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Volume targeted ventilation

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https://www.readbyqxmd.com/read/28206676/thoracic-ct-mri-co-registration-for-regional-pulmonary-structure-function-measurements-of-obstructive-lung-disease
#1
Fumin Guo, Sarah Svenningsen, Miranda Kirby, Dante P I Capaldi, Khadija Sheikh, Aaron Fenster, Grace Parraga
PURPOSE: Recent pulmonary imaging research has revealed that in patients with chronic obstructive pulmonary disease (COPD) and asthma, structural and functional abnormalities are spatially heterogeneous. This novel information may help optimize treatment in individual patients, monitor interventional efficacy and develop new treatments. Moreover, by automating the measurement of regional biomarkers for the 19 different anatomical lung segments, there is an opportunity to embed imaging biomarkers into clinically-acceptable clinical workflows and improve lung disease clinical care...
February 16, 2017: Medical Physics
https://www.readbyqxmd.com/read/28157140/a-quasi-experimental-before-after-trial-examining-the-impact-of-an-emergency-department-mechanical-ventilator-protocol-on-clinical-outcomes-and-lung-protective-ventilation-in-acute-respiratory-distress-syndrome
#2
Brian M Fuller, Ian T Ferguson, Nicholas M Mohr, Anne M Drewry, Christopher Palmer, Brian T Wessman, Enyo Ablordeppey, Jacob Keeperman, Robert J Stephens, Cristopher C Briscoe, Angelina A Kolomiets, Richard S Hotchkiss, Marin H Kollef
OBJECTIVES: To evaluate the impact of an emergency department mechanical ventilation protocol on clinical outcomes and adherence to lung-protective ventilation in patients with acute respiratory distress syndrome. DESIGN: Quasi-experimental, before-after trial. SETTING: Emergency department and ICUs of an academic center. PATIENTS: Mechanically ventilated emergency department patients experiencing acute respiratory distress syndrome while in the emergency department or after admission to the ICU...
February 2, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28142136/feasibility-and-safety-of-a-transthoracic-pneumostoma-airway-bypass-in-severe-emphysema-patients
#3
Gregory I Snell, Lynda Holsworth, Sadie Khorramnia, Glen P Westall, Trevor J Williams, Silvana Marasco, Julian H Gooi
BACKGROUND: Emphysema is characterised by airflow obstruction, hyperinflation, and resultant dyspnoea. It is worth investigating whether decompression improves lung mechanics and enhances quality of life (QoL). OBJECTIVES: The purpose of this study was to describe the feasibility and safety of creating a transthoracic pneumostoma to enable lung reduction. METHODS: A transthoracic 10-mm diameter Portaero Access Tube (Portaero™, Cupertino, CA, USA) was implanted via a third intercostal space incision in 15 severe emphysema patients [mean age 63 years, forced expiratory volume in 1 s 54% predicted, diffusing capacity for carbon monoxide 31% predicted, residual volume 246% predicted, Six-Minute Walk Test 296 m]...
February 1, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28121833/volume-targeted-ventilation-in-the-neonate-benchmarking-ventilators-on-an-active-lung-model
#4
Tobias J Krieger, Martin Wald
OBJECTIVE: Mechanically ventilated neonates have been observed to receive substantially different ventilation after switching ventilator models, despite identical ventilator settings. This study aims at establishing the range of output variability among 10 neonatal ventilators under various breathing conditions. DESIGN: Relative benchmarking test of 10 neonatal ventilators on an active neonatal lung model. SETTING: Neonatal ICU. SUBJECTS: Ten current neonatal ventilators...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28103806/the-effect-of-fresh-gas-flow-rate-and-type-of-anesthesia-machine-on-time-to-reach-target-sevoflurane-concentration
#5
Hye Won Shin, Hae Na Yu, Go Eun Bae, Hyub Huh, Ji Yong Park, Ji Young Kim
BACKGROUND: Anesthesia machines have been developed by the application of new technology for rapid and easier control of anesthetic concentration. In this study, we used a test lung to investigate whether the time taken to reach the target sevoflurane concentration varies with the rate of fresh gas flow (FGF) and type of anesthesia machine (AM). METHODS: We measured the times taken to reach the target sevoflurane concentration (2 minimum alveolar concentration = 4%) at variable rates of FGF (0...
