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Ventilation in COPD

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https://www.readbyqxmd.com/read/27903208/early-experience-of-a-new-extracorporeal-carbon-dioxide-removal-device-for-acute-hypercapnic-respiratory-failure
#1
Ravindranath Tiruvoipati, Hergen Buscher, James Winearls, Jeff Breeding, Debasish Ghosh, Shimonti Chaterjee, Gary Braun, Eldho Paul, John F Fraser, John Botha
BACKGROUND: Recent advances in the technology of extracorporeal respiratory assist systems have led to a renewed interest in extracorporeal carbon dioxide removal (ECCOR). The Hemolung is a new, low-flow, venovenous, minimally invasive, partial ECCOR device that has recently been introduced to clinical practice to aid in avoiding invasive ventilation or to facilitate lung-protective ventilation. OBJECTIVE: We report our early experience on use, efficacy and safety of the Hemolung in three Australian intensive care units...
December 2016: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/27903026/-severe-hypercapnic-respiratory-failure-in-acute-exacerbation-of-copd-significance-of-ventilation-and-extracorporal-co2-removal
#2
Michael Westhoff, Martin Bachmann, Stephan Braune, Christian Karagiannidis, Stefan Kluge, Philipp M Lepper, Thomas Müller, Bernd Schönhofer
In acute exacerbations of COPD with acute hypercapnic respiratory failure and a pH 7.25 - 7.35, the initiation of non-invasive ventilation is the gold standard. However, absolute and relative contraindications have to be taken into account. The implementation of non-invasive ventilation in case of a severe respiratory acidosis necessitates a skilled therapeutic team and a close monitoring in order to avoid or perceive a NIV failure in time. In this case, the intubation and invasive mechanical ventilation is recommended...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27889330/use-of-biologics-to-treat-acute-exacerbations-and-manage-disease-in-asthma-copd-and-ipf
#3
REVIEW
Lynne A Murray, Chris Grainge, Peter A Wark, Darryl A Knight
A common feature of chronic respiratory disease is the progressive decline in lung function. The decline can be indolent, or it can be accelerated by acute exacerbations, whereby the patient experiences a pronounced worsening of disease symptoms. Moreover, acute exacerbations may also be a marker of insufficient disease management. The underlying cause of an acute exacerbation can be due to insults such as pathogens or environmental pollutants, or the cause can be unknown. For each acute exacerbation, the patient may require medical intervention such as rescue medication, or in more severe cases, hospitalization and ventilation and have an increased risk of death...
November 23, 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27888995/efficacy-of-non-invasive-ventilation-as-a-rescue-therapy-for-relieving-dyspnea-in-patients-with-stable-severe-copd
#4
Yong-Er Ou, Zhi-Min Lin, Wei-Liang Wu, Qun Luo, Rong-Chang Chen
Exertional Dyspnea is a troublesome symptom in chronic obstructive pulmonary disease (COPD) even after optimal therapy, which is a physiological and perceptional burden to limit their activities. Non-invasive ventilation (NIV) might provide rescue therapy for this population to relieve exertional dyspnea. This was a randomized crossover study in 18 patients with stable severe COPD. Exertional dyspnea was induced with maximal symptom-limited incremental cycle exercise. Then the patients would randomly receive oxygen or NIV plus oxygen therapy...
December 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27882425/assessment-of-regional-emphysema-air-trapping-and-xenon-ventilation-using-dual-energy-computed-tomography-in-chronic-obstructive-pulmonary-disease-patients
#5
Sang Min Lee, Joon Beom Seo, Hye Jeon Hwang, Namkug Kim, Sang Young Oh, Jae Seung Lee, Sei Won Lee, Yeon-Mok Oh, Tae Hoon Kim
OBJECTIVES: To compare the parenchymal attenuation change between inspiration/expiration CTs with dynamic ventilation change between xenon wash-in (WI) inspiration and wash-out (WO) expiration CTs. METHODS: 52 prospectively enrolled COPD patients underwent xenon ventilation dual-energy CT during WI and WO periods and pulmonary function tests (PFTs). The parenchymal attenuation parameters (emphysema index (EI), gas-trapping index (GTI) and air-trapping index (ATI)) and xenon ventilation parameters (xenon in WI (Xe-WI), xenon in WO (Xe-WO) and xenon dynamic (Xe-Dyna)) of whole lung and three divided areas (emphysema, hyperinflation and normal) were calculated on virtual non-contrast images and ventilation images...
