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https://www.readbyqxmd.com/read/28525418/an-international-survey-on-ventilator-practices-among-extracorporeal-membrane-oxygenation-centers
#1
Christopher L Jenks, Jefferson Tweed, Kristin H Gigli, Ramgopal Venkataraman, Lakshmi Raman
Although the optimal ventilation strategy is unknown for patients placed on extracorporeal support, there are increasing reports of extubation being used. Our objective is to describe the change in ventilation strategies and use of tracheostomy and bronchoscopy practices among extracorporeal membrane oxygenation (ECMO) centers across the world. A descriptive, cross-sectional 22 item survey of neonatal, pediatric, and adult ECMO centers was used to evaluate ventilator strategies, extubation, bronchoscopy, and tracheostomy practices...
May 18, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28522770/current-practice-of-closed-loop-mechanical-ventilation-modes-on-intensive-care-units-a-nationwide-survey-in-the-netherlands
#2
E F E Wenstedt, A J R De Bie Dekker, A N Roos, J J M Verberne, H H M Korsten, M J Schultz, A J G H Bindels
BACKGROUND: The most recent modes for mechanical ventilation are closed-loop modes, which are able to automatically adjust certain respiratory settings. Although closed-loop modes have been investigated in various clinical trials, it is unclear to what extent these modes are actually used in clinical practice. The aim of this study was to determine closed-loop ventilation practice on intensive care units (ICUs) in the Netherlands, and to explore reasons for not applying closed-loop ventilation...
May 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/28510235/surfactants-in-acute-respiratory-distress-syndrome-in-infants-and-children-past-present-and-future
#3
REVIEW
Angela Amigoni, Andrea Pettenazzo, Valentina Stritoni, Maria Circelli
There is a lack of definitive data on the effective management of acute respiratory distress syndrome (ARDS) in infants and children. The development and validation of the Berlin definition (BD) for ARDS and the Pediatric Acute Lung Injury Consensus Conference (PALICC) recommendations in children represented a major advance in optimizing research and treatment, mainly due to the introduction of a severe ARDS category. Proposed reasons for the lack of consistent results with surfactants in children and infants compared with neonates include different causes, type of lung damage (direct or indirect), timing and mode of administration as well as the type of surfactant used...
May 16, 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/28506358/-research-advances-in-noninvasive-high-frequency-oscillatory-ventilation-in-neonates
#4
Jia Huang, Lin Yuan, Chao Chen
Noninvasive ventilation is an important respiratory management technique for the treatment of mild or moderate respiratory failure in the neonatal intensive care unit. Its reasonable application can effectively avoid the use of invasive ventilation and related complications. Recent studies have found that noninvasive high-frequency oscillatory ventilation has the advantages of both nasal continuous positive airway pressure and high-frequency ventilation and can rapidly improve oxygenation, effectively remove carbon dioxide, and improve respiratory failure...
May 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28497384/physiological-responses-to-incremental-interval-and-continuous-counterweighted-single-leg-and-double-leg-cycling-at-the-same-relative-intensities
#5
Martin J MacInnis, Nathaniel Morris, Michael W Sonne, Amanda Farias Zuniga, Peter J Keir, Jim R Potvin, Martin J Gibala
PURPOSE: We compared physiological responses to incremental, interval, and continuous counterweighted single-leg and double-leg cycling at the same relative intensities. The primary hypothesis was that the counterweight method would elicit greater normalized power (i.e., power/active leg), greater electromyography (EMG) responses, and lower cardiorespiratory demand. METHODS: Graded-exercise tests performed by 12 men (age: 21 ± 2 years; BMI: 24 ± 3 kg/m(2)) initially established that peak oxygen uptake ([Formula: see text]; 76 ± 8...
