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https://www.readbyqxmd.com/read/28079607/mapping-regional-differences-of-local-pressure-volume-curves-with-electrical-impedance-tomography
#1
Alessandro Beda, Alysson R Carvalho, Nadja C Carvalho, Sören Hammermüller, Marcelo B P Amato, Thomas Muders, Claudia Gittel, Katharina Noreikat, Hermann Wrigge, Andreas W Reske
OBJECTIVES: Lung-protective mechanical ventilation aims to prevent alveolar collapse and overdistension, but reliable bedside methods to quantify them are lacking. We propose a quantitative descriptor of the shape of local pressure-volume curves derived from electrical impedance tomography, for computing maps that highlight the presence and location of regions of presumed tidal recruitment (i.e., elastance decrease during inflation, pressure-volume curve with upward curvature) or overdistension (i...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28076685/diffusion-of-evidence-based-intensive-care-unit-organizational-practices-a-state-wide-analysis
#2
Rachel Kohn, Vanessa Madden, Jeremy M Kahn, David A Asch, Amber E Barnato, Scott D Halpern, Meeta Prasad Kerlin
RATIONALE: Several intensive care unit (ICU) organizational practices have been associated with improved patient outcomes. However, the uptake of these evidence-based practices is unknown. OBJECTIVE: To assess diffusion of ICU organizational practices across the state of Pennsylvania. METHODS: We conducted two web-based, cross-sectional surveys of ICU organizational practices in Pennsylvania acute care hospitals, in 2005 (chief nursing officer respondents) and 2014 (ICU nurse manager respondents)...
January 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28059848/hemodynamic-monitoring-in-thoracic-surgical-patients
#3
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/28048383/th-ef-bra-01-5d-respiratory-motion-model-based-iterative-reconstruction-method-for-4dcbct
#4
J Liu, D Low, H Gao
PURPOSE: The 4DCBCT image reconstruction suffers from the insufficient number of projections and the error from projection binning. We have recently developed a 5D respiratory motion model based iterative reconstruction method (5D method) for 4DCBCT in a proof-of-concept 2D setting. The 5D method reconstructs a reference image and two time-independent vector fields without projection binning, based on which any temporal phase at each projection can be generated. As a result, the 5D method needs fewer number of projections and is free from binning error...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047108/su-d-202-07-clinical-applicability-of-an-optical-surface-imaging-based-technique-for-spirometric-measurement-breathing-pattern-monitoring-and-body-drift-correction
#5
S Zhang, H Huang, J Wei, G Li
PURPOSE: To explore the capabilities of optical surface imaging (OSI) as a comprehensive tumor motion surrogate to provide dynamic spirometric measurements, breathing pattern monitoring and body positioning correction. METHODS: OSI captures the moving surface of the torso with all respiration-induced external motions in real time. Tidal volume (TV) and its time derivative (TV', airflow) were measured based on the volume conservation rule within the pseudo-closed torso system: torso volume change equals TV in reference to full exhalation...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28030449/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...
February 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28024336/fully-packaged-blue-energy-harvester-by-hybridizing-a-rolling-triboelectric-nanogenerator-and-an-electromagnetic-generator
#7
Xin Wang, Zhen Wen, Hengyu Guo, Changsheng Wu, Xu He, Long Lin, Xia Cao, Zhong Lin Wang
Ocean energy, in theory, is an enormous clean and renewable energy resource that can generate electric power much more than that required to power the entire globe without adding any pollution to the atmosphere. However, owing to a lack of effective technology, such blue energy is almost unexplored to meet the energy requirement of human society. In this work, a fully packaged hybrid nanogenerator consisting of a rolling triboelectric nanogenerator (R-TENG) and an electromagnetic generator (EMG) is developed to harvest water motion energy...
December 27, 2016: ACS Nano
https://www.readbyqxmd.com/read/27999775/protective-ventilation-improves-gas-exchange-reduces-incidence-of-atelectases-and-affects-metabolic-response-in-major-pancreatoduodenal-surgery
#8
Vsevolod V Kuzkov, Ludmila N Rodionova, Yana Y Ilyina, Aleksey A Ushakov, Maria M Sokolova, Eugenia V Fot, Boris L Duberman, Mikhail Y Kirov
BACKGROUND: Protective perioperative ventilation has been shown to improve outcomes and reduce the incidence of postoperative pulmonary complications. The goal of this study was to assess the effects of ventilation with low tidal volume (VT) either alone or in a combination with moderate permissive hypercapnia in major pancreatoduodenal interventions. MATERIALS AND METHODS: Sixty adult patients scheduled for elective pancreatoduodenal surgery with duration >2 h were enrolled into a prospective single-center study...
