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https://www.readbyqxmd.com/read/28068958/effects-of-ventilator-settings-nebulizer-and-exhalation-port-position-on-albuterol-delivery-during-non-invasive-ventilation-an-in-vitro-study
#1
Yuda Sutherasan, Lorenzo Ball, Pasquale Raimondo, Valentina Caratto, Elisa Sanguineti, Federico Costantino, Maurizio Ferretti, Robert M Kacmarek, Paolo Pelosi
BACKGROUND: Few studies have investigated the factors affecting aerosol delivery during non-invasive ventilation (NIV). Our aim was to investigate, using a bench-top model, the effect of different ventilator settings and positions of the exhalation port and nebulizer on the amount of albuterol delivered to a lung simulator. METHODS: A lung model simulating spontaneous breathing was connected to a single-limb NIV ventilator, set in bi-level positive airway pressure (BIPAP) with inspiratory/expiratory pressures of 10/5, 15/10, 15/5, and 20/10 cmH2O, or continuous positive airway pressure (CPAP) of 5 and 10 cmH2O...
January 10, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28066621/the-non-intubated-anesthesia-for-airway-surgery
#2
REVIEW
Katsuhiro Okuda, Ryoichi Nakanishi
Surgical treatment for lung cancer including airway resection following reconstruction is typically performed under general anesthesia with single-lung ventilation because it is necessary to maintain a sufficient working space and to adjust the airway pressure for the leak test. However, non-intubated thoracic surgery has been gradually developed in recent years for thoracoscopic surgery, due to its lower rate of postoperative complications, shorter hospitalization duration, and lower invasiveness than the usual single-lung anesthesia...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28043780/influence-of-mouth-opening-on-oropharyngeal-humidification-and-temperature-in-a-bench-model-of-neonatal-continuous-positive-airway-pressure
#3
Hendrik S Fischer, Tim L Ullrich, Christoph Bührer, Christoph Czernik, Gerd Schmalisch
Clinical studies show that non-invasive respiratory support by continuous positive airway pressure (CPAP) affects gas conditioning in the upper airways, especially in the presence of mouth leaks. Using a new bench model of neonatal CPAP, we investigated the influence of mouth opening on oropharyngeal temperature and humidity. The model features the insertion of a heated humidifier between an active model lung and an oropharyngeal head model to simulate the recurrent expiration of heated, humidified air. During unsupported breathing, physiological temperature and humidity were attained inside the model oropharynx, and mouth opening had no significant effect on oropharyngeal temperature and humidity...
December 30, 2016: Medical Engineering & Physics
https://www.readbyqxmd.com/read/27853329/high-flow-nasal-cannulae-versus-nasal-continuous-positive-airway-pressure-in-neonates-with-respiratory-distress-syndrome-managed-with-insure-method-a-randomized-clinical-trial
#4
Maliheh Kadivar, Ziba Mosayebi, Nosrat Razi, Shahin Nariman, Razieh Sangsari
BACKGROUND: In recent years, various noninvasive respiratory support (NRS) of ventilation has been provided more in neonates. The aim of this study was to compare the effect of HFNC with NCPAP in post-extubation of preterm infants with RDS after INSURE method (intubation, surfactant, extubation). METHODS: A total of 54 preterm infants with RDS (respiratory distress syndrome) were enrolled in this study. Using a randomized sequence, they were assigned into two groups after INSURE method...
November 2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27761035/a-randomised-trial-to-compare-i-gel-and-proseal%C3%A2-laryngeal-mask-airway-for-airway-management-in-paediatric-patients
#5
R Nirupa, Satinder Gombar, Vanita Ahuja, Preeti Sharma
BACKGROUND AND AIMS: i-gel™ is a newer supraglottic airway device with a unique non-inflatable cuff. We aimed to compare i-gel™ with ProSeal™ laryngeal mask airway (PLMA™) in children scheduled for surgery under general anaesthesia (GA) with controlled ventilation. METHODS: This prospective, randomised controlled study was conducted in 100 surgical patients, aged 2-6 years of American Society of Anesthesiologists Physical Status I-II scheduled under GA. Patients were randomly allocated to receive either size 2 i-gel™ or PLMA™ as an airway device...
