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https://www.readbyqxmd.com/read/28813446/variable-stretch-reduces-the-pro-inflammatory-response-of-alveolar-epithelial-cells
#1
Ines Rentzsch, Cíntia L Santos, Robert Huhle, Jorge M C Ferreira, Thea Koch, Christian Schnabel, Edmund Koch, Paolo Pelosi, Patricia R M Rocco, Marcelo Gama de Abreu
Mechanical ventilation has the potential to increase inflammation in both healthy and injured lungs. Several animal studies have shown that variable ventilation recruits the lungs and reduces inflammation. However, it is unclear which cellular mechanisms are involved in those findings. We hypothesized that variable stretch of LPS-stimulated alveolar epithelial cells (AECs) reduces the production of pro-inflammatory cytokines compared to non-variable stretch. AECs were subjected to non-variable or variable cyclic stretch (sinusoidal pattern), with and without LPS stimulation...
2017: PloS One
https://www.readbyqxmd.com/read/28803335/intraoperative-ventilation-during-thoracoscopic-repair-of-neonatal-congenital-diaphragmatic-hernia
#2
Tadaharu Okazaki, Manabu Okawada, Junya Ishii, Hiroyuki Koga, Go Miyano, Takashi Doi, Yuki Ogasawara, Geoffrey J Lane, Atsuyuki Yamataka
PURPOSE: To evaluate the optimal ventilation mode during thoracoscopic repair (TR) of neonatal congenital diaphragmatic hernia (CDH), we compared high-frequency oscillatory ventilation (HFOV) with conventional mechanical ventilation (CMV). METHODS: Twenty-three neonatal CDH cases who underwent TR without intraoperative inhalation of nitric oxide at our institution between 2007 and 2016 were reviewed. Patients were initially ventilated with HFOV, which was converted to CMV if the HFOV settings were decreased to FiO2 <0...
August 12, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28802791/difference-in-inspiratory-flow-between-volume-and-pressure-control-ventilation-in-patients-with-flow-dyssynchrony
#3
Juan B Figueroa-Casas, Ricardo Montoya
PURPOSE: Flow dyssynchrony is common during volume control ventilation but minimized during pressure control. Characterizing inspiratory flow during pressure control breaths can inform adjustments of the fixed flow of volume control to address flow dyssynchrony. This study compared inspiratory flow peak and pattern between volume control and adaptive pressure control breaths. MATERIAL AND METHODS: Subjects with or at risk for ARDS were ventilated with volume control decreasing ramp flow at different tidal volumes and subsequently with adaptive pressure control targeting those same tidal volumes...
August 5, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28794524/an-analysis-of-the-predictors-of-mortality-and-morbidity-in-patients-admitted-after-suicidal-hanging-to-an-indian-multidisciplinary-intensive-care-unit
#4
M K Renuka, M S Kalaiselvan, A S Arunkumar
BACKGROUND AND AIMS: Hanging is a frequently used method to attempt suicide in India. There is a lack of data in the Indian population regarding clinical features and outcomes of suicidal hanging. The purpose of this study was to evaluate the factors affecting mortality and morbidity in patients admitted with suicidal hanging to the Intensive Care Unit (ICU). METHODS: A 6-year retrospective study of adult patients admitted to the ICU with suicidal hanging was analysed for demographics, mode of hanging, lead time to emergency room (ER) admission, clinical presentation, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, admission Glasgow coma scale (GCS) and neurological outcomes...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28765493/variability-of-tidal-volume-in-patient-triggered-mechanical-ventilation-in-ards
#5
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/28743339/-predictive-value-of-ultrasonic-diaphragm-thickening-fraction-on-successful-weaning-for-patients-with-myasthenia-gravis-crisis
#6
Qiang Sun, Feng Shan, Hai Dong, Yan Jiang, Yongmei Sun, Yunbo Sun
OBJECTIVE: To confirm the predictive value of diaphragm thickening fraction (DTF) on successful weaning by bedside ultrasound in patients with myasthenia gravis crisis. METHODS: A prospective study was conducted. The patients with myasthenia gravis crisis undergoing mechanical ventilation admitted to Department of Critical Care Medicine of the Affiliated Hospital of Qingdao University from March 2015 to February 2017 were enrolled. All patients underwent a low level pressure support mode of spontaneous breathing test (SBT), and rapid shallow breathing index (RSBI) was recorded...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28723921/postnatal-dexamethasone-respiratory-and-neurodevelopmental-outcomes-at-two-years-in-babies-born-extremely-preterm
#7
Gordon Qin, Jessica W Lo, Neil Marlow, Sandy A Calvert, Anne Greenough, Janet L Peacock
IMPORTANCE: Postnatal dexamethasone is associated with reduction in bronchopulmonary dysplasia. There remains, however, concern that its short-term benefits are accompanied by long-term adverse effects e.g. poorer neurodevelopmental outcomes. OBJECTIVE: Our aim was to determine the effects of administration of postnatal dexamethasone on respiratory and neurodevelopmental outcome at two years of age after adjusting for neonatal and infant risk factors. MATERIALS AND METHODS: The study included 412 infants born at 23-28 weeks of gestation, 29% had received postnatal dexamethasone...