2016: Frontiers in Medicine
https://www.readbyqxmd.com/read/27984004/high-positive-end-expiratory-pressure-is-associated-with-improved-survival-in-obese-patients-with-acute-respiratory-distress-syndrome
#9
Christian Bime, Mallorie Fiero, Zhenqiang Lu, Eyal Oren, Cristine E Berry, Sairam Parthasarathy, Joe G N Garcia
BACKGROUND: In acute respiratory distress syndrome, minimizing lung injury from repeated collapse and reopening of alveoli by applying a high positive end expiratory pressure improves oxygenation without influencing mortality. Obesity causes alveolar atelectasis thus suggesting that a higher positive end expiratory pressure might be more protective among the obese. We hypothesized that the effect of applying a high positive end expiratory pressure on mortality from acute respiratory distress syndrome would differ by obesity status...
October 27, 2016: American Journal of Medicine
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
#10
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/27960245/bronchodilators-for-the-prevention-and-treatment-of-chronic-lung-disease-in-preterm-infants
#11
REVIEW
Geraldine Ng, Orlando da Silva, Arne Ohlsson
BACKGROUND: Chronic lung disease (CLD) occurs frequently in preterm infants. Bronchodilators have the potential effect of dilating small airways with muscle hypertrophy. Increased compliance and tidal volume and decreased pulmonary resistance have been documented with the use of bronchodilators in infants with CLD. Therefore, bronchodilators might have a role in the prevention and treatment of CLD. OBJECTIVES: To determine the effect of bronchodilators given as prophylaxis or as treatment for CLD on mortality and other complications of preterm birth in infants at risk for or identified as having CLD...
14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27956843/lung-protective-mechanical-ventilation-strategies-in-cardiothoracic-critical-care-a-retrospective-study
#12
Vasileios Zochios, Matthew Hague, Kimberly Giraud, Nicola Jones
A body of evidence supports the use of low tidal volumes in ventilated patients without lung pathology to slow progress to acute respiratory distress syndrome (ARDS) due to ventilator associated lung injury. We undertook a retrospective chart review and tested the hypothesis that tidal volume is a predictor of mortality in cardiothoracic (medical and surgical) critical care patients receiving invasive mechanical ventilation. Independent predictors of mortality in our study included: type of surgery, albumin, H(+), bilirubin, and fluid balance...
2016: International Journal of General Medicine
https://www.readbyqxmd.com/read/27936178/ex-vivo-lung-perfusion-in-the-rat-detailed-procedure-and-videos
#13
Giulia Alessandra Bassani, Caterina Lonati, Daniela Brambilla, Francesca Rapido, Franco Valenza, Stefano Gatti
Ex vivo lung perfusion (EVLP) is a promising procedure for evaluation, reconditioning, and treatment of marginal lungs before transplantation. Small animal models can contribute to improve clinical development of this technique and represent a substantial platform for bio-molecular investigations. However, to accomplish this purpose, EVLP models must sustain a prolonged reperfusion without pharmacological interventions. Currently available protocols only partly satisfy this need. The aim of the present research was accomplishment and optimization of a reproducible model for a protracted rat EVLP in the absence of anti-inflammatory treatment...
2016: PloS One
https://www.readbyqxmd.com/read/27933169/why-is-prone-positioning-so-unpopular
#14
EDITORIAL
Jason Chertoff
Recent studies have shown acute respiratory distress syndrome (ARDS) to be underdiagnosed and inadequately treated, as evidenced by underutilization of low-tidal volume ventilation. Despite a proven survival benefit in patients with severe ARDS, studies have also shown underutilization of prone positioning. Many questions persist as to the reasons for prone positioning's unpopularity. Additional studies are required to uncover the causes of this prone positioning underutilization phenomenon.
2016: Journal of Intensive Care
https://www.readbyqxmd.com/read/27931033/low-positive-airway-pressure-without-positive-end-expiratory-pressure-decreases-blood-loss-during-hepatectomy-in-living-liver-donors
#15
Tomohiro Iguchi, Toru Ikegami, Tetsuhiro Fujiyoshi, Tomoharu Yoshizumi, Ken Shirabe, Yoshihiko Maehara
BACKGROUND/AIMS: Despite the development of strategies to minimize blood loss during hepatectomy challenges remain. Our aim was to determine whether low positive airway pressure (PAP) without positive end-expiratory pressure (PEEP) could minimize blood loss during hepatectomy. METHODS: Forty-one living liver donors who underwent extended left lobectomy or right lobectomy between December 2012 and November 2013 were retrospectively analyzed. In the standard PAP group (n = 18), tidal volume was 8-10 ml/kg, respiratory rate was 10-12/min and PEEP was maintained at 5 cm H2O...
