Read by QxMD icon Read

low tidal volume

Daniel Langer, Casey E Ciavaglia, Azmy Faisal, Katherine A Webb, J Alberto Neder, Rik Gosselink, Sauwaluk Dacha, Marko Topalovic, Anna Ivanova, Denis E O'Donnell
Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max)...
March 15, 2018: Journal of Applied Physiology
Peter D Sottile, David Albers, Marc M Moss
BACKGROUND: Neuromuscular blockade (NMB) is a therapy for acute respiratory distress syndrome (ARDS). However, the mechanism by which NMB may improve outcome for ARDS patients remains unclear. We sought to determine whether NMB attenuates biomarkers of epithelial and endothelial lung injury and systemic inflammation in ARDS patients, and whether the association is dependent on tidal volume size and the initial degree of hypoxemia. METHODS: We performed a secondary analysis of patients enrolled in the ARDS network low tidal volume ventilation (ARMA) study...
March 10, 2018: Critical Care: the Official Journal of the Critical Care Forum
Hongli Chen, Xiaotong Sun, Xiaomei Yang, Yonghao Hou, Xiaoqian Yu, Yang Wang, Jianbo Wu, Dejie Liu, Huanliang Wang, Jingui Yu, Wenbo Yi
Mechanical ventilation (MV) may lead to ventilator-induced lung injury (VILI). Previous research has shown that dexmedetomidine attenuates pulmonary inflammation caused by MV, but the underlying mechanisms remain unclear. Our study aims to test whether dexmedetomidine has a protective effect against VILI and to explore the possible molecular mechanisms using the rat model. Thirty adult male Wistar rats weighing 200-250 g were randomly assigned to 5 groups (n = 6): control, low tidal volume MV (LMV), high tidal volume (HVT) MV (HMV), HVT MV + dexmedetomidine (DEX), HVT MV + dexmedetomidine + yohimbine (DEX+Y)...
February 20, 2018: Bosnian Journal of Basic Medical Sciences
Bao-Juan Zhang, Hai-Tao Tian, Hai-Ou Li, Jian Meng
The objective of the present study was to explore the effects of different one-lung ventilation (OLV) modes on lung function in elderly patients undergoing esophageal cancer surgery. A total of 180 consecutive elderly patients (ASA Grades I-II, with OLV indications) undergoing elective surgery were recruited in the study. Patients were randomly divided into 4 groups (n = 45). In Group A, patients received low tidal volume (VT < 8 mL/kg) + pressure controlled ventilation (PCV), low tidal volume (VT < 8 mL/kg) + volume-controlled ventilation (VCV) in Group B, high tidal volume (VT ≥ 8 mL/kg) + PCV in Group C and high tidal volume (VT ≥ 8 mL/kg) + VCV in Group D...
January 2018: Medicine (Baltimore)
Einav Nachman, Peter Clemensen, Katheryn Santos, Alexis R Cole, Brian D Polizzotti, Grace Hofmann, Kristen T Leeman, Sarah J van den Bosch, John N Kheir
BACKGROUND: The accurate measurement of oxygen consumption (VO2) and energy expenditure (EE) may be helpful to optimize the treatment of critically ill patients. However, current techniques are limited in their ability to accurately quantify these end points in infants due to a low VO2, low tidal volume, and rapid respiratory rate. This study describes and validates a new device intended to perform in this size range. METHODS: We created a customized device that quantifies inspiratory volume using a pneumotachometer and concentrations of oxygen and carbon dioxide gas in the inspiratory and expiratory limbs...
