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Meade Maureen O - - 2008
OBJECTIVE: To determine the magnitude, duration, and consistency of the effects of lung recruitment maneuvers (RMs) on oxygenation, lung mechanics, and comfort in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). METHODS: We conducted a prospective physiologic study at 3 tertiary-care hospitals. We enrolled 28 consecutive ...
Polglase Graeme R - - 2008
Positive end-expiratory pressure (PEEP) protects the lung from injury during sustained ventilation, but its role in protecting the lung from injury during the initiation of ventilation in the delivery room is not established. We aimed to evaluate whether PEEP and/or tidal volume (VT) within the first 15-min of ventilation are ...
Meier Torsten - - 2008
BACKGROUND: Positive end-expiratory pressure (PEEP) during mechanical ventilation may impose different degrees of stress on healthy lungs. On the assumption that stress is reflected by cytokine production, we performed a translational study investigating the effect of PEEP on bronchoalveolar and systemic mediator levels in isolated perfused mouse lungs (IPL) and ...
Ansermino J Mark - - 2008
PURPOSE: The automated recognition of critical clinical events by physiological monitors is a challenging task exacerbated by a lack of standardized and clinically relevant threshold criteria. The objective of this investigation was to develop consensus for such criteria regarding the identification of three ventilatory events: disconnection or significant leak in ...
Feihl François - - 2009
In Part I of this review, we have covered basic concepts regarding cardiorespiratory interactions. Here, we put this theoretical framework to practical use. We describe mechanisms underlying Kussmaul's sign and pulsus paradoxus. We review the literature on the use of respiratory variations of blood pressure to evaluate volume status. We ...
Carvalho Alysson R - - 2008
To evaluate the ability of three indices derived from the airway pressure curve for titrating positive end-expiratory pressure (PEEP) to minimize mechanical stress while improving lung aeration assessed by computed tomography (CT). Prospective, experimental study. University research facilities. Twelve pigs. Animals were anesthetized and mechanically ventilated with tidal volume of ...
Haitsma J J - - 2008
Pneumonia, the main cause of acute lung injury, is characterised by a local pro-inflammatory response and coagulopathy. Mechanical ventilation (MV) is often required. However, MV can lead to additional injury: so-called ventilator-induced lung injury (VILI). Therefore, the current authors investigated the effect of VILI on alveolar fibrin turnover in Streptococcus ...
Herff Holger - - 2008
OBJECTIVE: To investigate the effect of different ventilation settings on hemodynamic stability in severe controlled hemorrhagic shock. DESIGN: Prospective, randomized, controlled animal study. SETTING: Research laboratory in a university hospital. SUBJECTS: Approximately 35-45 kg domestic pigs. INTERVENTIONS: Twenty-four domestic pigs were bled 45 mL/kg (estimated 65% of their calculated blood ...
Miller Michael P - - 2008
OBJECTIVE: To compare pressure characteristics of mechanical ventilation and their impact on pediatric patients with severe ARDS in the pre-protective lung strategy (PLS) and post-PLS eras. METHODS: Medical records of 33 patients admitted to our pediatric ICU with ARDS from 1992 through 1994 (pre-PLS) and 52 patients with ARDS admitted ...
Rodriquez Dario D - - 2008
OBJECTIVE: The objective of this study was to determine the effects of inspired oxygen concentration (FIO2), positive end-expiratory pressure (PEEP), and breath type on the battery life of the LTV-1000 external lithium ion battery (LiB). METHODS: An LTV-1000 ventilator and external LiB were tested in the laboratory. The ventilator was ...
Sinclair Scott E - - 2009
Ventilator-induced lung injury (VILI) is a recognized complication of mechanical ventilation. Although the specific mechanism by which mechanical ventilation causes lung injury remains an active area of study, both alveolar overdistension and cyclical airway collapse and recruitment have been suggested as contributing causes. We hypothesized that mechanical ventilation in the ...
Ren Y - - 2008
Many studies have confirmed that applying positive end-expiratory pressure (PEEP) to the dependent lung during one-lung ventilation (OLV) improves oxygenation. Our purpose was to investigate the best time and level of PEEP application. Thirty patients undergoing thoracic surgery were randomised into three groups. After 20 minutes of two-lung ventilation (TLV) ...
Dellamonica Jean - - 2008
OBJECTIVE: Intrapulmonary percussive ventilation (IPV) is a form of high-frequency ventilation that can be superimposed on spontaneous breathing or conventional ventilation. Drawbacks include difficulties achieving adequate airway humidification and an inability to monitor delivered volumes and pressures, which may vary with patient characteristics. The objectives of this study were to ...
