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Ventilation in COPD

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https://www.readbyqxmd.com/read/29780244/severity-of-acidosis-affects-long-term-survival-in-copd-patients-with-hypoxemia-after-intensive-care-unit-discharge
#1
Sinem Gungor, Feyza Kargin, Ilim Irmak, Fulya Ciyiltepe, Eylem Acartürk Tunçay, Pinar Atagun Guney, Emine Aksoy, Birsen Ocakli, Nalan Adiguzel, Zuhal Karakurt
Background: Patients admitted to the intensive care unit (ICU) with acute respiratory failure (ARF) due to COPD have high mortality and morbidity. Acidosis has several harmful effects on hemodynamics and metabolism, and the current knowledge regarding the relationship between respiratory acidosis severity on the short- and long-term survival of COPD patients is limited. We hypothesized that COPD patients with severe acidosis would have a poorer short- and long-term prognosis compared with COPD patients with mild-to-moderate acidosis...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29724917/reductions-in-dead-space-ventilation-with-nasal-high-flow-depend-on-physiologic-dead-space-volume-metabolic-hood-measurements-during-sleep-in-patients-with-copd-and-controls
#2
Paolo Biselli, Kathrin Fricke, Ludger Grote, Andrew T Braun, Jason Kirkness, Philip Smith, Alan Schwartz, Hartmut Schneider
Background: Nasal high flow (NHF) reduces minute ventilation and ventilatory loads during sleep but mechanisms are not clear. We hypothesized NHF reduces ventilation in proportion of the physiologic but not anatomic dead space. Methods: 11 subjects (5 Controls and 6 COPD) underwent a polysomnography with transcutaneous CO2 (tcCO2 ) monitoring under a metabolic hood. During stable NREM 2 sleep, subjects received NHF (20 L/min) intermittently for periods of 5-10 min. We measured CO2 production and calculated dead space ventilation...
May 3, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29708848/clostridium-difficile-infection-in-trauma-surgery-and-medical-patients-admitted-to-the-intensive-care-unit
#3
Richard R Watkins, Caroline Mangira, Farid Muakkassa, Curtis J Donskey, Nairmeen A Haller
BACKGROUND: Clostridium difficile infection (CDI) causes significant morbidity and mortality rates, especially for patients in the intensive care unit (ICU). Data comparing trauma and surgery patients with CDI in the ICU with medical patients with CDI in the ICU are limited. METHODS: In a single-center study, we analyzed retrospective data from 25 trauma patients and 13 surgery patients aged 18 years or older who had CDI and had been admitted to the ICU. A comparison group of 156 medical patients aged 18 years or greater who had CDI and were admitted to the ICU also was identified...
April 30, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29705781/the-respiratory-overlap-syndrome-efficacy-and-usefulness-of-the-combined-double-bronchodilation
#4
Albino Petrone, Filippo Luca Fimognari, Francesco Mormile, Leonello Fuso, Michela Quartieri, Ludovico Petrone, Francesco Romano
The coexistence of chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea syndrome in a single patient is known as "overlap syndrome," and worsens the prognosis of the affected subjects. A marked bronchodilation may be useful for the treatment of this condition. In fact, as stated in the GOLD 2017 guidelines, the combination of indacaterol/glycopyrronium may exert positive synergistic effects on smooth muscle cell and airway resistance, with a more pronounced efficiency in reducing lung hyperinflation...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29703009/acute-respiratory-failure-requiring-mechanical-ventilation-in-severe-chronic-obstructive-pulmonary-disease-copd
#5
Shruti K Gadre, Abhijit Duggal, Eduardo Mireles-Cabodevila, Sudhir Krishnan, Xiao-Feng Wang, Katrina Zell, Jorge Guzman
There are limited data on the epidemiology of acute respiratory failure necessitating mechanical ventilation in patients with severe chronic obstructive pulmonary disease (COPD). The prognosis of acute respiratory failure requiring invasive mechanical ventilation is believed to be grim in this population. The purpose of this study was to illustrate the epidemiologic characteristics and outcomes of patients with underlying severe COPD requiring mechanical ventilation.A retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between January 2008 and December 2012 with a diagnosis of severe COPD and requiring invasive mechanical ventilation for acute respiratory failure...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29699825/chronic-obstructive-pulmonary-disease-is-associated-with-short-term-complications-following-total-knee-arthroplasty
#6
George A Yakubek, Gannon L Curtis, Anton Khlopas, Mhamad Faour, Alison K Klika, Michael A Mont, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major global health issue and a leading cause of morbidity and mortality. Patients with COPD are at increased risk of complications following surgery. The purpose of this study is to evaluate the postoperative total knee arthroplasty (TKA) outcomes in these patients in comparison to a non-COPD matching cohort. Specifically, we asked the following questions: (1) "Is COPD associated with adverse perioperative outcomes?" and (2) "Does COPD increase the risk of short-term complications following TKA?" METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 111,168 patients who underwent TKA between 2008 and 2014...
