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https://www.readbyqxmd.com/read/28886582/protective-effects-of-ghrelin-in-ventilator-induced-lung-injury-in-rats
#1
Guang Li, Jiao Liu, Wen-Fang Xia, Chen-Liang Zhou, Li-Qiong Lv
Ghrelin has exhibited potent anti-inflammatory effects on various inflammatory diseases. The aim of this study was to investigate the potential effects of ghrelin on a model of ventilator-induced lung injury (VILI) established in rats. Male Sprague-Dawley rats were randomly divided into three groups: low volume ventilation (LV, Vt=8ml/kg) group, a VILI group (Vt=30ml/kg), and a VILI group pretreated with ghrelin (GH+VILI). For the LV group, for the VILI and GH+VILI groups, the same parameters were applied except the tidal volume was increased to 40ml/kg...
September 5, 2017: International Immunopharmacology
https://www.readbyqxmd.com/read/28875449/an-extracorporeal-carbon-dioxide-removal-ecco2r-device-operating-at-hemodialysis-blood-flow-rates
#2
R Garrett Jeffries, Laura Lund, Brian Frankowski, William J Federspiel
BACKGROUND: Extracorporeal carbon dioxide removal (ECCO2R) systems have gained clinical appeal as supplemental therapy in the treatment of acute and chronic respiratory injuries with low tidal volume or non-invasive ventilation. We have developed an ultra-low-flow ECCO2R device (ULFED) capable of operating at blood flows comparable to renal hemodialysis (250 mL/min). Comparable operating conditions allow use of minimally invasive dialysis cannulation strategies with potential for direct integration to existing dialysis circuitry...
September 6, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28861863/protective-ventilation-reduces-pseudomonas-aeruginosa-growth-in-lung-tissue-in-a-porcine-pneumonia-model
#3
Jesper Sperber, Axel Nyberg, Miklos Lipcsey, Åsa Melhus, Anders Larsson, Jan Sjölin, Markus Castegren
BACKGROUND: Mechanical ventilation with positive end expiratory pressure and low tidal volume, i.e. protective ventilation, is recommended in patients with acute respiratory distress syndrome. However, the effect of protective ventilation on bacterial growth during early pneumonia in non-injured lungs is not extensively studied. The main objectives were to compare two different ventilator settings on Pseudomonas aeruginosa growth in lung tissue and the development of lung injury. METHODS: A porcine model of severe pneumonia was used...
August 31, 2017: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/28846440/low-tidal-volume-versus-non-volume-limited-strategies-for-patients-with-acute-respiratory-distress-syndrome-a-systematic-review-and-meta-analysis
#4
Allan J Walkey, Ewan Goligher, Lorenzo Del Sorbo, Carol Hodgson, Neill Kj Adhikari, Hannah Wunsch, Maureen O Meade, Elizabeth Uleryk, Dean Hess, Daniel S Talmor, B Taylor Thompson, Roy G Brower, Eddy Fan
RATIONALE: Trials investigating use of lower tidal volumes and inspiratory pressures for patients with acute respiratory distress syndrome (ARDS) have shown mixed results. OBJECTIVES: To compare clinical outcomes of mechanical ventilation strategies that limit tidal volumes and inspiratory pressures (LTV) to strategies with tidal volumes of 10-15 mL/kg among patients with ARDS. METHODS: Systematic review and meta-analysis of clinical trials investigating LTV mechanical ventilation strategies...
August 28, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28843606/impact-of-low-tidal-volumes-during-one-lung-ventilation-a-meta-analysis-of-randomized-controlled-trials
#5
Mohamed R El Tahan, Laura Pasin, Nandor Marczin, Giovanni Landoni
OBJECTIVES: The link between ventilation strategies and perioperative outcomes remains one of the fundamental paradigms of thoracic anaesthesia. During one-lung ventilation (OLV), one lung is excluded from gas exchange and ventilation is directed at the dependent lung. The authors hypothesised that the use of low tidal volumes (VT) during OLV provides adequate gas exchange and improves postoperative outcome. DESIGN: Meta-analysis of randomized clinical trials. SETTING: Thoracic surgery...