October 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27741103/establishing-predictors-for-successfully-planned-endotracheal-extubation
#6
Chih-Cheng Lai, Chin-Ming Chen, Shyh-Ren Chiang, Wei-Lun Liu, Shih-Feng Weng, Mei-I Sung, Shu-Chen Hsing, Kuo-Chen Cheng
The aim of this study was to establish predictors for successfully planned extubation, which can be followed by medical personnel. The patients who were admitted to the adult intensive care unit of a tertiary hospital and met the following criteria between January 2005 and December 2014 were collected retrospectively: intubation > 48 hours; and candidate for extubation. The patient characteristics, including disease severity, rapid shallow breath index (RSBI), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), cuff leak test (CLT) before extubation, and outcome, were recorded...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27608343/the-minimal-leak-test-technique-for-endotracheal-cuff-maintenance
#7
D A Harvie, J N Darvall, M Dodd, A De La Cruz, M Tacey, R L D'Costa, D Ward
Endotracheal tube (ETT) cuff pressure management is an essential part of airway management in intubated and mechanically ventilated patients. Both under- and over-inflation of the ETT cuff can lead to patient complications, with an ideal pressure range of 20-30 cmH2O defined. A range of techniques are employed to ensure adequate ETT cuff inflation, with little comparative data. We performed an observational cross-sectional study in a tertiary metropolitan ICU, assessing the relationship between the minimal leak test and cuff manometry...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27581993/synchronized-mechanical-ventilation-for-respiratory-support-in-newborn-infants
#8
REVIEW
Anne Greenough, Thomas E Rossor, Adesh Sundaresan, Vadivelam Murthy, Anthony D Milner
BACKGROUND: During synchronised mechanical ventilation, positive airway pressure and spontaneous inspiration coincide. If synchronous ventilation is provoked, adequate gas exchange should be achieved at lower peak airway pressures, potentially reducing baro/volutrauma, air leak and bronchopulmonary dysplasia. Synchronous ventilation can potentially be achieved by manipulation of rate and inspiratory time during conventional ventilation and employment of patient-triggered ventilation. OBJECTIVES: To compare the efficacy of:(i) synchronised mechanical ventilation, delivered as high-frequency positive pressure ventilation (HFPPV) or patient-triggered ventilation (assist control ventilation (ACV) and synchronous intermittent mandatory ventilation (SIMV)), with conventional ventilation or high-frequency oscillation (HFO);(ii) different types of triggered ventilation (ACV, SIMV, pressure-regulated volume control ventilation (PRVCV), SIMV with pressure support (PS) and pressure support ventilation (PSV))...
September 1, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27549212/comparison-of-the-clinical-performance-of-i-gel-lma-supreme-and-lma-proseal-in-elective-surgery
#9
Geoffrey Haw Chieh Liew, Esther Dawen Yu, Shitalkumar Sharad Shah, Harikrishnan Kothandan
INTRODUCTION: The LMA Supreme™, i-gel® and LMA ProSeal™ are second-generation supraglottic airway devices. We tested the hypothesis that these devices differ in performance when used for spontaneous ventilation during anaesthesia. METHODS: 150 patients who underwent general anaesthesia for elective surgery were randomly allocated into three groups. Data was collected on oropharyngeal leak pressures, ease and duration of device insertion, ease of gastric tube insertion, and airway safety...
August 2016: Singapore Medical Journal
https://www.readbyqxmd.com/read/27539719/synchronized-mechanical-ventilation-for-respiratory-support-in-newborn-infants
#10
REVIEW
Anne Greenough, Vadivelam Murthy, Anthony D Milner, Thomas E Rossor, Adesh Sundaresan
BACKGROUND: During synchronised mechanical ventilation, positive airway pressure and spontaneous inspiration coincide. If synchronous ventilation is provoked, adequate gas exchange should be achieved at lower peak airway pressures, potentially reducing baro/volutrauma, air leak and bronchopulmonary dysplasia. Synchronous ventilation can potentially be achieved by manipulation of rate and inspiratory time during conventional ventilation and employment of patient-triggered ventilation. OBJECTIVES: To compare the efficacy of:(i) synchronised mechanical ventilation, delivered as high-frequency positive pressure ventilation (HFPPV) or patient-triggered ventilation (assist control ventilation (ACV) and synchronous intermittent mandatory ventilation (SIMV)), with conventional ventilation or high-frequency oscillation (HFO);(ii) different types of triggered ventilation (ACV, SIMV, pressure-regulated volume control ventilation (PRVCV), SIMV with pressure support (PS) and pressure support ventilation (PSV))...
