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ventilator mode

Masahiro Kinoshita, Sachiko Iwata, Hisayoshi Okamura, Mamoru Saikusa, Naoko Hara, Chihoko Urata, Yuko Araki, Osuke Iwata
Studies suggested the presence of foetal adrenal rhythms of cortisol, which are entrained in antiphase to maternal rhythms. In contrast, neonates are thought to have no adrenal rhythm until 2-3 months after birth. To test the hypothesis that a foetal-type adrenal rhythm is preserved after birth, saliva samples were collected from 65 preterm/term infants during hospital stay (30-40 weeks corrected age) at 10:00 and 19:00 h. Cortisol levels were assessed for their diurnal difference and dependence on antenatal/postnatal clinical variables...
October 18, 2016: Scientific Reports
Hai Wang, Jiang-Li Sun, Zheng-Hai Bai, Xiao-Bo Wang, Zheng-Liang Zhang, Hong-Hong Pei
Preoxygenation can rapidly improve oxygenation and enhance the security of endotracheal intubation, so it is very essential before endotracheal intubation. The conventional preoxygenation method self-inflating bag (SIB) is not very effective in case of emergency. So our study aims to find a more effective method of preoxygenation in a critical situation.We retrospectively analyzed data of 105 patients in this study. A total of 49 patients with preoxygenation with invasive ventilator in volume control mode (VCM) and 56 patients with preoxygenation with SIB were included...
October 2016: Medicine (Baltimore)
Jonne Doorduin, Joeke L Nollet, Lisanne H Roesthuis, Hieronymus W H van Hees, Laurent J Brochard, Christer A Sinderby, Johannes G van der Hoeven, Leo M A Heunks
RATIONALE: Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high tidal volume and high transpulmonary pressure. As an alternative to high dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
José L Díaz-Gómez, Andres Borja Alvarez, Jonathan J Danaraj, Michelle L Freeman, Augustine S Lee, Farouk Mookadam, Brian P Shapiro, Harish Ramakrishna
OBJECTIVES: The tricuspid annular plane systolic excursion (TAPSE) is a validated measure of right ventricular function; however, the apical echocardiographic window varies and has limitations in intensive care unit (ICU) patients receiving mechanical ventilation or those with underlying disease and air entrapment. We aimed to evaluate the subcostal echocardiographic assessment of tricuspid annular kick (SEATAK) as an alternative to TAPSE in critically ill patients. METHODS: To measure SEATAK, we obtained the subcostal inferior vena cava view and used M-mode to measure excursion of the tricuspid annulus (kick)...
October 14, 2016: Echocardiography
Juliana Arcanjo Lino, Gabriela Carvalho Gomes, Nancy Delma Silva Vega Canjura Sousa, Andrea K Carvalho, Marcelo Emanoel Bezerra Diniz, Antonio Brazil Viana Junior, Marcelo Alcantara Holanda
BACKGROUND: Teaching mechanical ventilation at the bedside with real patients is difficult with many logistic limitations. Mechanical ventilators virtual simulators (MVVS) may have the potential to facilitate mechanical ventilation (MV) training by allowing Web-based virtual simulation. OBJECTIVE: We aimed to identify and describe the current available MVVS, to compare the usability of their interfaces as a teaching tool and to review the literature on validation studies...
June 14, 2016: JMIR Med Educ
Ramon Farré, Daniel Navajas, Josep M Montserrat
Current devices for providing noninvasive respiratory support contain sensors and built-in intelligence for automatically modifying ventilation according to the patient's needs. These devices, including automatic continuous positive airway pressure devices and noninvasive ventilators, are technologically complex and offer a considerable number of different modes of ventilation and setting options, the details of which are sometimes difficult to capture by the user. Therefore, better predicting and interpreting the actual performance of these ventilation devices in clinical application requires understanding their functioning principles and assessing their performance under well controlled bench test conditions with simulated patients...
January 2016: ERJ Open Research
Pnina Weiss, Meir Kryger
Positive airway pressure (PAP) is considered first-line therapy for moderate to severe obstructive sleep apnea and may also be considered for mild obstructive sleep apnea, particularly if it is symptomatic or there are concomitant cardiovascular disorders. Continuous PAP is most commonly used. Other modes, such as bilevel airway pressure, autotitrating positive airway pressure, average volume assured pressure support, and adaptive support ventilation, play important roles in the management of sleep-related breathing disorders...