May 11, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28485989/non-invasive-positive-airway-pressure-in-obesity-hypoventilation-syndrome-and-chronic-obstructive-pulmonary-disease-present-and-future-perspectives
#6
Victor R Ramírez-Molina, Francisco J Gómez-de-Terreros, Javier Barca-Durán, Juan F Masa
Obesity hypoventilation syndrome (OHS) is a sleep disorder that has acquired great importance worldwide because of its prevalence and association with obesity leading to increased morbidity and mortality with reduced quality of life. The primary feature is insufficient sleep-related ventilation, resulting in abnormally elevated arterial carbon dioxide pressure (PaCO2) during sleep and demonstration of daytime hypoventilation. There are three main mechanisms that can generate diurnal hypoventilation in obese patients: alteration of the respiratory mechanics secondary to obesity; central hypoventilation secondary to leptin resistance and sleep disorder with sleep hypoventilation and obstructive apnoeas, which can be potentially solved with the use of positive airway pressure: non-invasive ventilation (NIV) and continuous positive airway pressure (CPAP)...
May 9, 2017: COPD
https://www.readbyqxmd.com/read/28484929/functional-mri-for-assessment-of-the-default-mode-network-in-acute-brain-injury
#7
Daniel Kondziella, Patrick M Fisher, Vibeke Andrée Larsen, John Hauerberg, Martin Fabricius, Kirsten Møller, Gitte Moos Knudsen
BACKGROUND: Assessment of the default mode network (DMN) using resting-state functional magnetic resonance imaging (fMRI) may improve assessment of the level of consciousness in chronic brain injury, and therefore, fMRI may also have prognostic value in acute brain injury. However, fMRI is much more challenging in critically ill patients because of cardiovascular vulnerability, intravenous sedation, and artificial ventilation. METHODS: Using resting-state fMRI, we investigated the DMN in a convenience sample of patients with acute brain injury admitted to the intensive care unit...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28475684/the-use-of-extracorporeal-membrane-oxygenation-in-neonates-with-severe-congenital-diaphragmatic-hernia-a-26-year-experience-from-a-tertiary-centre%C3%A2
#8
Ricky Vaja, Ahmed Bakr, Annabel Sharkey, Vijay Joshi, Gail Faulkner, Claire Westrope, Chris Harvey
OBJECTIVES: Neonates with severe congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation (ECMO) have a high rate of mortality. There is controversy regarding optimal time of surgical intervention. We present our data over a 26-year period. METHODS: We analysed data from our Extracorporeal Life Support Organization registry forms between 1989 and 2015, in order to determine the factors affecting survival outcome for repair of congenital diaphragmatic hernia with ECMO as a bridge to surgery and/or recovery...
May 5, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28471973/a-randomized-comparison-of-volume-and-pressure-controlled-ventilation-in-children-with-the-i-gel-effects-on-peak-inspiratory-pressure-oropharyngeal-leak-pressure-and-gastric-insufflation
#9
Jin Ha Park, Ji Young Kim, Kyoungun Park, Hae Keum Kil
BACKGROUND: The i-gel provides good airway sealing but gastric insufflation may occur when peak inspiratory pressure (PIP) exceeds the sealing pressure of the i-gel without a gastric tube. Pressure-controlled ventilation (PCV) provides lower PIP compared with volume-controlled ventilation (VCV) and low PIP may reduce the incidence of gastric insufflation in children during positive pressure ventilation. This study was designed to evaluate PIP, oropharyngeal leak pressure, and gastric insufflation during VCV or PCV in children undergoing general anesthesia with i-gel without a gastric tube in situ...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28464911/impact-of-high-intensity-niv-on-the-heart-in-stable-copd-a-randomised-cross-over-pilot-study
#10
Marieke Leontine Duiverman, Petra Maagh, Friederike Sophie Magnet, Claudia Schmoor, Maria Paola Arellano-Maric, Axel Meissner, Jan Hendrik Storre, Peter Jan Wijkstra, Wolfram Windisch, Jens Callegari
BACKGROUND: Although high-intensity non-invasive ventilation has been shown to improve outcomes in stable COPD, it may adversely affect cardiac performance. Therefore, the aims of the present pilot study were to compare cardiac and pulmonary effects of 6 weeks of low-intensity non-invasive ventilation and 6 weeks of high-intensity non-invasive ventilation in stable COPD patients. METHODS: In a randomised crossover pilot feasibility study, the change in cardiac output after 6 weeks of each NIV mode compared to baseline was assessed with echocardiography in 14 severe stable COPD patients...
