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Lung volume recruitment

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https://www.readbyqxmd.com/read/29045567/individualized-positive-end-expiratory-pressure-in-obese-patients-during-general-anaesthesia-a-randomized-controlled-clinical-trial-using-electrical-impedance-tomography
#1
C Nestler, P Simon, D Petroff, S Hammermüller, D Kamrath, S Wolf, A Dietrich, L M Camilo, A Beda, A R Carvalho, A Giannella-Neto, A W Reske, H Wrigge
Background: General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects. Methods: Patients with a BMI ≥35 kg m-2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg-1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEPIND) or (ii) no RM and PEEP of 5 cm H2O (PEEP5)...
October 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29043834/higher-peep-versus-lower-peep-strategies-for-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#2
Allan J Walkey, Lorenzo Del Sorbo, Carol Hodgson, Neill Kj Adhikari, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Dean Hess, Daniel S Talmor, B Taylor Thompson, Roy G Brower, Eddy Fan
RATIONALE: Higher positive end-expiratory pressure (PEEP) levels may reduce atelectrauma but increase over-distention lung injury. Whether higher PEEP improves clinical outcomes among patients with acute respiratory distress syndrome (ARDS) is unclear. OBJECTIVE: To compare clinical outcomes of mechanical ventilation strategies using higher PEEP levels versus lower PEEP strategies in patients with ARDS. METHODS: We performed a systematic review and meta-analysis of clinical trials investigating mechanical ventilation strategies using higher versus lower PEEP levels...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29043832/high-frequency-oscillation-for-adult-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#3
Ewan Goligher, Laveena Munshi, Neill Kj Adhikari, Maureen O Meade, Carol Hodgson, Hannah Wunsch, Elizabeth Uleryk, Ognjen Gajic, Marcelo Amato, Niall D Ferguson, Gordon D Rubenfeld, Eddy Fan
RATIONALE: By minimizing tidal lung strain and maintaining alveolar recruitment, high frequency oscillatory ventilation (HFOV) may protect against ventilator-induced lung injury. OBJECTIVES: To summarize the current evidence in support of the use of HFOV in adult patients with ARDS. METHODS: We conducted a systematic review and meta-analysis of randomized trials comparing mortality rates with the use of HFOV vs. conventional mechanical ventilation for adult patients with acute respiratory distress syndrome...
October 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28979565/protective-ventilation-with-veno-venous-lung-assist-in-respiratory-failure-a-protocol-for-a-multicentre-randomised-controlled-trial-of-extracorporeal-carbon-dioxide-removal-in-patients-with-acute-hypoxaemic-respiratory-failure
#4
J J McNamee, M A Gillies, N A Barrett, A M Agus, R Beale, A Bentley, A Bodenham, S J Brett, D Brodie, S J Finney, A J Gordon, M Griffiths, D Harrison, C Jackson, C McDowell, C McNally, G D Perkins, W Tunnicliffe, A Vuylsteke, T S Walsh, M P Wise, D Young, D F McAuley
One of the few interventions to demonstrate improved outcomes for acute hypoxaemic respiratory failure is reducing tidal volumes when using mechanical ventilation, often termed lung protective ventilation. Veno-venous extracorporeal carbon dioxide removal (vv-ECCO2R) can facilitate reducing tidal volumes. pRotective vEntilation with veno-venouS lung assisT (REST) is a randomised, allocation concealed, controlled, open, multicentre pragmatic trial to determine the clinical and cost-effectiveness of lower tidal volume mechanical ventilation facilitated by vv-ECCO2R in patients with acute hypoxaemic respiratory failure...
May 2017: J Intensive Care Soc
https://www.readbyqxmd.com/read/28977263/does-the-use-of-high-peep-levels-prevent-ventilator-induced-lung-injury
#5
Guillermo Bugedo, Jaime Retamal, Alejandro Bruhn
Overdistention and intratidal alveolar recruitment have been advocated as the main physical mechanisms responsible for ventilator-induced lung injury. Limiting tidal volume has a demonstrated survival benefit in patients with acute respiratory distress syndrome and is recognized as the cornerstone of protective ventilation. In contrast, the use of high positive end-expiratory pressure levels in clinical trials has yielded conflicting results and remains controversial. In the present review, we will discuss the benefits and limitations of the open lung approach and will discuss some recent experimental and clinical trials on the use of high versus low/moderate positive end-expiratory pressure levels...
