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Br?llmann Gregor - - 2010
BACKGROUND: Portable respiratory inductive plethysmography (RIP) is promising for noninvasive monitoring of breathing patterns in unrestrained subjects. However, its use has been hampered by requiring recalibration after changes in body position. OBJECTIVES: To facilitate RIP application in unrestrained subjects, we developed a technique for adjustment of RIP calibration using position ...
Johannigman Jay A - - 2009
Transport of mechanically ventilated patients in a combat zone presents challenges, including conservation of resources. In the battlefield setting, provision of oxygen supplies remains an important issue. Autonomous control of oxygen concentration can allow a reduction in oxygen usage and reduced mission weight. Trauma patients requiring ventilation and inspired oxygen ...
Sixt Stephan Urs - - 2009
RATIONALE: Repair mechanisms resulting in alveolar protein degradation in acute respiratory distress syndrome (ARDS) are largely unknown. OBJECTIVES: To test whether the 20S proteasome is present and functional in the alveolar space in patients with ARDS. METHODS: Proteasome antigenic concentration in bronchoalveolar lavage (BAL) supernatants was measured by ELISA in ...
Bello Giuseppe - - 2009
BACKGROUND: The effect of the nonthyroidal illness syndrome (NTIS) on the duration of mechanical ventilation (MV) has not been extensively investigated. This study aims to determine whether the NTIS is associated with the duration of MV in patients admitted to the ICU. METHODS: We evaluated all patients admitted over a ...
Asselbergs Folkert W - - 2009
A 45-year-old man with end-stage renal disease due to polycystic kidney disease was admitted to the hospital because of recurrent abdominal pain, progressive peripheral motor neuron neuropathy, and respiratory failure. The diagnosis of acute intermittent porphyria was confirmed by an elevated porphyrin concentration in the urine and the presence of ...
Pomidori Luca - - 2009
PURPOSE: Yoga-derived breathing has been reported to improve gas exchange in patients with chronic heart failure and in participants exposed to high-altitude hypoxia. We investigated the tolerability and effect of yoga breathing on ventilatory pattern and oxygenation in patients with chronic obstructive pulmonary disease (COPD). METHODS: Patients with COPD (N ...
Guo Fuping - - 2009
OBJECTIVE: To report the clinical characteristics of myxedematous respiratory failure in the elderly and to facilitate early recognition of hypothyroidism in critically ill old patients. METHODS: Clinical characteristics of our reported 4 patients and that of 17 patients with myxedematous respiratory failure reported previously were reviewed. Demographic information, vital signs, ...
Johannigman Jay A - - 2009
BACKGROUND: Transport of mechanically ventilated patients in a combat zone presents challenges including conservation of resources. In the battlefield setting, the provision of adequate oxygen supplies remains a significant issue. Autonomous control of oxygen concentration may allow a reduction in mission load. METHODS: Trauma patients requiring ventilation and inspired oxygen ...
Kallet Richard H - - 2009
This conference brought together experts on noninvasive ventilation (NIV) to discuss and debate the advances in evidence and technology over the past decade. A major impetus for the conference was that many institutions have not systematically integrated NIV into their clinical practice, despite mounting, high-level evidence supporting its effectiveness. NIV ...
Fazzi P - - 2009
AIM: Redistribution of convective ventilation, the leading disorder in airway obstruction, is a target of pharmacological and mechanical ventilation treatments for patients with chronic obstructive pulmonary disease (COPD). Convective ventilation is visualized by ventilation scintigraphy using radiolabeled aerosol particles that should ideally deposit in the terminal airspaces, but not in ...
Beuret Pascal - - 2009
PURPOSE: This study aimed to evaluate an objective measure of cough strength, the peak cough expiratory flow (PCEF), as a predictive criterion of success or failure of extubation. METHODS: Patients under mechanical ventilation for more than 24 h who successfully passed the spontaneous breathing trial were included in the study. ...
de Wit Marjolein - - 2009
PURPOSE: Clinicians frequently administer sedation to facilitate mechanical ventilation. The purpose of this study was to examine the relationship between sedation level and patient-ventilator asynchrony. MATERIALS AND METHODS: Airway pressure and airflow were recorded for 15 minutes. Patient-ventilator asynchrony was assessed by determining the number of breaths demonstrating ineffective triggering, ...
