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https://www.readbyqxmd.com/read/29224257/models-of-care-for-non-invasive-ventilation-in-the-acute-copd-comparison-of-three-tertiary-hospitals-act3-study
#1
Kerry Parker, Vara Perikala, Ali Aminazad, Zheng Deng, Brigitte Borg, Catherine Buchan, Jo Toghill, Louis B Irving, Jeremy Goldin, David Charlesworth, Ajay Mahal, Suhith Illesinghe, Matthew T Naughton, Alan Young
BACKGROUND AND OBJECTIVE: Non-invasive ventilation (NIV) improves clinical outcomes in hypercapnic acute exacerbations of COPD (AECOPD), but the optimal model of care remains unknown. METHODS: We conducted a prospective observational non-inferiority study comparing three models of NIV care: general ward (Ward) (1:4 nurse to patient ratio, thrice weekly consultant ward round), a high dependency unit (HDU) (1:2 ratio, twice daily ward round) and an intensive care unit (ICU) (1:1 ratio, twice daily ward round) model in three similar teaching tertiary hospitals...
December 10, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29210771/effect-of-inhaled-nitric-oxide-on-hemodynamics-in-lambs-with-1%C3%A2-ventricle-circulation
#2
Hitoshi Kanamitsu, Yasuhiro Fujii, Luca Centola, Katsushi Kinouchi, Liqun Zhu, Robert K Riemer, Olaf Reinhartz
Inhaled nitric oxide (NO) is widely used to treat postoperative pulmonary hypertension in congenital heart disease. It is believed that NO increases cardiac output (CO) by decreasing pulmonary vascular resistance (PVR), leading to increased left ventricular preload. However, the effect of NO on CO in patients with 1½ ventricle circulation remains unclear. To evaluate this, a superior cavopulmonary (SCP) shunt was constructed in 10 juvenile sheep. A PTFE graft was inserted between the superior vena cava (SVC) and the main pulmonary artery (PA)...
November 27, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29210062/incidence-of-hyperoxia-and-related-in-hospital-mortality-in-critically-ill-patients-a-retrospective-data-analysis
#3
F Kraft, H Andel, J Gamper, K Markstaller, R Ullrich, K U Klein
BACKGROUND: Mechanical ventilation with oxygen is life-saving, however, may result in hyperoxia. The aim was to analyse the incidence and duration of hyperoxia burden and related in-hospital mortality in critically ill patients. METHODS: Patients of all ages admitted to intensive care units (ICUs) and with mechanical ventilation for at least seven consecutive days were included in this single centre retrospective medical record audit. The main outcome measure was time-weighted arterial partial pressure of oxygen (PaO2 ) over 7 days...
December 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29200008/four-types-of-pulse-oximeters-accurately-detect-hypoxia-during-low-perfusion-and-motion
#4
Aaron Louie, John R Feiner, Philip E Bickler, Laura Rhodes, Michael Bernstein, Jennifer Lucero
BACKGROUND: Pulse oximeter performance is degraded by motion artifacts and low perfusion. Manufacturers developed algorithms to improve instrument performance during these challenges. There have been no independent comparisons of these devices. METHODS: We evaluated the performance of four pulse oximeters (Masimo Radical-7, USA; Nihon Kohden OxyPal Neo, Japan; Nellcor N-600, USA; and Philips Intellivue MP5, USA) in 10 healthy adult volunteers. Three motions were evaluated: tapping, pseudorandom, and volunteer-generated rubbing, adjusted to produce photoplethsmogram disturbance similar to arterial pulsation amplitude...
December 4, 2017: Anesthesiology
https://www.readbyqxmd.com/read/29190801/comparison-between-manual-and-mechanical-chest-compressions-during-resuscitation-in-a-pediatric-animal-model-of-asphyxial-cardiac-arrest
#5
Jorge López, Sarah N Fernández, Rafael González, María J Solana, Javier Urbano, Blanca Toledo, Jesús López-Herce
AIMS: Chest compressions (CC) during cardiopulmonary resuscitation are not sufficiently effective in many circumstances. Mechanical CC could be more effective than manual CC, but there are no studies comparing both techniques in children. The objective of this study was to compare the effectiveness of manual and mechanical chest compressions with Thumper device in a pediatric cardiac arrest animal model. MATERIAL AND METHODS: An experimental model of asphyxial cardiac arrest (CA) in 50 piglets (mean weight 9...