Madke Gabriel Ribeiro - - 2008
PURPOSE: To evaluate the effects of alveolar recruitment based on mean airway pressure (MAP) on pig lungs submitted to thoracotomy through blood gas exchange and hemodynamic parameters. METHODS: Twelve pigs weighting approximately 25 Kg were intubated and ventilated on volume controlled ventilation (tidal volume 10 ml/Kg, respiratory rate 16 min, ...
Piacentini Enrique - - 2008
High vascular flow aggravates lung damage in animal models of ventilator-induced lung injury. Positive end-expiratory pressure (PEEP) can attenuate ventilator-induced lung injury, but its continued effectiveness in the setting of antecedent lung injury is unclear. The objective of the present study was to evaluate whether the application of PEEP diminishes ...
Lessard Martin - - 2008
Introduction: Mechanical ventilation is known to affect outcome in ARDS. Guidelines for ventilatory management have been published, but little is known about actual practice. The aim of this study was to describe ventilatory management in non-selected consecutive patients with ARDS in an academic centre. METHODS: This prospective observational cohort study ...
Ley-Zaporozhan Julia - - 2008
PURPOSE: This feasibility study in healthy animals should prove the concept that it is possible to quantitatively assess the effects of different ventilatory settings on the lung parenchyma during ongoing ventilation in respiratory gated 4-dimensional (D)-computed tomography (CT). For this purpose, the influence of different tidal volumes and positive end-expiratory ...
Starfinger C - - 2008
A cardiovascular system model and parameter identification method have previously been validated for porcine experiments of induced pulmonary embolism and positive end-expiratory pressure (PEEP) titrations, accurately tracking all the main hemodynamic trends. In this research, the model and parameter identification process are further validated by predicting the effect of intervention. ...
Koefoed-Nielsen J - - 2008
BACKGROUND: No methods are superior when setting positive end-expiratory pressure (PEEP) in acute lung injury (ALI). In ALI, the vertical distance (hysteresis) between the inspiratory and expiratory limbs of a static pressure-volume (PV) loop mainly indicates lung recruitment. We hypothesized that PEEP set at the pressure where hysteresis is 90% ...
Groeneveld A B J - - 2008
The response of arterial PO(2) (P(a)O(2)) to airway pressure has been used as a measure of recruitment in mechanically ventilated patients. We hypothesised that mixed venous PO(2) (P(mv)O(2)) directly affects P(a)O(2). Sixteen patients with acute lung injury (ALI, lung injury score > or = 1) on volume-controlled mechanical ventilation (F(I)O(2) ...
Cannizzaro Vincenzo - - 2008
Infant mice were ventilated with either high tidal volume (V(T)) with zero end-expiratory pressure (HVZ), high V(T) with positive end-expiratory pressure (PEEP) (HVP), or low V(T) with PEEP. Thoracic gas volume (TGV) was determined plethysmographically and low-frequency forced oscillations were used to measure the input impedance of the respiratory system. ...
Turner Nina L - - 2008
Workers wearing full-body safety harnesses are at risk for suspension trauma if they are not rescued in 5 to 30 min after a successfully arrested fall. Suspension trauma, which may be fatal, occurs when a person's legs are immobile in a vertical posture, leading to the pooling of blood in ...
Chaturvedi Rakesh K - - 2008
BACKGROUND: Little attention is given to the mode of mechanical ventilation after cardiac surgery. Positive pressure ventilation with positive end-expiratory pressure (PEEP) has been shown to reduce cardiac output. We hypothesized that positive pressure ventilation with continual negative pressure applied to the chest through a cuirass would increase cardiac output ...
Hua Yi-Ming - - 2008
A positive end-expiratory pressure (PEEP) above the lower inflection point (LIP) of the pressure-volume curve has been thought necessary to maintain recruited lung volume in acute lung injury (ALI). We used a strategy to identify the level of open-lung PEEP (OLP) by detecting the maximum tidal compliance during a decremental ...
Bellardine Black C L - - 2008
Image Functional Modeling (IFM) synthesizes three dimensional airway networks with imaging and mechanics data to relate structure to function. The goal of this study was to advance IFM to establish a method of exploring how heterogeneous alveolar flooding and collapse during lung injury would impact regional respiratory mechanics and flow ...
Cressoni Massimo - - 2008
OBJECTIVES: The lung-protective strategy employs positive end-expiratory pressure to keep open otherwise collapsed lung regions (anatomical recruitment). Improvement in venous admixture with positive end-expiratory pressure indicates functional recruitment to better gas exchange, which is not necessarily related to anatomical recruitment, because of possible global/regional perfusion modifications. Therefore, we aimed to ...