Carlucci Annalisa - - 2009
INTRODUCTION: Physiological determinants of weaning success and failure are usually studied in ventilator-supported patients, comparing those who failed a trial of spontaneous breathing with those who tolerated such a trial and were successfully extubated. A major limitation of these studies was that the two groups may be not comparable concerning ...
Monge García Manuel Ignacio - - 2009
INTRODUCTION: Although several parameters have been proposed to predict the hemodynamic response to fluid expansion in critically ill patients, most of them are invasive or require the use of special monitoring devices. The aim of this study is to determine whether noninvasive evaluation of respiratory variation of brachial artery peak ...
Nemer Sergio N - - 2009
INTRODUCTION: Indexes predicting weaning outcome are frequently inaccurate. We developed a new integrative weaning index aimed at improving the accuracy of the traditional indexes. METHODS: Three hundred and thirty-one patients mechanically-ventilated for more than 24 hours were evaluated. Initially, the threshold values of each index that best discriminate between a ...
Determann Rogier M - - 2009
BACKGROUND: Despite consensus criteria, diagnosing acute lung injury, or its more severe form acute respiratory distress syndrome (ALI/ARDS) remains challenging. Adding objective measures, such as plasma levels of biological markers could facilitate recognition of ALI/ARDS. This study was designed to assess and compare the diagnostic accuracy of biological markers for ...
Farah Raymond - - 2009
Chronic obstructive pulmonary disease (COPD) is a condition in which there is limited airflow during expiration (exhaling, or breathing out) that is not fully reversible and usually worsens over time. The disease is estimated to kill more than 100,000 Americans each year, and costs related to care of patients with ...
Arizmendi Carlos C Department of LSI, Technical University of Catalonia (UPC), C. Jordi Girona, 1-3, 08034, Barcelona, Spain. - - 2009
The process of weaning from mechanical ventilation is one of the challenges in intensive care. 149 patients under extubation process (T-tube test) were studied: 88 patients with successful trials (group S), 38 patients who failed to maintain spontaneous breathing and were reconnected (group F), and 23 patients with successful test ...
Onders Raymond P - - 2009
BACKGROUND: Diaphragm movement is essential for adequate ventilation, and when the diaphragm is adversely affected patients face lifelong positive-pressure mechanical ventilation or death. This report summarizes the complete worldwide multicenter experience with diaphragm pacing stimulation (DPS) to maintain and provide diaphragm function in ventilator-dependent spinal cord injury (SCI) patients and ...
Purro Andrea - - 2009
OBJECTIVE: The purpose of this study is to investigate the respiratory mechanics, breathing pattern, and pressure-generating capacity of respiratory muscles during the early phases of an acute exacerbation of COPD. DESIGN: Prospective study. SETTING: Division of Emergency Critical Care and Chronic Ventilator Unit. PATIENTS: A total of 24 COPD patients: ...
Moradi Mandana - - 2009
Oxidative stress has a proven role in pathophysiology of acute respiratory distress syndrome. The antioxidant drugs, especially N-acetylcysteine (NAC) have been used for years to overcome oxidative stress effects in patients. In the present study we have investigated the effects of NAC treatment (IV NAC in 150mg/kg at the first ...
Amirav Israel - - 2008
Acute pulmonary thromboembolism (PE) is a common cause of death in hospital patients. Quick and accurate diagnosis significantly decreases mortality. Many medical facilities still have ventilation/perfusion lung scans as the only available and preferred screening test for suspected PE. Although testing requires the patient's cooperation, many patients with PE are ...
Suri Pradeep - - 2008
Impaired cough that results in ineffective airway secretion clearance is an important contributor to pulmonary complications in patients with neuromuscular weakness including spinal cord injury. Mechanical insufflation-exsufflation (MI-E) is a respiratory aid used by patients with weak respiratory muscles to increase cough peak flows and improve cough effectiveness. Relative contraindications ...
Li Bei - - 2009
The postoperative course of cyanotic patients is generally more complicated than in acyanotic patients. The ischemic postconditioning provides protection from myocardial injury. We conducted a randomized trial to evaluate the clinical benefits of postconditioning in patients undergoing repair of tetralogy of Fallot. Ninety-nine patients with tetralogy of Fallot were randomly ...
Holguin Fernando - - 2008
BACKGROUND: The objective of this study was to evaluate the factors predictive of 28-day mortality and admission to Intensive Care Unit (ICU) in patients with ANCA-related pulmonary vasculitis. METHODS: We reviewed the medical records and imaging studies of 65 patients diagnosed with ANCA-related vasculitis hospitalized with pulmonary complications between February ...
