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Mechanical ventilation

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12 papers 0 to 25 followers
https://www.readbyqxmd.com/read/27761886/comparison-between-effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-and-diaphragmatic-damage-in-experimental-emphysema
#1
Gisele de A Padilha, Lucas F B Horta, Lillian Moraes, Cassia L Braga, Milena V Oliveira, Cíntia L Santos, Isalira P Ramos, Marcelo M Morales, Vera Luiza Capelozzi, Regina C S Goldenberg, Marcelo Gama de Abreu, Paolo Pelosi, Pedro L Silva, Patricia R M Rocco
BACKGROUND: In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. METHODS: Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27786562/spontaneous-breathing-during-mechanical-ventilation-risks-mechanisms-management
#2
Takeshi Yoshida, Yuji Fujino, Marcelo B P Amato, Brian P Kavanagh
Spontaneous respiratory effort during mechanical ventilation has long been recognized to improve oxygenation (1, 2) and because oxygenation is a key management target, such effort may seem beneficial. Also, disuse and loss of peripheral muscle and diaphragm function is increasingly recognized (3), and thus spontaneous breathing may confer additional advantage. Of course, all patients will need to transition to spontaneous effort if they are to become independent of the ventilator. Finally, epidemiologic data suggest that the use of partial (vs...
October 27, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27635518/ventilator-strategy-in-hematological-patients-when-and-how-first-step-influences-on-outcome
#3
Gulsah Karaoren, Sibel Ocak Serin, Antonio M Esquinas
No abstract text is available yet for this article.
October 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27655324/high-flow-nasal-cannula-oxygenation-in-immunocompromised-patients-with-acute-hypoxemic-respiratory-failure-a-groupe-de-recherche-respiratoire-en-r%C3%A3-animation-onco-h%C3%A3-matologique-study
#4
Virginie Lemiale, Matthieu Resche-Rigon, Djamel Mokart, Frédéric Pène, Laurent Argaud, Julien Mayaux, Christophe Guitton, Antoine Rabbat, Christophe Girault, Achille Kouatchet, François Vincent, Fabrice Bruneel, Martine Nyunga, Amélie Seguin, Kada Klouche, Gwenahel Colin, Loay Kontar, Pierre Perez, Anne-Pascale Meert, Dominique D Benoit, Laurent Papazian, Alexandre Demoule, Sylvie Chevret, Elie Azoulay
OBJECTIVE: In immunocompromised patients with acute respiratory failure, invasive mechanical ventilation remains associated with high mortality. Choosing the adequate oxygenation strategy is of the utmost importance in that setting. High-flow nasal oxygen has recently shown survival benefits in unselected patients with acute respiratory failure. The objective was to assess outcomes of immunocompromised patients with hypoxemic acute respiratory failure treated with high-flow nasal oxygen...
September 20, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27648700/prevention-or-treatment-of-ards-with-aspirin-a-review-of-preclinical-models-and-meta-analysis-of-clinical-studies
#5
Bernardo Amisa Panka, Harm-Jan de Grooth, Angeliquè Spoelstra-de Man, Mark Looney, Pieter-Roel Tuinman
BACKGROUND: The acute respiratory distress syndrome (ARDS) is a life-threating disorder that contributes significantly to critical illness. No specific pharmacological interventions directed at lung injury itself, have proven effective in improving outcome of patients with ARDS. Platelet activation was identified as a key component in ARDS pathophysiology and may provide an opportunity for preventive and therapeutic strategies. We hypothesize that use of acetyl salicylic acid (ASA) may prevent and/ or attenuate lung injury...
September 19, 2016: Shock
https://www.readbyqxmd.com/read/27622722/inhibition-of-constitutive-nitric-oxide-synthase-does-not-influence-ventilation-perfusion-matching-in-normal-prone-adult-sheep-with-mechanical-ventilation
#6
Mats J Johansson, John-Peder Escobar Kvitting, Torun Flatebø, Anne Nicolaysen, Gunnar Nicolaysen, Sten M Walther
BACKGROUND: Local formation of nitric oxide in the lung induces vasodilation in proportion to ventilation and is a putative mechanism behind ventilation-perfusion matching. We hypothesized that regional ventilation-perfusion matching occurs in part due to local constitutive nitric oxide formation. METHODS: Ventilation and perfusion were analyzed in lung regions (≈1.5 cm) before and after inhibition of constitutive nitric oxide synthase with N-nitro-L-arginine methyl ester (L-NAME) (25 mg/kg) in 7 prone sheep ventilated with 10 cm H2O positive end-expiratory pressure...
