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Covert Tessa T Tessa Covert, MSN, AGACNP-BC, CRNP, CCRN, has 10 years of nursing experience. She recently received her Master's of Science in Nursing from the University of Pennsylvania and currently works in the Medical ICU at Penn Presbyterian Hospital. Ng Tung Niu, MSN, CRNP, AGACNP-BC, CCRN, has 7 years of experience as an ICU RN. He recently graduated from the University of Pennsylvania and is now a CRNP at the University of Pennsylvania Trauma Critical Care - - 2015
The sickest patients often require mechanical ventilation. Although mechanical ventilation is often a lifesaving intervention for many, it can also have life-threatening complications. Monitoring a patient on mechanical ventilation requires skill and prompt troubleshooting to ensure its proper function. The high peak airway pressure (HPAP) alarm is one of the ...
Spaeth Johannes J Department of Anesthesiology and Intensive Care Medicine, University Medical Center Freiburg, Freiburg, - - 2014
During mechanical ventilation, the airway pressure (Paw ) is usually monitored. However, Paw comprises the endotracheal tube (ETT)-related pressure drop (∆PETT ) and thus does not reflect the pressure in the patients' lungs. Therefore, monitoring of mechanical ventilation should be based on the tracheal pressure (Ptrach ). We systematically investigated ...
Iyer Narayan P NP Division of Neonatology, Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University, Cleveland, - - 2014
Nasal noninvasive ventilation (NIV) is a common form of noninvasive respiratory mode used in newborn infants. A next-generation nasal cannula (Neotech RAM cannula) has recently been used to provide nasal NIV. The impact of the Neotech RAM cannula on the delivery of pressure needs to be studied. In this ex ...
Zanella Alberto A Dipartimento di Scienze della Salute, Università di Milano-Bicocca, Ospedale San Gerardo Nuovo dei Tintori, Monza, Italy. National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Maryland. - - 2014
The literature generally describes the trachea as oriented toward the right and back, but there is very little detailed characterization. Therefore, the aim of this study was to precisely determine the spatial orientation and to better characterize the physical properties of the human trachea. We analyzed lung computed tomography scans ...
Lundin S S Department of Anesthesiology and Intensive Care, Sahlgrenska University Hospital, Gothenburg, - - 2014
Transpulmonary pressure is a key factor for protective ventilation. This requires measurements of oesophageal pressure that is rarely used clinically. A simple method may be found, if it could be shown that tidal and positive end-expiratory pressure (PEEP) inflation of the lungs with the same volume increases transpulmonary pressure equally. ...
Guo Ray R Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, - - 2014
The cornerstone of lung protective ventilation in patients with acute respiratory distress syndrome (ARDS) is a pressure- and volume-limited strategy. Other interventions have also been investigated. Although no method for positive end-expiratory pressure (PEEP) titration has proven most advantageous, experimental and clinical data support the use of higher PEEP in ...
Roberson Russell S RS Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center at Dallas, 5909 Harry Hines Blvd, Dallas, TX 75390-9202, USA. Electronic address: - - 2014
It is often unclear whether or not a patient's stroke volume will increase following a fluid bolus. Volume responsiveness is defined by an increase in stroke volume following a fluid bolus. For patients being mechanically ventilated, the cardiopulmonary interactions associated with positive pressure ventilation create pulse pressure and stroke volume ...
Mendes Paulo R PR Department of Internal Medicine, School of Medical Sciences, University of Campinas, São Paulo, - - 2014
Hypertensive patients are predisposed to left ventricular (LV) remodeling and frequently exhibit decline in lung function as compared with the general population. Here, we investigated the association between spirometric and echocardiographic data in non-smoking hypertensive subjects and the role of gender in this regard. In a cross-sectional study, 107 hypertensive ...
Garnero A A Service de réanimation polyvalente, Hôpital Sainte Musse, 54 avenue Henri Sainte Claire Deville, 83056 Toulon, France - - - 2014
Chest wall mechanics can be abnormal in patients with Acute Respiratory Disease Syndrome (ARDS). Therefore, partitioning respiratory system between lungs and chest wall at the bedside is useful to optimize ventilator settings. A non--invasive method for assessing lung elastance (EL), called lung barometry, was previously described on an animal model. ...
