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Ventilation in COPD

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https://www.readbyqxmd.com/read/28814848/pathophysiological-mechanism-of-long-term-noninvasive-ventilation-in-stable-hypercapnic-patients-with-copd-using-functional-respiratory-imaging
#1
Bita Hajian, Jan De Backer, Claire Sneyers, Francisca Ferreira, Katherine C Barboza, Glenn Leemans, Wim Vos, Wilfried De Backer
INTRODUCTION: Patients with severe COPD often develop chronic hypercapnic respiratory failure. Their prognosis worsens and they are more likely to develop exacerbations. This has major influence on the health-related quality of life. Currently, there is no information about the success of long-term noninvasive ventilation (NIV) among patients who receive NIV in acute settings. Also, little is known about the pathophysiological mechanism of NIV. METHODS: Ten Global Initiative for Obstructive Lung Disease stage III and IV COPD patients with respiratory failure who were hospitalized following acute exacerbation were treated with NIV using a Synchrony BiPAP device for 6 months...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28812150/respiratory-complications-after-colonic-procedures-in-chronic-obstructive-pulmonary-disease-does-laparoscopy-offer-a-benefit
#2
Sarath Sujatha-Bhaskar, Reza Fazl Alizadeh, Colette S Inaba, Christina Y Koh, Mehraneh D Jafari, Steven D Mills, Joseph C Carmichael, Michael J Stamos, Alessio Pigazzi
BACKGROUND: Patients with severe chronic obstructive pulmonary disease (COPD) are at a higher risk for postoperative respiratory complications. Despite the benefits of a minimally invasive approach, laparoscopic pneumoperitoneum can substantially reduce functional residual capacity and raise alveolar dead space, potentially increasing the risk of respiratory failure which may be poorly tolerated by COPD patients. This raises controversy as to whether open techniques should be preferentially employed in this population...
August 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28810276/-home-mechanical-ventilation-concepts-and-therapy-recommendations
#3
Sarah Bettina Schwarz, Friederike Sophie Magnet, Bernd Schönhofer, Wolfram Windisch
The prognosis of patients receiving home mechanical ventilation is very heterogeneous and depends on the underlying disease, the degree of respiratory dependency and the comorbidities. Due to the severe chronic diseases, the initiation of a long-term NIV must be done during an inpatient treatment. Two recently published randomized controlled trials using more aggressive forms of NPPV targeted at normalizing hypercapnic PaCO2 values, showed improved long term survival also in patients with an underlying diagnosis of COPD...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28795334/mathematical-modeling-of-extracorporeal-co2-removal-therapy-a-validation-carried-out-on-ten-pigs
#4
Simon Habran, Thomas Desaive, Philippe Morimont, Bernard Lambermont, Pierre Dauby
The extracorporeal CO2 removal device (ECCO2RD) is used in clinics to treat patients suffering from respiratory failures like acute respiratory distress syndrome (ARDS) or chronic obstructive pulmonary disease (COPD). The aim of this device is to decarboxylate blood externally with low blood flow. A mathematical model is proposed to describe protective ventilation, ARDS, and an extracorporeal CO2 removal therapy (ECCO2RT). The simulations are compared with experimental data carried out on ten pigs. The results show a good agreement between the mathematical simulations and the experimental data, which provides a nice validation of the model...
August 9, 2017: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/28790813/asynchrony-in-respiratory-movements-between-the-pulmonary-lobes-in-patients-with-copd-continuous-measurement-of-lung-density-by-4-dimensional-dynamic-ventilation-ct
#5
Tsuneo Yamashiro, Hiroshi Moriya, Shin Matsuoka, Yukihiro Nagatani, Maho Tsubakimoto, Nanae Tsuchiya, Sadayuki Murayama
PURPOSE: Four-dimensional dynamic-ventilation CT imaging demonstrates continuous movement of the lung. The aim of this study was to assess the correlation between interlobar synchrony in lung density and spirometric values in COPD patients and smokers, by measuring the continuous changes in lung density during respiration on the dynamic-ventilation CT. MATERIALS AND METHODS: Thirty-two smokers, including ten with COPD, underwent dynamic-ventilation CT during free breathing...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28790180/pseudomonas-aeruginosa-lasb-protease-impairs-innate-immunity-in-mice-and-humans-by-targeting-a-lung-epithelial-cystic-fibrosis-transmembrane-regulator-il-6-antimicrobial-repair-pathway
#6
Vinciane Saint-Criq, Bérengère Villeret, Fabien Bastaert, Saadé Kheir, Aurélie Hatton, Aurélie Cazes, Zhou Xing, Isabelle Sermet-Gaudelus, Ignacio Garcia-Verdugo, Aleksander Edelman, Jean-Michel Sallenave
BACKGROUND: Pseudomonas aeruginosa lung infections are a huge problem in ventilator-associated pneumonia, cystic fibrosis (CF) and in chronic obstructive pulmonary disease (COPD) exacerbations. This bacterium secretes virulence factors that may subvert host innate immunity. OBJECTIVE: We evaluated the effect of P. aeruginosa elastase LasB, an important virulence factor secreted by the type II secretion system, on ion transport, innate immune responses and epithelial repair, both in vitro and in vivo...