May 2, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28459325/ajrccm-100-year-anniversary-homeward-bound-a-centenary-of-home-mechanical-ventilation
#11
Matthew Hind, Michael I Polkey, Anita K Simonds
The evolution of home mechanical ventilation is an intertwined chronicle of negative and positive pressure modes and their role in managing ventilatory failure in neuromuscular diseases and other chronic disorders. The uptake of noninvasive positive pressure ventilation has resulted in widespread growth in home ventilation internationally and fewer patients being ventilated invasively. As with many applications of domiciliary medical technology, home ventilatory support has either led or run in parallel with acute hospital applications and has been influenced by medical and societal shifts in the approach to chronic care, the creation of community support teams, a preference of recipients to be treated at home, and economic imperatives...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28457405/diaphragm-muscle-surface-electromyography-in-patients-submitted-to-liver-transplant-and-eligible-for-extubation
#12
R P Duarte, A C Sentanin, A M O da Silva, R M Tonella, G L Duarte, L S R Ratti, I F S F Boin
INTRODUCTION: Liver disease induces many organic and metabolic changes, leading to malnutrition and weight and muscular function loss. Surface electromyography is an easily applicable, noninvasive study, through which the magnitudes of the peaks on the charts depict voluntary muscle activity. AIM: To evaluate the diaphragmatic surface electromyography of postoperative liver transplantation subjects. METHODS: Subjects were patients who underwent liver transplantation and extubation in the Clinical Hospital of State University of Campinas...
May 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28443559/the-evolution-of-modern-respiratory-care-for-preterm-infants
#13
REVIEW
Louise S Owen, Brett J Manley, Peter G Davis, Lex W Doyle
Preterm birth rates are rising, and many preterm infants have breathing difficulty after birth. Treatments for infants with prolonged breathing difficulty include oxygen therapy, exogenous surfactant, various modes of respiratory support, and postnatal corticosteroids. In this Series paper, we review the history of neonatal respiratory care and its effect on long-term outcomes, and we outline the future direction of the research field. The delivery and monitoring of oxygen therapy remains controversial, despite being in use for more than 50 years...
April 22, 2017: Lancet
https://www.readbyqxmd.com/read/28427883/born-not-breathing-a-randomised-trial-comparing-two-self-inflating-bag-masks-during-newborn-resuscitation-in-tanzania
#14
Monica Thallinger, Hege Langli Ersdal, Fortunata Francis, Anita Yeconia, Estomih Mduma, Hussein Kidanto, Jørgen Erland Linde, Joar Eilevstjønn, Nina Gunnes, Ketil Størdal
AIMS: Effective ventilation is crucial to save non-breathing newborns. We compared standard equipment for newborn resuscitation to a new Upright bag, in an area with high neonatal mortality. METHODS: Newborns requiring resuscitation at Haydom Lutheran Hospital, Tanzania, were ventilated with 230ml standard or 320ml Upright bag-mask by weekly non-blinded block randomization. A Laerdal Newborn Resuscitation Monitor collected ventilation data through a flow sensor between mask and bag and heart rate with electrocardiography electrodes...