Chai C M - - 2008
BACKGROUND: Solutions of iodine contrast media (CM) used for selective coronary arteriography (CA) should have minimal propensity to cause ventricular fibrillation (VF). Commonly used CM for CA are nonionic monomers or dimers. PURPOSE: To compare VF propensity of ready-to-use solutions of one nonionic dimer, iodixanol, and five nonionic monomers, iobitridol, ...
Ko S-C - - 2008
BACKGROUND: Different levels of positive end-expiratory pressure (PEEP) with and without a recruitment maneuver (RM) may have a significant impact on ventilator-induced lung injury but this issue has not been well addressed. METHODS: Anesthetized rats received hydrochloric acid (HCl, pH 1.5) aspiration, followed by mechanical ventilation with a tidal volume ...
Caramez Maria Paula - - 2008
To determine whether hypercarbia occurs following the use of open suctioning in lung lavage injured sheep and whether the baseline PaCO2 and duration of suctioning affect gas exchange. Prospective laboratory evaluation. Animal laboratory in a university hospital. Seven female Dorset sheep. Lung lavage was used to create acute respiratory distress ...
Albaiceta Guillermo M - - 2008
BACKGROUND: Monocyte deactivation, defined as the decrease of surface expression of class II molecules of the main histocompatibility complex (MHC) on circulating monocytes, can occur after severe injuries, like trauma, sepsis, or major surgery. We hypothesized that mechanical ventilation could also be a cause. METHODS: Prospective experimental study. Intact and ...
Wang Zhaoxi - - 2008
Previous microarray-based studies of acute respiratory distress syndrome (ARDS) were performed using various models to mimic disease pathogenesis. The complexity of the pathophysiologic response to direct or indirect lung injury in ARDS is difficult to reconstruct in experimental conditions. Thus, direct analysis of ARDS patient blood may provide valuable information. ...
Bikker Ido G - - 2008
INTRODUCTION: Functional residual capacity (FRC) reference values are obtained from spontaneous breathing patients, and are measured in the sitting or standing position. During mechanical ventilation FRC is determined by the level of positive end-expiratory pressure (PEEP), and it is therefore better to speak of end-expiratory lung volume. Application of higher ...
Wolthuis Esther K - - 2008
BACKGROUND: Mechanical ventilation with high tidal volumes aggravates lung injury in patients with acute lung injury or acute respiratory distress syndrome. The authors sought to determine the effects of short-term mechanical ventilation on local inflammatory responses in patients without preexisting lung injury. METHODS: Patients scheduled to undergo an elective surgical ...
Kim Je Hyeong - - 2008
INTRODUCTION: Poly (ADP-ribose) polymerase (PARP) participates in inflammation by cellular necrosis and the nuclear factor-kappa-B (NF-kappaB)-dependent transcription. The purpose of this study was to examine the roles of PARP in ventilator-induced lung injury (VILI) in normal mice lung. METHODS: Male C57BL/6 mice were divided into four groups: sham tracheostomized (sham), ...
Maisch Stefan - - 2008
BACKGROUND: "Optimal" positive end-expiratory pressure (PEEP) can be defined as the PEEP that prevents recollapse after a recruitment maneuver, avoids over-distension, and, consequently, leads to optimal lung mechanics at minimal dead space ventilation. In this study, we analyzed the effects of PEEP and recruitment on functional residual capacity (FRC), compliance, ...
Lee Bonsan B - - 2008
OBJECTIVE: Evaluation of noninvasive stimulation modalities to augment cough and assist tracheostomy decannulation in high-level tetraplegia. STUDY DESIGN: Single case study. METHODS: A 65-year-old man with C4 ASIA C tetraplegia had delayed rehabilitation due to a tracheostomy and recurrent pneumonia primarily resulting from ineffective cough. Anterior surface electrical stimulation (SES) ...
Lambermont Bernard - - 2008
Functional residual capacity (FRC) measurement is now available on new ventilators as an automated procedure. We compared FRC, static thoracopulmonary compliance (Crs) and PaO2 evolution in an experimental model of acute respiratory distress syndrome (ARDS) during a reversed, sequential ramp procedure of positive end-expiratory pressure (PEEP) changes to investigate the ...
Elgalaid Taher O - - 2008
OBJECTIVE: The aim of this study was to determine the repeatability of apparatus designed to assess dentine permeability at two different pressures. METHOD: Forty-five human coronal tooth portions were prepared and permeability was measured at two separate time points, 5h apart, at 14 cm H2O pressure and then at 100 ...
