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https://www.readbyqxmd.com/read/28212050/volume-controlled-ventilation-does-not-prevent-injurious-inflation-during-spontaneous-effort
#1
Takeshi Yoshida, Susumu Nakahashi, Maria Aparecida Miyuki Nakamura, Yukiko Koyama, Rollin Roldan, Vinicius Torsani, Roberta R De Santis, Susimeire Gomes, Akinori Uchiyama, Marcelo B P Amato, Brian P Kavanagh, Yuji Fujino
RATIONALE: Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and tidal volume, and worsens lung injury. Intuitively, controlling tidal volume and transpulmonary pressure might limit injury from added spontaneous effort. OBJECTIVES: To test the hypothesis that during spontaneous effort in injured lungs, tidal volume and transpulmonary pressure limitation by volume-controlled ventilation results in less injurious patterns of inflation...
February 17, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208980/contributing-factors-for-morbidity-and-mortality-in-patients-with-organophosphate-poisoning-on-mechanical-ventilation-a-retrospective-study-in-a-teaching-hospital
#2
Gurulingappa Patil, Navya Murthy, M Nikhil
INTRODUCTION: One of the most common causes of poisoning in agricultural based developing countries like India is due to Organophosphorus (OP) compound. Its widespread use and easy availability has increased the likelihood of poisoning with these compounds. AIM: To study the morbidity and mortality in patients with acute OP poisoning requiring mechanical ventilation. MATERIALS AND METHODS: This was a retrospective study constituting patients of all age groups admitted to the Intensive Care Unit (ICU) with diagnosis of OP poisoning between January 2015 to December 2015...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28196936/influences-of-duration-of-inspiratory-effort-respiratory-mechanics-and-ventilator-type-on-asynchrony-with-pressure-support-and-proportional-assist-ventilation
#3
Renata S Vasconcelos, Raquel P Sales, Luíz H de P Melo, Liégina S Marinho, Vasco Pd Bastos, Andréa da Nc Nogueira, Juliana C Ferreira, Marcelo A Holanda
BACKGROUND: Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). METHODS: We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0...
February 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28196820/combined-use-of-neurally-adjusted-ventilatory-assist-nava-and-vertical-expandable-prostethic-titanium-rib-veptr-in-a-patient-with-spondylocostal-dysostosis-and-associated-bronchomalacia
#4
Martí Pons-Odena, Alba Verges, Natalia Arza, Francisco José Cambra
Jarcho-Levin syndrome is a rare disorder characterised by defects in vertebral and costal segmentation of varying severity. Respiratory complications are the main cause of death or severe comorbidity due to a restrictive rib cage. A 3 months old infant with Spondylocostal dysostosis and associated bronchomalacia experiencing severe asynchrony during the weaning process is reported. The Neurally Adjusted Ventilatory Assist (NAVA) mode was used to improve adaptation to mechanical ventilation after Vertical Expandable Prosthetic Titanium Ribs (VEPTRs) were implanted...
February 14, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28196755/characterization-of-particle-emission-from-laser-printers
#5
Mauro Scungio, Tania Vitanza, Luca Stabile, Giorgio Buonanno, Lidia Morawska
Emission of particles from laser printers in office environments is claimed to have impact on human health due to likelihood of exposure to high particle concentrations in such indoor environments. In the present paper, particle emission characteristics of 110 laser printers from different manufacturers were analyzed, and estimations of their emission rates were made on the basis of measurements of total concentrations of particles emitted by the printers placed in a chamber, as well as particle size distributions...
February 10, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28195072/complement-activation-contributes-to-ventilator-induced-lung-injury-in-rats
#6
B Petersen, T Busch, J Gaertner, J J Haitsma, S Krabbendam, M Ebsen, B Lachmann, U X Kaisers
The complement system contributes to ventilator induced lung injury (VILI). We hypothesized that pretreatment with the C1 esterase inhibitor (C1INH) Berinert® constrains complement activation consecutively inducing improvements in arterial oxygenation and histological pulmonary damage. At baseline, male Sprague-Dawley rats underwent mechanical ventilation in a conventional mode (PIP 13 cm H2O, PEEP 3 cm H2O). In the Control group, the ventilator setting was maintained (Control, n = 15). The other animals randomly received intravenous pretreatment with either 100 units/kg of the C1-INH Berinert® (VILI-C1INH group, n = 15) or 1 ml saline solution (VILI-C group, n = 15)...