November 23, 2016: European Radiology
https://www.readbyqxmd.com/read/27872166/consistency-of-medical-record-reporting-of-a-set-of-indicators-for-proactive-palliative-care-in-patients-with-chronic-obstructive-pulmonary-disease-a-pilot-study
#6
Ria G Duenk, Stans C Verhagen, Mireille Ae Janssen, Richard Pnr Dekhuijzen, Kris Cp Vissers, Yvonne Engels, Yvonne Heijdra
To identify patients hospitalized for an acute exacerbation of chronic obstructive pulmonary disease (COPD) who have a poor prognosis and might benefit from proactive palliative care, a set of indicators had been developed from the literature. A patient is considered eligible for proactive palliative care when meeting ≥2 criteria of the proposed set of 11 indicators. In order to develop a doctor-friendly and patient-convenient tool, our primary objective was to examine whether these indicators are documented consistently in the medical records...
November 21, 2016: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/27859552/low-pass-imaging-of-dynamic-acquisitions-lida-with-a-group-oriented-registration-goreg-for-proton-mr-imaging-of-lung-ventilation
#7
Andreas Voskrebenzev, Marcel Gutberlet, Till F Kaireit, Frank Wacker, Jens Vogel-Claussen
PURPOSE: To compare low-pass imaging dynamic acquisitions (LIDA) approach in combination with a group-oriented registration (GOREG) scheme with conventional Fourier decomposition (FD). METHODS: Dynamic images of six healthy volunteers and one chronic obstructive pulmonary disease (COPD) patient were acquired on a 1.5 Tesla scanner using a spoiled gradient echo sequence. For the volunteers each slice was acquired during regular (RB) and irregular breathing (IB). For conventional registration (CR), all images were directly registered to the intermediate respiratory position...
November 18, 2016: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/27853876/impact-of-non-invasive-ventilation-on-sympathetic-nerve-activity-in-chronic-obstructive-pulmonary-disease
#8
Helge Haarmann, Jan Folle, Xuan Phuc Nguyen, Peter Herrmann, Karsten Heusser, Gerd Hasenfuß, Stefan Andreas, Tobias Raupach
PURPOSE: Chronic obstructive pulmonary disease (COPD) is associated with elevated sympathetic nerve activity, which is probably linked to an increased cardiovascular risk, and may contribute to muscle dysfunction by heightened muscle vasoconstrictor drive. We hypothesized that resistive unloading of respiratory muscles by intermittent non-invasive ventilation (NIV) reduces sympathetic tone at rest and during subsequent handgrip exercise in patients with COPD. METHODS: Muscle sympathetic nerve activity (MSNA) in the peroneal nerve, heart rate, blood pressure, CO2, and SpO2 were continuously recorded in 5 COPD patients with intermittent NIV and 11 control COPD patients without NIV...
November 16, 2016: Lung
https://www.readbyqxmd.com/read/27842553/disharmony-between-wake-and-respiration-promoting-activities-effects-of-modafinil-on-ventilatory-control-in-rodents
#9
Jiro Terada, Isato Fukushi, Kotaro Takeda, Yohei Hasebe, Mieczyslaw Pokorski, Koichiro Tatsumi, Yasumasa Okada
BACKGROUND: Modafinil is a wake-promoting drug and has been widely used for daytime sleepiness in patients with narcolepsy and other sleep disorders. A recent case series reported that daily oral modafinil alleviated hypercapnic respiratory failure in patients with COPD. However, the precise action of modafinil on respiration such as hypercapnic and/or hypoxic ventilatory responses remains unclear. The aim of this study is to clarify the effect of modafinil on the ventilatory control...
November 14, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27842545/rising-total-costs-and-mortality-rates-associated-with-admissions-due-to-copd-exacerbations
#10
Nicolas Molinari, Pascal Chanez, Nicolas Roche, Engi Ahmed, Isabelle Vachier, Arnaud Bourdin
BACKGROUND: To examine trends in mortality, costs and in-hospital management and outcomes of severe COPD exacerbations admitted in France. METHODS: Patients hospitalized from 2007 to 2012 with COPD exacerbation as the primary diagnosis were identified from the exhaustive French medico-administrative hospitalizations database records. Four groups of severe COPD exacerbations were defined: hospitalisation in a general ward (GW) without acute respiratory failure (ARF), GW with ARF, ICU without invasive mechanical ventilation (MV), and ICU with MV...