Valenza Franco - - 2007
BACKGROUND: The authors studied the effects of the beach chair (BC) position, 10 cm H2O positive end-expiratory pressure (PEEP), and pneumoperitoneum on respiratory function in morbidly obese patients undergoing laparoscopic gastric banding. METHODS: The authors studied 20 patients (body mass index 42 +/- 5 kg/m2) during the supine and BC ...
Beck Jennifer - - 2008
OBJECTIVE: Neurally adjusted ventilatory assist uses the electrical activity of the diaphragm (EAdi)--a pneumatically-independent signal--to control the timing and pressure of the ventilation delivered, and should not be affected by leaks. The aim of this study was to evaluate whether NAVA can deliver assist in synchrony and proportionally to EAdi ...
D'Angelo Edgardo - - 2008
Lung morpho-functional alterations and inflammatory response to various types of mechanical ventilation (MV) have been assessed in normal, anesthetized, open-chest rats. Measurements were taken during protective MV [tidal volume (Vt) = 8 ml/kg; positive end-expiratory pressure (PEEP) = 2.6 cmH(2)O] before and after a 2- to 2.5-h period of ventilation ...
Talmor Daniel - - 2007
There are reports of rigors and/or clinical deterioration following recruitment maneuvers (RMs), leading us to question whether the use of sustained high-pressure inflation could lead to release of inflammatory mediators. Prospective cohort study of 26 patients with ARDS receiving mechanical ventilation. A single RM was performed during which the mean ...
Hammes S - - 2007
BACKGROUND AND OBJECTIVE: The use of cold air cooling (CAC) and cryogen spray cooling during dye laser treatment of port-wine stains (PWS) has become a standard in recent years. Still unsolved is the question of which fluences are necessary in combination with CAC in order to achieve an optimum clearance ...
Guérin Claude - - 2007
OBJECTIVE: To investigate the viscoelastic properties of lungs and thoracic wall in piglets. STUDY DESIGN: Prospective experimental study. ANIMALS: Six piglets weighting 30 kg. METHODS: Animals were tracheotomized, anesthetized and mechanically ventilated under controlled conditions. After control measurements of the mechanical properties of the lung of the pigs had been ...
Nagele Udo - - 2007
BACKGROUND AND PURPOSE: In recent years, mini-percutaneous nephrolitholapaxy (mini-PCNL) has gained popularity because of its reduced invasiveness. To improve clinical outcomes further, research is ongoing in selected centers. Important areas of interest include extravasation into the retroperitoneal space, acute absorption syndrome, and septicemia. The aim of this experimental study was ...
LaFollette Ryan - - 2007
The evolution of respiratory care on patients with acute respiratory distress syndrome (ARDS) has been focused on preventing the deleterious effects of mechanical ventilation, termed ventilator-induced lung injury (VILI). Currently, reduced tidal volume is the standard of ventilatory care for patients with ARDS. The current focus, however, has shifted to ...
Thammanomai Apiradee - - 2007
We investigated the influence of load impedance on ventilator performance and the resulting effects of reduced tidal volume (Vt) on lung physiology during a 30-min ventilation of normal mice and 10 min of additional ventilation following lavage-induced injury at two positive end-expiratory pressure (PEEP) levels. Respiratory mechanics were regularly monitored, ...
Grasso Salvatore - - 2007
RATIONALE: In patients with acute respiratory distress syndrome (ARDS), a focal distribution of loss of aeration in lung computed tomography predicts low potential for alveolar recruitment and susceptibility to alveolar hyperinflation with high levels of positive end-expiratory pressure (PEEP). OBJECTIVES: We tested the hypothesis that, in this cohort of patients, ...
Meier Torsten - - 2008
OBJECTIVE: To investigate whether electrical impedance tomography (EIT) is capable of monitoring regional lung recruitment and lung collapse during a positive end-expiratory pressure (PEEP) trial. DESIGN: Experimental animal study of acute lung injury. SUBJECT: Six pigs with saline-lavage-induced acute lung injury. INTERVENTIONS: An incremental and decremental PEEP trial at ten ...
Yagui Ana Cristina Z - - 2007
OBJECTIVE: To observe the effects of the prone position and the need for positive end-expiratory pressure (PEEP) to improve oxygenation. METHOD: Sixteen rats were anesthetized and ventilated at a tidal volume of 8 mL/kg, respiratory rate of 60 rpm and PEEP = 0 cmH(2)O (ZEEP), in the supine position for ...
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