March 1, 2018: Anesthesia and Analgesia
Raquel S Santos, Ligia de A Maia, Milena V Oliveira, Cíntia L Santos, Lillian Moraes, Eliete F Pinto, Cynthia Dos S Samary, Joana A Machado, Anna Carolinna Carvalho, Marcos Vinícius de S Fernandes, Vanessa Martins, Vera L Capelozzi, Marcelo M Morales, Thea Koch, Marcelo Gama de Abreu, Paolo Pelosi, Pedro L Silva, Patricia R M Rocco
BACKGROUND: The authors hypothesized that low tidal volume (VT) would minimize ventilator-induced lung injury regardless of the degree of mechanical power. The authors investigated the impact of power, obtained by different combinations of VT and respiratory rate (RR), on ventilator-induced lung injury in experimental mild acute respiratory distress syndrome (ARDS). METHODS: Forty Wistar rats received Escherichia coli lipopolysaccharide intratracheally. After 24 h, 32 rats were randomly assigned to be mechanically ventilated (2 h) with a combination of different VT (6 ml/kg and 11 ml/kg) and RR that resulted in low and high power...
February 28, 2018: Anesthesiology
Kevin Delucchi, Katie R Famous, Lorraine B Ware, Polly E Parsons, B Taylor Thompson, Carolyn S Calfee
RATIONALE: Two distinct acute respiratory distress syndrome (ARDS) subphenotypes have been identified using data obtained at time of enrolment in clinical trials; it remains unknown if these subphenotypes are durable over time. OBJECTIVE: To determine the stability of ARDS subphenotypes over time. METHODS: Secondary analysis of data from two randomised controlled trials in ARDS, the ARMA trial of lung protective ventilation (n=473; patients randomised to low tidal volumes only) and the ALVEOLI trial of low versus high positive end-expiratory pressure (n=549)...
February 24, 2018: Thorax
María Lema Tome, Francisco Andrés De la Gala, Patricia Piñeiro, Luis Olmedilla, Ignacio Garutti
INTRODUCTION: In last few years, emphasis was placed in goal-directed therapy in order to optimize patient's hemodynamic status and improve their prognosis. Parameters based on the interaction between heart and lungs have been questioned in situations like low tidal volume and open chest surgery. The goal of the study was to analyze the changes that one-lung ventilation can produce over stroke volume variation and to assess the possible impact of airway pressures and lung compliance over stroke volume variation...
February 21, 2018: Revista Brasileira de Anestesiologia
Eddy Fan, Daniel Brodie, Arthur S Slutsky
Importance: Acute respiratory distress syndrome (ARDS) is a life-threatening form of respiratory failure that affects approximately 200 000 patients each year in the United States, resulting in nearly 75 000 deaths annually. Globally, ARDS accounts for 10% of intensive care unit admissions, representing more than 3 million patients with ARDS annually. Objective: To review advances in diagnosis and treatment of ARDS over the last 5 years. Evidence Review: We searched MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 2012 to 2017 focusing on randomized clinical trials, meta-analyses, systematic reviews, and clinical practice guidelines...
February 20, 2018: JAMA: the Journal of the American Medical Association
Joao Henrique Neves Soares, Alysson Roncally Carvalho, Bruno Curty Bergamini, Maria Alice Kuster Gress, Frederico Caetano Jandre, Walter Araujo Zin, Antonio Giannella-Neto
PURPOSE: We compared respiratory mechanics between the positive end-expiratory pressure of minimal respiratory system elastance (PEEP minErs ) and three levels of PEEP during low-tidal-volume (6 mL/kg) ventilation in rats. METHODS: Twenty-four rats were anesthetized, paralyzed, and mechanically ventilated. Airway pressure (P aw ), flow (F), and volume (V) were fitted by a linear single compartment model (LSCM) P aw (t) = E rs × V(t) + R rs × F(t) + PEEP or a volume- and flow-dependent SCM (VFDSCM) P aw (t) = (E 1 + E 2 × V(t)) × V(t) + (K 1 + K 2 × |F(t)|) × F(t) + PEEP, where E rs and R rs are respiratory system elastance and resistance, respectively; E 1 and E 2 × V are volume-independent and volume-dependent E rs , respectively; and K 1 and K 2 × F are flow-independent and flow-dependent R rs , respectively...