Majid Adnan - - 2008
RATIONALE: Central airway stabilization with silicone stents can improve respiratory symptoms in patients with severe symptomatic tracheobronchomalacia (TBM) but is associated with a relatively high rate of complications. Surgery with posterior tracheobronchial splinting using a polypropylene mesh has also been used for this condition but to date has not been ...
E Abbassi; MSc of ...
Background:Speech is the most important communication tool and is the smooth product of four systems: respiratory, phonatory, resonatory, and articulatory. Currently, a variety of voice disorder occurred because of life style and environmental pollutants. Vocal nodule is one of the most prevalent disorders in this category. Considering the point that ...
Tsangaris Iraklis - - 2009
INTRODUCTION: Increased levels of plasminogen activator inhibitor-1 (PAI-1) have been associated with worse outcome in ALI/ARDS. A single guanosine insertion/deletion (4G/5G) polymorphism in the promoter region of the PAI-1 gene, may play an important role in the regulation of PAI-1 expression. The objective of the study was to evaluate the ...
Daly Melissa - - 2008
The goal of this study is to develop a controlled approach to quantifying the amount of lung damage after blunt chest trauma. The presented method is used to analyze computed tomography scans and to assess patients' risk for developing acute respiratory distress syndrome (ARDS). When used to predict which patients ...
Devlin John W - - 2008
PURPOSE OF REVIEW: To review pharmacological-related factors that affect the incidence of oversedation in mechanically ventilated adults. RECENT FINDINGS: Recent epidemiologic studies have identified a high frequency of oversedation in the ICU that is attributable, in part, to a number of pharmacokinetic, pharmacogenetic, and pharmacodynamic factors. New evidence suggests that ...
Funk Duane J - - 2008
BACKGROUND: Severe pulmonary contusions are a common cause of acute respiratory distress syndrome (ARDS) and are associated with significant morbidity. High frequency oscillatory ventilation (HFOV) is a ventilatory mode that employs a lung protective strategy consistent with the ARDSNet low tidal volume ventilation strategy and may result in reduced morbidity. ...
Jayawardane Pradeepa - - 2008
Intermediate syndrome (IMS) is a major cause of death from respiratory failure following acute organophosphate poisoning. The objective of this study was to determine repetitive nerve stimulation (RNS) predictors of IMS that would assist in patient management and clinical research. Seventy-eight consenting symptomatic patients with organophosphate poisoning were assessed prospectively ...
Shah Archan M - - 2008
Choriocarcinoma is associated with high mortality in immunocompromised patients, in contrast to a good prognosis in immunocompetent individuals. Respiratory failure due to metatstatic choriocarcinoma is associated with high mortality in any patient. We report a case of a woman with AIDS that survived metastatic choriocarcinoma and respiratory failure. We also ...
Faubel Sarah - - 2008
The development of respiratory failure in patients with AKI is a particularly devastating consequence that greatly increases patient mortality. When respiratory failure and AKI occur together, the mortality is greater than 80%. A clear understanding of the mechanisms leading to respiratory failure is of great clinical relevance to patients with ...
Murphy Glenn S - - 2008
BACKGROUND: Incomplete recovery of neuromuscular function may impair pulmonary and upper airway function and contribute to adverse respiratory events in the postanesthesia care unit (PACU). The aim of this investigation was to assess and quantify the severity of neuromuscular blockade in patients with signs or symptoms of critical respiratory events ...
Akada Shinji - - 2008
BACKGROUND: Agitation is associated with failure of noninvasive ventilation (NIV). We investigated the effect of dexmedetomidine in patients with NIV. METHODS: This was a prospective clinical investigation in an intensive care unit. Dexmedetomidine was infused in 10 patients in whom NIV was difficult because of agitation. RESULTS: Ramsay and Richmond ...
Fanelli G - - 2008
BACKGROUND: The authors investigated the accuracy of transcutaneous capnometry (TcPCO(2)) in estimating arterial blood carbon dioxide partial pressure (PaCO(2)) during spontaneous breathing in patients admitted to our surgical intensive care unit (ICU). METHODS: Serial TcPCO(2) and PaCO(2) measurements were taken in stable patients undergoing postoperative monitoring after major abdominal, vascular, ...
