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Ventilation in COPD

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https://www.readbyqxmd.com/read/29135616/intermittent-extracorporeal-co2-removal-in-chronic-obstructive-pulmonary-disease-patients-a-fiction-or-an-option
#1
Francesco Alessandri, Francesco Pugliese, Luciana Mascia, Marco V Ranieri
PURPOSE OF REVIEW: Aim of this article is to review evidence recently generated on the application of extracorporeal carbon dioxide removal (ECCO2R) in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) requiring mechanical ventilation (invasive and non invasive) for hypercapnic respiratory failure. RECENT FINDINGS: To date, the paucity of evidences on ECCO2R to decrease the rate of noninvasive ventilation (NIV) failure and to wean hypercapnic patients from invasive mechanical ventilation (IMV) precludes to systematically apply this technology to COPD patients...
November 11, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29132514/ventilator-strategies-for-chronic-obstructive-pulmonary-disease-and-acute-respiratory-distress-syndrome
#2
REVIEW
Nathan T Mowery
The management of the ventilator in patients with chronic obstructive pulmonary disease (COPD) and acute respiratory distress syndrome (ARDS) has a dramatic effect on the overall outcome. The incidence of COPD is increasing as the US population grows older. The most effective means to deal with pulmonary complications is to avoid them, but both COPD and ARDS have evidence-based interventions that have been shown to improve outcomes. Pulmonary complications affect up to 40% of patients, and their occurrence is associated with an increased duration of hospital stay, and an increased mortality...
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29127842/budesonide-facilitates-weaning-from-mechanical-ventilation-in-difficult-to-wean-very-severe-copd-patients-association-with-inflammatory-mediators-and-cells
#3
Seyed Mohammadreza Hashemian, Esmaeil Mortaz, Hamidreza Jamaati, Leila Bagheri, Seyed Amir Mohajerani, Johan Garssen, Masoud Movassaghi, Peter J Barnes, Nicholas S Hill, Ian M Adcock
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients...
October 31, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29123390/hyperinflated-lungs-compress-the-heart-during-expiration-in-copd-patients-a-new-finding-on-dynamic-ventilation-computed-tomography
#4
Yanyan Xu, Tsuneo Yamashiro, Hiroshi Moriya, Maho Tsubakimoto, Nanae Tsuchiya, Yukihiro Nagatani, Shin Matsuoka, Sadayuki Murayama
Purpose: The aims of this study were to evaluate dynamic changes in heart size during the respiratory cycle using four-dimensional computed tomography (CT) and to understand the relationship of these changes to airflow limitation in smokers. Materials and methods: A total of 31 smokers, including 13 with COPD, underwent four-dimensional dynamic-ventilation CT during regular breathing. CT data were continuously reconstructed every 0.5 s, including maximum cross-sectional area (CSA) of the heart and mean lung density (MLD)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29092656/effect-of-anemia-on-mortality-in-mechanically-ventilated-patients-with-chronic-obstructive-pulmonary-disease
#5
Shruti K Gadre, Aravdeep Singh Jhand, Sami Abuqayyas, Xiaofeng Wang, Jorge Guzman, Abhijit Duggal
RATIONALE: The effect of anemia on patients with chronic obstructive pulmonary disease (COPD) requiring invasive mechanical ventilation for acute respiratory failure is unknown. OBJECTIVES: To examine the association between anemia (hemoglobin <12 g/dL) and 90-day and overall mortality in patients with COPD having acute respiratory failure requiring invasive mechanical ventilation. METHODS: Retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between October 2007 and December 2012 with a diagnosis of COPD and requiring invasive mechanical ventilation for acute respiratory failure of any cause...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29068643/diagnosis-and-management-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-digest
#6
Van Holden, Donald Slack Iii, Michael T McCurdy, Nirav G Shah, Nachi Gupta, Jeffrey Nusbaum
Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a clinical diagnosis that is based on changes in dyspnea, cough, and/or sputum production in a COPD patient; however, patients presenting with an acute exacerbation may be undiagnosed or have a variety of comorbid conditions that can complicate diagnosis. This issue presents strategies and algorithms for the early use of evidence-based interventions, including appropriate use of antibiotics, bronchodilators, and corticosteroids, along with noninvasive ventilation with capnography, to minimize morbidity and mortality associated with this disease...