Hartland Benjamin L BL Department of Nurse Anesthesia, Virginia Commonwealth University, Richmond, Virginia. - - 2014
The sigh is a normal homeostatic reflex that maintains lung compliance and decreases atelectasis. General anesthesia abolishes the sigh reflex with rapid onset of atelectasis in 100% of patients. Studies show a strong correlation between atelectasis and postoperative pulmonary complications, raising health-care costs. Alveolar recruitment maneuvers recruit collapsed alveoli, increase ...
Wirth S S Department of Anesthesiology and Intensive Care Medicine, University Medical Center Freiburg, Hugstetter Straße 55, Freiburg D-79106, Germany - - 2014
Lung-protective mechanical ventilation during general surgery including the application of PEEP can reduce postoperative pulmonary complications. In a prospective clinical observation study, we evaluated volume-dependent respiratory system compliance in adult patients undergoing ear-nose-throat surgery with ventilation settings chosen empirically by the attending anaesthetist. In 40 patients, we measured the respiratory ...
Motoyama Hideki H Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, - - 2014
Although ex vivo lung perfusion (EVLP) has been clinically applied as a novel rig to evaluate marginal donor lungs, no parameters have been reported to objectively detect regional lung damage during EVLP. The aim of this study was to investigate whether regional donor lung malperfusion-related damage caused by a thrombus ...
Preiss David A DA Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School/Massachusetts General Hospital, Boston, MA, - - 2015
A non-invasive means of measuring pulmonary blood flow (PBF) would have numerous benefits in medicine. Traditionally, respiratory-based methods require breathing maneuvers, partial rebreathing, or foreign gas mixing because exhaled CO2 volume on a per-breath basis does not accurately represent alveolar exchange of CO2. We hypothesized that if the dilutional effect ...
Beker Friederike F The Royal Women's Hospital, Parkville, Victoria, Australia; The Mercy Hospital for Women, Heidelberg, Victoria, Australia; Monash Medical Centre, Clayton, Victoria, - - 2014
Previous studies suggest that high airway pressure may compromise cardiac output. We investigated the effect of 3 nasal continuous positive airway pressure levels on cardiac output in preterm infants with evolving chronic lung disease. We found that brief changes in continuous positive airway pressure did not affect cardiac output.
Dori Guy G Department of Internal Medicine E, HaEmek Medical Center, Afula, Israel. Electronic address: - - 2014
Cardiogenic pulmonary edema (PEd) is a life-threatening condition where fluid accumulates in the lungs due to increasing hydrostatic pressure building up in the pulmonary vasculature (PV): veins, venules and capillaries. Atrial fibrillation (AF) is accepted as an arrhythmia which triggers and promotes the pathophysiological processes leading to pulmonary congestion and ...
Kyu Lee Dong D Departments of *Anesthesiolafogy and Pain - - 2014
One-lung ventilation is considered to be mandatory in video-assisted thoracoscopic surgery. However, the authors showed in a previous report that two-lung ventilation with low tidal volume is feasible in thoracoscopic bleb resection (TBR). In this study, they evaluated optimal respiratory rate during TBR under two-lung ventilation with low-tidal volume anesthesia. ...
Brassard Charles L CL Department of Anesthesiology and Critical Care, Université Laval, Quebec City, QC, - - 2014
The purpose of this Continuing Professional Development Module is to review the issues pertinent to one-lung ventilation (OLV) and to propose a management strategy for ventilation before, during, and after lung isolation. The need for optimal lung isolation has increased with the advent of video-assisted thoracoscopic surgery, as surgical exposure ...
Mortola Jacopo P - - 2014
Respiratory sinus arrhythmia (RSA) is an acceleration of heart rate during inspiration and deceleration with expiration. We asked whether or not in humans some of the volume-related information necessary for RSA originated from the chest wall. Men and women, 19-20 years old, were breathing supine. Rib cage and abdomen displacement ...