February 12, 2018: Lung
Detajin Junhasavasdikul, Irene Telias, Domenico Luca Grieco, Lu Chen, Cinta Millan Gutierrez, Thomas Piraino, Laurent Brochard
Expiratory flow limitation (EFL) is present when the flow cannot rise despite an increase of the expiratory driving pressure. The mechanisms of EFL are debated but are thought to be related to the collapsibility of small airways. In mechanically ventilated patients, EFL can exist during tidal ventilation, representing an extreme situation where lung volume cannot decrease whatever the expiratory driving forces. It is a key factor for the generation of auto- or intrinsic positive end-expiratory pressure (auto-PEEP or PEEPi) and requires specific management such as positioning and adjustment of external PEEP...
February 9, 2018: Chest
Zhanqi Zhao, Wei Wang, Zuojing Zhang, Meiying Xu, Inez Frerichs, Jing-Xiang Wu, Knut Moeller
The aim of the study was to explore the feasibility of titrating tidal volume (VT) and positive end-expiratory pressure (PEEP) during one-lung ventilation (OLV) based on ventilation distribution and oxygenation. Approach: Twenty four consecutive patients requiring intubation with a double-lumen tube and subsequent OLV for thoracic surgical procedures were examined prospectively in lateral posture. Electrical impedance tomography (EIT), blood gases, respiratory mechanics were successfully measured in 21 patients at various combinations of VT (4 ml/kg, 6 ml/kg, 8 ml/kg body weight) and PEEP (0 cmH2O, 4 cmH2O, 8 cmH2O) during OLV...
February 12, 2018: Physiological Measurement
Anna Geke Algera, Luigi Pisani, Renato Carneiro de Freitas Chaves, Thiago Chaves Amorim, Thomas Cherpanath, Rogier Determann, Dave A Dongelmans, Frederique Paulus, Pieter Roel Tuinman, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J Schultz, Ary Serpa Neto
It is well-known that positive end-expiratory pressure (PEEP) can prevent ventilator-induced lung injury (VILI) and improve pulmonary physiology in animals with injured lungs. It's uncertain whether PEEP has similar effects in animals with uninjured lungs. A systematic review of randomized controlled trials (RCTs) comparing different PEEP levels in animals with uninjured lungs was performed. Trials in animals with injured lungs were excluded, as were trials that compared ventilation strategies that also differed with respect to other ventilation settings, e...
January 2018: Annals of Translational Medicine
Yi Xin, Maurizio Cereda, Hooman Hamedani, Mehrdad Pourfathi, Sarmad Siddiqui, Natalie Meeder, Stephen Kadlecek, Ian Duncan, Harrilla Profka, Jennia Rajaei, Nicholas J Tustison, James C Gee, Brian P Kavanagh, Rahim R Rizi
BACKGROUND: It remains unclear how prone positioning improves survival in acute respiratory distress syndrome (ARDS). Using serial computed tomography (CT), we previously reported that 'unstable' inflation, i.e. partial aeration with large tidal density swings (indicating increased local strain) is associated with injury progression. We prospectively tested whether prone position contains the early propagation of experimental lung injury by stabilizing inflation. METHODS: Injury was induced by tracheal hydrochloric acid (HCl) in rats; after randomization to supine or prone position, injurious ventilation was commenced using high tidal volume and low PEEP...
February 8, 2018: American Journal of Respiratory and Critical Care Medicine
K Terziyski, A Draganova
Characterized by periodic crescendo-decrescendo pattern of breathing alternating with central apneas, Central sleep apnea (CSA) with Cheyne-Stokes Breathing represents a highly prevalent, yet underdiagnosed comorbidity in chronic heart failure (CHF). A diverse body of evidence demonstrates increased morbidity and mortality in the presence of CSB. CSB has been described in both CHF patients with preserved and reduced ejection fraction, regardless of drug treatment. Risk factors for CSB are older age, male gender, high BMI, atrial fibrillation and hypocapnia...