2017: PloS One
https://www.readbyqxmd.com/read/29183321/effects-of-controlled-hypoxemia-or-hypovolemia-on-global-and-intestinal-oxygenation-and-perfusion-in-isoflurane-anesthetized-horses-receiving-an-alpha-2-agonist-infusion
#6
Klaus Hopster, Liza Wittenberg-Voges, Florian Geburek, Charlotte Hopster-Iversen, Sabine B R Kästner
BACKGROUND: Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia...
November 28, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/29168167/interdependent-feedback-regulation-of-breathing-by-the-carotid-bodies-and-the-retrotrapezoid-nucleus
#7
Patrice G Guyenet, Douglas A Bayliss, Ruth L Stornetta, Roy Kanbar, Yingtang Shi, Benjamin B Holloway, George M P R Souza, Tyler M Basting, Stephen B G Abbott, Ian C Wenker
The retrotrapezoid nucleus, RTN, regulates breathing in a CO2 and state-dependent manner. RTN neurons are glutamatergic and innervate principally the respiratory pattern generator; they regulate multiple aspects of breathing, including active expiration, and maintain breathing automaticity during non-REM sleep. RTN neurons encode arterial PCO2 /pH via cell-autonomous and paracrine mechanisms, and via input from other CO2 -responsive neurons. In short, RTN neurons are a pivotal structure for breathing automaticity and arterial PCO2 homeostasis...
November 22, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/29142384/hypercapnic-respiratory-failure-in-case-of-chiari-1-5-malformation-case-report-and-review-of-the-literature
#8
Viralkumar M Vasani, Subhas Kanti Konar, S Satish
Type 2 respiratory failure is defined as hypercapnia associated with hypoxia. Chiari 1.5 is known as herniation of the cerebellar tonsils along with brain stem and fourth ventricle. We report a 35-year-old male who presented with acute hypercapnic respiratory failure (Type 2), without any preexisting neurological or respiratory abnormality. Analysis of blood gases in emergency revealed a pH of 7.12, pCO2 of 132 mmHg, and arterial oxygen tension of 118 mm Hg. He was intubated and ventilated. Magnetic resonance imaging brain revealed herniation of the cerebellar tonsils along with brain stem and fourth ventricle...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29135399/-investigation-of-parameters-related-to-prognosis-in-diffuse-parenchymal-lung-diseases-prognosis-in-interstitial-lung-diseases
#9
Coşkun Canıvar, Züleyha Bingöl, Zeki Kılıçaslan, Tülin Çağatay, N Gülfer Okumuş
Introduction: Parameters related to prognosis in diffuse parenchymal lung disease (DPLD) have a decisive influence on treatment and follow-up processes. We aimed to define baseline characteristics and factors that effect the mortality of the group of patients with DPLD and to determine distinctions between subgroups. Materials and Methods: Demographic characteristics, complaints, comorbidity, treatment, pulmonary function tests, echocardiographic findings, six minute walking test (6MWT), arterial blood gases analysis, radiological findings and survival time were collected from outpatient clinics database...
September 2017: Tüberküloz Ve Toraks
https://www.readbyqxmd.com/read/29122894/dyspnoea-in-lupus
#10
Jeremy Fleri Soler, Andrew Borg, Cecilia Mercieca
A 32-year-old woman suffering from systemic lupus erythematosus presented with a 6-week history of progressive dyspnoea and pleuritic chest pain. Examination was normal apart from reduced air entry at the lung bases.Arterial blood gases showed hypoxaemia and chest X-ray revealed raised hemidiaphragms without any pleural effusions. Lung function showed a restrictive pathology while high-resolution chest CT and CT pulmonary angiogram were negative. Echocardiography showed normal ventricular diameters and no pericardial effusion...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29122649/the-impact-of-global-hemodynamics-oxygen-and-carbon-dioxide-on-epileptiform-eeg-activity-in-comatose-survivors-of-out-of-hospital-cardiac-arrest
#11
C Moonen, R Lemmens, W Van Paesschen, A Wilmer, W Eertmans, B Ferdinande, M Dupont, C De Deyne, J Dens, S Janssens, K Ameloot
AIM: To study the association between global hemodynamics, blood gases, epileptiform EEG activity and survival after out-of-hospital CA (0HCA). METHODS: We retrospectively analyzed 195 comatose post-CA patients. At least one EEG recording per patient was evaluated to diagnose epileptiform EEG activity. Refractory epileptiform EEG activity was defined as persisting epileptic activity on EEG despite the use of 2 or more anti-epileptics. The time weighted average mean arterial pressure 48hours (TWA-MAP48), the percentage of time with a MAP below 65 and above 85mmHg and the percentage of time with normoxia, hypoxia (<70mmHg), hyperoxia (>150mmHg), normocapnia, hypocapnia (<35mmHg) and hypercapnia (>45mmHg) were calculated...
