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https://www.readbyqxmd.com/read/28443559/the-evolution-of-modern-respiratory-care-for-preterm-infants
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28388984/case-control-study-on-risk-factors-of-unplanned-extubation-based-on%C3%A2-patient-safety-model-in-critically-ill-patients-with-mechanical-ventilation
#9
EunOk Kwon, KyungSook Choi
PURPOSE: This study aimed to identify risk factors of unplanned extubation in intensive care unit (ICU) patients with mechanical ventilation using a patient safety model. METHODS: This study was designed to be a case-control study. Data collection sheets, including 29 risk factors of unplanned extubation in mechanically ventilation patients were retrospectively collected based on a patient safety model over 3 years. From 41,207 mechanically ventilated patients, 230 patients were identified to have unplanned extubation during their ICU stay...
March 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/28385477/espen-guideline-clinical-nutrition-in-surgery
#10
Arved Weimann, Marco Braga, Franco Carli, Takashi Higashiguchi, Martin Hübner, Stanislaw Klek, Alessandro Laviano, Olle Ljungqvist, Dileep N Lobo, Robert Martindale, Dan L Waitzberg, Stephan C Bischoff, Pierre Singer
Early oral feeding is the preferred mode of nutrition for surgical patients. Avoidance of any nutritional therapy bears the risk of underfeeding during the postoperative course after major surgery. Considering that malnutrition and underfeeding are risk factors for postoperative complications, early enteral feeding is especially relevant for any surgical patient at nutritional risk, especially for those undergoing upper gastrointestinal surgery. The focus of this guideline is to cover nutritional aspects of the Enhanced Recovery After Surgery (ERAS) concept and the special nutritional needs of patients undergoing major surgery, e...
June 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28379133/-non-invasive-ventilation-in-patients-with-diaphragmatic-paralysis-case-report
#11
Magali Blanco, Glenda Ernst, A Salvado, V H Cambursano, E Borsini
Background Diaphragmatic paralysis (DP) is a rare disease, usually secondary to systemic processes, although idiopathic forms have been described. Aim To describe the use of non-invasive ventilation as a treatment to patients with DP. Material and methods Descriptive study about consecutive cases of DP in a general hospital. Results It has been described 4 patients, all of them with a diminished the maximum mouth pressures and vital capacity in supine position. Three patients presented hypercapnia, and one of them, required intubation with invasive mechanical ventilation...
2017: Revista de la Facultad de Ciencias Médicas
https://www.readbyqxmd.com/read/28377920/automated-weaning-from-mechanical-ventilation-after-off-pump-coronary-artery-bypass-grafting
#12
Evgenia V Fot, Natalia N Izotova, Angelika S Yudina, Aleksei A Smetkin, Vsevolod V Kuzkov, Mikhail Y Kirov
BACKGROUND: The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28374969/randomized-cross-over-trial-of-ventilator-modes-during-non-invasive-ventilation-titration-in-amyotrophic-lateral-sclerosis
#13
Bart Vrijsen, Bertien Buyse, Catharina Belge, Goele Vanpee, Philip Van Damme, Dries Testelmans
BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) improves survival, quality of life and sleep in patients with amyotrophic lateral sclerosis (ALS). Nevertheless, NIV titration is conducted in different ways. We aim to provide more insight into NIV titration by comparing the effects of a spontaneous (S) and spontaneous-timed (ST) modes on gas exchange, sleep architecture and patient-ventilator asynchronies (PVAs). METHODS: After an initial night of NIV titration, patients were randomized to S or ST mode in a cross-over design...
April 4, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28372575/implementing-a-bedside-assessment-of-respiratory-mechanics-in-patients-with-acute-respiratory-distress-syndrome
#14
Lu Chen, Guang-Qiang Chen, Kevin Shore, Orest Shklar, Concetta Martins, Brian Devenyi, Paul Lindsay, Heather McPhail, Ashley Lanys, Ibrahim Soliman, Mazin Tuma, Michael Kim, Kerri Porretta, Pamela Greco, Hilary Every, Chris Hayes, Andrew Baker, Jan O Friedrich, Laurent Brochard
BACKGROUND: Despite their potential interest for clinical management, measurements of respiratory mechanics in patients with acute respiratory distress syndrome (ARDS) are seldom performed in routine practice. We introduced a systematic assessment of respiratory mechanics in our clinical practice. After the first year of clinical use, we retrospectively assessed whether these measurements had any influence on clinical management and physiological parameters associated with clinical outcomes by comparing their value before and after performing the test...