April 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28973363/effect-of-lung-recruitment-and-titrated-positive-end-expiratory-pressure-peep-vs-low-peep-on-mortality-in-patients-with-acute-respiratory-distress-syndrome-a-randomized-clinical-trial
#6
RANDOMIZED CONTROLLED TRIAL
Alexandre Biasi Cavalcanti, Érica Aranha Suzumura, Ligia Nasi Laranjeira, Denise de Moraes Paisani, Lucas Petri Damiani, Helio Penna Guimarães, Edson Renato Romano, Marisa de Moraes Regenga, Luzia Noriko Takahashi Taniguchi, Cassiano Teixeira, Roselaine Pinheiro de Oliveira, Flavia Ribeiro Machado, Fredi Alexander Diaz-Quijano, Meton Soares de Alencar Filho, Israel Silva Maia, Eliana Bernardete Caser, Wilson de Oliveira Filho, Marcos de Carvalho Borges, Priscilla de Aquino Martins, Mirna Matsui, Gustavo Adolfo Ospina-Tascón, Thiago Simões Giancursi, Nelson Dario Giraldo-Ramirez, Silvia Regina Rios Vieira, Maria da Graça Pasquotto de Lima Assef, Mohd Shahnaz Hasan, Wojciech Szczeklik, Fernando Rios, Marcelo Britto Passos Amato, Otávio Berwanger, Carlos Roberto Ribeiro de Carvalho
Importance: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. Objective: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. Design, Setting, and Participants: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS...
October 10, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28969484/combined-measurement-of-fetal-lung-volume-and-pulmonary-artery-resistance-index-is-more-accurate-for-prediction-of-neonatal-respiratory-distress-syndrome-in-preterm-fetuses-a-pilot-study
#7
Mohamed Laban, Ghada Mansour, Ahmed El-Kotb, Alaa Hassanin, Zina Laban, Abdelrahman Saleh
OBJECTIVE: To estimate optimal cut-off values for mean fetal lung volume (FLV) and pulmonary artery resistance index (PA-RI) as noninvasive measures to predict neonatal respiratory distress syndrome (RDS) in preterm fetuses. METHODS: A prospective study conducted at Ain Shams University Maternity Hospital, Egypt from May 2015 to July 2017: eighty eligible women diagnosed with preterm labor were recruited at 32-36 weeks' gestation. Before delivery, three-dimensional ultrasound was used to estimate FLV using virtual organ computer-aided analysis (VOCAL), while PA-RI was measured by Doppler ultrasonography...
October 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28967868/respiratory-mechanics-to-understand-ards-and-guide-mechanical-ventilation
#8
Tommaso Mauri, Marta Lazzeri, Giacomo Bellani, Alberto Zanella, Giacomo Grasselli
As precision medicine is becoming standard of care to select tailored rather than average treatments, physiological measurements might represent the first step to apply personalized therapy in the intensive care unit (ICU). Systematic assessment of respiratory mechanics in patients with the acute respiratory distress syndrome (ARDS) could represent a step towards this direction for two main reasons. On the one hand, respiratory mechanics are a powerful physiological method to understand the severity of this syndrome in each single patient...
October 2, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28967439/new-evidence-in-one-lung-ventilation
#9
H Meleiro, I Correia, P Charco Mora
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included...
September 26, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28958873/effects-of-respiratory-muscle-strength-training-in-classically-trained-singers
#10
Christin Ray, Michael D Trudeau, Scott McCoy
Many voice pedagogy practices revolve around the notion of controlling airflow and lung volumes and focus heavily on the concepts of breath support and breath control. Despite this emphasis, the effects of increased respiratory muscle strength on airflow and phonation patterns in trained singers remain unknown. This study addressed whether singers could increase respiratory muscle strength with progressive threshold training and whether respiratory muscle strength increases had measurable effect on voice outcomes...