February 7, 2018: Advances in Experimental Medicine and Biology
Simon-Richard Finke, Daniel C Schroeder, Hannes Ecker, Sabine Wingen, Jochen Hinkelbein, Wolfgang A Wetsch, Daniela Köhler, Bernd W Böttiger
AIM: Bystander CPR-rates are embarrassingly low in some European countries. To increase bystander CPR-rates, many different approaches are used; one of them is training of schoolchildren in CPR. Multiple authors investigated practical and theoretical CPR performance and demonstrated gender differences related to schoolchildren CPR. The objective was to elaborate gender aspects in practical and theoretical CPR-performance from the current literature to better address female and male students...
February 3, 2018: Resuscitation
Carlos Ferrando, Marina Soro, Carmen Unzueta, Fernando Suarez-Sipmann, Jaume Canet, Julián Librero, Natividad Pozo, Salvador Peiró, Alicia Llombart, Irene León, Inmaculada India, Cesar Aldecoa, Oscar Díaz-Cambronero, David Pestaña, Francisco J Redondo, Ignacio Garutti, Jaume Balust, Jose I García, Maite Ibáñez, Manuel Granell, Aurelio Rodríguez, Lucía Gallego, Manuel de la Matta, Rafael Gonzalez, Andrea Brunelli, Javier García, Lucas Rovira, Francisco Barrios, Vicente Torres, Samuel Hernández, Estefanía Gracia, Marta Giné, María García, Nuria García, Lisset Miguel, Sergio Sánchez, Patricia Piñeiro, Roger Pujol, Santiago García-Del-Valle, José Valdivia, María J Hernández, Oto Padrón, Ana Colás, Jaume Puig, Gonzalo Azparren, Gerardo Tusman, Jesús Villar, Javier Belda
BACKGROUND: The effects of individualised perioperative lung-protective ventilation (based on the open-lung approach [OLA]) on postoperative complications is unknown. We aimed to investigate the effects of intraoperative and postoperative ventilatory management in patients scheduled for abdominal surgery, compared with standard protective ventilation. METHODS: We did this prospective, multicentre, randomised controlled trial in 21 teaching hospitals in Spain. We enrolled patients who were aged 18 years or older, were scheduled to have abdominal surgery with an expected time of longer than 2 h, had intermediate-to-high-risk of developing postoperative pulmonary complications, and who had a body-mass index less than 35 kg/m2...
January 19, 2018: Lancet Respiratory Medicine
Shuji Okahara, Kazuyoshi Shimizu, Satoshi Suzuki, Kenzo Ishii, Hiroshi Morimatsu
BACKGROUND: The interest in perioperative lung protective ventilation has been increasing. However, optimal management during one-lung ventilation (OLV) remains undetermined, which not only includes tidal volume (VT ) and positive end-expiratory pressure (PEEP) but also inspired oxygen fraction (FI O2 ). We aimed to investigate current practice of intraoperative ventilation during OLV, and analyze whether the intraoperative ventilator settings are associated with postoperative pulmonary complications (PPCs) after thoracic surgery...
January 25, 2018: BMC Anesthesiology
Rabijit Dutta, Tao Xing, Craig Swanson, Jeff Heltborg, Gordon K Murdoch
A comparison between flow and gas washout data for High Frequency Percussive Ventilation (HFPV) and pressure control ventilation (PCV) under similar conditions is currently not available. This bench study aims to compare and describe the flow and gas washout behavior of HFPV and PCV in a newly designed experimental setup and establish a framework for future clinical and animal studies. Approach: We studied gas washout behavior using a newly designed experimental setup that is motivated by the multi-breath nitrogen washout measurements...
January 25, 2018: Physiological Measurement
Lieuwe D Bos, Ignacio Martin-Loeches, Marcus J Schultz
This review discusses the clinical challenges associated with ventilatory support and pharmacological interventions in patients with acute respiratory distress syndrome (ARDS). In addition, it discusses current scientific challenges facing researchers when planning and performing trials of ventilatory support or pharmacological interventions in these patients.Noninvasive mechanical ventilation is used in some patients with ARDS. When intubated and mechanically ventilated, ARDS patients should be ventilated with low tidal volumes...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"