August 19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27530418/continuous-high-frequency-oscillation-therapy-in-invasively-ventilated-pediatric-subjects-in-the-critical-care-setting
#11
Stephen Morgan, Christoph P Hornik, Niyati Patel, Walter L Williford, David A Turner, Ira M Cheifetz
BACKGROUND: Continuous high-frequency oscillation (CHFO) creates a pressure gradient in the small airways that accelerates expiratory flow. The intended use of CHFO therapy is to facilitate secretion removal and treat atelectasis. Our objective was to assess the feasibility, safety, and efficacy of CHFO in the mechanically ventilated pediatric population. METHODS: After institutional review board approval, we retrospectively reviewed medical records of mechanically ventilated children treated with CHFO (the MetaNeb system) at our institution from July 1, 2007 through August 31, 2012...
August 16, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27043327/telemonitoring-of-cpap-therapy-may-save-nursing-time
#12
Ulla Anttalainen, Sari Melkko, Sirkka Hakko, Tarja Laitinen, Tarja Saaresranta
PURPOSE: Telemonitoring might enhance continuous positive airway pressure (CPAP) adherence and save nursing time at the commencement of CPAP therapy. We tested wireless telemonitoring (ResTraxx Online System®, ResMed) during the habituation phase of the CPAP therapy in obstructive sleep apnea syndrome (OSAS). METHODS: In total, 111 consecutive OSAS patients were enrolled. After CPAP titration, patients were followed with the telemonitoring (TM, N = 50) or the usual care (UC, N = 61)...
December 2016: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/27029657/intensive-care-management-of-children-intubated-for-croup-a-retrospective-analysis
#13
B Gelbart, S Parsons, A Sarpal, P Ninova, W Butt
Croup remains the commonest reason for acute upper airway obstruction in children, yet there are scarce contemporary data of airway management in those requiring intubation. We performed a retrospective analysis of the intensive care management of children intubated for croup in two quaternary Paediatric Intensive Care Units: Royal Children's Hospital Melbourne, Australia and Alberta Children's Hospital Calgary, Canada. Patients intubated for less than three days were compared with those intubated for greater than three days...
March 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/26957697/assessment-of-suitability-of-i-gel-and-laryngeal-mask-airway-supreme-for-controlled-ventilation-in-anesthetized-paralyzed-patients-a-prospective-randomized-trial
#14
Kusuma Srividya Radhika, R Sripriya, M Ravishankar, V R Hemanth Kumar, V Jaya, S Parthasarathy
CONTEXT: Laryngeal mask airway supreme (LMA-S) has an inflatable cuff while i-gel has a noninflatable cuff made of thermoplastic elastomer. AIMS: To study the efficacy of ventilation and the laryngeal seal pressures (LSPs) with either device. Our secondary objectives were to compare the ease of insertion, adequacy of positioning the device, hemodynamic response to device insertion, and any postoperative oropharyngeal morbidity. SETTINGS AND DESIGN: A prospective, randomized, single-blinded study at Teaching Medical School in South India...
January 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/26956620/changes-in-intracuff-pressure-of-cuffed-endotracheal-tubes-while-positioning-for-adenotonsillectomy-in-children
#15
Griffin H Olsen, Senthil G Krishna, Kris R Jatana, Charles A Elmaraghy, James M Ruda, Joseph D Tobias
BACKGROUND: When using cuffed endotracheal tubes (cETTs), changes in head and neck position can lead to changes in intracuff pressure. AIM: The aim of this study was to assess the combined effect of neck extension, shoulder roll placement, and Crowe-Davis retractor use during adenotonsillectomy on the intracuff pressure of cETTs in children. METHODS: Patients <18 years of age undergoing adenotonsillectomy under general anesthesia following the placement of a cETT were included in the study...