June 7, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28839101/hyperoxia-treatment-of-trek-1-trek-2-traak-deficient-mice-is-associated-with-a-reduction-in-surfactant-proteins
#6
Andreas Schwingshackl, Benjamin Lopez, Bin Teng, Charlean L Luellen, Florian Lesage, John Belperio, Riccardo Olcese, Christopher M Waters
We previously proposed a role for the 2-pore domain potassium (K2P) channel TREK-1 in hyperoxia (HO)-induced lung injury. To determine whether redundancy between the 3 TREK isoforms (TREK-1, TREK-2, TRAAK) could protect from HO-induced injury, we now examined the effect of deletion of all 3 TREK isoforms in a clinically relevant scenario of prolonged HO exposure and mechanical ventilation (MV). We exposed WT and TREK-1/TREK-2/TRAAK-deficient (triple ko) mice to either room air, 72 hours HO, MV (high and low tidal volume), or a combination of HO+MV, and measured quasi-static lung compliance, BAL protein concentration, histologic lung injury scores (LIS), cellular apoptosis, and cytokine levels...
August 24, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/28830928/evaluation-of-simulated-ventilation-techniques-with-the-upright-and-conventional-self-inflating-neonatal-resuscitators
#7
Indira Narayanan, Marvesh Mendhi, Pooja Bansil, Patricia S Coffey
BACKGROUND: The study assessed the impact of simulated ventilation techniques using upright and conventional self-inflating neonatal resuscitators on delivered tidal volume (VT) and pressure. METHODS: We analyzed videos of participants ventilating a manikin using an upright (upright, n = 33) and a conventional resuscitator (conventional, n = 32) under normal and low lung compliance. Mask hold, number of fingers squeezing the bag, and degree of bag squeeze were compared with VT and peak inspiratory pressure (PIP)...
August 22, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28828372/high-flow-nasal-oxygen-therapy-and-noninvasive-ventilation-in-the-management-of-acute-hypoxemic-respiratory-failure
#8
REVIEW
Jean-Pierre Frat, Rémi Coudroy, Nicolas Marjanovic, Arnaud W Thille
High-flow nasal cannula (HFNC) oxygen therapy is a recent technique delivering a high flow of heated and humidified gas. HFNC is simpler to use and apply than noninvasive ventilation (NIV) and appears to be a good alternative treatment for hypoxemic acute respiratory failure (ARF). HFNC is better tolerated than NIV, delivers high fraction of inspired oxygen (FiO2), generates a low level of positive pressure and provides washout of dead space in the upper airways, thereby improving mechanical pulmonary properties and unloading inspiratory muscles during ARF...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828364/prone-positioning-acute-respiratory-distress-syndrome-patients
#9
REVIEW
Claude Guérin
Prone position has been used in acute respiratory distress syndrome (ARDS) patients for more than 40 years in ICU. After having demonstrated its capability to significantly improve oxygenation in a large number of patients, sometimes dramatically, this procedure has been found to prevent ventilator-induced lung injury, the primary concern for the intensivists managing ARDS patients. Over the time, several trials have been done, which regularly improved and refined from each other. At the end, significant improvement in survival has been demonstrated in the most severe ARDS patients, at a threshold of 100-150 mmHg PaO2/FiO2 ratio...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28828362/tidal-volume-in-acute-respiratory-distress-syndrome-how-best-to-select-it
#10
REVIEW
Michele Umbrello, Antonella Marino, Davide Chiumello
Mechanical ventilation is the type of organ support most widely provided in the intensive care unit. However, this form of support does not constitute a cure for acute respiratory distress syndrome (ARDS), as it mainly works by buying time for the lungs to heal while contributing to the maintenance of vital gas exchange. Moreover, it can further damage the lung, leading to the development of a particular form of lung injury named ventilator-induced lung injury (VILI). Experimental evidence accumulated over the last 30 years highlighted the factors associated with an injurious form of mechanical ventilation...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28816521/plume-activity-and-tidal-deformation-on-enceladus-influenced-by-faults-and-variable-ice-shell-thickness
#11
Marie Běhounková, Ondřej Souček, Jaroslav Hron, Ondřej Čadek
We investigated the effect of variations in ice shell thickness and of the tiger stripe fractures crossing Enceladus' south polar terrain on the moon's tidal deformation by performing finite element calculations in three-dimensional geometry. The combination of thinning in the polar region and the presence of faults has a synergistic effect that leads to an increase of both the displacement and stress in the south polar terrain by an order of magnitude compared to that of the traditional model with a uniform shell thickness and without faults...