December 9, 2016: Digestive Surgery
https://www.readbyqxmd.com/read/27925582/remote-depth-based-lung-function-assessment
#16
Vahid Soleimani, Majid Mirmehdi, Dima Damen, James Dodd, Sion Hannuna, Charles Sharp, Massimo Camplani, Jason Viner
OBJECTIVE: We propose a remote, non-invasive approach to develop Pulmonary Function Testing (PFT) using a depth sensor. METHOD: After generating a point cloud from scene depth values, we construct a 3D model of the subject's chest. Then, by estimating the chest volume variation throughout a sequence, we generate volume-time and flow-time data for two prevalent spirometry tests: Forced Vital Capacity (FVC) and Slow Vital Capacity (SVC). Tidal volume and main effort sections of volume-time data are analysed and calibrated separately to remove the effects of a subject's torso motion...
December 1, 2016: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/27922879/the-changes-in-pulse-pressure-variation-or-stroke-volume-variation-after-a-tidal-volume-challenge-reliably-predict-fluid-responsiveness-during-low-tidal-volume-ventilation
#17
Sheila Nainan Myatra, Natesh R Prabu, Jigeeshu Vasishtha Divatia, Xavier Monnet, Atul Prabhakar Kulkarni, Jean-Louis Teboul
OBJECTIVES: Stroke volume variation and pulse pressure variation do not reliably predict fluid responsiveness during low tidal volume ventilation. We hypothesized that with transient increase in tidal volume from 6 to 8 mL/kg predicted body weight, that is, "tidal volume challenge," the changes in pulse pressure variation and stroke volume variation will predict fluid responsiveness. DESIGN: Prospective, single-arm study. SETTING: Medical-surgical ICU in a university hospital...
December 5, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27922547/changes-in-stroke-volume-induced-by-lung-recruitment-maneuver-predict-fluid-responsiveness-in-mechanically-ventilated-patients-in-the-operating-room
#18
Matthieu Biais, Romain Lanchon, Musa Sesay, Lisa Le Gall, Bruno Pereira, Emmanuel Futier, Karine Nouette-Gaulain
BACKGROUND: Lung recruitment maneuver induces a decrease in stroke volume, which is more pronounced in hypovolemic patients. The authors hypothesized that the magnitude of stroke volume reduction through lung recruitment maneuver could predict preload responsiveness. METHODS: Twenty-eight mechanically ventilated patients with low tidal volume during general anesthesia were included. Heart rate, mean arterial pressure, stroke volume, and pulse pressure variations were recorded before lung recruitment maneuver (application of continuous positive airway pressure of 30 cm H2O for 30 s), during lung recruitment maneuver when stroke volume reached its minimal value, and before and after volume expansion (250 ml saline, 0...
December 5, 2016: Anesthesiology
https://www.readbyqxmd.com/read/27903339/-effect-of-goal-directed-haemodynamic-management-on-the-postoperative-outcome-in-elderly-patients-with-fragile-cardiac-function-undergoing-abdominal-surgery
#19
L S Zheng, E W Gu, X H Peng, L Zhang, Y Y Cao
Objective: To investigate the effect of goal-directed haemodynamic management based on stroke volume variation (SVV), cardiac index (CI) and mean arterial blood pressure (MAP) on the postoperative outcome in elderly patients with fragile cardiac function undergoing gastrointestinal surgery. Methods: Ninety patients with fragile cardiac function, aged 65-90 years old, ASAⅡ or Ⅲ, NYHA Ⅱor Ⅲ, scheduled for abdominal surgery were enrolled in this study.The patients were randomly assigned to two groups: Experience anesthesia group (group E, n=45) and goal-directed hemodynamic management group (G group, n=45)...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27898439/limiting-sedation-for-patients-with-acute-respiratory-distress-syndrome-time-to-wake-up
#20
Faraaz Ali Shah, Timothy D Girard, Sachin Yende
PURPOSE OF REVIEW: Critically ill patients with acute respiratory distress syndrome (ARDS) may require sedation in their clinical care. The goals of sedation in ARDS patients are to improve patient comfort and tolerance of supportive and therapeutic measures without contributing to adverse outcomes. This review discusses the current evidence for sedation management in patients with ARDS. RECENT FINDINGS: Deep sedation strategies should be avoided in the care of patients with ARDS because deep sedation has been associated with increased time on mechanical ventilation, longer ICU and hospital length of stay, and higher mortality in critically ill patients...
February 2017: Current Opinion in Critical Care
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