November 14, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27836002/cardiac-dysfunction-induced-by-weaning-from-mechanical-ventilation-incidence-risk-factors-and-effects-of-fluid-removal
#11
Jinglun Liu, Feng Shen, Jean-Louis Teboul, Nadia Anguel, Alexandra Beurton, Nadia Bezaz, Christian Richard, Xavier Monnet
BACKGROUND: Weaning-induced pulmonary oedema (WiPO) is a well-recognised cause of failure of weaning from mechanical ventilation, but its incidence and risk factors have not been reliably described. We wanted to determine the incidence and risk factors in a population of critically ill patients. In addition, we wanted to describe the effects of diuretics when they are administered in this context. METHODS: We monitored 283 consecutive spontaneous breathing trials (SBT; T-piece trial) performed in 81 patients...
November 12, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27822114/danish-register-of-chronic-obstructive-pulmonary-disease
#12
REVIEW
Peter Lange, Sandra Søgaard Tøttenborg, Anne Dichmann Sorknæs, Jørgen Steen Andersen, Mette Søgaard, Henrik Nielsen, Reimar Wernich Thomsen, Katrine Abildtrup Nielsen
AIM OF DATABASE: The Danish Register of Chronic Obstructive Pulmonary Disease (DrCOPD) is a nationwide database aiming to describe the quality of treatment of all patients with chronic obstructive pulmonary disease (COPD) in Denmark. STUDY POPULATION: DrCOPD comprises data on all patients with a diagnosis of COPD. In the hospital setting, both in- and outpatients are included. In the setting of the general practice (GP), DrCOPD aims to include all patients with a COPD diagnosis who attend an annual control visit for COPD...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27815367/nasal-high-flow-therapy-reduces-work-of-breathing-compared-to-oxygen-during-sleep-in-copd-and-smoking-controls-prospective-observational-study
#13
Paolo Jose Cesare Biselli, Jason P Kirkness, Ludger Grote, Kathrin Fricke, Alan R Schwartz, Philip Lees Smith, Hartmut Schneider
RATIONALE: Patients with COPD endure excessive resistive and elastic loads leading to chronic respiratory failure. Oxygen supplementation corrects hypoxemia but is not expected to reduce mechanical loads. Nasal High Flow therapy (NHF) supports breathing by reducing dead space but it is unclear how it affects mechanical loads of patients with COPD. OBJECTIVE: To compare the effects of low-flow oxygen and NHF on ventilation and work of breathing (WOB) in patients with COPD and controls during sleep...
November 4, 2016: Journal of Applied Physiology
https://www.readbyqxmd.com/read/27807016/coexistence-of-osa-may-compensate-for-sleep-related-reduction-in-neural-respiratory-drive-in-patients-with-copd
#14
Bai-Ting He, Gan Lu, Si-Chang Xiao, Rui Chen, Joerg Steier, John Moxham, Michael I Polkey, Yuan-Ming Luo
BACKGROUND: The mechanisms underlying sleep-related hypoventilation in patients with coexisting COPD and obstructive sleep apnoea (OSA), an overlap syndrome, are incompletely understood. We compared neural respiratory drive expressed as diaphragm electromyogram (EMGdi) and ventilation during stage 2 sleep in patients with COPD alone and patients with overlap syndrome. METHODS: EMGdi and airflow were recorded during full polysomnography in 14 healthy subjects, 14 patients with OSA and 39 consecutive patients with COPD...
November 2, 2016: Thorax
https://www.readbyqxmd.com/read/27805309/positive-end-expiratory-pressure-titration-guided-by-plateau-pressure-in-chronic-obstructive-pulmonary-disease-patients
#15
Guopeng Liang, Zhongwei Zhang
BACKGROUND: PEEP decreases intrinsic PEEP (PEEPi) in COPD patients. However, the best PEEP for someone with COPD is unclear. METHODS: Ten COPD patients who received invasive mechanical ventilation were enrolled. Before PEEP titration, subjects were sedated and received mandatory ventilation. PEEP increased from 0 to 15 cmH2 O. At each PEEP, peak pressure (Ppeak), plateau pressure (Pplat), PEEPi, and other variables were recorded. Increment of Pplat (ΔPplat) and PEEPi were plotted against PEEP applied...