January 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28059848/hemodynamic-monitoring-in-thoracic-surgical-patients
#6
Jacob Raphael, Lindsay A Regali, Robert H Thiele
PURPOSE OF REVIEW: This article reviews the technology and clinical data describing hemodynamic monitoring devices available to anesthesiologists and intensivists caring for patients undergoing thoracic surgical procedures, so that they may better utilize available technology to improve outcomes in this high-risk surgical population. RECENT FINDINGS: Noninvasive stroke volume monitors are based on several different technology platforms, all of which have distinct performance characteristics...
January 3, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28030449/hemodynamic-monitoring-in-thoracic-surgical-patients
#7
Jacob Raphael, Lindsay A Regali, Robert H Thiele
PURPOSE OF REVIEW: This article reviews the technology and clinical data describing hemodynamic monitoring devices available to anesthesiologists and intensivists caring for patients undergoing thoracic surgical procedures, so that they may better utilize available technology to improve outcomes in this high-risk surgical population. RECENT FINDINGS: Noninvasive stroke volume monitors are based on several different technology platforms, all of which have distinct performance characteristics...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28019649/the-relative-accuracy-of-4d-dose-accumulation-for-lung-radiotherapy-using-rigid-dose-projection-versus-dose-recalculation-on-every-breathing-phase
#8
Gilmer Valdes, Chul Lee, Stephen Tenn, Percy Lee, Clifford Robinson, Keisuke Iwamoto, Daniel Low, James M Lamb
PURPOSE: To investigate the accuracy of 4D dose accumulation using projection of dose calculated on the end-exhalation, mid-ventilation, or average intensity breathing phase CT scan, versus dose accumulation performed using full Monte Carlo dose recalculation on every breathing phase. METHODS: Radiotherapy plans for 10 patients with stage I-II lung cancer were analyzed. All patients had respiratory-correlated computed tomography (4D-CT) performed as part of an IRB-approved research protocol...
December 26, 2016: Medical Physics
https://www.readbyqxmd.com/read/28017395/left-atrial-function-dynamics-during%C3%A2-exercise-in-heart-failure-pathophysiological-implications-on-the-right-heart-and-exercise-ventilation-inefficiency
#9
Tadafumi Sugimoto, Francesco Bandera, Greta Generati, Eleonora Alfonzetti, Claudio Bussadori, Marco Guazzi
OBJECTIVES: The hypothesis of this study was that left atrial (LA) dynamic impairment during exercise may trigger right ventricular (RV)-to-pulmonary circulation (PC) uncoupling and ventilation inefficiency. BACKGROUND: LA function plays a key role in the hemodynamics of heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF). Extensive investigation of LA dynamics, however, has been performed exclusively at rest...
December 12, 2016: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/27977460/perioperative-outcomes-and-management-in-pediatric-complex-cranial-vault-reconstruction-a-multicenter-study-from-the-pediatric-craniofacial-collaborative-group
#10
Paul A Stricker, Susan M Goobie, Franklyn P Cladis, Charles M Haberkern, Petra M Meier, Srijaya K Reddy, Thanh T Nguyen, Lingyu Cai, Marcia Polansky, Peter Szmuk, John Fiadjoe, Codruta Soneru, Ricardo Falcon, Timothy Petersen, Courtney Kowalczyk-Derderian, Nicholas Dalesio, Stefan Budac, Neels Groenewald, Daniel Rubens, Douglas Thompson, Rheana Watts, Katherine Gentry, Iskra Ivanova, Mali Hetmaniuk, Vincent Hsieh, Michael Collins, Karen Wong, Wendy Binstock, Russell Reid, Kim Poteet-Schwartz, Heike Gries, Rebecca Hall, Jeffrey Koh, Carolyn Bannister, Wai Sung, Ranu Jain, Allison Fernandez, Gerald F Tuite, Ernesto Ruas, Oleg Drozhinin, Lisa Tetreault, Bridget Muldowney, Karene Ricketts, Patrick Fernandez, Lisa Sohn, John Hajduk, Brad Taicher, Jessica Burkhart, Allison Wright, Jane Kugler, Lea Barajas-DeLoa, Meera Gangadharan, Veronica Busso, Kayla Stallworth, Susan Staudt, Kristen L Labovsky, Chris D Glover, Henry Huang, Helena Karlberg-Hippard, Samantha Capehart, Cynthia Streckfus, Kim-Phuong T Nguyen, Peter Manyang, Jose Luis Martinez, Jennifer K Hansen, Heather Mitzel Levy, Alyssa Brzenski, Franklin Chiao, Pablo Ingelmo, Razaz Mujallid, Olutoyin A Olutoye, Tariq Syed, Hubert Benzon, Adrian Bosenberg
