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https://www.readbyqxmd.com/read/29792537/recognizing-quantifying-and-managing-patient-ventilator-asynchrony-in-invasive-and-noninvasive-ventilation
#1
Eugenio Garofalo, Andrea Bruni, Corrado Pelaia, Luisa Liparota, Nicola Lombardo, Federico Longhini, Paolo Navalesi
Patient-ventilator asynchrony may occur with modes of partial ventilatory support. Because this problem is associated with worsened outcomes, identifying and managing asynchronies has been recognized as a relevant clinical problem during both invasive and non-invasive (NIV) mechanical ventilation. Areas covered: In this review article, we first describe the different forms of patient-ventilator asynchrony and how they are classified and quantified. Then, we show how these asynchronies can be recognized, considering the techniques used to properly detect asynchronies, by either ventilator waveform observation, or through systems based on more complexes mathematical algorithms, by means of adjunctive signals, such as the electrical activity of the diaphragm or esophageal pressure...
May 24, 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29790382/towards-respiratory-gated-retrograde-intrarenal-surgery-a-prospective-randomized-controlled-study
#2
Vasileios Kourmpetis, Snir Dekalo, Tomer Nir, Nadav Levy, Yuval Bar-Yosef, Avi Beri, Ofer Yossepowitch, Mario Sofer
INTRODUCTION: We set out to investigate whether general anesthesia with low ventilation (LV, respiratory rate ≤8/min and tidal volume <500 ml) could reduce renal mobility and thereby facilitate improved retrograde intrarenal surgery (RIRS) compared to general anesthesia with standard ventilation (SV). MATERIALS AND METHODS: All 60 consecutive patients who presented for RIRS in our department from September 1, 2017 to December 31, 2017 were prospectively randomized 1:1 into one group that was selected to receive SV and another that received LV...
May 23, 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29779601/noninvasive-ventilation-for-neuromuscular-disease
#3
REVIEW
Dean R Hess
Noninvasive ventilation (NIV) is standard practice for patients with neuromuscular respiratory failure. The interface distinguishes noninvasive from invasive ventilation. Interfaces are commercially available in a variety of styles and sizes. There are now available portable ventilators with good leak compensation and with a variety of modes. Although much has been written about the technical aspects of interfaces and ventilators, the initiation of NIV is an art. Selection of an appropriate interface and ventilator settings requires a close working relationship between clinicians, patients, and families...
June 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29776385/generation-of-ventilation-perfusion-ratio-map-in-surgical-patients-by-dual-energy-ct-after-xenon-inhalation-and-intravenous-contrast-media
#4
Kohei Aoki, Yotaro Izumi, Wataru Watanabe, Yuji Shimizu, Hisato Osada, Norinari Honda, Toshihide Itoh, Mitsuo Nakayama
BACKGROUND: While many studies have evaluated the change in lung volume before and after lung resection and correlated this with pulmonary function test results, there is very little evidence on the changes in ventilation perfusion ratio (V/Q) before versus after lung resection. In the present pilot study, we evaluated if V/Q mapping can be constructed using dual energy CT images. METHODS: Thirty-one lung cancer patients planned for pulmonary resection were included in this study...
May 18, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29775671/variable-ventilation-decreases-airway-responsiveness-and-improves-ventilation-efficiency-in-a-rat-model-of-asthma
#5
Fatemeh Ilka, Mohammad Javan, Mohammad Reza Raoufy
The optimal ventilation strategy in patients receiving mechanical ventilation for severe asthma remains unclear. The effect of conventional ventilation (with constant tidal volume and respiratory rate) and variable ventilation (with the same average but variable tidal volume and respiratory rate) on peak airway pressure and airway exacerbation induced by increasing doses of methacholine was compared in a rat model of asthma. The respiratory rate and tidal volume data were obtained from a spontaneously breathing intact rat during immobility using a whole-body plethysmograph...
May 15, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29774549/extracorporeal-membrane-oxygenation-characteristics-and-outcomes-in-adult-patients-with-down-syndrome
#6
Vicky Duffy, Daniel Gomez, Peter Rycus, Brian Rivera, Stephanie L Santoro, Carl H Backes, Clifford L Cua
Patients with Down syndrome (DS) may have multiple medical issues that place them at risk for requiring extracorporeal membrane oxygenation. Use of extracorporeal membrane oxygenation in pediatric patients with Down syndrome has been described, but minimal data exist for extracorporeal membrane oxygenation use in adults with Down syndrome. The goal of this study was to describe the clinical characteristics and to determine if there were differences between adult extracorporeal membrane oxygenation patients with Down syndrome that were alive (aDS) versus those that died (dDS) prior to hospital discharge...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29767416/utility-of-electrical-velocimetry-based-noninvasive-stroke-volume-variation-in-predicting-fluid-responsiveness-under-different-ventilation-modes-in-anaesthetized-dogs
#7
Kazumasu Sasaki, Tatsushi Mutoh, Shuzo Yamamoto, Yasuyuki Taki, Ryuta Kawashima
We evaluated the utility of noninvasive stroke volume variation (SVV) as a functional haemodynamic predictor for fluid responsiveness under different ventilation modes [assist control (A/C), synchronized intermittent mandatory ventilation (SIMV), and continuous positive airway pressure (CPAP)] in 45 anaesthetized dogs, using an electrical velocimetry device. Receiver operating curve analysis confirmed the best predictive value during SVVA /C (12.5% of cut-off value; 75% sensitivity and 86% specificity) followed by SVVSIMV (13...
