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Mechanical ventilation weaning

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https://www.readbyqxmd.com/read/28411422/ventilation-distribution-and-lung-recruitment-with-speaking-valve-use-in-tracheostomised-patient-weaning-from-mechanical-ventilation-in-intensive-care
#1
Anna-Liisa Sutt, Chris M Anstey, Lawrence R Caruana, Petrea L Cornwell, John F Fraser
PURPOSE: Speaking valves (SV) are used infrequently in tracheostomised ICU patients due to concerns regarding their putative effect on lung recruitment. A recent study in cardio-thoracic population demonstrated increased end-expiratory lung volumes during and post SV use without examining if the increase in end-expiratory lung impedance (EELI) resulted in alveolar recruitment or potential hyperinflation in discrete loci. MATERIALS AND METHODS: A secondary analysis of Electrical Impedance Tomography (EIT) data from a previous study was conducted...
April 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28405876/laparoscopic-sleeve-gastrectomy-in-kidney-transplant-candidates-a-case-series
#2
Sergio Carandina, Laurent Genser, Manuela Bossi, Laura Montana, Alexandre Cortes, Marie Seman, Marc Danan, Christophe Barrat
BACKGROUND: Patients with a body mass index (BMI) >35 kg/m(2) who need kidney transplant present with increased postoperative mortality and reduced kidney graft survival compared to patients with a lower BMI. For this reason, obese patients are often excluded from the transplantation waiting list. The aim of this study was to evaluate the feasibility and the results of laparoscopic sleeve gastrectomy (LSG) for obese patients awaiting a kidney transplant. METHODS: This was a retrospective study on patients with dialysis-dependent renal failure (DDRF) operated on at two first-level bariatric centers in Paris (France)...
April 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28403404/hospital-outcomes-and-long-term-survival-after-referral-to-a-specialized-weaning-unit
#3
M G Davies, T G Quinnell, N S Oscroft, S P Clutterbuck, J M Shneerson, I E Smith
Background.: Prolonged invasive mechanical ventilation (IMV) is a frequent challenge, and an increasing number of patients are transferred from intensive care units to long-term acute care hospitals or specialized weaning units. There are few published data for discharge home rates, use of noninvasive ventilation (NIV), or long-term survival. Methods.: A case-note and database review was conducted of patients admitted to a UK national specialized weaning unit for weaning from IMV between 1992 and 2012...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28402093/extracorporeal-co2-removal-ecco2r-in-critically-ill-patients-a-systematic-review
#4
Fabio S Taccone, Maximilian V Malfertheiner, Fiorenza Ferrari, Matteo DI Nardo, Justyna Swol, Lars M Broman, Leen Vercaemst, Nicholas Barrett, Federico Pappalardo, Jan Belohlavek, Thomas Mueller, Roberto Lorusso, Mirko Belliato
INTRODUCTION: The use of extracorporeal CO2 removal (ECCO2R) is increasingly employed in critically ill patients. However, the clinical evidence supporting its efficacy remains currently poor. EVIDENCE ACQUISITION: A systematic review using MEDLINE via PubMed was performed to identify eligible studies (until 30th September 2016). The amount of CO2 reduction, the effect on the duration of mechanical ventilation and weaning, the impact on patients' outcome and the occurrence of complications were evaluated...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28393778/safety-and-efficacy-of-ketamine-dexmedetomidine-versus-ketamine-propofol-combinations-for-sedation-in-patients-after-coronary-artery-bypass-graft-surgery
#5
Mona Mohamed Mogahd, Mohammed Shafik Mahran, Ghada Foad Elbaradi
BACKGROUND AND AIMS: Prolonged mechanical ventilation after cardiac surgery is associated with serious complications that increase morbidity and mortality. The present study was designed to compare ketamine-propofol (KP) and ketamine-dexmedetomidine (KD) combinations for sedation and analgesia in patients after coronary artery bypass graft (CABG) surgery as regards hemodynamics, total fentanyl dose, time of weaning from mechanical ventilation, time of extubation, and any adverse outcome...
April 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28387889/a-study-of-the-protective-effect-and-mechanism-of-ketamine-on-acute-lung-injury-induced-by-mechanical-ventilation
#6
W-F Wang, S Liu, B Xu
OBJECTIVE: To investigate the protective effects and mechanism of ketamine on acute lung injury induced by mechanical ventilation. PATIENTS AND METHODS: 63 patients with acute lung injury caused by mechanical ventilation in our hospital between June 2014 and May 2015 were chosen and divided into three groups: group A, B, and C. Group A (20 cases) received conventional treatment. Group B (21 cases) was treated with propofol and group C (22 cases) with ketamine. The ventilator application time, the success rate of weaning, the mortality rate, inflammation index (IL-1, Caspase-1, and NF-κB), pulmonary function index and oxygen saturation were compared...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28382808/weaning-of-neurological-early-rehabilitation-patients-from-mechanical-ventilation-a-retrospective-observational-study
#7
Jens D Rollnik, Joachim K Krauss, Christoph Gutenbrunner, Claus Wallesch, Thomas Münte, Martin Stangel
BACKGROUND: There is little known about the factors influencing the weaning process of long-term mechanically ventilated patients in the neurological early rehabilitation. AIM: To identify salient clinical and neurophysiological variables with impact upon weaning from mechanical ventilation during neurological and neurosurgical early rehabilitation. DESIGN: Observational, retrospective data analysis. POPULATION: A sample of 65 mechanically ventilated neurological and neurosurgical early rehabilitation patients of the BDH-Clinic Hessisch Oldendorf in Northern Germany...
