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Lung volume recruitment

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https://www.readbyqxmd.com/read/28108209/the-impact-of-cognitive-impairment-on-efficacy-of-pulmonary-rehabilitation-in-patients-with-copd
#1
Fiona A H M Cleutjens, Martijn A Spruit, Rudolf W H M Ponds, Lowie E G W Vanfleteren, Frits M E Franssen, Jeanette B Dijkstra, Candy Gijsen, Emiel F M Wouters, Daisy J A Janssen
OBJECTIVES: To compare changes in pulmonary rehabilitation (PR) dropout and outcomes between chronic obstructive pulmonary disease (COPD) patients with and without cognitive impairment. DESIGN: A cross-sectional observational study. SETTING: Patients with COPD were recruited from a PR centre in the Netherlands. PARTICIPANTS: The study population consisted of 157 patients with clinically stable COPD who were referred for and completed PR...
January 17, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28108076/safety-and-effectiveness-of-alveolar-recruitment-maneuvers-and-positive-end-expiratory-pressure-during-general-anesthesia-for-cesarean-section-a-prospective-randomized-trial
#2
D Aretha, F Fligou, P Kiekkas, C Messini, E Panteli, E Zintzaras, M Karanikolas
INTRODUCTION: During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. METHODS: Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH2O and peak airway inspiratory pressure gradually increased to 45-50cmH2O...
December 23, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28107207/dynamic-mechanical-interactions-between-neighboring-airspaces-determine-cyclic-opening-and-closure-in-injured-lung
#3
Ludovic Broche, Gaetano Perchiazzi, Liisa Porra, Angela Tannoia, Mariangela Pellegrini, Savino Derosa, Alessandra Sindaco, João Batista Borges, Loïc Degrugilliers, Anders Larsson, Göran Hedenstierna, Anthony S Wexler, Alberto Bravin, Sylvia Verbanck, Bradford J Smith, Jason H T Bates, Sam Bayat
OBJECTIVES: Positive pressure ventilation exposes the lung to mechanical stresses that can exacerbate injury. The exact mechanism of this pathologic process remains elusive. The goal of this study was to describe recruitment/derecruitment at acinar length scales over short-time frames and test the hypothesis that mechanical interdependence between neighboring lung units determines the spatial and temporal distributions of recruitment/derecruitment, using a computational model. DESIGN: Experimental animal study...
January 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28103932/biomarkers-of-extracellular-matrix-turnover-are-associated-with-emphysema-and-eosinophilic-bronchitis-in-copd
#4
Asger Reinstrup Bihlet, Morten Asser Karsdal, Jannie Marie Bülow Sand, Diana Julie Leeming, Mustimbo Roberts, Wendy White, Russell Bowler
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by airflow obstruction and loss of lung tissue mainly consisting of extracellular matrix (ECM). Three of the main ECM components are type I collagen, the main constituent in the interstitial matrix, type VI collagen, and elastin, the signature protein of the lungs. During pathological remodeling driven by inflammatory cells and proteases, fragments of these proteins are released into the bloodstream, where they may serve as biomarkers for disease phenotypes...
January 19, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28100357/-hemoptysis-in-adults-with-bronchiectasis-correlation-with-disease-severity-and-exacerbation-risk
#5
W J Guan, J J Yuan, Y H Gao, H M Li, N S Zhong, R C Chen
Objective: To investigate the association between hemoptysis and disease severity and risks of acute exacerbations in patients with bronchiectasis. Methods: Between September 2012 and January 2014, we recruited 148 patients (56 males, 92 females, mean age: 44.6 years) with clinically stable bronchiectasis, who were classified into hemoptysis group (36 males, 70 females, mean age: 45.6 years) and non-hemoptysis group (20 males, 22 females, mean age: 41.8 years). We inquired the past history, and evaluated chest imaging characteristics, lung function, cough sensitivity assessed using capsaicin cough challenge tests, and airway inflammation...
January 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28100177/effect-of-desflurane-remifentanil-vs-propofol-remifentanil-anesthesia-on-arterial-oxygenation-during-one-lung-ventilation-for-thoracoscopic-surgery-a-prospective-randomized-trial
#6
Youn Joung Cho, Tae Kyong Kim, Deok Man Hong, Jeong-Hwa Seo, Jae-Hyon Bahk, Yunseok Jeon
BACKGROUND: One-lung ventilation during thoracic surgery frequently disturbs normal systemic oxygenation. However, the effect of anesthetics on arterial oxygenation during one-lung ventilation has not been well established in human study. In this clinical trial, we investigated whether a difference between desflurane-remifentanil and propofol-remifentanil anesthesia can be observed with regard to oxygenation during one-lung ventilation for thoracoscopic surgery. METHODS: Adult patients with lung cancer, scheduled for video-assisted thoracoscopic lobectomy without preoperative oxygen support, were screened and randomized to receive desflurane or propofol, with remifentanil continuous infusion in both groups...
January 18, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#7
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28092910/effects-of-in-utero-and-postnatal-exposure-to-secondhand-smoke-on-lung-function-by-gender-and-asthma-status-the-seven-northeastern-cities-snec-study
#8
Li-Wen Hu, Mo Yang, Shu Chen, Kuntal Shah, Yismaw Hailegiorgis, Richai Burgens, Michael Vaughn, Jin Huang, Pamela Xaverius, Gunther Paul, Lidia Morawska, Tao Lu, Shao Lin, Shou-Qiang Zhong, Min-Li Kong, Yan-Qi Xie, Yuan-Tao Hao, Xiao-Wen Zeng, Zhengmin Qian, Guang-Hui Dong
BACKGROUND: Little information exists on whether gender or asthma status modifies the effects of secondhand smoke (SHS) exposure on lung function. OBJECTIVE: To evaluate whether gender or asthma status modifies the association of SHS exposure with lung function. METHODS: A total of 6,740 children (average 11.6 years) were recruited from 24 districts of 7 cities in northeast China in 2012. SHS exposure included exposure to environmental and maternal smoking both in utero and during early childhood (postnatal)...
January 17, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28079660/anesthetic-management-of-a-child-with-jeune-syndrome-for-tracheotomy-a-case-report
#9
Masakazu Kotoda, Tadahiko Ishiyama, Katsumi Okuyama, Takashi Matsukawa
Jeune syndrome is a rare autosomal-recessive skeletal disorder. Anesthetic management of these patients is often difficult because of thoracic and lung hypoplasia. A 5-month-old boy with Jeune syndrome was scheduled to undergo a tracheotomy. Despite 5-minute preoxygenation with continuous positive airway pressure, the patient's oxygen saturation rapidly dropped during the induction of anesthesia. The continuous positive airway pressure should have been titrated to effective tidal volume during preoxygenation to recruit the patient's functional residual capacity and to prevent desaturation...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28079607/mapping-regional-differences-of-local-pressure-volume-curves-with-electrical-impedance-tomography
#10
Alessandro Beda, Alysson R Carvalho, Nadja C Carvalho, Sören Hammermüller, Marcelo B P Amato, Thomas Muders, Claudia Gittel, Katharina Noreikat, Hermann Wrigge, Andreas W Reske
OBJECTIVES: Lung-protective mechanical ventilation aims to prevent alveolar collapse and overdistension, but reliable bedside methods to quantify them are lacking. We propose a quantitative descriptor of the shape of local pressure-volume curves derived from electrical impedance tomography, for computing maps that highlight the presence and location of regions of presumed tidal recruitment (i.e., elastance decrease during inflation, pressure-volume curve with upward curvature) or overdistension (i...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#11
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28055002/identifying-possible-asthma-copd-overlap-syndrome-in-patients-with-a-new-diagnosis-of-copd-in-primary-care
#12
Camilla Boslev Baarnes, Peter Kjeldgaard, Mia Nielsen, Marc Miravitlles, Charlotte Suppli Ulrik
The asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) remains poorly characterised. Our aim was to describe an algorithm for identifying possible ACOS in adults with newly diagnosed COPD in primary care. General practitioners (n=241) consecutively recruited subjects ⩾35 years, with tobacco exposure, at least one respiratory symptom and no previous diagnosis of obstructive lung disease. Possible ACOS was defined as chronic airflow obstruction, i.e., post-bronchodilator (BD) forced expiratory volume 1/forced vital capacity (FEV1/FVC) ratio<0...