September 25, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28940117/determination-of-respiratory-system-compliance-during-pressure-support-ventilation-by-small-variations-of-pressure-support
#11
Tobias Becher, Dirk Schädler, Philipp Rostalski, Günther Zick, Inéz Frerichs, Norbert Weiler
In mechanically ventilated patients, measurement of respiratory system compliance (Crs) is of high clinical interest. Spontaneous breathing activity during pressure support ventilation (PSV) can impede the correct assessment of Crs and also alter the true Crs by inducing lung recruitment. We describe a method for determination of Crs during PSV and assess its accuracy in a study on 20 mechanically ventilated patients. To assess Crs during pressure support ventilation (Crs,PSV), we performed repeated changes in pressure support level by ± 2 cmH2O...
September 22, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28936695/early-application-of-airway-pressure-release-ventilation-may-reduce-the-duration-of-mechanical-ventilation-in-acute-respiratory-distress-syndrome
#12
Yongfang Zhou, Xiaodong Jin, Yinxia Lv, Peng Wang, Yunqing Yang, Guopeng Liang, Bo Wang, Yan Kang
PURPOSE: Experimental animal models of acute respiratory distress syndrome (ARDS) have shown that the updated airway pressure release ventilation (APRV) methodologies may significantly improve oxygenation, maximize lung recruitment, and attenuate lung injury, without circulatory depression. This led us to hypothesize that early application of APRV in patients with ARDS would allow pulmonary function to recover faster and would reduce the duration of mechanical ventilation as compared with low tidal volume lung protective ventilation (LTV)...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28930639/50-years-of-research-in-ards-tidal-volume-selection-in-the-acute-respiratory-distress-syndrome
#13
Sarina K Sahetya, Jordi Mancebo, Roy G Brower
Mechanical ventilation (MV) is critical in the management of many patients with the acute respiratory distress syndrome (ARDS). However, MV can also cause ventilator-induced lung injury (VILI). The selection of an appropriate tidal volume is an essential part of a lung-protective MV strategy. Since the publication of a large randomized clinical trial demonstrating the benefit of lower tidal volumes, the use of tidal volumes of 6 mL/kg predicted body weight (PBW, based on sex and height) has been recommended in clinical practice guidelines...
September 20, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28903915/obesity-modulates-diaphragm-curvature-in-subjects-with-and-without-copd
#14
Aladin M Boriek, Michael A Lopez, Cristina Velasco, Azam A Bakir, Anna Frolov, Shari Wynd, Tony G Babb, Nicola A Hanania, Eric A Hoffman, Amir Sharafkhaneh
BACKGROUND: Obesity is a common co-morbidity of COPD and has been associated with worse outcomes. However, it is unknown whether the interaction between obesity and COPD modulates diaphragm shape and consequently its function. The body mass index has been used as a correlate of obesity. We tested the hypothesis that the shape of the diaphragm muscle and size of the ring of its insertion in Non-COPD and COPD subjects are modulated by BMI. METHODS: We recruited 48 COPD patients with post-bronchiodilator FEV1/FVC < 0...
September 13, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28865600/the-association-of-genetic-polymorphisms-of-hypoxia-inducible-factor-1-alpha-and-vascular-endothelial-growth-factor-with-increased-risk-of%C3%A2-chronic-obstructive-pulmonary-disease-a%C3%A2-case-control-study
#15
Zhen-Gang Yu, Bing-Zhe Wang, Zhao-Zhong Cheng
Accumulated data over the years have suggested that hypoxia inducible factor-1 alpha (HIF-1α) and its downstream vascular endothelial growth factor (VEGF) gene may be linked with chronic obstructive pulmonary disease (COPD). This study aims to investigate the association of HIF-1α and VEGF genetic polymorphisms and their correlated risks with COPD. COPD patients (case group) and healthy individuals (control group) were recruited. DNA was extracted to detect HIF-1α and VEGF genetic polymorphisms. Basal lung volume and forced expiratory capacity in 1st second (FEV1)/forced vital capacity (FVC) and FEV1/predicted value (pred)% were calculated...