2017: PloS One
https://www.readbyqxmd.com/read/28721033/interfaces-and-ventilator-settings-for-long-term-noninvasive-ventilation-in-copd-patients
#8
Jens Callegari, Friederike Sophie Magnet, Steven Taubner, Melanie Berger, Sarah Bettina Schwarz, Wolfram Windisch, Jan Hendrik Storre
INTRODUCTION: The establishment of high-intensity (HI) noninvasive ventilation (NIV) that targets elevated PaCO2 has led to an increase in the use of long-term NIV to treat patients with chronic hypercapnic COPD. However, the role of the ventilation interface, especially in more aggressive ventilation strategies, has not been systematically assessed. METHODS: Ventilator settings and NIV compliance were assessed in this prospective cross-sectional monocentric cohort study of COPD patients with pre-existing NIV...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28716645/update-in-management-of-severe-hypoxemic-respiratory-failure
#9
REVIEW
Dharani Kumari Narendra, Dean R Hess, Curtis N Sessler, Habtamu M Belete, Kalpalatha K Guntupalli, Felix Khusid, Charles Mark Carpati, Mark Elton Astiz, Suhail Raoof
Mortality related to severe-moderate and severe ARDS remains high. We searched the literature to update this topic. We defined severe hypoxemic respiratory failure as Pao2/Fio2 < 150 mm Hg (ie, severe-moderate and severe ARDS). For these patients, we support setting the ventilator to a tidal volume of 4 to 8 mL/kg predicted body weight (PBW), with plateau pressure (Pplat) ≤ 30 cm H2O, and initial positive end-expiratory pressure (PEEP) of 10 to 12 cm H2O. To promote alveolar recruitment, we propose increasing PEEP in increments of 2 to 3 cm provided that Pplat remains ≤ 30 cm H2O and driving pressure does not increase...
July 14, 2017: Chest
https://www.readbyqxmd.com/read/28713509/mechanical-ventilation-practice-in-egyptian-pediatric-intensive-care-units
#10
Bassant Salah Meligy, Sally Kamal, Seham Awad El Sherbini
INTRODUCTION: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). METHODS: This prospective observational study was conducted from January 2014 to December 2014 in two pediatric intensive care units at Cairo University Pediatric Hospital...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28711179/immediate-birth-an-analysis-of-women-and-their-babies-undergoing-time-critical-birth-in-a-tertiary-referral-obstetric-hospital
#11
M H Warren, J Kamania, A T Dennis
BACKGROUND: At our institution, the emergency obstetric 'code green' activates the system for immediate birth, usually by caesarean section. This study aimed to determine the incidence of immediate birth, indications, modes of anaesthesia, and short-term neonatal and maternal outcomes. METHOD: A review was performed for all women at the Royal Women's Hospital, Parkville, Australia who underwent immediate birth over a two-year period: January 1, 2013 to December 31, 2014...