BACKGROUND: The Pediatric Craniofacial Collaborative Group established the Pediatric Craniofacial Surgery Perioperative Registry to elucidate practices and outcomes in children with craniosynostosis undergoing complex cranial vault reconstruction and inform quality improvement efforts. The aim of this study is to determine perioperative management, outcomes, and complications in children undergoing complex cranial vault reconstruction across North America and to delineate salient features of current practices...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27965949/a-novel-prototype-neonatal-resuscitator-that-controls-tidal-volume-and-ventilation-rate-a-comparative-study-of-mask-ventilation-in-a-newborn-manikin
#11
Anne Lee Solevåg, Enrico Haemmerle, Sylvia van Os, Katinka P Bach, Po-Yin Cheung, Georg M Schmölzer
The objective of this randomized controlled manikin trial was to examine tidal volume (VT) delivery and ventilation rate during mask positive pressure ventilation (PPV) with five different devices, including a volume-controlled prototype Next Step™ device for neonatal resuscitation. We hypothesized that VT and rate would be closest to target with the Next Step™. Twenty-five Neonatal Resuscitation Program providers provided mask PPV to a newborn manikin (simulated weight 1 kg) in a randomized order with a self-inflating bag (SIB), a disposable T-piece, a non-disposable T-piece, a stand-alone resuscitation system T-piece, and the Next Step™...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27920518/significant-lung-volume-reduction-with-endobronchial-valves-in-a-patient-despite-the-presence-of-microcollaterals-masked-by-low-flow-chartis-phenotype
#12
Yan Yin, Gang Hou, Felix J Herth, Xiao-Bo Wang, Qiu-Yue Wang, Jian Kang
Satisfactory functional outcomes following bronchoscopic lung volume reduction (BLVR) using endobronchial valves (EBVs) depend on the absence of collateral ventilation (CV) between the target and adjunct lobes. The Chartis system has proven to be useful for determining whether CV is present or absent, but this system can also erroneously indicate the absence of CV, which can lead to BLVR failure. Here, we describe low-flow Chartis phenotype in the target lobe resulted in difficult judgment of existence of CV...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27899539/reliability-of-displayed-tidal-volume-in-healthy-and-surfactant-depleted-piglets
#13
A Cecilia Mendiondo Luedloff, Tracy L Thurman, Shirley J Holt, Shasha Bai, Mark J Heulitt, Sherry E Courtney
BACKGROUND: Volutrauma has been established as the key factor in ventilator-induced lung injury and can only be avoided if tidal volume (VT) is accurately displayed and delivered. The purpose of this study was to investigate the accuracy of displayed exhaled VT in a ventilator commonly used in small infants with or without a proximal flow sensor and using 3 methods to achieve a target VT in both a healthy and lung-injured neonatal pig model. METHODS: This was a prospective animal study utilizing 8 male pigs, approximately 2...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879380/performance-of-leak-compensation-in-all-age-icu-ventilators-during-volume-targeted-neonatal-ventilation-a-lung-model-study
#14
Taiga Itagaki, Desmond J Bennett, Christopher T Chenelle, Daniel F Fisher, Robert M Kacmarek
BACKGROUND: Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. METHODS: Four ICU ventilators (Servo-i, PB980, V500, and Avea) were compared in available invasive volume-targeted ventilation modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV])...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27876355/lung-protective-ventilatory-strategies-in-intubated-preterm-neonates-with-rds
#15
REVIEW
F Reiterer, B Schwaberger, T Freidl, G Schmölzer, G Pichler, B Urlesberger
This article provides a narrative review of lung-protective ventilatory strategies (LPVS) in intubated preterm infants with RDS. A description of strategies is followed by results on short-and long-term respiratory and neurodevelopmental outcomes. Strategies will include patient-triggered or synchronized ventilation, volume targeted ventilation, the technique of intubation, surfactant administration and rapid extubation to NCPAP (INSURE), the open lung concept, strategies of high-frequency ventilation, and permissive hypercapnia...