October 20, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29066879/efficacy-of-long-term-noninvasive-positive-pressure-ventilation-in-stable-hypercapnic-copd-patients-with-respiratory-failure-a-meta-analysis-of-randomized-controlled-trials
#7
Hao Liao, Wendi Pei, Hongfu Li, Yuwen Luo, Kai Wang, Rui Li, Limei Xu, Xin Chen
INTRODUCTION: The efficacy of long-term noninvasive positive pressure ventilation (NPPV) in stable hypercapnic COPD patients with respiratory failure remains unclear. The aim of this meta-analysis was to critically assess the efficacy of long-term NPPV on mortality, acute exacerbation, exercise capacity, symptoms and significant physiological parameters (lung function, respiratory muscle function and gas exchange). PATIENTS AND METHODS: We performed an electronic literature search using the PubMed, Cochrane Library, Embase, OVID and Chinese Biomedical Literature Database in May 2017...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29062228/impact-and-prevention-of-severe-exacerbations-of-copd-a-review-of-the-evidence
#8
REVIEW
David Mg Halpin, Marc Miravitlles, Norbert Metzdorf, Bartolomé Celli
Severe exacerbations of COPD, ie, those leading to hospitalization, have profound clinical implications for patients and significant economic consequences for society. The prevalence and burden of severe COPD exacerbations remain high, despite recognition of the importance of exacerbation prevention and the availability of new treatment options. Severe COPD exacerbations are associated with high mortality, have negative impact on quality of life, are linked to cardiovascular complications, and are a significant burden on the health-care system...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29059648/determine-the-effectiveness-of-lipid-lowering-therapy-in-patients-with-chronic-obstructive-pulmonary-disease-combined-with-coronary-heart-disease
#9
Vyacheslav Zhdan, Galina Khaymenova, Lyudmila Shilkina, Daria Martynyuk, Marina Babanina, Tatyana Mamontova
INTRODUCTION: In complex treatment of chronic obstructive pulmonary disease (COPD) combined with ischemic heart disease (IHD) more and more attention is drawn to pleiotropic effect of statins. The aim of our researches became determining the effectivity of utilization of rosuvastatin (CRESTOR®, IPR PHARMACEUTICALS, Inc.) in complex treatment of COPD combined with IHD. MATERIALS AND METHODS: Basing on pulmonology department of Poltava regional clinical hospital, 30 patients with COPD combined with IHD have been examined (stable effort angina FC II) aged from 51 to 67 y...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29053337/obesity-and-severity-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease
#10
Tadahiro Goto, Atsushi Hirayama, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
RATIONALE: Obesity is relatively common among individuals with chronic obstructive pulmonary disease (COPD). However, little is known about the association of obesity with severity of acute exacerbation of COPD (AECOPD) and in-hospital mortality. OBJECTIVES: To examine the association of obesity with severity markers of AECOPD and in-hospital mortality. METHODS: This is a retrospective cohort study using population-based data - the 2012-2013 State Inpatient Databases - of seven US states (Arkansas, Florida, Iowa, Nebraska, New York, Utah, and Washington)...