January 5, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28047252/su-f-t-391-comparative-study-of-treatment-planning-between-imrt-and-imat-for-malignant-pleural-mesothelioma
#13
J Duan
PURPOSE: The purpose of this study was to compare the dosimetric differences between intensitymodulated radiation therapy (IMRT) and intensity modulated arc therapy (IMAT) for malignant pleural mesothelioma (MPM) patients with regard to the sparing effect on organs at risk (OARs), plan quality, and delivery efficiency. METHODS: Ten MPM patients were recruited in this study. To avoid the inter-operator variability, IMRT and IMAT plans for each patient were performed by one experienced dosimetrist...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046219/th-ef-bra-07-evaluation-of-internal-target-volume-derived-from-a-prototype-4d-mri-sequence-with-3d-radial-stack-of-stars-trajectory-and-k-space-self-gating
#14
W Yang, Z Fan, Z Deng, J Pang, X Bi, M Fenchel, D Li, B Fraass, B Hakimian, R Reznik, M Bryant, H Sandler, R Tuli
PURPOSE: 4D-MRI based on resorting of 2D-cine-MRI images shows great potential to assess tumor motion more accurately compared to 4D-CT, however, it suffers from low through-plane resolution and stitching artifacts. 4D-MRI based on 3D acquisition results in stitching-artifact-free images with high in-plane and through-plane resolutions. In this study, we report our early clinical experience of a prototype 4D-MRI sequence with 3D stack-of-stars (SOS) trajectory for internal target volume (ITV) definition...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28013057/neural-control-of-ventilation-prevents-both-over-distension-and-de-recruitment-of-experimentally-injured-lungs
#15
Lukas Brander, Onnen Moerer, Göran Hedenstierna, Jennifer Beck, Jukka Takala, Arthur S Slutsky, Christer Sinderby
BACKGROUND: Endogenous pulmonary reflexes may protect the lungs during mechanical ventilation. We aimed to assess integration of continuous neurally adjusted ventilatory assist (cNAVA), delivering assist in proportion to diaphragm's electrical activity during inspiration and expiration, and Hering-Breuer inflation and deflation reflexes on lung recruitment, distension, and aeration before and after acute lung injury (ALI). METHODS: In 7 anesthetised rabbits with bilateral pneumothoraces, we identified adequate cNAVA level (cNAVAAL) at the plateau in peak ventilator pressure during titration procedures before (healthy lungs with endotracheal tube, [HLETT]) and after ALI (endotracheal tube [ALIETT] and during non-invasive ventilation [ALINIV])...
December 22, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27941393/use-of-rosuvastatin-in-hiv-associated-chronic-obstructive-pulmonary-disease-a-randomized-pilot-study
#16
Alison Morris, Meghan Fitzpatrick, Marnie Bertolet, Shulin Qin, Lawrence Kingsley, Nicolas Leo, Cathy Kessinger, Heather Michael, Deborah Mcmahon, Rene Weinman, Stephen Stone, Joseph K Leader, Eric Kleerup, Laurence Huang, Stephen R Wisniewski
OBJECTIVES: Chronic obstructive pulmonary disease (COPD) is more prevalent in HIV-infected individuals and is associated with persistent inflammation. Therapies unique to HIV are lacking. We performed a pilot study of the HMG Co-A reductase inhibitor rosuvastatin to determine effects on lung function. DESIGN: Randomized, placebo-controlled, triple-blinded trial METHODS:: HIV-infected individuals with abnormal lung function were recruited from an ongoing lung function study...