April 4, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28380204/pendelluft-diagnosed-from-ventilator-weaning-indexes-obtained-through-bioelectrical-impedance-tomography-a-case-report
#8
Fabiana Aparecida Lopes, Lidiane Andrade Monteiro de Souza, Juliana Tavares Neves Bernardi, Carlos Eduardo Rocha, Luciana Castilho de Figueiredo, Ana Paula Ragonete Dos Anjos Agostini, Desanka Dragosavac, Daniela Cristina Dos Santos Faez
CONTEXT: Today, through major technological advances in diagnostic resources within medicine, evaluation and monitoring of clinical parameters at the patient's bedside in intensive care units (ICUs) has become possible. CASE REPORT: This case report presents results and interpretations from predictive mechanical ventilation weaning indexes obtained through monitoring using chest electrical bioimpedance tomography. These indexes included maximum inspiratory pressure, maximum expiratory pressure, shallow breathing index and spontaneous breathing test...
April 3, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28380189/extracorporeal-respiratory-support-in-adult-patients
#9
Thiago Gomes Romano, Pedro Vitale Mendes, Marcelo Park, Eduardo Leite Vieira Costa
In patients with severe respiratory failure, either hypoxemic or hypercapnic, life support with mechanical ventilation alone can be insufficient to meet their needs, especially if one tries to avoid ventilator settings that can cause injury to the lungs. In those patients, extracorporeal membrane oxygenation (ECMO), which is also very effective in removing carbon dioxide from the blood, can provide life support, allowing the application of protective lung ventilation. In this review article, we aim to explore some of the most relevant aspects of using ECMO for respiratory support...
January 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28377920/automated-weaning-from-mechanical-ventilation-after-off-pump-coronary-artery-bypass-grafting
#10
Evgenia V Fot, Natalia N Izotova, Angelika S Yudina, Aleksei A Smetkin, Vsevolod V Kuzkov, Mikhail Y Kirov
BACKGROUND: The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28376012/are-doctors-and-nurses-sharing-the-responsibility-for-timely-and-safe-weaning-of-mechanically-ventilated-pediatric-patients
#11
Maureen Banigan, Angela T Wratney
No abstract text is available yet for this article.
April 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28373296/a-proteomic-approach-to-identify-alterations-in-the-sumo-network-during-controlled-mechanical-ventilation-in-rat-diaphragm-muscle
#12
Arvind Venkat Namuduri, Gabriel Heras, Jia Mi, Nicola Cacciani, Katarina Hörnaeus, Anne Konzer, Sara Bergström Lind, Lars Larsson, Stefano Gastaldello
The Small Ubiquitin-like Modifier (SUMO) is as a regulator of many cellular functions by reversible conjugation to a broad number of substrates. Under endogenous or exogenous perturbations, the SUMO network becomes a fine sensor of stress conditions by alterations in the expression level of SUMO enzymes and consequently changing the status of SUMOylated proteins. The diaphragm is the major inspiratory muscle, which is continuously active under physiological conditions, but its structure and function is severely affected when passively displaced for long extents during mechanical ventilation (MV)...
April 3, 2017: Molecular & Cellular Proteomics: MCP
https://www.readbyqxmd.com/read/28366462/side-to-side-tracheobronchoplasty-to-reconstruct-complex-congenital-tracheobronchial-stenosis
#13
William S Ragalie, Robert H Chun, Timothy Martin, Nancy S Ghanayem, Richard J Berens, David J Beste, Michael E Mitchell
BACKGROUND: Long segment tracheobronchial stenosis is a rare congenital anomaly that can also occur in combination with abnormal bronchial arborization. Long segment tracheal reconstruction in the setting of a supernumerary bridging bronchus has been reported; however, these repairs can be particularly complex. We present our experience using the bridging bronchus to augment long segment tracheal stenosis with a side-to-side tracheobronchoplasty. METHODS: Four patients with complex long segment tracheobronchial stenosis involving a bronchus suis (right upper lobe bronchus) and a bridging bronchus presented with refractory respiratory distress requiring urgent tracheal reconstruction...