December 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27606837/transpulmonary-pressure-the-importance-of-precise-definitions-and-limiting-assumptions
#7
Stephen H Loring, George P Topulos, Rolf D Hubmayr
Recent studies applying the principles of respiratory mechanics to respiratory disease have used inconsistent and mutually exclusive definitions of the term "transpulmonary pressure." By the traditional definition, transpulmonary pressure is the pressure across the whole lung including the intrapulmonary airways, i.e., the pressure difference between the opening to the pulmonary airway and the pleural surface. However more recently, transpulmonary pressure has also been defined as the pressure across only the lung tissue, i...
September 8, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27545828/airway-driving-pressure-and-lung-stress-in-ards-patients
#8
Davide Chiumello, Eleonora Carlesso, Matteo Brioni, Massimo Cressoni
BACKGROUND: Lung-protective ventilation strategy suggests the use of low tidal volume, depending on ideal body weight, and adequate levels of PEEP. However, reducing tidal volume according to ideal body weight does not always prevent overstress and overstrain. On the contrary, titrating mechanical ventilation on airway driving pressure, computed as airway pressure changes from PEEP to end-inspiratory plateau pressure, equivalent to the ratio between the tidal volume and compliance of respiratory system, should better reflect lung injury...
August 22, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27483127/sedation-with-dexmedetomidine-or-propofol-impairs-hypoxic-control-of-breathing-in-healthy-male-volunteers-a-nonblinded-randomized-crossover-study
#9
Åse Lodenius, Anette Ebberyd, Anna Hårdemark Cedborg, Eva Hagel, Souren Mkrtchian, Eva Christensson, Johan Ullman, Mika Scheinin, Lars I Eriksson, Malin Jonsson Fagerlund
BACKGROUND: In contrast to general anesthetics such as propofol, dexmedetomidine when used for sedation has been put forward as a drug with minimal effects on respiration. To obtain a more comprehensive understanding of the regulation of breathing during sedation with dexmedetomidine, the authors compared ventilatory responses to hypoxia and hypercapnia during sedation with dexmedetomidine and propofol. METHODS: Eleven healthy male volunteers entered this randomized crossover study...
October 2016: Anesthesiology
https://www.readbyqxmd.com/read/27477213/biotrauma-and-ventilator-induced-lung%C3%A2-injury-clinical-implications
#10
Gerard F Curley, John G Laffey, Haibo Zhang, Arthur S Slutsky
The pathophysiological mechanisms by which mechanical ventilation can contribute to lung injury, termed "ventilator-induced lung injury" (VILI), is increasingly well understood. "Biotrauma" describes the release of mediators by injurious ventilatory strategies, which can lead to lung and distal organ injury. Insights from preclinical models demonstrating that traditional high tidal volumes drove the inflammatory response helped lead to clinical trials demonstrating lower mortality in patients who underwent ventilation with a lower-tidal-volume strategy...
November 2016: Chest
https://www.readbyqxmd.com/read/27448995/mechanical-ventilation-strategies-for-intensive-care-unit-patients-without-acute-lung-injury-or-acute-respiratory-distress-syndrome-a-systematic-review-and-network-meta-analysis
#11
Lei Guo, Weiwei Wang, Nana Zhao, Libo Guo, Chunjie Chi, Wei Hou, Anqi Wu, Hongshuang Tong, Yue Wang, Changsong Wang, Enyou Li
BACKGROUND: It has been shown that the application of a lung-protective mechanical ventilation strategy can improve the prognosis of patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). However, the optimal mechanical ventilation strategy for intensive care unit (ICU) patients without ALI or ARDS is uncertain. Therefore, we performed a network meta-analysis to identify the optimal mechanical ventilation strategy for these patients. METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, EMBASE, MEDLINE, CINAHL, and Web of Science for studies published up to July 2015 in which pulmonary compliance or the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO2/FIO2) ratio was assessed in ICU patients without ALI or ARDS, who received mechanical ventilation via different strategies...
July 22, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27405798/intraoperative-compliance-profiles-and-regional-lung-ventilation-improve-with-increasing-positive-end-expiratory-pressure
#12
S Wirth, M Kreysing, J Spaeth, S Schumann
BACKGROUND: Anaesthesia and mechanical ventilation can lead to impaired lung. Intraoperative positive end-expiratory pressure (PEEP) should prevent intratidal recruitment/derecruitment without causing overdistension. The intratidal compliance profile indicates both unwanted phenomena. We hypothesized that a higher than usual PEEP improves the intratidal compliance and the regional lung ventilation of patients with healthy lungs. METHODS: After ethics approval, 30 adult patients scheduled for limb surgery were investigated at PEEP 5, 7 and 9 cm H2 O during mechanical ventilation...
October 2016: Acta Anaesthesiologica Scandinavica
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