April 4, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28368939/application-of-the-novel-ventilation-mode-flow-controlled-expiration-flex-a-crossover-proof-of-principle-study-in-lung-healthy-patients
#15
Steffen Wirth, Sebastian Springer, Johannes Spaeth, Silke Borgmann, Ulrich Goebel, Stefan Schumann
BACKGROUND: Traditionally, mechanical ventilation is achieved via active lung inflation during inspiration and passive lung emptying during expiration. By contrast, the novel FLEX (FLow-controlled EXpiration) ventilator mode actively decreases the rate of lung emptying. We investigated whether FLEX can be used during intraoperative mechanical ventilation of lung-healthy patients. METHODS: In 30 adult patients scheduled for neurosurgical procedures, we studied respiratory system mechanics, regional ventilation, oxygenation, and hemodynamics during ventilation with and without FLEX at positive end-expiratory pressure (PEEP) of 5 and 7 cm H2O...
March 31, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28366356/comparison-of-effort-of-breathing-for-infants-on-nasal-modes-of-respiratory-support
#16
Asavari Kamerkar, Justin Hotz, Rica Morzov, Christopher J L Newth, Patrick A Ross, Robinder G Khemani
OBJECTIVE: To directly compare effort of breathing between high flow nasal cannula (HFNC), nasal intermittent mechanical ventilation (NIMV), and nasal continuous positive airway pressure (NCPAP). STUDY DESIGN: This was a single center prospective cross-over study for patients <6 months in the cardiothoracic or pediatric intensive care unit receiving nasal noninvasive respiratory support after extubation. We measured effort of breathing using esophageal manometry with pressure-rate product (PRP) on all 3 modes...
March 30, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28352342/different-ventilation-modes-combined-with-ambroxol-in-the-treatment-of-respiratory-distress-syndrome-in-premature-infants
#17
Bin Zhou, Jing-Fang Zhai, Jie-Bin Wu, Bao Jin, Yan-Yan Zhang
The aim of the present study was to compare the effectiveness of different modes of mechanical ventilation in combination with secretolytic therapy with ambroxol in premature infants with respiratory distress syndrome. Seventy-three premature infants with hyaline membrane disease (HMD) (stage III-IV), also known as respiratory distress syndrome, who were supported by mechanical ventilation in the neonatal intensive care unit (NICU) of Xuzhou Central Hospital, were involved in the present study, between January 2013 and February 2015...
February 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28347790/key-conceptional-considerations-on-nebulization-of-antimicrobial-agents-to-mechanically-ventilated-patients
#18
Jordi Rello, Jean Jacques Rouby, Candela Sole-Lleonart, Jean Chastre, Stijn Blot, Charles Edouard Luyt, Jordi Riera, Margreet C Vos, Antoine Monsel, Jayesh Dhanani, Jason A Roberts
Nebulized antibiotics have an established role in patients with cystic fibrosis or bronchiectasis. Their potential benefit to treat respiratory infections in mechanically ventilated patients is receiving increasing interest. In this Consensus Paper of the European Society of Clinical Microbiology and Infectious Diseases, the body of evidence of the therapeutic utility of aerosolized antibiotics in mechanically ventilated patients was reviewed and resulted in the following recommendations: A. Vibrating mesh nebulizers should be preferred to jet or ultrasonic nebulizers; B...
March 24, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28345309/a-survey-of-clinicians-regarding-respiratory-physiotherapy-intervention-for-intubated-and-mechanically-ventilated-patients-with-community-acquired-pneumonia-what-is-current-practice-in-australian-icus
#19
Lisa van der Lee, Anne-Marie Hill, Shane Patman
RATIONALE, AIMS, AND OBJECTIVES: Community-acquired pneumonia (CAP) is a common cause for intensive care unit (ICU) admission resulting in high morbidity and mortality. There is a paucity of evidence regarding respiratory physiotherapy for intubated and mechanically ventilated patients with CAP, and anecdotally clinical practice is variable in this cohort. The aims of this study were to identify the degree of variability in physiotherapy practice for intubated adult patients with CAP and to explore ICU physiotherapist perceptions of current practice for this cohort and factors that influence physiotherapy treatment mode, duration, and frequency...
March 27, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28345056/arctic-sea-ice-eurasia-snow-and-extreme-winter-haze-in-china
#20
Yufei Zou, Yuhang Wang, Yuzhong Zhang, Ja-Ho Koo
The East China Plains (ECP) region experienced the worst haze pollution on record for January in 2013. We show that the unprecedented haze event is due to the extremely poor ventilation conditions, which had not been seen in the preceding three decades. Statistical analysis suggests that the extremely poor ventilation conditions are linked to Arctic sea ice loss in the preceding autumn and extensive boreal snowfall in the earlier winter. We identify the regional circulation mode that leads to extremely poor ventilation over the ECP region...
March 2017: Science Advances
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