October 20, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29051274/effect-of-morphine-on-breathlessness-and-exercise-endurance-in-advanced-copd-a%C3%A2-randomised-crossover-trial
#11
Sara J Abdallah, Courtney Wilkinson-Maitland, Nathalie Saad, Pei Zhi Li, Benjamin M Smith, Jean Bourbeau, Dennis Jensen
The objective of the present study was to evaluate the effect of morphine on exertional breathlessness and exercise endurance in advanced chronic obstructive pulmonary disease (COPD).In a randomised crossover trial, we compared the acute effect of immediate-release oral morphine versus placebo on physiological and perceptual responses during constant-load cardiopulmonary cycle exercise testing (CPET) in 20 adults with advanced COPD and chronic breathlessness syndrome.Compared with placebo, morphine reduced exertional breathlessness at isotime by 1...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29051040/on-the-potential-role-of-mri-biomarkers-of-copd-to-guide-bronchoscopic-lung-volume-reduction
#12
Colin J Adams, Dante P I Capaldi, Robert Di Cesare, David G McCormack, Grace Parraga
RATIONALE AND OBJECTIVES: In patients with severe emphysema and poor quality of life, bronchoscopic lung volume reduction (BLVR) may be considered and guided based on lobar emphysema severity. In particular, x-ray computed tomography (CT) emphysema measurements are used to identify the most diseased and the second-most diseased lobes as BLVR targets. Inhaled gas magnetic resonance imaging (MRI) also provides chronic obstructive pulmonary disease (COPD) biomarkers of lobar emphysema and ventilation abnormalities...
October 16, 2017: Academic Radiology
https://www.readbyqxmd.com/read/29042486/parameters-for-simulation-of-adult-patients-during-mechanical-ventilation
#13
Jean-Michel Arnal, Aude Garnero, Mathieu Saoli, Robert L Chatburn
BACKGROUND: Simulation studies are often used to examine ventilator performance. However, there are no standards for selecting simulation parameters. This study collected data in passively-ventilated adult human subjects and summarized the results as a set of parameters that can be used for simulation studies of intubated, passive, adult subjects with normal lungs, COPD, or ARDS. METHODS: Consecutive adult patients admitted to the ICU were included if they were deeply sedated and mechanically ventilated for <48 h without any spontaneous breathing activity...
October 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29040482/strategies-to-reduce-pulmonary-complications-after-transhiatal-esophagectomy
#14
A M Gillinov, R F Heitmiller
Background: By eliminating a thoracotomy, transhiatal esophagectomy (THE) is purported to reduce postoperative pulmonary complications. However, data from many early series do not support this contention, documenting pulmonary complications in up to 50% of patients and pneumonia in 5%-20%. Since 1990, we have implemented a management strategy designed to maximize airway protection in the postoperative period. The purpose of this study was to determine the current incidence of pulmonary complications after transhiatal esophagectomy without thoracotomy...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29036955/-comparision-of-risk-factors-and-pathogens-in-patients-with-early-and-late-onset-ventilator-associated-pneumonia-in-intensive-care-unit
#15
Y J Liang, Z L Li, L Wang, B Y Liu, R Y Ding, X C Ma
Objective: To compare risk factors and bacterial etiology in patients with early-onset versus late-onset ventilator-associated pneumonia (VAP) in intensive care unit (ICU). Methods: This prospective cohort study enrolled mechanically ventilated patients hospitalized for more than 48 hours in the first affiliated hospital, China Medical University from Jan 2012 to Jun 2016. Subjects were classified by ventilator status: early-onset VAP (< 5 d ventilation, E-VAP) or late-onset VAP (≥ 5 d ventilation, L-VAP)...
October 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29018832/pharyngeal-myiasis-caused-by-sheep-botfly-oestrus-ovis-diptera-oestridae-larva-tabriz-east-azarbaijan-province-iran-a-case-report
#16
Teimour Hazratian, Ali Tagizadeh, Mohammad Chaichi, Madineh Abbasi
Myiasis is caused by the larvae of flies infesting animal or human tissues and organs. This report aims to present a case of pharyngeal myiasis caused by the larvae of Oestrus ovis (Diptera: Oestridae). A 55-yr old drug addict living in the Shahindeje village of Western Azerbaijan Province, northwestern Iran was referred to the Emam Reza Hospital in Tabriz, having a medical history of Chronic Obstructive Pulmonary Disease (COPD) and hospitalized due to respiratory distress, 20 days ago. He was intubated with a mechanical ventilator (MV) because of his respiratory distress condition...