June 16, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28698268/effects-of-volume-guaranteed-ventilation-combined-with-two-different-modes-in-preterm-infants
#12
Sezin Unal, Ebru Ergenekon, Selma Aktas, Nilgun Altuntas, Serdar Beken, Ebru Kazanci, Ferit Kulali, Ozlem Gulbahar, Ibrahim M Hirfanoglu, Esra Onal, Canan Turkyilmaz, Esin Koc, Yildiz Atalay
BACKGROUND: Volume-controlled ventilation modes have been shown to reduce duration of mechanical ventilation, incidence of chronic lung disease, failure of primary mode of ventilation, hypocarbia, severe intraventricular hemorrhage, pneumothorax, and periventricular leukomalacia in preterm infants when compared with pressure limited ventilation modes. Volume-guarantee (VG) ventilation is the most commonly used mode for volume-controlled ventilation. Assist control, pressure-support ventilation (PSV), and synchronized intermittent mandatory ventilation (SIMV) can be combined with VG; however, there is a lack of knowledge on the superiority of each regarding clinical outcomes...
July 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28694199/initiation-of-non-invasive-ventilation-for-sleep-related-hypoventilation-disorders-advanced-modes-and-devices
#13
REVIEW
Bernardo J Selim, Lisa Wolfe, John M Coleman, Naresh Dewan
Although non-invasive ventilation (NIV) has been used since the 1960's in the polio epidemic, the development of modern bilevel PAP devices did not become a reality until the 1990's. Over the last 25 years bilevel PAP technology options have exponentially increased. The number of patients receiving this treatment both in the acute setting as well as at home is steadily growing. However, a knowledge gap exists in the way these device settings are adjusted to achieve synchrony and match patient's unique respiratory failure physiology...
July 7, 2017: Chest
https://www.readbyqxmd.com/read/28684287/high-frequency-oscillatory-ventilation-in-adults-with-ards-past-present-and-future
#14
REVIEW
Michael C Sklar, Eddy Fan, Ewan C Goligher
High-frequency oscillatory ventilation (HFOV) is a unique mode of mechanical ventilation that uses nonconventional gas exchange mechanisms to deliver ventilation at very low tidal volumes and high frequencies. The properties of HFOV make it a potentially ideal mode to prevent ventilator-induced lung injury in patients with ARDS. Despite a compelling physiological basis and promising experimental data, large randomized controlled trials have not detected an improvement in survival with the use of HFOV, and its use as an early lung-protective strategy in patients with ARDS may be harmful...
July 3, 2017: Chest
https://www.readbyqxmd.com/read/28683763/new-setting-of-neurally-adjusted-ventilatory-assist-for-noninvasive-ventilation-by-facial-mask-a-physiologic-study
#15
Federico Longhini, Chun Pan, Jianfeng Xie, Gianmaria Cammarota, Andrea Bruni, Eugenio Garofalo, Yi Yang, Paolo Navalesi, Haibo Qiu
BACKGROUND: Noninvasive ventilation (NIV) is generally delivered using pneumatically-triggered and cycled-off pressure support (PSP) through a mask. Neurally adjusted ventilatory assist (NAVA) is the only ventilatory mode that uses a non-pneumatic signal, i.e., diaphragm electrical activity (EAdi), to trigger and drive ventilator assistance. A specific setting to generate neurally controlled pressure support (PSN) was recently proposed for delivering NIV by helmet. We compared PSN with PSP and NAVA during NIV using a facial mask, with respect to patient comfort, gas exchange, and patient-ventilator interaction and synchrony...