Teichert-Kuliszewska Krystyna K Division of Cardiology, Department of Medicine, University of Toronto, Toronto, - - 2014
S100A1, a 10-kDa, Ca(2+) -binding protein is expressed in endothelial cells (EC) and binds eNOS. Its absence is associated with impaired production of nitric oxide (NO) and mild systemic hypertension. As endothelial dysfunction contributes to clinical and experimental pulmonary hypertension (PH), we investigated the impact of deleting S100A1 in mice, ...
Guazzi Marco M Cardiology, I.R.C.C.S. Policlinico San Donato, University of Milano, San Donato Milanese, Italy. Electronic address: - - 2014
Cardiac dysfunction of both systolic and diastolic origin leads to increased left atrial pressure, lung capillary injury and increased resistance to gas transfer. Acutely, pressure-induced trauma disrupts the endothelial and alveolar anatomical configuration and definitively causes an impairment of cellular pathways involved in fluid-flux regulation and gas exchange efficiency, a ...
Cheifetz Ira M IM Department of Pediatrics, Children's Services, and Pediatric Critical Care Medicine, Duke University Medical Center, Duke Children's Hospital, Durham, North Carolina. - - 2014
The overall goal of the cardiorespiratory system is to provide the organs and tissues of the body with an adequate supply of oxygen in relation to oxygen consumption. An understanding of the complex physiologic interactions between the respiratory and cardiac systems is essential to optimal patient management. Alterations in intrathoracic ...
DiBlasi Robert M RM Seattle Children's Hospital, Seattle, Washington. Center for Developmental Therapeutics, Seattle Children's Hospital Research Institute, Seattle, Washington. - - 2014
Inhaled nitric oxide (INO) has been used with heated and humidified high-flow nasal cannula (HFNC), nasal CPAP and several forms of noninvasive ventilation (NIV). This study was designed to evaluate the delivered dose of INO, level of NO2 generation, and effect of net gas delivery (addition of INO to the ...
Cowie B B Department of Anaesthesia, St. Vincent's Hospital, Melbourne, Victoria, Australia; Department of Anesthesiology, University Hospitals Leuven, - - 2014
With the reduction in use of the pulmonary artery catheter, alternative methods of pulmonary pressure estimation are required. The use of echocardiographically-derived right ventricular systolic pressure has recently been questioned, but this technique has not been validated in anaesthetised surgical patients with transoesophageal echocardiography. One hundred measurements of right ventricular ...
Mellies Uwe U University of Essen, Pediatric Pulmonology and Sleep Medicine, Essen, Germany ; - - 2014
Background: For patients with neuromuscular disorders (NMD), lung insufflation with positive pressure is an accepted technique to increase inspiratory volume over Vital Capacity (VC) in order to improve Peak Cough Flow (PCF). However, the pressure or volume required to achieve the highest individual PCF is not known. Methods: In 40 ...
Soldati Gino G Emergency Medicine Unit, Castelnuovo Garfagnana General Hospital, Lucca, - - 2014
Background: Echographic vertical artifacts (B-lines) in chest ultrasonography have often been associated with pathological patterns. A scientifically sound explanation of these artifacts has not yet been proposed. Objectives: The 'spongy' nature of the lung in its liquid and solid components and the changes that take place in peripheral airspace (PAS) ...
Yun Du Gyun DG Department of Anesthesiology and Pain Medicine, Ewha Womans University School of Medicine, Seoul, - - 2014
The present study will focus on the rationale for the use of small tidal volume with 6 cmH2O positive end expiratory pressure (PEEP) with the changes of arterial oxygen tension, plateau airway pressure, and static lung compliance during one lung ventilation for endoscopic thoracic surgery. Forty-three patients were intubated with ...
Di Marco Fabiano F From the *Pneumologia, Ospedale San Paolo, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy; †Department of Experimental Medicine, University of Milano-Bicocca, Italy; ‡Centro Cardiologico Monzino IRCCS, Milano, Italy; §Centro Cardiologico Monzino IRCCS, Dipartimento di Scienze Cliniche e di Comunità, Sezione cardiovascolare, Università di Milano, Milan, Italy; ‖Division of Pulmonary and Critical Care and Medicine, Department of Medicine, University of Washington, Seattle, Washington; and ¶Anesthesia and Intensive Care, Ospedale Niguarda Ca' