheal diameter in children by using ultrasonography technique as objective tool and compare it with commonly used aged based formulas for the ETT size estimation. PATIENTS AND METHODS: Patients undergoing elective surgery in a tertiary children's hospital were prospectively enrolled. The subglottic transverse tracheal diameter was determined by ultrasonography...
June 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29756057/clinical-application-of-limiting-laryngeal-mask-airway-cuff-pressures-utilizing-inflating-syringe-intrinsic-recoil
#8
David M Corda, Christopher B Robards, Mark J Rice, Timothy E Morey, Nikolaus Gravenstein, Terrie Vasilopoulos, Sorin J Brull
Background: Overinflation of the laryngeal mask airway (LMA) cuff may cause many of the complications associated with the use of the LMA. There is no clinically acceptable (cost effective and practical) method to ensure cuff pressure is maintained below the manufacturer's recommended maximum value of 60 cm H2 O (44 mmHg). We studied the use of the intrinsic recoil of the LMA inflating syringe as an effective and practical way to limit cuff pressures at or below the manufacturer's recommended values...
April 2018: Romanian Journal of Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29752149/tourniquet-pressure-settings-based-on-limb-occlusion-pressure-determination-or-arterial-occlusion-pressure-estimation-in-total-knee-arthroplasty-a-prospective-randomized-double-blind-trial
#9
Bahattin Tuncali, Hakan Boya, Zeynep Kayhan, Sukru Arac
OBJECTIVE: The aim of this study was to compare the limb occlusion pressure (LOP) determination and arterial occlusion pressure (AOP) estimation methods for tourniquet pressure setting in adult patients undergoing knee arthroplasty under combined spinal-epidural anesthesia. METHODS: Ninety-three patients were randomized into two groups. Pneumatic tourniquet inflation pressures were adjusted based either on LOP determination or AOP estimation in Group 1 (46 patients, 38 female and 8 male; mean age: 67...
May 8, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29748721/impact-of-acute-dynamic-exercise-on-radial-artery-low-flow-mediated-constriction-in-humans
#10
Robert O Elliott, Sultan Alsalahi, James P Fisher
PURPOSE: A "low-flow mediated constriction" (L-FMC) is evoked in the radial artery by the inflation of an ipsilateral wrist cuff to a supra-systolic pressure. We sought to test the hypothesis that the radial artery L-FMC response is augmented immediately following acute dynamic leg exercise in young healthy individuals. METHODS: Ten healthy and recreationally active men (23 ± 4 years) undertook a 30-min trial of incremental dynamic leg cycling exercise (10 min at 50, 100 and 150 W) and a 30-min time control trial (seated rest)...
May 10, 2018: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/29744251/comparison-of-different-cuff-pressure-use-with-the-supreme-laryngeal-mask-airway-on-haemodynamic-response-seal-pressure-and-postoperative-adverse-events-a-prospective-randomized-study
#11
Achmet Ali, Demet Altun, Nukhet Sivrikoz, Mesut Yornuk, Namigar Turgut, İbrahim Özkan Akıncı
Objective: The Supreme™ laryngeal mask airway (SLMA) is a supra glottic airway (SGA) device that is used as an alternative to endotracheal tubes. In the present study, we aimed to compare the use of the SLMA with normal cuff pressure and low cuff pressure, primarily for haemodynamic response. Methods: In the present study, 120 patients diagnosed with hypertension and scheduled for varicose vein or inguinal hernia operation were enrolled and 99 patients finished...
April 2018: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29742457/some-technical-issues-of-vagal-nerve-stimulation-an-approach-using-a-hippocampal-formation-theta-rhythm
#12
Adam Broncel, Renata Bocian, Paulina Kłos-Wojtczak, Jan Konopacki
Previously, we have demonstrated that hippocampal (HPC) theta rhythm can be produced, depending on current intensity, directly during vagal nerve stimulation (VNS) or with a time delay following stimulation. This suggests that theta EEG pattern can also be used as a bio-indicator of the efficiency of VNS. In the present study, we focused on three specific, technical issues related to the stimulation procedure of the vagal nerve: i/does the type of the electrode used for VNS and the technique of its implantation affect the parameters of the HPC theta rhythm? ii/does the type of electrode used determine the current intensity threshold of VNS-induced HPC theta? iii/is the repeatability of the VNS effect determined by the type of electrode used? We demonstrated that a platinum-iridium cuff electrode offers some important advantages over a tungsten electrode...
May 6, 2018: Brain Research Bulletin
https://www.readbyqxmd.com/read/29741931/arginase-up-regulation-and-enos-uncoupling-contribute-to-impaired-endothelium-dependent-vasodilation-in-a-rat-model-of-intrauterine-growth-restriction
#13
Isabelle Grandvuillemin, Christophe Buffat, Farid Boubred, Edouard Lamy, Julien Fromonot, Philippe Charpiot, Stephanie Simoncini, Florence Sabatier, Françoise Dignat-George, Anne-Christine Peyter, Umberto Simeoni, Catherine Yzydorczyk
Individuals born after intrauterine growth restriction (IUGR) are at increased risk of developing cardiovascular diseases in adulthood, notably hypertension (HTN). Alterations in the vascular system, particularly impaired endothelium-dependent vasodilation, may play an important role in long-term effects of IUGR. Whether such vascular dysfunction precedes HTN has not been fully established in individuals born after IUGR. Moreover, the intimate mechanisms of altered endothelium-dependent vasodilation remain incompletely elucidated...
May 9, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29740088/cuffless-blood-pressure-estimation-using-only-a-smartphone
#14
Kenta Matsumura, Peter Rolfe, Sogo Toda, Takehiro Yamakoshi
Cuffless blood pressure (BP) measurement is an all-inclusive term for a method that aims to measure BP without using a cuff. Recent cuffless technology has made it possible to estimate BP with reasonable accuracy. However, mainstream methods require an electrocardiogram and photoplethysmogram measurements, and frequent calibration procedures using a cuff sphygmomanometer. We therefore developed a far simpler cuffless method, using only heart rate (HR) and modified normalized pulse volume (mNPV) that can be measured using a smartphone, based on the knowledge that ln BP = ln cardiac output (CO) + ln total peripheral resistance (TPR), where CO and TPR are correlated with HR and mNPV, respectively...
May 8, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29737880/new-non-invasive-indexes-of-arterial-stiffness-are-significantly-correlated-with-severity-and-complexity-of-coronary-atherosclerosis
#15
Hiroshi Doi, Tomoaki Ishigami, Rie Nakashima-Sasaki, Tabito Kino, Lin Chen, Kentaro Arakawa, Sae Teranaka, Shintaro Minegishi, Kaito Abe, Toshiyuki Ishikawa, Teruyasu Sugano, Kouichi Tamura
BACKGROUND: Endothelial dysfunction and increased arterial stiffness gradually develop before the manifestation of catastrophic cardiovascular events. Therefore, detection and assessment of vascular function are required to address pre-existing pathological conditions. However, the currently available diagnostic devices and methods are insufficient due to variability among investigators and the time-consuming nature of manual procedures. METHODS: Recently, novel devices were developed for the detection of both arterial stiffness and endothelial dysfunction in a single blood pressure measurement using a cuff-oscillometric technique (AVE-1500, Shisei Datum, Japan)...
May 8, 2018: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29733824/preoperative-aortic-arch-size-and-late-outcome-following-coarctation-repair-via-lateral-thoracotomy
#16
Preeti Ramachandran, Philip R Khoury, Robert H Beekman, Erik C Michelfelder, Peter B Manning, James S Tweddell, James F Cnota
BACKGROUND: The approach (lateral thoracotomy vs median sternotomy) to repair coarctation of aorta is frequently based on arch dimensions from the preoperative echocardiogram. Few studies have assessed the relationship between preoperative arch dimensions and late postoperative outcome. This study aims to define how preoperative arch dimensions relate to late outcomes and identify long term predictors of successful surgery. METHODS: We performed a retrospective review of 102 neonates and infants undergoing isolated coarctation repair via lateral thoracotomy between 2003-2012...
May 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29731445/synthesis-characterization-and-antihypertensive-activity-of-2-phenyl-substituted-benzimidazoles
#17
Muhammad Tariq Khan, Muhammad Tahir Razi, Syed Umer Jan, Muhammad Mukhtiar, Rahman Gul, - IzharUllah, Abid Hussain, Asif Mehmood Hashmi, Muhammad Taufiq Ahmad, Nisar Ahmed Shahwani, Imran Rabbani
Hypertension is one of cardiovascular disease that is not sufficiently prevented and controlled at both hospital and community levels. Hypertension resulted in significant morbidity and mortality. The benz-imidazole ring is very important pharmacophore in modern drug discovery. The substituted benzimidazoles are the important for medicinal research. Researchers have reported that substituted Benzimidazoles are the structural isosteres of nucleotides, and easily allow them to interact with the different biopolymers, possess pharmacological activity especially antihypertensive activity...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29722434/changes-in-hardness-and-resilience-of-i-gel-tm-cuffs-with-temperature-a-benchtop-study
#18
J Dingley, J Stephenson, V Allender, S Dawson, D Williams
The i-gelTM is a supraglottic airway with a gel-like thermoplastic cuff. It has been suggested that the seal around the larynx improves following insertion. Perhaps the most intuitive hypothesis proposed for this is that cuff softening occurs during warming from ambient to body temperature. We investigated this using a food industry texture analyser over a wide temperature range. Size 2 and 3 i-gels were secured to a platform within a temperature-controlled water bath, which was in turn mounted on a texture analyser test stand...
May 3, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29720752/current-practice-patterns-of-supraglottic-airway-device-usage-in-paediatric-patients-amongst-anaesthesiologists-a-nationwide-survey
#19
Ruchi A Jain, Devangi A Parikh, Anila D Malde, Bhuvneshwari Balasubramanium
Background and Aims: Supraglottic airway devices (SGADs) are increasingly being used for airway management in paediatric patients undergoing general anaesthesia. This survey was designed to assess the nationwide practice patterns of SGAD usage in paediatric patients. Methods: A questionnaire of 28 questions was circulated amongst 16,532 members of the Indian Society of Anaesthesiologists through online survey engine Google Forms® and served manually to 500 delegates attending the Asian Society of Paediatric Anaesthesiologists conference 2017...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29710289/association-of-a-smartphone-application-with-medication-adherence-and-blood-pressure-control-the-medisafe-bp-randomized-clinical-trial
#20
Kyle Morawski, Roya Ghazinouri, Alexis Krumme, Julie C Lauffenburger, Zhigang Lu, Erin Durfee, Leslie Oley, Jessica Lee, Namita Mohta, Nancy Haff, Jessie L Juusola, Niteesh K Choudhry
Importance: Medication nonadherence accounts for up to half of uncontrolled hypertension. Smartphone applications (apps) that aim to improve adherence are widely available but have not been rigorously evaluated. Objective: To determine if the Medisafe smartphone app improves self-reported medication adherence and blood pressure control. Design, Setting, and Participants: This was a 2-arm, randomized clinical trial (Medication Adherence Improvement Support App For Engagement-Blood Pressure [MedISAFE-BP])...
April 16, 2018: JAMA Internal Medicine
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