December 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28187154/comparison-of-different-inspiratory-triggering-settings-in-automated-ventilators-during-cardiopulmonary-resuscitation-in-a-porcine-model
#7
Dingyu Tan, Jun Xu, Shihuan Shao, Yangyang Fu, Feng Sun, Yazhi Zhang, Yingying Hu, Joseph Walline, Huadong Zhu, Xuezhong Yu
BACKGROUND: Mechanical ventilation via automated in-hospital ventilators is quite common during cardiopulmonary resuscitation. It is not known whether different inspiratory triggering sensitivity settings of ordinary ventilators have different effects on actual ventilation, gas exchange and hemodynamics during resuscitation. METHODS: 18 pigs enrolled in this study were anaesthetized and intubated. Continuous chest compressions and mechanical ventilation (volume-controlled mode, 100% O2, respiratory rate 10/min, and tidal volumes 10ml/kg) were performed after 3 minutes of ventricular fibrillation...
2017: PloS One
https://www.readbyqxmd.com/read/28180985/crossover-study-of-assist-control-ventilation-and-neurally-adjusted-ventilatory-assist
#8
Sandeep Shetty, Katie Hunt, Janet Peacock, Kamal Ali, Anne Greenough
: Some studies of infants with acute respiratory distress have demonstrated that neurally adjusted ventilator assist (NAVA) had better short-term results compared to non-triggered or other triggered models. We determined if very prematurely born infants with evolving or established bronchopulmonary dysplasia (BPD) had a lower oxygenation index (OI) on NAVA compared to assist control ventilation (ACV). Infants were studied for 1 h each on each mode. At the end of each hour, blood gas analysis was performed and the OI calculated...
February 8, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28153938/exertional-dyspnea-associated-with-chest-wall-strapping-is-reduced-when-external-dead-space-substitutes-for-part-of-the-exercise-stimulus-to-ventilation
#9
Luke Albert Garske, Ravin Lal, Ian Braidwood Stewart, Norman R Morris, Troy James Cross, Lewis Adams
Chest wall strapping has been used to assess mechanisms of dyspnea with restrictive lung disease. This study examined the hypothesis that dyspnea with restriction depends principally on the degree of reflex ventilatory stimulation. We compared dyspnea at the same (iso-)ventilation when added dead space provided a component of the ventilatory stimulus during constant work exercise. Eleven healthy males undertook a randomized controlled cross-over trial which compared four constant work exercise conditions (i) CTRL: unrestricted breathing at 90% Gas Exchange Threshold (GET), (ii) CTRL+DS: unrestricted breathing with 0...
February 2, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28151764/increased-resistance-to-flow-and-ventilator-failure-secondary-to-faulty-co2-absorbent-insert-not-detected-during-automated-anesthesia-machine-check-a-case-report
#10
Ingrid Moreno-Duarte, Julio Montenegro, Konstantin Balonov, Roman Schumann
Most modern anesthesia workstations provide automated checkout, which indicates the readiness of the anesthesia machine. In this case report, an anesthesia machine passed the automated machine checkout. Minutes after the induction of general anesthesia, we observed a mismatch between the selected and delivered tidal volumes in the volume auto flow mode with increased inspiratory resistance during manual ventilation. Endotracheal tube kinking, circuit obstruction, leaks, and patient-related factors were ruled out...