November 2, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27793158/clinical-and-echocardiographic-predictors-of-mortality-in-acute-pulmonary-embolism
#16
Talal Dahhan, Irfan Siddiqui, Victor F Tapson, Eric J Velazquez, Stephanie Sun, Clemontina A Davenport, Zainab Samad, Sudarshan Rajagopal
PURPOSE: The aim of this study was to evaluate the utility of adding quantitative assessments of cardiac function from echocardiography to clinical factors in predicting the outcome of patients with acute pulmonary embolism (PE). METHODS: Patients with a diagnosis of acute PE, based on a positive ventilation perfusion scan or computed tomography (CT) chest angiogram, were identified using the Duke University Hospital Database. Of these, 69 had echocardiograms within 24-48 h of the diagnosis that were suitable for offline analysis...
October 28, 2016: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27779551/does-exercise-ventilatory-inefficiency-predict-poor-outcome-in-heart-failure-patients-with-copd
#17
Maria Clara Alencar, Flavio F Arbex, Aline Souza, Adriana Mazzuco, Priscila A Sperandio, Alcides Rocha, Daniel M Hirai, Frederico Mancuso, Danilo C Berton, Audrey Borghi-Silva, Dirceu Almeida, Denis E OʼDonnel, J Alberto Neder
PURPOSE: To investigate whether the opposite effects of heart failure (HF) and chronic obstructive pulmonary disease (COPD) on exercise ventilatory inefficiency (minute ventilation [(Equation is included in full-text article.)E]-carbon dioxide output [(Equation is included in full-text article.)CO2] relationship) would negatively impact its prognostic relevance. METHODS: After treatment optimization and an incremental cardiopulmonary exercise test, 30 male patients with HF-COPD (forced expiratory volume in 1 second [FEV1] = 57% ± 17% predicted, ejection fraction = 35% ± 6%) were prospectively followed up during 412 ± 261 days for major cardiac events...
November 2016: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/27773350/global-end-diastolic-volume-index-vs-central-venous-pressure-goal-directed-fluid-resuscitation-for-chronic-obstructive-pulmonary-disease-patients-with-septic-shock-a-randomized-controlled-trial
#18
Jiangquan Yu, Ruiqiang Zheng, Hua Lin, Qihong Chen, Jun Shao, Daxin Wang
PURPOSE: This study aimed to investigate the clinical effects of early goal-directed therapy according to the global end-diastolic volume index (GEDI) on chronic obstructive pulmonary disease (COPD) patients with septic shock. METHODS: A total of 71 COPD patients with septic shock were randomly assigned to 2 groups. In the control group (n = 37), fluid resuscitation was performed based on the central venous pressure. In the study group (n = 34), fluid resuscitation was performed until GEDI reached 800 mL/m(2)...
October 8, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27770016/association-of-chronic-obstructive-pulmonary-disease-and-postresection-lung-cancer-survival-a-systematic-review-and-meta-analysis
#19
Lan-Eng Tan, Razak A M, Chor-Shen Lim
Patients with lung cancer often have chronic obstructive pulmonary disease (COPD), but the impact of COPD on postresection survival of patients with lung cancer is unclear. This study evaluated the impact of COPD on survival of patients with lung cancer following pulmonary resection. Databases searched included PubMed, Cochrane, and Embase until March 2016. Study outcomes were overall survival and pulmonary complication rate (pneumonia, bronchial fistula, and prolonged mechanical ventilation). 6 studies with a total of 3761 patients were included...
October 21, 2016: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/27761452/a-new-horizon-for-the-use-of-non-invasive-ventilation-in-patients-with-acute-respiratory-distress-syndrome
#20
COMMENT
Michele Carron
Non-invasive ventilation (NIV) has assumed an important role in the management of acute respiratory failure (ARF). NIV, compared with standard medical therapy, improves survival and reduces complications in selected patients with ARF. NIV represents the first-line intervention for some forms of ARF, such as chronic obstructive pulmonary disease (COPD) exacerbations and acute cardiogenic pulmonary edema. The use of NIV is also well supported for immunocompromised patients who are at high risk for infectious complications from endotracheal intubation...
September 2016: Annals of Translational Medicine
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