May 16, 2018: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/29756744/monitoring-the-oxygen-reserve-index-can-contribute-to-the-early-detection-of-deterioration-in-blood-oxygenation-during-one-lung-ventilation
#8
Wakana Koishi, Motoi Kumagai, Shohei Ogawa, Shuhei Hongo, Kenji Suzuki
BACKGROUND: Hypoxemia can occur during one-lung ventilation (OLV), but monitoring blood oxygenation using percutaneous oxygen saturation (SpO2) can be limited by detection latency, and SpO2 sometimes does not change during OLV. The Oxygen Reserve Index (ORiTM) is a novel index reported to detect impending desaturation before this is observed with SpO2 monitoring. This study assessed whether the ORi decreased earlier than SpO2 during OLV and evaluated its correlation with the partial pressure of arterial oxygen (PaO2) during OLV...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29756065/the-effects-of-mechanical-ventilation-on-the-quality-of-sleep-of-hospitalised-patients-in-the-intensive-care-unit
#9
REVIEW
Hana Locihová, Katarína Žiaková
Aim: To examine the effects of mechanical ventilation on the quality of sleep in patients in the intensive care unit (ICU) using recent and relevant literature. Methods: To verify the examined objective, the results of the analysis of available original scientific works have been used including defined inclusion/exclusion criteria and search strategy. Appropriate works found were analysed further. The applied methodology was in line with the general principles of Evidence-Based Medicine...
April 2018: Romanian journal of anaesthesia and intensive care
https://www.readbyqxmd.com/read/29746613/aging-effects-on-alveolar-sacs-under-mechanical-ventilation
#10
Parya Aghasafari, Rebeca L Heise, Angela Reynolds, Ramana Pidaparti
Alveolar sacs are primarily responsible for gas exchange in the human respiratory system and lose their functionality with aging. Three-dimensional (3D) models of young and old human alveolar sacs were constructed and fluid-solid interaction (FSI) was employed to investigate the contribution of age-related changes to decline in alveolar sacs function under mechanical ventilation (MV). Simulations results illustrated that compliance and pressure reduced in the alveolar sacs of the elderly, and they have to work harder to breathe...
May 9, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/29743121/high-frequency-oscillatory-ventilation-guided-by-transpulmonary-pressure-in-acute-respiratory-syndrome-an-experimental-study-in-pigs
#11
Philipp Klapsing, Onnen Moerer, Christoph Wende, Peter Herrmann, Michael Quintel, Annalen Bleckmann, Jan Florian Heuer
BACKGROUND: Recent clinical studies have not shown an overall benefit of high-frequency oscillatory ventilation (HFOV), possibly due to injurious or non-individualized HFOV settings. We compared conventional HFOV (HFOVcon ) settings with HFOV settings based on mean transpulmonary pressures (PLmean ) in an animal model of experimental acute respiratory distress syndrome (ARDS). METHODS: ARDS was induced in eight pigs by intrabronchial installation of hydrochloric acid (0...
May 9, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29739857/how-ventilation-is-delivered-during-cardiopulmonary-resuscitation-an-international-survey
#12
Ricardo Luiz Cordioli, Laurent Brochard, Laurent Suppan, Aissam Lyazidi, François Templier, Abdo Khoury, Stephane Delisle, Dominique Savary, Jean-Christophe Richard
BACKGROUND: Recommendations regarding ventilation during cardiopulmonary resuscitation (CPR) are based on a low level of scientific evidence. We hypothesized that practices about ventilation during CPR might be heterogeneous and may differ worldwide. To address this question, we surveyed physicians from several countries on their practices during CPR. METHODS: We used a Web-based opinion survey. Links to the survey were sent by e-mail newsletters and displayed on the Web sites of medical societies involved in CPR practice from December 2013 to March 2014...
May 8, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29734208/improved-lung-recruitment-and-oxygenation-during-mandatory-ventilation-with-a-new-expiratory-ventilation-assistance-device-a-controlled-interventional-trial-in-healthy-pigs
#13
Johannes Schmidt, Christin Wenzel, Marlene Mahn, Sashko Spassov, Heidi Cristina Schmitz, Silke Borgmann, Ziwei Lin, Jörg Haberstroh, Stephan Meckel, Sebastian Eiden, Steffen Wirth, Hartmut Buerkle, Stefan Schumann
BACKGROUND: In contrast to conventional mandatory ventilation, a new ventilation mode, expiratory ventilation assistance (EVA), linearises the expiratory tracheal pressure decline. OBJECTIVE: We hypothesised that due to a recruiting effect, linearised expiration oxygenates better than volume controlled ventilation (VCV). We compared the EVA with VCV mode with regard to gas exchange, ventilation volumes and pressures and lung aeration in a model of peri-operative mandatory ventilation in healthy pigs...