March 30, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28360483/mapleson-d-continuous-positive-airway-pressure-system-for-weaning-of-mechanical-ventilation-in-pediatric-patients-in-response
#14
Miguel Angel Palomero Rodríguez, Héctor Chozas de Arteaga, Yolanda Laporta Báez, Jesús de Vicente Sánchez, Antonio Pérez Ferrer
No abstract text is available yet for this article.
March 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28360482/mapleson-d-continuous-positive-airway-pressure-system-for-weaning-of-mechanical-ventilation-in-pediatric-patients
#15
Anirban Mandal, Puneet Kaur Sahi
No abstract text is available yet for this article.
March 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28355363/the-effects-of-individually-ventilated-cages-on-the-respiratory-systems-of-male-and-female-wistar-rats-from-birth-until-adulthood
#16
Guilherme D'Aprile Marchesi, Sônia de Fatima Soto, Isac de Castro, Thiago Guimarães Rodrigues, Henrique Takachi Moriya, Francine Maria de Almeida, Rogerio Pazetti, Joel Claudio Heimann, Luzia Naôko Shinohara Furukawa
OBJECTIVE: To evaluate the respiratory systems of male and female rats maintained in individually ventilated cages (IVCs) from birth until adulthood. METHODS: Female Wistar rats were housed in individually ventilated cages or conventional cages (CCs) and mated with male Wistar rats. After birth and weaning, the male offspring were separated from the females and kept in cages of the same type until 12 weeks of age. RESULTS: The level of food consumption was lower in male offspring (IVC=171...
March 2017: Clinics
https://www.readbyqxmd.com/read/28353560/a-life-threatening-case-of-tafro-syndrome-with-dramatic-response-to-tocilizumab-rituximab-and-pulse-steroids-the-first-case-report-in-latin-america
#17
Fabio Freire José, Lucila Nassif Kerbauy, Guilherme Fleury Perini, Danielle Isadora Blumenschein, Denise da Cunha Pasqualin, Denise Maria Avancini Costa Malheiros, Guilherme de Carvalho Campos Neto, Fabio Pires de Souza Santos, Ronaldo Piovesan, Nelson Hamerschlak
RATIONALE: This is the report of the first case of TAFRO syndrome (Thrombocytopenia, Anasarca, myelofibrosis, Renal dysfunction, Organomegaly) in Latin America. PATIENT CONCERNS: The patient was a 61-year-old white woman of Ashkenazi Jewish descent, who presented with a history of 8 days of nausea, vomiting, and fever; severe pitting edema in both legs, ascites, splenomegaly, and palpable axillary lymph nodes. DIAGNOSES: Abdominal computed tomography (CT) showed bilateral pleural effusion and retroperitoneal lymph node enlargement...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28343681/ultrasound-evaluation-of-diaphragm-function-and-its-application-in-critical-patients-mechanical-ventilation-and-brachial-plexus-block
#18
F de B de la Quintana Gordon, B Nacarino Alcorta, M Fajardo Pérez
Before diaphragm ultrasonography, assessment of diaphragm function was very difficult due to the complex nature of its exploration. The use of this new technique has shed light on diagnostic problems and treatment with an improvement in final outcomes for critically ill patients, in whom the incidence of diaphragm weakness or dysfunction has been underestimated. Better knowledge of diaphragm function enables us earlier diagnosis by quantification of diaphragm contractile activity or evaluation of functional status after delivery of plexus block anaesthesia, facilitating therapeutic decisions...
March 23, 2017: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/28338483/prevalence-and-impact-on-weaning-of-pleural-effusion-at-the-time-of-liberation-from-mechanical-ventilation-a-multicenter-prospective-observational-study
#19
Martin Dres, Damien Roux, Tài Pham, Alexandra Beurton, Jean-Damien Ricard, Muriel Fartoukh, Alexandre Demoule
BACKGROUND: Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown. METHODS: In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion (small, moderate, and large). Weaning failure was defined by a failed spontaneous breathing trial and/or extubation requiring any form of ventilatory support within 48 h...
March 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28328824/early-use-of-noninvasive-techniques-for-clearing-respiratory-secretions-during-noninvasive-positive-pressure-ventilation-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-and-hypercapnic-encephalopathy-a-prospective-cohort-study
#20
Jinrong Wang, Zhaobo Cui, Shuhong Liu, Xiuling Gao, Pan Gao, Yi Shi, Shufen Guo, Peipei Li
Noninvasive positive-pressure ventilation (NPPV) might be superior to conventional mechanical ventilation (CMV) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPDs). Inefficient clearance of respiratory secretions provokes NPPV failure in patients with hypercapnic encephalopathy (HE). This study compared CMV and NPPV combined with a noninvasive strategy for clearing secretions in HE and AECOPD patients.The present study is a prospective cohort study of AECOPD and HE patients enrolled between October 2013 and August 2015 in a critical care unit of a major university teaching hospital in China...
March 2017: Medicine (Baltimore)
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