October 6, 2016: Otolaryngologic Clinics of North America
Maulee Hiromi Arambewela, Noel P Somasundaram, Chaminda Garusinghe
BACKGROUND: Hypernatremia is a frequent occurrence among hospitalized patients. Severe hypernatremia is associated with mortality rates of over 60 %. Extreme hypernatremia, defined as sodium levels >190 mmol/l, is a rare occurrence. The literature on electrocardiographic changes occurring with this degree of hypernatremia is extremely scarce. We report the case of an 11-year-old Sri Lankan girl who presented with sodium levels of 226 mmol/l following infusion with 3 % hypertonic saline who developed diffuse QT prolongation leading to fatal ventricular tachycardia...
October 1, 2016: Journal of Medical Case Reports
Daniel P Redmond, Yeong Shiong Chiew, Vincent Major, J Geoffrey Chase
Monitoring of respiratory mechanics is required for guiding patient-specific mechanical ventilation settings in critical care. Many models of respiratory mechanics perform poorly in the presence of variable patient effort. Typical modelling approaches either attempt to mitigate the effect of the patient effort on the airway pressure waveforms, or attempt to capture the size and shape of the patient effort. This work analyses a range of methods to identify respiratory mechanics in volume controlled ventilation modes when there is patient effort...
September 23, 2016: Computer Methods and Programs in Biomedicine
Julien Bordes, Philippe Goutorbe, Pierre Julien Cungi, Marie Caroline Boghossian, Eric Kaiser
STUDY OBJECTIVE: To assess the effects of noninvasive ventilation (NIV) during spontaneous breathing anesthesia on functional residual capacity and ventilation distribution. DESIGN: Prospective and observational study. SETTING: Operating room, military teaching hospital. PATIENTS: Eighteen adult patients submitted to digestive endoscopic procedures under spontaneous breathing anesthesia. INTERVENTIONS: Anesthetic management was standardized...
November 2016: Journal of Clinical Anesthesia
T Wesley Templeton, Lauren K Hoke, Jill Yaung, Carol A Aschenbrenner, Danielle M Rose, Leah B Templeton, Yvon F Bryan
STUDY OBJECTIVE: To determine quantitative differences in several routinely measured ventilation parameters using a standardized anesthetic technique and 3 different ventilation modalities in pediatric patients with a ProSeal laryngeal mask airway (PLMA). DESIGN: Randomized prospective study. SETTING: Pediatric hospital of a tertiary care academic medical center. PATIENTS: Thirty-three, American Society of Anesthesiologists classification 1-2, pediatric patients (12 months to 5 years)...
November 2016: Journal of Clinical Anesthesia
Osama M Assad, Ayman A El Sayed, Mohamed A Khalil
STUDY OBJECTIVE: To analyze the effects of pressure-controlled ventilation-volume guaranteed (PCV-VG) and volume controlled ventilation (VCV) on airway pressures and respiratory and circulatory indicators during laparoscopic surgery in Trendelenburg position. DESIGN: Prospective randomized comparative clinical study. SETTING: Tertiary hospital. PATIENTS: Forty ASA physical status 1 and 2 patients who underwent elective laparoscopic surgery in Trendelenburg position...
November 2016: Journal of Clinical Anesthesia
A Demoule, M Clavel, C Rolland-Debord, S Perbet, N Terzi, A Kouatchet, F Wallet, H Roze, F Vargas, C Guerin, J Dellamonica, S Jaber, L Brochard, T Similowski
PURPOSE: Neurally adjusted ventilatory assist (NAVA) is a ventilatory mode that tailors the level of assistance delivered by the ventilator to the electromyographic activity of the diaphragm. The objective of this study was to compare NAVA and pressure support ventilation (PSV) in the early phase of weaning from mechanical ventilation. METHODS: A multicentre randomized controlled trial of 128 intubated adults recovering from acute respiratory failure was conducted in 11 intensive care units...
September 30, 2016: Intensive Care Medicine
A Mukerji, K Sarmiento, B Lee, K Hassall, V Shah
OBJECTIVE: Non-invasive high-frequency ventilation (NIHFV), a relatively new modality, is gaining popularity despite limited data. We sought to evaluate the effectiveness of NIHFV versus bi-phasic continuous positive airway pressure (BP-CPAP) in preterm infants failing CPAP. STUDY DESIGN: Infants with BW<1250 g on CPAP were randomly assigned to NIHFV or BP-CPAP if they met pre-determined criteria for CPAP failure. Infants were eligible for randomization after 72 h age and until 2000 g...