February 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28149559/a-bench-evaluation-of-fraction-of-oxygen-in-air-delivery-and-tidal-volume-accuracy-in-home-care-ventilators-available-for-hospital-use
#11
Loredana Baboi, Fabien Subtil, Claude Guérin
BACKGROUND: Turbine-powered ventilators are not only designed for long-term ventilation at home but also for hospital use. It is important to verify their capabilities in delivering fraction of oxygen in air (FIO2) and tidal volume (VT). METHODS: We assessed the FIO2 accuracy and the VT delivery in four home care ventilators (HCV) on the bench. The four HCV were Astral 150, Elisée 150, Monnal T50 and Trilogy 200 HCV, which were connected to a lung model (ASL 5000)...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28149025/comparison-of-patient-ventilator-asynchrony-during-pressure-support-ventilation-and-proportional-assist-ventilation-modes-in-surgical-intensive-care-unit-a-randomized-crossover-study
#12
Parshotam Lal Gautam, Gaganjot Kaur, Sunil Katyal, Ruchi Gupta, Preetveen Sandhu, Nikhil Gautam
BACKGROUND: The patient-ventilator asynchrony is almost observed in all modes of ventilation, and this asynchrony affects lung mechanics adversely resulting in deleterious outcome. Innovations and advances in ventilator technology have been trying to overcome this problem by designing newer modes of ventilation. Pressure support ventilation (PSV) is a commonly used flow-cycled mode where a constant pressure is delivered by ventilator. Proportional assist ventilation (PAV) is a new dynamic inspiratory pressure assistance and is supposed to be better than PSV for synchrony and tolerance, but reports are still controversial...
December 2016: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28145212/-when-is-a-venous-blood-gas-analysis-sufficient-in-the-emergency-department
#13
J A J M van Exsel, S O Simons, C Kramers, Y F Heijdra
Blood gas analysis plays an important role in the initial assessment of a patient in the emergency ward. We present three different patient cases to illustrate when to opt for a venous or an arterial blood gas analysis. Arterial punctures are more painful and carry a higher risk of complications compared to venous punctures. It is possible to use a venous blood gas to screen for acute acid/base disturbances. Ventilatory compensation or anion gap cannot be calculated reliably with a venous blood gas. On the other hand, the diagnosis diabetic keto-acidosis can be made with a venous blood gas; this mode of sampling can also be used for lactate measurement at the emergency department as an independent prognostic marker for mortality...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28138234/respiratory-muscle-activity-and-patient-ventilator-asynchrony-during-different-settings-of-noninvasive-ventilation-in-stable-hypercapnic-copd-does-high-inspiratory-pressure-lead-to-respiratory-muscle-unloading
#14
Marieke L Duiverman, Anouk S Huberts, Leo A van Eykern, Gerrie Bladder, Peter J Wijkstra
INTRODUCTION: High-intensity noninvasive ventilation (NIV) has been shown to improve outcomes in stable chronic obstructive pulmonary disease patients. However, there is insufficient knowledge about whether with this more controlled ventilatory mode optimal respiratory muscle unloading is provided without an increase in patient-ventilator asynchrony (PVA). PATIENTS AND METHODS: Ten chronic obstructive pulmonary disease patients on home mechanical ventilation were included...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28122007/impact-of-stroke-therapy-academic-industry-roundtable-stair-guidelines-on-peri-anesthesia-care-for-rat-models-of-stroke-a-meta-analysis-comparing-the-years-2005-and-2015
#15
Aurelie Thomas, Johann Detilleux, Paul Flecknell, Charlotte Sandersen
Numerous studies using rats in stroke models have failed to translate into successful clinical trials in humans. The Stroke Therapy Academic Industry Roundtable (STAIR) has produced guidelines on the rodent stroke model for preclinical trials in order to promote the successful translation of animal to human studies. These guidelines also underline the importance of anaesthetic and monitoring techniques. The aim of this literature review is to document whether anaesthesia protocols (i.e., choice of agents, mode of ventilation, physiological support and monitoring) have been amended since the publication of the STAIR guidelines in 2009...