October 26, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/27861175/transient-receptor-potential-vanilloid-4-and-serum-glucocorticoid-regulated-kinase-1-are-critical-mediators-of-lung-injury-in-overventilated-mice-in-vivo
#16
Laura Michalick, Lasti Erfinanda, Ulrike Weichelt, Markus van der Giet, Wolfgang Liedtke, Wolfgang M Kuebler
BACKGROUND: Mechanical ventilation can cause lung endothelial barrier failure and inflammation cumulating in ventilator-induced lung injury. Yet, underlying mechanotransduction mechanisms remain unclear. Here, the authors tested the hypothesis that activation of the mechanosensitive Ca channel transient receptor potential vanilloid (TRPV4) by serum glucocorticoid-regulated kinase (SGK) 1 may drive the development of ventilator-induced lung injury. METHODS: Mice (total n = 54) were ventilated for 2 h with low (7 ml/kg) or high (20 ml/kg) tidal volumes and assessed for signs of ventilator-induced lung injury...
February 2017: Anesthesiology
https://www.readbyqxmd.com/read/27817945/respiratory-motion-management-in-stereotactic-body-radiation-therapy-for-lung-cancer-a-dosimetric-comparison-in-an-anthropomorphic-lung-phantom-luca
#17
Stefanie Ehrbar, Rosalind Perrin, Marta Peroni, Kinga Bernatowicz, Thomas Parkel, Izabela Pytko, Stephan Klöck, Matthias Guckenberger, Stephanie Tanadini-Lang, Damien Charles Weber, Antony Lomax
BACKGROUND AND PURPOSE: The objective of this study was to compare the latest respiratory motion-management strategies, namely the internal-target-volume (ITV) concept, the mid-ventilation (MidV) principle, respiratory gating and dynamic couch tracking. MATERIALS AND METHODS: An anthropomorphic, deformable and dynamic lung phantom was used for the dosimetric validation of these techniques. Stereotactic treatments were adapted to match the techniques and five distinct respiration patterns, and delivered to the phantom while radiographic film measurements were taken inside the tumor...
November 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27794085/should-we-use-volume-targeted-noninvasive-ventilation-in-patients-with-acute-hypercapnic-respiratory-failure
#18
EDITORIAL
Jean-Pierre Frat, Arnaud W Thille
No abstract text is available yet for this article.
November 2016: Respiratory Care
https://www.readbyqxmd.com/read/27794079/volume-targeted-versus-pressure-limited-noninvasive-ventilation-in-subjects-with-acute-hypercapnic-respiratory-failure-a-multicenter-randomized-controlled-trial
#19
Zhixin Cao, Zujin Luo, Anna Hou, Qingrong Nie, Baoyuan Xie, Xiaojie An, Zifen Wan, Xianwei Ye, Yanju Xu, Xisheng Chen, Honghai Zhang, Zhenyang Xu, Jinxiang Wang, Fucheng An, Pengfei Li, Chunxiao Yu, Yandong Liang, Yongxiang Zhang, Yingmin Ma
BACKGROUND: Volume-targeted noninvasive ventilation (VT-NIV), a hybrid mode that delivers a preset target tidal volume (VT) through the automated adjustment of pressure support, could guarantee a relatively constant target VT over pressure-limited noninvasive ventilation (PL-NIV) with fixed-level pressure support. Whether VT-NIV is more effective in improving ventilatory status in subjects with acute hypercapnic respiratory failure (AHRF) remains unclear. Our aim was to verify whether, in comparison with PL-NIV, VT-NIV would be more effective in correcting hypercapnia, hence reducing the need for intubation and improving survival in subjects with AHRF...
November 2016: Respiratory Care
https://www.readbyqxmd.com/read/27755068/clinical-practice-guidelines-for-sustained-neuromuscular-blockade-in-the-adult-critically-ill-patient
#20
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
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