May 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26847369/a-new-suction-mask-to-reduce-leak-during-neonatal-resuscitation-a-manikin-study
#16
Laila Lorenz, Dominic A Maxfield, Jennifer A Dawson, C Omar F Kamlin, Lorraine McGrory, Marta Thio, Susan M Donath, Peter G Davis
OBJECTIVE: Leak around the face mask is a common problem during neonatal resuscitation. A newly designed face mask using a suction system to enhance contact between the mask and the infant's face might reduce leak and improve neonatal resuscitation. The aim of the study is to determine whether leak is reduced using the suction mask (Resusi-sure mask) compared with a conventional mask (Laerdal Silicone mask) in a manikin model. METHODS: Sixty participants from different professional categories (neonatal consultants, fellows, registrars, nurses, midwives and students) used each face mask in a random order to deliver 2 min of positive pressure ventilation to a manikin...
September 2016: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/26787800/overinflation-of-the-cuff-and-pressure-on-the-neck-reduce-the-preventive-effect-of-supraglottic-airways-on-pulmonary-aspiration-an-experimental-study-in-human-cadavers
#17
M Hensel, W Schmidbauer, D Geppert, S Sehner, G Bogusch, T Kerner
BACKGROUND: The oesophageal leak pressure is defined as the pressure which breaks the seal between the cuff of a supraglottic airway and the peri-cuff mucosa, allowing penetration of fluid into the pharynx and the oral cavity. As a consequence, a decrease in this variable increases the risk of reflux and can lead to pulmonary aspiration. The aim of this study was to analyse the effects of cuff overinflation and pressure on the neck on the oesophageal leak pressure of seven supraglottic airways...
February 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26759160/failed-caudal-block-due-to-physiologic-changes-associated-with-a-cerebrospinal-fluid-leak-a-case-report
#18
Erin Bruce, Adam O Spencer, Mehmet Sait Albayram
PURPOSE: The sum of the volumes of brain tissue, cerebrospinal fluid (CSF), and intracranial blood remain constant. This tenet of the Monroe-Kellie hypothesis is most often considered in the setting of intracranial hypertension, but it can also be applied in the setting of CSF volume depletion. We used this hypothesis to explain a case of failed caudal block in a patient with an iatrogenic CSF leak. CLINICAL FEATURES: A one-month-old baby (3 kg) born at 35 weeks' gestation presented for right inguinal hernia repair...
May 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26757212/therapeutic-pneumoperitoneum-relevant-or-obsolete-in-2015
#19
Eitan Podgaetz, Jonathan Berger, Joe Small, Rafael Garza, Rafael Andrade
Background Therapeutic pneumoperitoneum (TP) is one alternative to manage pleural space problems. We describe our technique and experience. Materials and Methods Medical records of all patients who underwent TP from January 1, 2007, to January 1, 2015, were reviewed after Institutional Review Board approval. We report indication, preprocedure pulmonary function tests, volume of insufflated air, time to chest tube removal, and complications. We place a red rubber catheter into the peritoneal space through the diaphragm or a small abdominal incision, insufflate with room air, record volume (liters), intraperitoneal pressure (goal 9-10 mm Hg), and monitor vital signs, airway pressures, and urine output...
January 12, 2016: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/26695112/a-method-for-evaluating-aerosol-leakage-through-the-interface-between-protective-suits-and-full-face-respirators
#20
Kristina Arnoldsson, Signar Danielsson, Marianne Thunéll
Military personnel and first responders use a range of personal equipment including protective suits, gloves, boots, and respirators to prevent exposure of their skin and airways to hazardous chemical, biological, radiological, and/or nuclear substances. Although each individual item of personal protective equipment is well tested against existing standards, it is also necessary to consider the performance of the interfaces between items in terms of prevention from exposure, and the protection system as a whole...
2016: Journal of Occupational and Environmental Hygiene
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