September 2017: Astrobiology
https://www.readbyqxmd.com/read/28808493/pulmonary-consequences-of-hypothyroidism
#12
Samiaa Hamdy Sadek, Walaa Anwar Khalifa, Ahmad Metwally Azoz
BACKGROUND: Although hypothyroidism has an insidious onset and relatively asymptomatic, exertional dyspnea and fatigue can be the presenting complaints. OBJECTIVES: The aim is to assess functional lung impairment in hypothyroid patients both at rest and during exercise. METHODS: A case-control study was carried out on 42 patients with newly diagnosed hypothyroidism and 12 control subjects. Hypothyroidism was diagnosed based on high value of thyroid stimulating hormone (TSH) ≥6 μIU/ml, and low value of free thyroxin (FT4) ≤0...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28803774/do-low-tidal-volumes-decrease-lung-injury-during-one-lung-ventilation
#13
EDITORIAL
Peter D Slinger
No abstract text is available yet for this article.
July 8, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28800778/effects-of-intraoperative-peep-optimization-on-postoperative-pulmonary-complications-and-the-inflammatory-response-study-protocol-for-a-randomized-controlled-trial
#14
Zoltán Ruszkai, Erika Kiss, Ildikó László, Fanni Gyura, Erika Surány, Péter Töhötöm Bartha, Gergely Péter Bokrétás, Edit Rácz, István Buzogány, Zoltán Bajory, Erzsébet Hajdú, Zsolt Molnár
BACKGROUND: Patients undergoing general anesthesia and mechanical ventilation during major abdominal surgery commonly develop pulmonary atelectasis and/or hyperdistention of the lungs. Recent studies show benefits of lung-protective mechanical ventilation with the use of low tidal volumes, a moderate level of positive end-expiratory pressure (PEEP) and regular alveolar recruitment maneuvers during general anesthesia, even in patients with healthy lungs. The purpose of this clinical trial is to evaluate the effects of intraoperative lung-protective mechanical ventilation, using individualized PEEP values, on postoperative pulmonary complications and the inflammatory response...
August 11, 2017: Trials
https://www.readbyqxmd.com/read/28777284/outcomes-of-primary-posterior-spinal-fusion-for-scoliosis-in-spinal-muscular-atrophy-clinical-radiographic-and-pulmonary-outcomes-and-complications
#15
Joshua B Holt, Lori A Dolan, Stuart L Weinstein
BACKGROUND: Spinal muscular atrophy (SMA) is a progressive neuromuscular disease commonly including progressive scoliosis resulting in severe deformity and negatively affecting pulmonary function. Surgical correction and stabilization of this progressive deformity is generally recommended; however, the timing and method of surgical fixation remains controversial. METHODS: Retrospective review of clinical, radiographic, and pulmonary function data from 16 children with SMA and surgically treated scoliosis between 1985 and 2013...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28771042/a-critical-care-clinician-survey-comparing-attitudes-and-perceived-barriers-to-low-tidal-volume-ventilation-with-actual-practice
#16
Curtis H Weiss, David W Baker, Katrina Tulas, Shayna Weiner, Meagan Bechel, Alfred Rademaker, Angela Fought, Richard G Wunderink, Stephen D Persell
RATIONALE: Low tidal volume ventilation lowers mortality in patients with acute respiratory distress syndrome (ARDS) but is underused. Little is known about clinician attitudes toward and perceived barriers to low tidal volume ventilation use and their association with actual low tidal volume ventilation use. OBJECTIVES: The objectives of this study were to assess clinicians' attitudes toward and perceived barriers to low tidal volume ventilation (tidal volume <6...