September 2017: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/28864634/evaluation-of-the-lysophosphatidic-acid-receptor-type-1-radioligand-11-c-bmt-136088-for-lung-imaging-in-rhesus-monkeys
#16
Jean-Dominique Gallezot, Nabeel B Nabulsi, Daniel Holden, Shu-Fei Lin, David Labaree, Jim Ropchan, Soheila Najafzadeh, David J Donnelly, Kai Cao, Samuel Bonacorsi, Jon Seiders, Jeffrey Roppe, Wendy Hayes, Yiyun Huang, Shuyan Du, Richard E Carson
The lysophosphatidic acid receptor type 1 (LPA1) is one of six known receptors of the extracellular signaling molecule LPA. It mediates effects such as cell proliferation, migration and differentiation. In the lung, LPA1 is involved in pathways leading, after lung tissue injury, to pulmonary fibrosis instead of normal healing, by mediating fibroblast recruitment and vascular leak. Thus, a LPA1 positron emission tomography (PET) radiotracer may be useful to study lung fibrosis, or to develop LPA1-targeting drugs...
September 1, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28851233/shuttle-walk-tests-in-people-with-copd-who-demonstrate-exercise-induced-oxygen-desaturation-an-analysis-of-test-repeatability-and-cardiorespiratory-responses
#17
Zoe McKeough, Regina Leung, Ji Hui Neo, Sue Jenkins, Anne Holland, Kylie Hill, Norman Morris, Lissa Spencer, Catherine Hill, Annemarie Lee, Helen Seale, Nola Cecins, Christine McDonald, Jennifer Alison
Exercise-induced oxygen desaturation (EID) is prevalent in people with chronic obstructive pulmonary disease (COPD). This article reports a sub-analysis from a randomized controlled trial (RCT) in people with COPD and EID (COPD/EID). The primary aim, in people with COPD/ EID, was to determine the repeatability of the distance and time walked in the incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT), respectively. A secondary aim was to determine whether any participant characteristics predicted those who did not demonstrate improvements on a repeat ISWT or ESWT...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28835891/patient-experience-of-lung-volume-reduction-procedures-for-emphysema-a-qualitative-service-improvement-project
#18
Sara Buttery, Adam Lewis, Inger Oey, Joanne Hargrave, David Waller, Michael Steiner, Pallav L Shah, Samuel V Kemp, Simon Jordan, Nicholas S Hopkinson
The aim of this service improvement project was to gain understanding of the patient experience of lung volume reduction surgery (LVRS) and endobronchial valve (EBV) placement, from referral through to post-discharge care. Focus group interviews were carried out in two tertiary centres in London and Leicester, UK. Sixteen patients who had undergone lung volume reduction surgery (LVRS), endobronchial valve (EBV) placement, or both, were recruited. Prior to participation in each focus group, participants completed a questionnaire to guide and focus discussion...
July 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28828365/recruitment-maneuvers-in-acute-respiratory-distress-syndrome
#19
REVIEW
Jean-Michel Constantin, Thomas Godet, Matthieu Jabaudon, Jean-Etienne Bazin, Emmanuel Futier
The rationale for the use of recruitment maneuvers (RMs) in acute respiratory distress syndrome (ARDS) is to promote alveolar recruitment, leading to an increased end-expiratory lung volume and thus decreased ventilator-induced lung injury (VILI). RMs consists of a transient increase in transpulmonary pressure that can re-open previously collapsed alveoli. RMs represents a physiological response to lung aggression in different conditions by re-opening the collapsed part of the lung and decreasing lung oedema...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28826457/prevalence-and-risk-factors-of-restrictive-spirometry-in-a-cohort-of-peruvian-adults
#20
T Siddharthan, M Grigsby, C H Miele, A Bernabe-Ortiz, J J Miranda, R H Gilman, R A Wise, J C Porter, J R Hurst, W Checkley
INTRODUCTION: Few studies have described the prevalence of and lung function decline among those with a restrictive spirometric pattern (RSP) in low- and middle-income countries. METHODS: We analyzed prospective data from 3055 adults recruited across four diverse settings in Peru over a 3-year period. Multivariable logistic regression was used to study the association between the presence of restriction and associated risk factors. Multivariable linear mixed models were used to determine lung function decline...
September 1, 2017: International Journal of Tuberculosis and Lung Disease
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