2017: PloS One
https://www.readbyqxmd.com/read/28121833/volume-targeted-ventilation-in-the-neonate-benchmarking-ventilators-on-an-active-lung-model
#16
Tobias J Krieger, Martin Wald
OBJECTIVE: Mechanically ventilated neonates have been observed to receive substantially different ventilation after switching ventilator models, despite identical ventilator settings. This study aims at establishing the range of output variability among 10 neonatal ventilators under various breathing conditions. DESIGN: Relative benchmarking test of 10 neonatal ventilators on an active neonatal lung model. SETTING: Neonatal ICU. SUBJECTS: Ten current neonatal ventilators...
January 24, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28115126/determination-of-time-and-size-dependent-fine-particle-emission-with-varied-oil-heating-in-an-experimental-kitchen
#17
Shuangde Li, Jiajia Gao, Yiqing He, Liuxu Cao, Ang Li, Shengpeng Mo, Yunfa Chen, Yaqun Cao
Particulate matter (PM) from cooking has caused seriously indoor air pollutant and aroused risk to human health. It is urged to get deep knowledge of their spatial-temporal distribution of source emission characteristics, especially ultrafine particles (UFP<100nm) and accumulation mode particles (AMP 100-665nm). Four commercial cooking oils are auto dipped water to simulate cooking fume under heating to 265°C to investigate PM emission and decay features between 0.03 and 10μm size dimension by electrical low pressure impactor (ELPI) without ventilation...
January 2017: Journal of Environmental Sciences (China)
https://www.readbyqxmd.com/read/28107207/dynamic-mechanical-interactions-between-neighboring-airspaces-determine-cyclic-opening-and-closure-in-injured-lung
#18
Ludovic Broche, Gaetano Perchiazzi, Liisa Porra, Angela Tannoia, Mariangela Pellegrini, Savino Derosa, Alessandra Sindaco, João Batista Borges, Loïc Degrugilliers, Anders Larsson, Göran Hedenstierna, Anthony S Wexler, Alberto Bravin, Sylvia Verbanck, Bradford J Smith, Jason H T Bates, Sam Bayat
OBJECTIVES: Positive pressure ventilation exposes the lung to mechanical stresses that can exacerbate injury. The exact mechanism of this pathologic process remains elusive. The goal of this study was to describe recruitment/derecruitment at acinar length scales over short-time frames and test the hypothesis that mechanical interdependence between neighboring lung units determines the spatial and temporal distributions of recruitment/derecruitment, using a computational model. DESIGN: Experimental animal study...
January 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28103806/the-effect-of-fresh-gas-flow-rate-and-type-of-anesthesia-machine-on-time-to-reach-target-sevoflurane-concentration
#19
Hye Won Shin, Hae Na Yu, Go Eun Bae, Hyub Huh, Ji Yong Park, Ji Young Kim
BACKGROUND: Anesthesia machines have been developed by the application of new technology for rapid and easier control of anesthetic concentration. In this study, we used a test lung to investigate whether the time taken to reach the target sevoflurane concentration varies with the rate of fresh gas flow (FGF) and type of anesthesia machine (AM). METHODS: We measured the times taken to reach the target sevoflurane concentration (2 minimum alveolar concentration = 4%) at variable rates of FGF (0...
January 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28103448/bedside-contribution-of-electrical-impedance-tomography-to-set-positive-end-expiratory-pressure-for-ecmo-treated-severe-ards-patients
#20
Guillaume Franchineau, Nicolas Bréchot, Guillaume Lebreton, Guillaume Hekimian, Ania Nieszkowska, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Charles-Edouard Luyt, Alain Combes, Matthieu Schmidt
RATIONALE: Optimal positive end-expiratory pressure (PEEP) is unknown in severe acute respiratory distress syndrome (ARDS) patients on extracorporeal membrane oxygenation (ECMO) receiving mechanical ventilation with very low tidal volume. OBJECTIVES: To evaluate electrical impedance tomography's (EIT) ability to monitor a PEEP trial and to derive from EIT the best compromise PEEP in this setting. METHODS: A decremental PEEP trial (20-0 cmH2O) in 5 cmH2O steps was monitored by EIT, with lung images divided into four ventral-to-dorsal horizontal regions of interest...
January 19, 2017: American Journal of Respiratory and Critical Care Medicine
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