July 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28683216/pulmonary-drug-delivery-following-continuous-vibrating-mesh-nebulization-and-inspiratory-synchronized-vibrating-mesh-nebulization-during-noninvasive-ventilation-in-healthy-volunteers
#16
Jean-Bernard Michotte, Enrico Staderini, Anne-Sophie Aubriot, Emilie Jossen, Jonathan Dugernier, Giuseppe Liistro, Gregory Reychler
BACKGROUND: A breath-synchronized nebulization option that could potentially improve drug delivery during noninvasive positive pressure ventilation (NIPPV) is currently not available on single-limb circuit bilevel ventilators. The aim of this study was to compare urinary excretion of amikacin following aerosol delivery with a vibrating mesh nebulizer coupled to a single-limb circuit bilevel ventilator, using conventional continuous (Conti-Neb) and experimental inspiratory synchronized (Inspi-Neb) nebulization modes...
July 6, 2017: Journal of Aerosol Medicine and Pulmonary Drug Delivery
https://www.readbyqxmd.com/read/28682316/neonatal-outcomes-based-on-mode-and-intensity-of-delivery-room-resuscitation
#17
A Bashir, B Bird, L Wu, S Welles, H Taylor, E Anday, V Bhandari
OBJECTIVE: To examine outcomes of neonates based on the mode and intensity of resuscitation received in the delivery room (DR). STUDY DESIGN: A retrospective study of 439 infants with birth weight ⩽1500 g receiving DR resuscitation at two hospital centers in Philadelphia, Pennsylvania. RESULTS: Of 439 infants, 22 (5%) received routine care, 188 (43%) received noninvasive positive pressure ventilation (PPV) and 229 (52%) received endotracheal tube (ETT) intubation in the DR...
July 6, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28679200/closed-loop-ventilation-mode-in-intensive-care-unit-a-randomized-controlled-clinical-trial-comparing-the-numbers-of-manual-ventilator-setting-changes
#18
Jean-Michel Arnal, Aude Garnero, Dominik Novotni, Gaëlle Corno, Stéphane Y Donati, Didier Demory, Gabrielle Quintana, Laurent Ducros, Thomas Laubscher, Jacques Durand-Gasselin
BACKGROUND: There is an equipoise regarding closed-loop ventilation modes and the ability to reduce workload for providers. On one hand some settings are managed by the ventilator but on another hand the automatic mode introduces new settings for the user. METHODS: This randomized controlled trial compared the number of manual ventilator setting changes between a full closed loop ventilation and oxygenation mode (INTELLiVENT-ASV®) and conventional ventilation modes (volume assist control and pressure support) in intensive care unit (ICU) patients...
July 5, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28673877/remifentanil-effects-on-respiratory-drive-and-timing-during-pressure-support-ventilation-and-neurally-adjusted-ventilatory-assist
#19
Roberta Costa, Paolo Navalesi, Gianmaria Cammarota, Federico Longhini, Giorgia Spinazzola, Flora Cipriani, Giuliano Ferrone, Olimpia Festa, Massimo Antonelli, Giorgio Conti
We assessed the effects of varying doses of remifentanil on respiratory drive and timing in patients receiving Pressure Support Ventilation (PSV) and Neurally Adjusted Ventilatory Assist (NAVA). Four incrementing remifentanil doses were randomly administered to thirteen intubated patients (0.03, 0.05, 0.08, and 0.1μg·Kg(-1)·min(-)1) during both PSV and NAVA. We measured the patient's (Ti/Ttotneu) and ventilator (Ti/Ttotmec) duty cycle, the Electrical Activity of the Diaphragm (EAdi), the inspiratory (Delaytrinsp) and expiratory (Delaytrexp) trigger delays and the Asynchrony Index (AI)...
July 1, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28673814/comparison-between-pressure-regulated-volume-controlled-and-volume-controlled-ventilation-on-oxygenation-parameters-airway-pressures-and-immune-modulation-during-thoracic-surgery
#20
Khaled Mahmoud, Amany Ammar, Zeinab Kasemy
OBJECTIVES: To compare 2 different ventilatory strategies: pressure-regulated volume-controlled (PRVC) versus volume-controlled ventilation during thoracotomy. DESIGN: Prospective randomized study. SETTING: University hospital. PARTICIPANTS: The study comprised 70 adult patients undergoing thoracic surgery. INTERVENTIONS: Evaluation of oxygenation parameters, airway pressures, and immune modulation...
March 22, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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