April 17, 2017: Resuscitation
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#15
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28406364/fume-emissions-from-a-low-cost-3-d-printer-with-various-filaments
#16
Evan L Floyd, Jun Wang, James L Regens
3-D printing is an additive manufacturing process involving the injection of melted thermoplastic polymers, which are then laid down in layers to achieve a pre-designed shape. The heated deposition process raises concerns of potential aerosol and volatile organic compounds (VOC) emission and exposure. The decreasing cost of desktop 3-D printers has made the use of 3-D printers more acceptable in non-industrial workplaces lacking sufficient ventilation. Meanwhile, little is known about the characteristics of 3-D printing fume emission...
April 13, 2017: Journal of Occupational and Environmental Hygiene
https://www.readbyqxmd.com/read/28403406/comparison-of-effectiveness-of-two-commonly-used-two-handed-mask-ventilation-techniques-on-unconscious-apnoeic-obese-adults
#17
M Fei, J L Blair, M J Rice, D A Edwards, Y Liang, M A Pilla, M S Shotwell, Y Jiang
Background.: Mask ventilation and tracheal intubation are basic techniques for airway management and mutually inclusive rescue measures to restore ventilation. The aim of this study was to compare the effectiveness of mask ventilation between two commonly used techniques of two-handed mask ventilation in obese unconscious apnoeic adults. Methods.: Eighty-one obese adults received mask ventilation after induction using C-E clamp and modified V-E clamp techniques in a randomized crossover manner...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28403404/hospital-outcomes-and-long-term-survival-after-referral-to-a-specialized-weaning-unit
#18
M G Davies, T G Quinnell, N S Oscroft, S P Clutterbuck, J M Shneerson, I E Smith
Background.: Prolonged invasive mechanical ventilation (IMV) is a frequent challenge, and an increasing number of patients are transferred from intensive care units to long-term acute care hospitals or specialized weaning units. There are few published data for discharge home rates, use of noninvasive ventilation (NIV), or long-term survival. Methods.: A case-note and database review was conducted of patients admitted to a UK national specialized weaning unit for weaning from IMV between 1992 and 2012...
April 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28399118/feasibility-and-physiological-effects-of-non-invasive-neurally-adjusted-ventilatory-assist-niv-nava-in-preterm-infants
#19
Christopher Gibu, Phillip Cheng, Raymond J Ward, Benjamin Castro, Gregory P Heldt
BACKGROUND: Non-invasive Neurally Adjusted Ventilator Assist (NIV-NAVA) was introduced to our clinical practice via a pilot and a randomized observational study to assess its safety, feasibility, and short term physiological effects. METHODS: The pilot protocol applied NIV-NAVA to 11 infants on nasal CPAP, high-flow nasal cannula (HFNC), or nasal IMV (NIMV), in multiple 2-4 h periods of NIV-NAVA for comparison. This provided the necessary data to design a randomized, controlled observational cross-over study in 8 additional infants to compare the physiological effects of NIV-NAVA to NIMV during 2-hour steady state conditions...
April 11, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28394653/in-vitro-in-vivo-comparison-of-inhaled-salbutamol-dose-delivered-by-jet-nebulizer-vibrating-mesh-nebulizer-and-metered-dose-inhaler-with-spacer-during-non-invasive-ventilation
#20
Ahmed Hassan, Randa Salah Eldin, Maha M Abdelrahman, Mohamed E Abdelrahim
BACKGROUND: Patients receiving noninvasive ventilation (NIV) may benefit from medical aerosol, but most guidance on dosing with different aerosol devices is limited to in-vitro studies. The study was designed to in-vitro, ex-vivo, and in-vivo compare aerosol delivery during bilevel NIV with three types of aerosol generators: metered dose inhaler with AeroChamber-MV spacer (AC), Aerogen Pro vibrating mesh nebulizer (PRO), and Sidestream jet nebulizer (SIDE). MATERIALS AND METHOD: A bilevel ventilator with dry single limb circuit and fixed expiratory port was set in spontaneous mode with initial inspiratory and expiratory pressures of 20 and 5 cmH20, 1:3 inspiratory-expiratory ratio, and 15 breaths...
February 2017: Experimental Lung Research
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