December 8, 2016: AIDS
https://www.readbyqxmd.com/read/27941354/the-endothelial-glycocalyx-and-perioperative-lung-injury
#17
Florian Brettner, Vera von Dossow, Daniel Chappell
PURPOSE OF REVIEW: Ventilator-induced lung injury is a major contributor to perioperative lung injury. The end-expiratory lung volume, regional lung overdistension, and tidal recruitment are known to be the main factors causing subsequent alveolar damage and inflammation. The alveolar-capillary membrane including the endothelial glycocalyx as an integral part of the vascular endothelium seems to play a major role in different kinds of lung injury. RECENT FINDINGS: Recent studies underline the pivotal importance of the endothelial glycocalyx in lung injury...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27922547/changes-in-stroke-volume-induced-by-lung-recruitment-maneuver-predict-fluid-responsiveness-in-mechanically-ventilated-patients-in-the-operating-room
#18
Matthieu Biais, Romain Lanchon, Musa Sesay, Lisa Le Gall, Bruno Pereira, Emmanuel Futier, Karine Nouette-Gaulain
BACKGROUND: Lung recruitment maneuver induces a decrease in stroke volume, which is more pronounced in hypovolemic patients. The authors hypothesized that the magnitude of stroke volume reduction through lung recruitment maneuver could predict preload responsiveness. METHODS: Twenty-eight mechanically ventilated patients with low tidal volume during general anesthesia were included. Heart rate, mean arterial pressure, stroke volume, and pulse pressure variations were recorded before lung recruitment maneuver (application of continuous positive airway pressure of 30 cm H2O for 30 s), during lung recruitment maneuver when stroke volume reached its minimal value, and before and after volume expansion (250 ml saline, 0...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27881405/effectiveness-of-individualized-lung-recruitment-strategies-at-birth-an-experimental-study-in-preterm-lambs
#19
David G Tingay, Anushi Rajapaksa, Emanuela Zannin, Prue M Pereira-Fantini, Raffaele L Dellaca, Elizabeth J Perkins, Cornelis E E Zonneveld, Andy Adler, Don Black, Inéz Frerichs, Anna Lavizzari, Magdy Sourial, Bartłomiej Grychtol, Fabio Mosca, Peter G Davis
Respiratory transition at birth involves rapidly clearing fetal lung liquid and preventing efflux back into the lung while aeration is established. We have developed a sustained inflation (SIOPT) individualized to volume response and a dynamic tidal positive end-expiratory pressure (PEEP) (open lung volume, OLV) strategy that both enhance this process. We aimed to compare the effect of each with a group managed with PEEP of 8 cmH2O and no recruitment maneuver (No-RM), on gas exchange, lung mechanics, spatiotemporal aeration, and lung injury in 127 ± 1 day preterm lambs...
January 1, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27876834/the-measurement-of-lung-volumes-using-body-plethysmography-and-helium-dilution-methods-in-copd-patients-a-correlation-and-diagnosis-analysis
#20
Yongjiang Tang, Mingke Zhang, Yulin Feng, Binmiao Liang
Chronic obstructive pulmonary disease (COPD) is a chronic airway disease characterized by persistent airflow limitation. Moreover, lung hyperinflation evaluated by lung volumes is also the key pathophysiologic process during COPD progression. Nevertheless, there is still no preferred method to evaluate lung volumes. For this study, we recruited 170 patients with stable COPD to assess lung volumes stratified by airflow limitation severity. Lung volumes including residual volume (RV) and total lung capacity (TLC) were determined by both body plethysmography and helium dilution methods...
November 23, 2016: Scientific Reports
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