May 4, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29727951/highlighting-the-importance-of-transitional-ventilation-regimes-in-the-management-of-mediterranean-show-caves-nerja-pintada-system-southern-spain
#14
C Liñán, Y Del Rosal, F Carrasco, I Vadillo, J Benavente, L Ojeda
This study shows the utilization of the air CO2 exhaled by a very high number of visitors in the Nerja Cave as both a tracer and an additional tool to precisely evaluate the air circulation through the entire karst system, which includes non-touristic passages, originally free of anthropogenic CO2 . The analysis of the temporal - spatial evolution of the CO2 content and other monitoring data measured from January 2015 to December 2016 in the Nerja-Pintada system, including air microbiological controls, has allowed us to define a new general ventilation model, of great interest for the conservation of the subterranean environment...
August 1, 2018: Science of the Total Environment
https://www.readbyqxmd.com/read/29725174/clinico-radiologic-profile-of-pediatric-traumatic-brain-injury-in-western-rajasthan
#15
Pawan Kumar Dara, Manish Parakh, Shyama Choudhary, Hemant Jangid, Priyanka Kumari, Satyendra Khichar
Objective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI). Design: Prospective observational study. Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. S. N. Medical College, Jodhpur (tertiary care hospital). Participants: A total of 188 children (1 month-18 years) were enrolled and 108 admitted. Intervention: TBI classified as mild, moderate, or severe TBI...
April 2018: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/29724123/evidence-supporting-clinical-use-of-proportional-assist-ventilation-a-systematic-review-and-meta-analysis-of-clinical-trials
#16
Bharath Kumar Tirupakuzhi Vijayaraghavan, Shatha Hamed, Aditi Jain, Timothy Chimunda, Irene Telias, Jan O Friedrich, Karen E A Burns
BACKGROUND: While proportional assist ventilation (PAV), generates pressure in proportion to effort without a preselected target, proportional assist ventilation plus (PAV+) measures compliance and resistance, calculates work of breathing, and adjusts support to a preset assistance level. OBJECTIVE: To summarize randomized controlled trials (RCTs) comparing invasive or noninvasive PAV or PAV+ in critically ill patients. DATA SOURCES: We searched multiple databases to April 2017 without language restrictions and conference proceedings from 5 meetings to identify randomized parallel-group and crossover RCTs that compared invasive or noninvasive PAV or PAV+ to another mode in critically ill adults or children and reported at least 1 clinically important outcome...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29723923/a-humidifier-in-the-invasive-mode-during-non-invasive-respiratory-support-could-increase-condensation-and-thereby-impair-airway-patency
#17
Rutger C Flink, Anton H van Kaam, Frans H de Jongh
AIM: Humidifying non-invasively ventilated preterm infants is critical to prevent dehydration of respiratory mucosa, but over humidification can result in impaired airway patency and lung mechanics. This neonatal bench study investigated the humidity delivered using invasive and non-invasive humidification modes during nasal continuous positive airway pressure. METHODS: The study was conducted at the neonatal intensive care unit of Emma Children's Hospital, the Netherlands, in March 2014...
May 3, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29712611/the-development-of-extracorporeal-membrane-oxygenation
#18
Don K Nakayama
Evolving from the development of heart-lung machines for open-heart surgery, extracorporeal membrane oxygenation has reemerged as a rescue modality for patients with acute respiratory failure that cannot be supported by conventional modes of ventilation. The history of extracorporeal membrane oxygenation begins with the discovery of heparin, fundamental to the success of extracorporeal circulation and membrane lungs. Engineers and scientists created suitable artificial membranes that allowed gas exchange while keeping gas and blood phases separate...
April 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29707341/short-term-one-lung-ventilation-does-not-influence-local-inflammatory-cytokine-response-after-lung-resection
#19
Silvia Fiorelli, Veronica Defraia, Fabiola Cipolla, Cecilia Menna, Mohsen Ibrahim, Claudio Andreetti, Maurizio Simmaco, Monica Rocco, Erino Angelo Rendina, Marina Borro, Domenico Massullo
Background: One-lung ventilation (OLV) is a ventilation procedure used for pulmonary resection which may results in lung injury. The aim of this study was to evaluate the local inflammatory cytokine response from the dependent lung after OLV and its correlation to VT. The secondary aim was to evaluate the clinical outcome of each patient. Methods: Twenty-eight consecutive patients were enrolled. Ventilation was delivered in volume-controlled mode with a VT based on predicted body weight (PBW)...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29692352/respiratory-care-in-neuromuscular-diseases
#20
REVIEW
Ashima S Sahni, Lisa Wolfe
Caring for patients with neuromuscular disease (NMD) is challenging. Respiratory care is of the utmost importance because it is a major determinant of quality of life and survival. Noninvasive ventilation (NIV) is one of the few modalities that has shown survival benefit in the NMD patient population. Newer modes with smart technologies are being developed to assist in better ventilation. Some noninvasive methods have shown success in the management of sialorrhea, which is of paramount importance in the initiation of NIV...
April 24, 2018: Respiratory Care
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