Hravnak Marilyn - - 2008
To our knowledge, detection of cardiorespiratory instability using noninvasive monitoring via electronic integrated monitoring systems (IMSs) in intermediate or step-down units (SDUs) has not been described. We undertook this study to characterize respiratory status in an SDU population, to define features of cardiorespiratory instability, and to evaluate an IMS index ...
van der Heijden M - - 2008
BACKGROUND: Angiopoietin-2 and vascular endothelial growth factor (VEGF) may impair vascular barrier function while angiopoietin-1 may protect it. It was hypothesised that circulating angiopoietin-2 is associated with pulmonary permeability oedema and severity of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) during septic or non-septic critical illness. METHODS: Plasma levels ...
Freeman Bradley D - - 2008
OBJECTIVES: To examine the feasibility and potential utility of a tracheostomy protocol based on a standardized approach to ventilator weaning. DESIGN: Prospective, observational data collection. SETTING: Academic medical center. PATIENTS: Surgical intensive care unit patients requiring mechanical ventilatory support. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Tracheostomy practice in 200 patients ...
Sinderby Christer - - 2008
Understanding the regulation of breathing in the critical care patient is multifaceted, especially in ventilator-dependent patients who must interact with artificial respiration. Mechanical ventilation originally consisted of simple, manually-driven pump devices, but it has developed into advanced positive pressure ventilators for continuous support of patients in respiratory failure. This evolution ...
Berkowitz David M - - 2008
Measurements of extravascular lung water (EVLW) correlate to the degree of pulmonary edema and have substantial prognostic information in critically ill patients. Prior studies using single indicator thermodilution have reported that 21% to 35% of patients with clinical acute respiratory distress syndrome (ARDS) have normal EVLW (<10 mL/kg). Given that ...
Lytle Francis Theodore - - 2008
Mechanical ventilation of patients undergoing thoracic surgery is often challenging. These patients frequently have significant underlying comorbidities, including cardiopulmonary disease, and often must undergo 1-lung ventilation. Perioperative respiratory complications are common and are multifactorial in etiology. Increasing evidence suggests that mechanical ventilation is associated with, and may even cause, lung ...
Ferrer M - - 2008
Patients with chronic airflow obstruction and difficulty in weaning from mechanical ventilation are at increased risk for intubation-associated complications and mortality because of prolonged invasive mechanical ventilation. Non-invasive ventilation (NIV) may avert most of the pathophysiologic mechanisms associated with weaning failure in these patients. Several randomised controlled trials have shown ...
Kirsch Matthias - - 2008
BACKGROUND: Mechanical circulatory support has become a well-established procedure for some patients with cardiogenic shock. However, patient selection and timing of implantation remains critical. This retrospective study was undertaken to identify preoperative predictors of survival in ICU of patients requiring mechanical circulatory support. METHODS: Between 1996 and 2006, 71 patients ...
Vargas Frédéric - - 2009
PURPOSE: The aims of this prospective study were (1) to select, after weaning and extubation, chronic obstructive pulmonary disease (COPD) patients with expiratory flow limitation (EFL) measured by the negative expiratory pressure method and (2) to assess, in these patients, the short-term (30 minutes) physiologic effect of a session of ...
Teixeira C - - 2008
Standard clinical practice recommends minimal doses of vasoactive drugs during weaning of patients from mechanical ventilation. However there are currently no clinical data to inform clinicians about whether the use of noradrenaline during weaning predisposes to weaning failure. The objective of this study was to evaluate whether the necessity of ...
Kim Y H - - 2008
Flexible bronchoscopy is a useful diagnostic procedure in patients with respiratory failure due to unexplained pulmonary infiltrates, but its safety and usefulness in ventilator-dependent patients with severe thrombocytopenia have not been established. A retrospective review of the medical records of all patients who underwent bronchoscopy while receiving mechanical ventilation support ...
Freudenmann R W - - 2008
Quetiapine is an atypical antipsychotic with good tolerability, but has recently been associated with respiratory dysfunction. The aim of this work is to report on moderate to severe respiratory dysfunction after normal oral doses of quetiapine in two obese patients with sleep apnea syndrome (SAS). In the first case, acute ...
Enomoto Noriyuki - - 2008
BACKGROUND AND OBJECTIVE: Acute exacerbations of interstitial pneumonias (IP) can occasionally occur, and have an extremely poor prognosis. Recently, direct haemoperfusion with a polymyxin B immobilized fibre column (PMX-DHP) was shown to have a beneficial effect in acute exacerbations of IPF. However, little is known about the efficacy of PMX-DHP ...
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