August 3, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28770093/the-clinical-practice-guideline-for-the-management-of-ards-in-japan
#17
Satoru Hashimoto, Masamitsu Sanui, Moritoki Egi, Shinichiro Ohshimo, Junji Shiotsuka, Ryutaro Seo, Ryoma Tanaka, Yu Tanaka, Yasuhiro Norisue, Yoshiro Hayashi, Eishu Nango
BACKGROUND: The Japanese Society of Respiratory Care Medicine and the Japanese Society of Intensive Care Medicine provide here a clinical practice guideline for the management of adult patients with ARDS in the ICU. METHOD: The guideline was developed applying the GRADE system for performing robust systematic reviews with plausible recommendations. The guideline consists of 13 clinical questions mainly regarding ventilator settings and drug therapies (the last question includes 11 medications that are not approved for clinical use in Japan)...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28768153/effects-of-mechanical-ventilation-on-gene-expression-profiles-in-renal-allografts-from-brain-dead-rats
#18
Maximilia C Hottenrott, Joerg Krebs, Paolo Pelosi, Thomas Luecke, Patricia R M Rocco, Carsten Sticht, Annette Breedijk, Benito Yard, Charalambos Tsagogiorgas
Pathophysiological changes of brain death (BD) are impairing distal organ function and harming potential renal allografts. Whether ventilation strategies influence the quality of renal allografts from BD donors has not been thoroughly studied. 28 adult male Wistar rats were randomly assigned to four groups: 1) no brain death (NBD) with low tidal volume/low positive endexpiratory pressure (PEEP) titrated to minimal static elastance of the respiratory system (LVT/OLPEEP); 2) NBD with high tidal volume/low PEEP (HVT/LPEEP); 3) brain death (BD) with LVT/OLPEEP; and 4) BD with HVT/LPEEP...
July 30, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28765493/variability-of-tidal-volume-in-patient-triggered-mechanical-ventilation-in-ards
#19
Sophie Perinel-Ragey, Loredana Baboi, Claude Guérin
BACKGROUND: Limiting tidal volume (VT) in patients with ARDS may not be achieved once patient-triggered breaths occur. Furthermore, ICU ventilators offer numerous patient-triggered modes that work differently across brands. We systematically investigated, using a bench model, the effect of patient-triggered modes on the size and variability of VT at different breathing frequencies (f), patient effort, and ARDS severity. METHODS: We used a V500 Infinity ICU ventilator connected to an ASL 5000 lung model whose compliance was mimicking mild, moderate, and severe ARDS...
August 1, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28759484/impact-of-different-ventilation-strategies-on-driving-pressure-mechanical-power-and-biological-markers-during-open-abdominal-surgery-in-rats
#20
Lígia de A Maia, Cynthia S Samary, Milena V Oliveira, Cintia L Santos, Robert Huhle, Vera L Capelozzi, Marcelo M Morales, Marcus J Schultz, Marcelo G Abreu, Paolo Pelosi, Pedro L Silva, Patricia Rieken Macedo Rocco
BACKGROUND: Intraoperative mechanical ventilation may yield lung injury. To date, there is no consensus regarding the best ventilator strategy for abdominal surgery. We aimed to investigate the impact of the mechanical ventilation strategies used in 2 recent trials (Intraoperative Protective Ventilation [IMPROVE] trial and Protective Ventilation using High versus Low PEEP [PROVHILO] trial) on driving pressure (ΔPRS), mechanical power, and lung damage in a model of open abdominal surgery...
October 2017: Anesthesia and Analgesia
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