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Volume targeted ventilation

Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
Jonne Doorduin, Joeke L Nollet, Lisanne H Roesthuis, Hieronymus W H van Hees, Laurent J Brochard, Christer A Sinderby, Johannes G van der Hoeven, Leo M A Heunks
RATIONALE: Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high tidal volume and high transpulmonary pressure. As an alternative to high dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
Hatice Yagmurdur, Figen Leblebici
BACKGROUND AND OBJECTIVES: This study's main aim was to observe the effects of a fibre-enriched nutrition solution on requisite feeding volume, which is directly proportional to energy intake in mechanically ventilated patients with enteral nutrition. METHODS AND STUDY DESIGN: Some 120 patients who required mechanical ventilation and enteral nutrition with a nasogastric tube were studied. Upon ICU admission, the patient's age, gender, weight, height, comorbidities, diagnosis and APACHE II score were recorded...
December 2016: Asia Pacific Journal of Clinical Nutrition
Osama M Assad, Ayman A El Sayed, Mohamed A Khalil
STUDY OBJECTIVE: To analyze the effects of pressure-controlled ventilation-volume guaranteed (PCV-VG) and volume controlled ventilation (VCV) on airway pressures and respiratory and circulatory indicators during laparoscopic surgery in Trendelenburg position. DESIGN: Prospective randomized comparative clinical study. SETTING: Tertiary hospital. PATIENTS: Forty ASA physical status 1 and 2 patients who underwent elective laparoscopic surgery in Trendelenburg position...
November 2016: Journal of Clinical Anesthesia
Xiaofang Huang, Wei Zhou, Shifang Ding
OBJECTIVE: To explore the effect of Smad4 on the extracellular matrix remodeling in ventilator-induced lung injury (VILI). METHODS: We randomized 24 C57BL/6 mice to 4 groups for treatment (n=6/group): control, ventilation, non-targeted (scramble) lentivirus transfection plus ventilation, and Smad4 small interfering RNA (siRNA) lentivirus transfection plus ventilation. Lentivirus was delivered by intranasal instillation. Four weeks later, the 3 ventilated groups underwent high tidal volume (VT 40mL/kg) ventilation to induce lung injury...
September 2016: Annals of Clinical and Laboratory Science
R H Ireland, B A Tahir, J M Wild, C E Lee, M Q Hatton
For patients with lung cancer undergoing curative intent radiotherapy, functional lung imaging can be incorporated into treatment planning to modify the dose distribution within non-target volume lung by differentiation of lung regions that are functionally defective or viable. This concept of functional image-guided lung avoidance treatment planning has been investigated with several imaging modalities, primarily single photon emission computed tomography (SPECT), but also hyperpolarised gas magnetic resonance (MR) imaging, positron emission tomography (PET) and computed tomography (CT)-based measures of lung biomechanics...
November 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
Senem Alkan Ozdemir, Esra Arun Ozer, Ozkan Ilhan, Sumer Sutcuoglu
BACKGROUND: Mechanical ventilation is an essential therapy in the treatment of respiratory failure in preterm infants. However, optimal ventilation strategy continues to be difficult to define. OBJECTIVE: To compare the effects of volume guarantee (VG) combined with intermittent mandatory ventilation (SIMV) and VG combined with pressure support ventilation (PSV) on the pulmonary mechanics and short term prognosis in preterm infants with respiratory distress syndrome...
September 13, 2016: Pediatric Pulmonology
Juan B Figueroa-Casas, Ricardo Montoya
RATIONALE: Although increasingly recommended, compliance with low tidal volume ventilation remains suboptimal. Dyssynchrony induced by low tidal volumes may be a reason for it. OBJECTIVES: To determine the effect of tidal volume size, and of the ventilator mode used for its delivery (volume vs pressure control), on the magnitude of patient-ventilator dyssynchrony in patients with or at risk for acute respiratory distress syndrome (ARDS). METHODS: Nineteen mechanically ventilated patients underwent 6 consecutive ventilatory conditions...
September 6, 2016: Annals of the American Thoracic Society
Arschang Valipour, Dirk-Jan Slebos, Felix Herth, Kaid Darwiche, Manfred Wagner, Joachim H Ficker, Christoph Petermann, Ralf-Harto Hubner, Franz Stanzel, Ralf Eberhardt
RATIONALE: Endobronchial valves (EBV) have been successfully used in patients with severe heterogeneous emphysema to improve lung physiology. Limited available data suggests that EBVs are also effective in homogeneous emphysema. OBJECTIVE: To evaluate the efficacy and safety of EBV in patients with homogeneous emphysema with absence of collateral ventilation assessed by Chartis. METHODS: Prospective, multicenter 1:1 randomized controlled trial of EBV plus standard-of-care (SoC) or (SoC) alone...
August 31, 2016: American Journal of Respiratory and Critical Care Medicine
T David Koster, Eva M van Rikxoort, Ralf-Harto Huebner, Felix Doellinger, Karin Klooster, Jean-Paul Charbonnier, Sri Radhakrishnan, Felix J F Herth, Dirk-Jan Slebos
BACKGROUND: Bronchoscopic lung volume reduction using one-way endobronchial valves (EBVs) has been proven to be effective in patients with severe emphysema. However, the selection of patients without collateral ventilation prior to treatment is critical for procedural success. Collateral ventilation can be assessed directly with the Chartis system or indirectly using computed tomography (CT) fissure analysis. OBJECTIVES: We retrospectively evaluated the diagnostic value of a combination of the quantitative CT interlobar fissure completeness score (FCS) and Chartis in predicting responders to EBV therapy...