November 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29104807/neural-vascular-mechanism-for-the-cerebral-blood-flow-autoregulation-after-hemorrhagic-stroke
#12
REVIEW
Ming Xiao, Qiang Li, Hua Feng, Le Zhang, Yujie Chen
During the initial stages of hemorrhagic stroke, including intracerebral hemorrhage and subarachnoid hemorrhage, the reflex mechanisms are activated to protect cerebral perfusion, but secondary dysfunction of cerebral flow autoregulation will eventually reduce global cerebral blood flow and the delivery of metabolic substrates, leading to generalized cerebral ischemia, hypoxia, and ultimately, neuronal cell death. Cerebral blood flow is controlled by various regulatory mechanisms, including prevailing arterial pressure, intracranial pressure, arterial blood gases, neural activity, and metabolic demand...
2017: Neural Plasticity
https://www.readbyqxmd.com/read/29094511/a-comparison-of-nanoparticullate-cpg-immunotherapy-with-and-without-allergens-in-spontaneously-equine-asthma-affected-horses-an-animal-model
#13
John Klier, Sabine Geis, Jeanette Steuer, Katharina Geh, Sven Reese, Sebastian Fuchs, Ralf S Mueller, Gerhard Winter, Heidrun Gehlen
INTRODUCTION: New therapeutic strategies to modulate the immune response of human and equine allergic asthma are still under extensive investigation. Immunomodulating agents stimulating T-regulatory cells offer new treatment options beyond conventional symptomatic treatment or specific immunotherapy for human and equine allergic airway diseases, with the goal of a homoeostatic T-helper cell balance. The aim of this study was to evaluate the effects of a nebulized gelatin nanoparticle-CpG formulation (CpG-GNP) with and without specific allergens for the treatment of spontaneous allergic equine asthma as a model for human asthma...
November 1, 2017: Immunity, Inflammation and Disease
https://www.readbyqxmd.com/read/29081581/xylazine-infusion-in-isoflurane-anesthetized-and-ventilated-healthy-horses-effects-on-cardiovascular-parameters-and-intestinal-perfusion
#14
Klaus Hopster, Liza Wittenberg-Voges, Sabine B R Kästner
To investigate the effects of a xylazine infusion during isoflurane anesthesia on global perfusion parameters and gastrointestinal oxygenation and microperfusion, 8 adult warmblood horses were sedated with xylazine and anesthesia induced with midazolam and ketamine. Horses were mechanically ventilated during anesthesia. After 3 h of stable isoflurane anesthesia (FEIso 1.3 Vol %), a xylazine infusion with 1 mg/kg body weight (BW) per hour was started for 1 h and then stopped. Before, during, and after xylazine infusion, heart rate (HR), arterial blood pressure (MAP), cardiac output (CO), central venous pressure (CVP), and pulmonary artery pressure (PAP) were measured and systemic vascular resistance (SVR) was calculated...
October 2017: Canadian Journal of Veterinary Research, Revue Canadienne de Recherche Vétérinaire
https://www.readbyqxmd.com/read/29080056/oxygen-15-labeled-co2-o2-and-co-pet-in-small-animals-evaluation-using-a-3d-mode-micropet-scanner-and-impact-of-reconstruction-algorithms
#15
Genki Horitsugi, Tadashi Watabe, Yasukazu Kanai, Hayato Ikeda, Hiroki Kato, Sadahiro Naka, Mana Ishibashi, Keiko Matsunaga, Kayako Isohashi, Eku Shimosegawa, Jun Hatazawa
BACKGROUND: Positron emission tomography (PET) studies using (15)O-labeled CO2, O2, and CO have been used in humans to evaluate cerebral blood flow (CBF), the cerebral oxygen extraction fraction (OEF), and the cerebral metabolic rate of oxygen (CMRO2) and cerebral blood volume (CBV), respectively. In preclinical studies, however, PET studies using (15)O-labeled gases are not widely performed because of the technical difficulties associated with handling labeled gases with a short half-life...