September 29, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
Brian K Walsh, Craig D Smallwood
Electrical impedance tomography (EIT) is a noninvasive, non-radiologic imaging modality that may be useful for the quantification of lung disorders and titration of mechanical ventilation. The principle of operation is based on changes in electrical conductivity that occur as a function of changes in lung volume during ventilation. EIT offers potentially important benefits over standard imaging modalities because the system is portable and non-radiologic and can be applied to patients for long periods of time...
October 2016: Respiratory Care
Zhihua Lu, Qiuping Xu, Yuehua Yuan, Ge Zhang, Feng Guo, Huiqing Ge
BACKGROUND: Diaphragmatic dysfunction is often underdiagnosed and is among the risk factors for failed weaning. The purpose of this study was to determine the prevalence of diaphragmatic dysfunction diagnosed by B-mode ultrasonography and to determine whether prolonged weaning subjects with diaphragmatic dysfunction have increased duration of mechanical ventilation compared with those without diaphragmatic dysfunction. METHODS: This was a prospective observational study in mechanically ventilated subjects who failed ≥3 spontaneous breathing trials or required >7 d of weaning after the first spontaneous breathing trial...
October 2016: Respiratory Care
Savino Spadaro, Salvatore Grasso, Tommaso Mauri, Francesca Dalla Corte, Valentina Alvisi, Riccardo Ragazzi, Valentina Cricca, Giulia Biondi, Rossella Di Mussi, Elisabetta Marangoni, Carlo Alberto Volta
BACKGROUND: The rapid shallow breathing index (RSBI), which is the ratio between respiratory rate (RR) and tidal volume (VT), is one of the most widely used indices to predict weaning outcome. Whereas the diaphragm plays a fundamental role in generating VT, in the case of diaphragmatic dysfunction the inspiratory accessory muscles may contribute. If this occurs during a weaning trial, delayed weaning failure is likely since the accessory muscles are more fatigable than the diaphragm. Hence, we hypothesised that the traditional RSBI could be implemented by substituting VT with the ultrasonographic evaluation of diaphragmatic displacement (DD)...
September 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
Cécile Magne, Vincent Pichenot, Péan Didier, Luc Bérard, Corinne Lejus-Bourdeau
BACKGROUND: Our purpose was to evaluate I-gel™ sizes 1 and 1.5. METHODS: I-Gel™ insertion was attempted in 60 children<2 years of age undergoing short elective surgery. The main endpoints were the determination of independent factors associated with successful first-attempt insertion and those associated with uneventful anaesthesia (i.e. no adverse events during insertion or during the intraoperative period of removal). RESULTS: Size 1 and a size 1...
September 23, 2016: Anaesthesia, Critical Care & Pain Medicine
Taiga Itagaki, Christopher T Chenelle, Desmond J Bennett, Daniel F Fisher, Robert M Kacmarek
BACKGROUND: During both nasal noninvasive ventilation (NIV) and invasive ventilation of neonates, the presence of air leaks causes triggering and cycling asynchrony. METHODS: Five ICU ventilators (PB840, PB980, Servo-i, V500, and Avea) were compared in available invasive ventilation and NIV ventilator modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV]). The V500 and Avea do not provide PC-CSV and PC-CMV in NIV...
September 20, 2016: Respiratory Care
Marc R Mendler, Claudia Weber, Mohammad A Hassan, Li Huang, Benjamin Mayer, Helmut D Hummler
BACKGROUND: There are few data available on the interaction of inflations, chest compressions (CC), and delivery of tidal volumes in newborn infants undergoing resuscitation in the presence of endotracheal tube (ET) leaks. OBJECTIVES: To determine the effects of different respiratory support strategies along with CC on changes in tidal volume and ET leaks in hypoxic newborn piglets with cardiac arrest. METHODS: Asphyxiated newborn piglets, intubated with weight-adapted uncuffed ET, were randomized into three groups and resuscitated according to ILCOR 2010 guidelines: (1) T-piece resuscitator (TPR) group = peak inspiratory pressure (PIP)/positive end-expiratory pressure (PEEP) 25/5 cm H2O, rate 30/min, inflations interposed between CC (3:1 ratio); (2) self- inflating bag (SIB) group = PIP 25 cm H2O without PEEP, rate 30/min, inflations interposed between CC (3:1 ratio), and (3) ventilator group = PIP/PEEP of 25/5 cm H2O, rate 30/min...
September 20, 2016: Neonatology
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