2016: Respiration; International Review of Thoracic Diseases
C Rabec, A Cuvelier, C Cheval, S Jaffre, J-P Janssens, M Mercy, A Prigent, S Rouault, S Talbi, S Vandenbroeck, J Gonzalez-Bermejo
A task force issued from the Groupe Assistance Ventilatoire (GAV) of the Société de Pneumologie de Langue Française (SPLF) was committed to develop a series of expert advice concerning various practical topics related to long-term non invasive ventilation by applying the Choosing Wisely(®) methodology. Three topics were selected: monitoring of noninvasive ventilation, the interpretation of data obtained from built-in devices coupled to home ventilators and the role of hybrid modes (target volume with variable pressure support...
August 23, 2016: Revue des Maladies Respiratoires
Dirk Skowasch, Andreas Fertl, Björn Schwick, Harald Schäfer, Andreas Hellmann, Felix J F Herth
BACKGROUND: Randomized controlled trials indicate that significant lung volume reduction (ELVR) can be obtained with Zephyr® valves by occluding the target lobe in the absence of collateral ventilation, leading to relevant functional benefits in advanced emphysema patients. OBJECTIVES: To observe the long-term effects of endobronchial valve (EBV) implantation in emphysema patients screened by Chartis assessment in the context of daily pulmonology practice. METHODS: The LIVE Study is a prospective, observational, open-label, single-arm, multicenter trial conducted in Germany...
2016: Respiration; International Review of Thoracic Diseases
N González-Pacheco, M Sánchez-Luna
No abstract text is available yet for this article.
September 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
G P Prashanth, K Hebbal, S K Ismail
No abstract text is available yet for this article.
September 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Sarah L Harris, Nicola C Austin, Malcolm Battin, Roland Broadbent, John Horwood, Ross Keenan, Scott Wells, Carole Spencer, Patricia Graham, Lianne J Woodward, Brian A Darlow
AIMS: To describe the survival, in-hospital morbidity, brain metrics and two-year neurodevelopmental outcomes of two extremely preterm cohorts and discuss the contribution of changes in clinical practice to these outcomes. METHODS: Retrospective comparative cohort study, of two cohorts of neonates born <28 weeks gestation: 47 infants born 1998-2000 and 39 infants 2006-2009. RESULTS: Comparing historical to the contemporary cohort respectively, admission temperature (35...
2016: New Zealand Medical Journal
Andreas Schwingshackl
Mechanical ventilation (MV) and oxygen therapy (hyperoxia; HO) comprise the cornerstones of life-saving interventions for patients with acute respiratory distress syndrome (ARDS). Unfortunately, the side effects of MV and HO include exacerbation of lung injury by barotrauma, volutrauma, and propagation of lung inflammation. Despite significant improvements in ventilator technologies and a heightened awareness of oxygen toxicity, besides low tidal volume ventilation few if any medical interventions have improved ARDS outcomes over the past two decades...
September 1, 2016: American Journal of Physiology. Lung Cellular and Molecular Physiology
S Kjellberg, B K Houltz, O Zetterström, P D Robinson, Per M Gustafsson
Suboptimal asthma control is common despite modern asthma therapy. The degree of peripheral airway involvement remains unclear and poor medication delivery to these regions might be a contributing reason for this failure in obtaining adequate symptom control. A cohort of 196 adults (median (range) age 44 (18-61) years, 109 females, 54 ex-smokers, six current smokers) with physician-diagnosed asthma were recruited from primary care. Subjects were characterized clinically by interviews, questionnaires, skin prick tests (SPT) and blood eosinophil counts...
August 2016: Respiratory Medicine
Bernardo Selim, Kannan Ramar
INTRODUCTION: Volume assured pressure support (VAPS) and adaptive servo ventilation (ASV) are non-invasive positive airway pressure (PAP) modes with sophisticated negative feedback control systems (servomechanism), having the capability to self-adjust in real time its respiratory controlled variables to patient's respiratory fluctuations. However, the widespread use of VAPS and ASV is limited by scant clinical experience, high costs, and the incomplete understanding of propriety algorithmic differences in devices' response to patient's respiratory changes...
September 2016: Expert Review of Medical Devices
Jonathan Dugernier, Gregory Reychler, Xavier Wittebole, Jean Roeseler, Virginie Depoortere, Thierry Sottiaux, Jean-Bernard Michotte, Rita Vanbever, Thierry Dugernier, Pierre Goffette, Marie-Agnes Docquier, Christian Raftopoulos, Philippe Hantson, François Jamar, Pierre-François Laterre
BACKGROUND: Volume-controlled ventilation has been suggested to optimize lung deposition during nebulization although promoting spontaneous ventilation is targeted to avoid ventilator-induced diaphragmatic dysfunction. Comparing topographic aerosol lung deposition during volume-controlled ventilation and spontaneous ventilation in pressure support has never been performed. The aim of this study was to compare lung deposition of a radiolabeled aerosol generated with a vibrating-mesh nebulizer during invasive mechanical ventilation, with two modes: pressure support ventilation and volume-controlled ventilation...
December 2016: Annals of Intensive Care
Marlina E Lovett, Todd J Karsies
Independent lung ventilation is an infrequently used ventilation strategy in the Pediatric Intensive Care Unit, but can be beneficial in unique patient subsets, such as patients who have asymmetric pulmonary pathology. Independent lung ventilation allows for the independent delivery of the appropriate effective tidal volume to each lung based upon individual compliance and pathology. In theory, it may help avoid alveolar overdistension and ventilator induced lung injury in the non-diseased lung. In addition, it allows for targeted interventions...
July 15, 2016: Annals of the American Thoracic Society
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