October 27, 2017: EJNMMI Research
https://www.readbyqxmd.com/read/29056418/hemodynamic-effects-of-dexmedetomidine-with-and-without-mk-467-following-intramuscular-administration-in-cats-anesthetized-with-isoflurane
#16
Kristine T Siao, Bruno H Pypendop, Juhana Honkavaara, Jan E Ilkiw
OBJECTIVE: To characterize the hemodynamic effects of dexmedetomidine, with or without MK-467, following intramuscular (IM) administration in cats. STUDY DESIGN: Randomized, crossover, experimental study. ANIMALS: Six healthy adult male castrated purpose-bred cats. METHODS: Cats were anesthetized with isoflurane in oxygen and instrumented. Cats were administered dexmedetomidine (25 μg kg(-1)), with (DM) or without (D) MK-467 (600 μg kg(-1)), IM in the epaxial muscles...
May 4, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29054769/positive-end-expiratory-pressure-adjusted-for-intra-abdominal-pressure-a-pilot-study
#17
Adrian Regli, Bart Leon De Keulenaer, Annamaria Palermo, Peter Vernon van Heerden
PURPOSE: Intra-abdominal hypertension (IAH) is associated with impaired respiratory function. Animal data suggest that positive end-expiratory pressure (PEEP) levels adjusted to intra-abdominal pressure (IAP) levels may counteract IAH-induced respiratory dysfunction. In this pilot study, our aim was to assess whether PEEP adjusted for IAP can be applied safely in patients with IAH. MATERIALS AND METHODS: We included patients on mechanical ventilation and with IAH...
October 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29037800/clinical-comparison-of-dexmedetomidine-and-medetomidine-for-isoflurane-balanced-anaesthesia-in-horses
#18
Muriel Sacks, Simone K Ringer, Andrea S Bischofberger, Sabrina M Berchtold, Regula Bettschart-Wolfensberger
OBJECTIVE: To compare the effects of two balanced anaesthetic protocols (isoflurane-dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses. STUDY DESIGN: Prospective, blinded, randomized clinical study. ANIMALS: Sixty healthy adult warm blood horses undergoing elective surgery. METHODS: Thirty horses each were sedated with dexmedetomidine 3.5 μg kg(-1) (group DEX) or medetomidine 7 μg kg(-1) (group MED) intravenously...
April 26, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29034967/evaluation-of-a-method-for-isocapnic-hyperventilation-a-clinical-pilot-trial
#19
K Hallén, P Jildenstål, O Stenqvist, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) is a method that shortens time to extubation after inhalation anaesthesia using hyperventilation (HV) without lowering airway CO2 . In a clinical trial on patients undergoing long-duration sevoflurane anaesthesia for major ear-nose-throat (ENT) surgery, we evaluated the utility of a technique for CO2 delivery (DCO2 ) to the inspiratory limb of a closed breathing circuit, during HV, to achieve isocapnia. METHODS: Fifteen adult ASA 1-3 patients were included...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29033043/in%C3%A2-vivo-lung-perfusion-rehabilitates-sepsis-induced-lung-injury
#20
J Hunter Mehaffey, Eric J Charles, Sarah Schubert, Morgan Salmon, Ashish K Sharma, Dustin Money, Mark H Stoler, Victor E Laubach, Curtis G Tribble, Mark E Roeser, Irving L Kron
BACKGROUND: Sepsis is the leading cause of lung injury in adults and can lead to acute respiratory distress syndrome (ARDS). Using a novel technique of isolated in vivo lung perfusion (IVLP), we hypothesized that normothermic IVLP will improve oxygenation and compliance in a porcine model of sepsis-induced lung injury. METHODS: Mature adult swine (n = 8) were administered lipopolysaccharide (LPS; 50 μg/kg over 2 hours) via the external jugular vein, followed by sternotomy and central extracorporeal membrane oxygenation (ECMO) cannulation (right atrium to ascending aorta)...
September 14, 2017: Journal of Thoracic and Cardiovascular Surgery
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