March 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29692351/intrapulmonary-percussive-ventilation-as-an-airway-clearance-technique-in-subjects-with-chronic-obstructive-airway-diseases
#7
REVIEW
Gregory Reychler, Emilie Debier, Olivier Contal, Nicolas Audag
BACKGROUND: Airway clearance techniques are regularly proposed as a part of the treatment in chronic obstructive airway diseases. Intrapulmonary percussive ventilation (IPV) is used as an airway clearance technique in patients affected by excessive lung secretions. The aim of this systematic review is to summarize the physiological and clinical effects related to the use of IPV as an airway clearance technique in chronic obstructive airway diseases. METHODS: This systematic review followed the PRISMA guidelines...
April 24, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29687438/sleep-in-critically-ill-mechanically-ventilated-patients-with-severe-sepsis-or-copd
#8
Y Boyko, P Jennum, H Oerding, J T Lauridsen, M Nikolic, P Toft
BACKGROUND: The standard method for scoring polysomnographic (PSG) sleep is insufficient in the intensive care unit (ICU). A modified classification has been proposed, but has not been tested in specific groups of ICU patients. We aimed firstly to (1) use the modified classification to describe sleep in two groups of ICU patients: a severe sepsis group and a chronic obstructive pulmonary disease (COPD) group, and (2) to compare sleep stage distribution in the groups; secondly to compare the PSG findings with nurses' sleep evaluation...
April 23, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29685118/predictors-of-post-stroke-fever-and-infections-a-systematic-review-and-meta-analysis
#9
Maja Wästfelt, Yang Cao, Jakob O Ström
BACKGROUND: Fever after stroke is common, and often caused by infections. In the current study, we aimed to test the hypothesis that pneumonia, urinary tract infection and all-cause fever (thought to include at least some proportion of endogenous fever) have different predicting factors, since they differ regarding etiology. METHODS: PubMed was searched systematically for articles describing predictors for post-stroke pneumonia, urinary tract infection and all-cause fever...
April 23, 2018: BMC Neurology
https://www.readbyqxmd.com/read/29684979/the-degree-of-arm-elevation-impacts-the-endurance-and-cardiopulmonary-adaptations-of-copd-patients-performing-upper-limb-exercise-a-cross-over-study
#10
Mara Paneroni, Carla Simonelli, Pierantonio Laveneziana, Massimiliano Gobbo, Manuela Saleri, Luca Bianchi, Michele Vitacca
BACKGROUND: In Chronic Obstructive Pulmonary Disease (COPD), upper limb exercise is widely recommended. However, how the degree of shoulder flexion may influence the exercise response is unknown. AIM: We compared metabolic, ventilatory and symptomatic responses during constant-load supported and unsupported exercise performed at 80° and 120° arm elevation. DESIGN: Randomized cross-over study. SETTING: Pulmonary Pathophysiology Service in an Italian Respiratory Rehabilitative Division, in-patients were enrolled...