March 2017: Journal of Arthropod-borne Diseases
https://www.readbyqxmd.com/read/28994328/th17-treg-immunoregulation-and-implications-in-treatment-of-sulfur-mustard-gas-induced-lung-diseases
#17
Maryam Iman, Ramazan Rezaei, Sadegh Azimzadeh Jamalkandi, Parvin Shariati, Farrah Kheradmand, Jafar Salimian
Sulfur mustard (SM) is an extremely toxic gas used in chemical warfare to cause massive lung injury and death. Victims exposed to SM gas acutely present with inhalational lung injury, but among those who survive, some develop obstructive airway diseases referred to as SM-lung syndrome. Pathophysiologically, SM-lung shares many characteristics with smoking-induced chronic obstructive pulmonary disease (COPD), including airway remodeling, goblet cell metaplasia, and obstructive ventilation defect. Some of the hallmarks of COPD pathogenesis, which include dysregulated lung inflammation, neutrophilia, recruitment of interleukin 17A (IL -17A) expressing CD4(+)T cells (Th17), and the paucity of lung regulatory T cells (Tregs), have also been described in SM-lung...
December 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28993264/sensory-mechanical-effects-of-a-dual-bronchodilator-and-its-anticholinergic-component-in-copd
#18
Denis E O'Donnell, Amany F Elbehairy, Azmy Faisal, J Alberto Neder, Katherine A Webb
This randomized, double-blind, crossover study examined the physiological rationale for using a dual long-acting bronchodilator (umeclidinium/vilanterol (UME/VIL)) versus its muscarinic-antagonist component (UME) as treatment for dyspnea and exercise intolerance in moderate COPD. After each 4-week treatment period, subjects performed pulmonary function and symptom-limited constant-work rate cycling tests with diaphragm electromyogram (EMGdi), esophageal (Pes), gastric (Pga) and transdiaphragmatic (Pdi) pressure measurements...
October 7, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28974646/factors-associated-with-re-intubation-within-14-days-after-ventilator-liberation
#19
Chia-Chen Chu, Chin-Jung Liu, Suh-May Yen, Wen-Yu Chou, Pei-Tseng Kung, Yuh-Show Tsai, Wen-Chen Tsai
BACKGROUND: According to Taiwan's integrated delivery system policy, ventilator-dependent patients are successfully liberated from mechanical ventilation in accordance with step-down care. However, premature discharge affects the 14-d readmission quality index. Therefore, we explored the risk and related factors of subjects liberated from mechanical ventilation who were re-intubated within 14 d. METHODS: This retrospective study analyzed a cohort of ventilator-dependent subjects 17 y of age and older using a population-based database from the Taiwan National Health Research Institutes Database from 2006 to 2010...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28972817/free-breathing-dynamic-19-f-gas-mr-imaging-for-mapping-of-regional-lung-ventilation-in-patients-with-copd
#20
Marcel Gutberlet, Till F Kaireit, Andreas Voskrebenzev, Florian Lasch, Julia Freise, Tobias Welte, Frank Wacker, Jens M Hohlfeld, Jens Vogel-Claussen
Purpose To quantify regional lung ventilation in patients with chronic obstructive pulmonary disease (COPD) by using free-breathing dynamic fluorinated (fluorine 19 [(19)F]) gas magnetic resonance (MR) imaging. Materials and Methods In this institutional review board-approved prospective study, 27 patients with COPD were examined by using breath-hold (19)F gas wash-in MR imaging during inhalation of a normoxic fluorinated gas mixture (perfluoropropane) and by using free-breathing dynamic (19)F gas washout MR imaging after inhalation of the gas mixture was finished for a total of 25-30 L...
October 3, 2017: Radiology
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