August 8, 2017: Thorax
https://www.readbyqxmd.com/read/28780877/-identification-of-risk-factors-of-multiresistant-infections-on-two-intensive-care-units
#7
Marcell Szabó, Noémi Kanász, Katalin Darvas, János Gál
INTRODUCTION: Intensive care units are favourable environment for infections, many of them are caused by antibiotic resistant bacteria. AIM: Identifying risk factors of ICU-acquired multiresistant infections. METHOD: We performed observational study on two academic intensive care units (a multidisciplinary and a surgical ICU) between 01/09/2014 and 30/11/2015. Patients with a first infection caused by predefined organisms (P. aeruginosa, E...
August 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28776915/invasive-out-of-hospital-ventilation-emergencies-and-outcome-an-observational-study-over-a-1-year-period
#8
Sven Stieglitz, Sandhya Matthes, Ilona Kietzmann, Christina Priegnitz, Lars Hagmeyer, Winfried Randerath
OBJECTIVES: The number of ventilated patients is further increasing which leads to an increasing number of patients with weaning failure. In Germany, the treatment of patients with invasive out-of-hospital becomes more and more common. The aim of the study was to observe the outcome, the frequency and character of emergencies of patients with invasive out-of-hospital ventilation. METHODS: We conducted a prospective study over 1 year. 59 invasively ventilated patients living either at home or at nursing homes specialized in ventilator medicine were included...
August 4, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28775071/the-acute-effects-of-long-acting-bronchodilators-on-small-airways-detected-in-copd-patients-by-single-breath-n2-test-and-lung-p-v-curve
#9
Matteo M Pecchiari, Pierachille Santus, Dejan Radovanovic, Edgardo Giacomo D'Angelo
Small airways represent the key factor of chronic obstructive pulmonary disease (COPD) pathophysiology. The effect of different classes of bronchodilators on small airways is still poorly understood and difficult to assess. Hence, the acute effects of tiotropium (18 µg) and indacaterol (150 µg) on closing volume (CV) and ventilation inhomogeneity were investigated and compared in 51 stable patients (mean age (SD): 70±7 years; 82% males) with moderate to very severe COPD. Patients underwent body-plethysmography, arterial blood gas-analysis, tidal expiratory flow limitation (EFL), dyspnea assessment, and simultaneous recording of single breath nitrogen test (SBN) and transpulmonary pressure-volume curve (PL-V), before and one hour after drug administration...
August 3, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28774205/effect-of-respiratory-rehabilitation-techniques-on-the-autonomic-function-in-patients-with-chronic-obstructive-pulmonary-disease-a-systematic-review
#10
Jibril Mohammed, Hellen Da Silva, Jessica Van Oosterwijck, Patrick Calders
Patients with chronic obstructive pulmonary disease (COPD) show several extrapulmonary abnormalities such as impairment in the autonomic function (AF). Similarly, the use of respiratory training techniques such as controlled breathing techniques, noninvasive mechanical ventilation (NIMV), and oxygen supplementation for AF modulation in patients with COPD is popular in existing literature. However, the evidence to support their use is nonexistent. A systematic search of studies reporting on the effect of controlled breathing techniques, NIMV, and/or oxygen supplementation techniques on AF outcome parameters was conducted in three online databases: PubMed, Embase, and Web of Science...
August 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28765496/impact-of-a-post-discharge-integrated-disease-management-program-on-copd-hospital-readmissions
#11
Ashlee N Russo, Gayathri Sathiyamoorthy, Chris Lau, Didem Saygin, Xiaozhen Han, Xiao-Feng Wang, Richard Rice, Loutfi S Aboussouan, James K Stoller, Umur Hatipoğlu
BACKGROUND: Readmission following a hospitalization for COPD is associated with significant health-care expenditure. METHODS: A multicomponent COPD post-discharge integrated disease management program was implemented at the Cleveland Clinic to improve the care of patients with COPD and reduce readmissions. This retrospective study reports our experience with the program. Groups of subjects who were exposed to different components of the program were compared regarding their readmission rates...
August 1, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28765494/effects-of-expiratory-positive-airway-pressure-on-exercise-tolerance-dynamic-hyperinflation-and-dyspnea-in-copd
#12
Ricardo Gass, Pietro Merola, Mariane B Monteiro, Dannuey M Cardoso, Dulciane N Paiva, Paulo Jz Teixeira, Marli M Knorst, Danilo C Berton
INTRODUCTION: The application of expiratory positive airway pressure (EPAP) in patients with COPD during exercise may reduce dynamic hyperinflation, while, on the other hand, it can increase the resistive work of breathing. Therefore, we evaluated the effects of 2 intensities of EPAP during exercise on tolerance, dynamic hyperinflation, and dyspnea in subjects with moderate to very severe COPD. METHODS: We performed a cross-sectional, experimental, 4-visit study...
August 1, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28750180/association-between-inspiratory-muscle-weakness-and-slowed-oxygen-uptake-kinetics-in-patients-with-chronic-obstructive-pulmonary-disease
#13
Andiara Wolpat, Francisco V Lima, Fabiola M Silva, Micheli Tochetto, Andressa Freitas, Tatiane Grandi, Leonardo Rodrigues, Verônica Paiva, Gerson Cipriano, Adriana M Chiappa, Julio Zago, Gaspar R Chiappa
INTRODUCTION: Patients with chronic obstructive pulmonary disease (COPD) may have poor inspiratory muscle function, which reduces minute and alveolar ventilation, leading to increased hypoxemia and slow pulmonary oxygen uptake ( O2) kinetics. However, little is known about the effect of inspiratory muscle weakness (IMW) on oxygen uptake kinetics in patients with COPD. Thus, we tested the hypothesis that COPD patients with IMW have slowed O2 kinetics. METHODS: An observational study was conducted including COPD patients with moderate to severe airflow limitation and a history of intolerance to exercise...
July 27, 2017: Applied Physiology, Nutrition, and Metabolism, Physiologie Appliquée, Nutrition et Métabolisme
https://www.readbyqxmd.com/read/28741217/effects-of-non-invasive-ventilation-in-patients-with-acute-respiratory-failure-excluding-post-extubation-respiratory-failure-cardiogenic-pulmonary-edema-and-exacerbation-of-copd-a-systematic-review-and-meta-analysis
#14
Yutaka Kondo, Junji Kumasawa, Atsushi Kawaguchi, Ryutaro Seo, Eishu Nango, Satoru Hashimoto
BACKGROUND: This meta-analysis compared the effects of non-invasive ventilation (NIV) with invasive mechanical ventilation (InMV) and standard oxygen (O2) therapy on mortality and rate of tracheal intubation in patients presenting acute respiratory failure (ARF). METHODS: We searched the MEDLINE, EMBASE and Cochrane Central Register of clinical trials databases between 1949 and May 2015 to identify randomized trials of NIV for ARF. We excluded the ARF caused by extubation, cardiogenic pulmonary edema, and COPD...
July 24, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28729471/hypoxic-vascular-response-and-ventilation-perfusion-matching-in-end-stage-copd-may-depend-on-p22phox
#15
Chandran Nagaraj, Christoph Tabeling, Bence M Nagy, Pritesh P Jain, Leigh M Marsh, Rita Papp, Michael Pienn, Martin Witzenrath, Bahil Ghanim, Walter Klepetko, E Kenneth Weir, Stefan Heschl, Grazyna Kwapiszewska, Andrea Olschewski, Horst Olschewski
Chronic obstructive pulmonary disease (COPD) is a heterogeneous disease in which the amount of emphysema and airway disease may be very different between individuals, even in end-stage disease. Emphysema formation may be linked to the involvement of the small pulmonary vessels. The NAPDH oxidase (Nox) family is emerging as a key disease-related factor in vascular diseases, but currently its role in hypoxia-induced pulmonary remodelling in COPD remains unclear.Here we investigate the role of p22phox, a regulatory subunit of Nox, in COPD lungs, hypoxic pulmonary vasoconstriction (HPV), hypoxia-induced pulmonary vascular remodelling and pulmonary hypertension...
July 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28721033/interfaces-and-ventilator-settings-for-long-term-noninvasive-ventilation-in-copd-patients
#16
Jens Callegari, Friederike Sophie Magnet, Steven Taubner, Melanie Berger, Sarah Bettina Schwarz, Wolfram Windisch, Jan Hendrik Storre
INTRODUCTION: The establishment of high-intensity (HI) noninvasive ventilation (NIV) that targets elevated PaCO2 has led to an increase in the use of long-term NIV to treat patients with chronic hypercapnic COPD. However, the role of the ventilation interface, especially in more aggressive ventilation strategies, has not been systematically assessed. METHODS: Ventilator settings and NIV compliance were assessed in this prospective cross-sectional monocentric cohort study of COPD patients with pre-existing NIV...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28719228/successful-use-of-noninvasive-ventilation-in-chronic-obstructive-pulmonary-disease-how-do-high-performing-hospitals-do-it
#17
Kimberly A Fisher, Kathleen M Mazor, Sarah Goff, Mihaela S Stefan, Penelope S Pekow, Lauren A Williams, Vida Rastegar, Michael B Rothberg, Nicholas S Hill, Peter K Lindenauer
RATIONALE: Noninvasive ventilation (NIV) is a cornerstone of treatment for patients with severe exacerbations of chronic obstructive pulmonary disease (COPD) where it has been shown to reduce the need for intubation, hospital length of stay, and mortality. Despite high quality evidence and strong recommendations in clinical guidelines, use of NIV varies widely across hospitals. OBJECTIVE: To identify approaches used by hospitals which have been successful in implementing NIV to treat patients with severe exacerbations of COPD...
July 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28711381/effectiveness-assessment-of-a-guideline-based-protocol-for-ventilatory-support-management-of-copd-exacerbations-in-an-emergency-department
#18
Franciele Plachi, Fernando Nataniel Vieira, Danilo Cortozi Berton, Marli Knorst, Alexandre Simões Dias, Fernanda Machado Balzan
OBJECTIVES: To investigate clinical outcomes according to ventilatory support indication in subjects with chronic obstructive pulmonary disease exacerbation in a "real-life" Emergency Department and to analyze potential predictors of successful noninvasive positive pressure ventilation. METHODS: Retrospective cohort performed over an 18-month period, comparing the following patient groups with chronic obstructive pulmonary disease exacerbation: Group A composed of patients initially selected to receive noninvasive positive pressure ventilation without the subsequent need for invasive mechanical ventilation (successful-noninvasive positive pressure ventilation); Group B composed of patients transitioning from noninvasive positive pressure ventilation to invasive mechanical ventilation (failed-noninvasive positive pressure ventilation); and Group C composed of patients who presented with immediate need for invasive mechanical ventilation (without prior noninvasive positive pressure ventilation)...
July 5, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28707030/-update-acute-hypercapnic-respiratory-failure
#19
REVIEW
F Seiler, F C Trudzinski, M Kredel, C Lotz, P M Lepper, R M Muellenbach
BACKGROUND: Hypercapnic respiratory failure is a frequent problem in critical care and mainly affects patients with acute exacerbation of COPD (AECOPD) and acute respiratory distress syndrome (ARDS). In recent years, the usage of extracorporeal CO2 removal (ECCO2R) has been increasing. OBJECTIVE: Summarizing the state of the art in the management of hypercapnic respiratory failure with special regard to the role of ECCO2R. METHODS: Review based on a selective literature search and the clinical and scientific experience of the authors...
July 13, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28702957/non-invasive-ventilation-for-the-management-of-acute-hypercapnic-respiratory-failure-due-to-exacerbation-of-chronic-obstructive-pulmonary-disease
#20
REVIEW
Christian R Osadnik, Vanessa S Tee, Kristin V Carson-Chahhoud, Joanna Picot, Jadwiga A Wedzicha, Brian J Smith
BACKGROUND: Non-invasive ventilation (NIV) with bi-level positive airway pressure (BiPAP) is commonly used to treat patients admitted to hospital with acute hypercapnic respiratory failure (AHRF) secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). OBJECTIVES: To compare the efficacy of NIV applied in conjunction with usual care versus usual care involving no mechanical ventilation alone in adults with AHRF due to AECOPD. The aim of this review is to update the evidence base with the goals of supporting clinical practice and providing recommendations for future evaluation and research...
July 13, 2017: Cochrane Database of Systematic Reviews
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