April 20, 2018: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29657370/delirium-in-the-intensive-care-unit-incidence-risk-factors-and-impact-on-outcome
#11
Nejla Tilouche, Mohamed Fekih Hassen, Habiba Ben Sik Ali, Oussamma Jaoued, Rim Gharbi, S Souheil El Atrous
Background: The incidence and risk factors for delirium vary among studies. Objective: We aimed to determine the incidence, risk factors, and impact on outcome of delirium in a medical Intensive Care Unit (ICU) in Tunisia using a prospective observational study. Patients: All consecutive patients admitted to the ICU between May 2012 and April 2013 were included if they were aged more than 18 years and had an ICU stay of more than 24 h. Patients who had a cardiac arrest or have a history of dementia or psychosis were excluded...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29652758/is-inspiratory-muscle-weakness-a-determinant-of-endurance-exercise-tolerance-during-niv-supported-exercise-in-patients-with-copd
#12
Rodrigo Koch, Gabriel Victor Guimarães Rapello, Paulo de Tarso Müller
PURPOSE: Previous research has reported that inspiratory muscle weakness is critical to decreased exercise tolerance and exercise tolerance improves with 10 cmH2O pressure support ventilation in patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to evaluate the effects of proportional assist ventilation (PAV) and continuous positive airway pressure (CPAP) compared with sham on exercise tolerance in patients with and without inspiratory muscle weakness...
April 11, 2018: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/29650284/-home-non-invasive-ventilation-for-chronic-obstructive-pulmonary-disease
#13
S Toujani, S Dabboussi, H Snene, M Mjid, S Kamoun, A Hedhli, S Cheikh Rouhou, R Cheikh, M Beji, Y Ouahchi, J Cherif
INTRODUCTION: The benefits of long-term non-invasive ventilation (NIV) in the management of chronic obstructive pulmonary disease (COPD) patients remain controversial. AIM: To analyze the characteristics of COPD patients under home NIV and to evaluate its impact among this population. METHODS: We carried out a retrospective study between January 2002 and April 2016 of COPD patients under long-term NIV at "la Rabta" and the Military Hospital...
April 9, 2018: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/29649849/-copd-importance-of-lung-function-testing-for-diagnosis-and-treatment
#14
Wolfram Windisch, Carl Peter Criée
Pulmonary function testing is essential for diagnosis and treatment-guidance of chronic obstructive pulmonary disease (COPD). Airway obstruction as assessed by spirometry should follow the reference-values provided by the Global Lung Initiative (GLI) of the European Respiratory Society (ERS). In addition, lung function testing should also include the assessment of lung hyperinflation and pulmonary emphysema by full-body plethysmography and determination of diffusion capacity. This is important since both, lung hyperinflation and pulmonary emphysema, can present without existing airway obstruction...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29629405/evaluation-of-systemic-corticosteroids-in-patients-with-an-acute-exacerbation-of-copd-and-a-diagnosis-of-pneumonia
#15
Tyler Scholl, Tyree H Kiser, Sheryl F Vondracek
Background: Chronic obstructive pulmonary disease (COPD) and pneumonia are leading causes of morbidity and mortality and are frequently comorbid. Studies of systemic corticosteroids in pneumonia have shown conflicting outcomes, whereas studies in acute exacerbations of COPD (AECOPD) have shown significant benefits. No studies have evaluated systemic corticosteroids in patients with both an AECOPD and pneumonia. Purpose: To evaluate the use of systemic corticosteroids in patients with both an AECOPD and pneumonia...
January 24, 2018: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
https://www.readbyqxmd.com/read/29628437/chronic-respiratory-failure-in-patients-with-chronic-obstructive-pulmonary-disease-under-home-noninvasive-ventilation-real-life-study
#16
V Durão, M Grafino, P Pamplona
BACKGROUND: Home noninvasive ventilation (NIV) has been increasingly used in stable chronic obstructive pulmonary disease (COPD) with chronic hypercapnic respiratory failure (CHRF). However its effectiveness remains debatable. AIM: To describe a follow-up of COPD patients under home NIV. METHODS: Retrospective descriptive study based on a prospective 3-year database that included COPD patients under home NIV between August 2011 and July 2014...
April 5, 2018: Pulmonology
https://www.readbyqxmd.com/read/29623307/implications-of-drg-classification-in-a-bundled-payment-initiative-for-copd
#17
Trisha M Parekh, Surya P Bhatt, Andrew O Westfall, James M Wells, Denay Kirkpatrick, Anand S Iyer, Michael Mugavero, James H Willig, Mark T Dransfield
OBJECTIVES: Institutions participating in the Medicare Bundled Payments for Care Improvement (BPCI) initiative invest significantly in efforts to reduce readmissions and costs for patients who are included in the program. Eligibility for the BPCI initiative is determined by diagnosis-related group (DRG) classification. The implications of this methodology for chronic diseases are not known. We hypothesized that patients included in a BPCI initiative for chronic obstructive pulmonary disease (COPD) would have less severe illness and decreased hospital utilization compared with those excluded from the bundled payment initiative...
December 2017: American Journal of Accountable Care
https://www.readbyqxmd.com/read/29607148/ventilator-associated-events-after-cardiac-surgery-evidence-from-1-709-patients
#18
Siyi He, Fan Wu, Xiaochen Wu, Mei Xin, Sheng Ding, Jian Wang, Hui Ouyang, Jinbao Zhang
Background: Ventilator-associated event (VAE) is a new surveillance for nosocomial infections in mechanically ventilated patients. To date, little is known about VAEs after cardiac surgeries. The present study firstly focused on patients who have undergone heart operations, intending to draw a comprehensive description of VAEs. Methods: Postoperative patients from September 2012 to December 2015 were monitored for VAEs. By reviewing electronic medical records and preserved files retrospectively, clinical data were further analyzed...
February 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29606641/is-transcatheter-aortic-valve-replacement-better-than-surgical-aortic-valve-replacement-in-patients-with-chronic-obstructive-pulmonary-disease-a-nationwide-inpatient-sample-analysis
#19
Tomo Ando, Oluwole Adegbala, Emmanuel Akintoye, Said Ashraf, Mohit Pahuja, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Luis Afonso, Theodore Schreiber
BACKGROUND: Chronic obstructive pulmonary disease (COPD) patients are at increased risk of respiratory related complications after cardiac surgery. It is unclear whether transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR) results in favorable outcomes among COPD patients. METHODS AND RESULTS: Patients were identified from the Nationwide Inpatient Sample database from 2011 to 2014. Patients with age ≥60, COPD, and either went transarterial TAVR or SAVR were included in the analysis...
April 1, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29602814/polysomnography-versus-limited-respiratory-monitoring-and-nurse-led-titration-to-optimise-non-invasive-ventilation-set-up-a-pilot-randomised-clinical-trial
#20
Maxime Patout, Gill Arbane, Antoine Cuvelier, Jean Francois Muir, Nicholas Hart, Patrick Brian Murphy
Polysomnography (PSG) is recommended for non-invasive ventilation (NIV) set-up in patients with chronic respiratory failure. In this pilot randomised clinical trial, we compared the physiological effectiveness of NIV set-up guided by PSG to limited respiratory monitoring (LRM) and nurse-led titration in patients with COPD-obstructive sleep apnoea (OSA) overlap. The principal outcome of interest was change in daytime arterial partial pressure of carbon dioxide (PaCO2 ) at 3 months. Fourteen patients with daytime PaCO2 >6 kPa and body mass index >30 kg/m2 were recruited...
March 30, 2018: Thorax
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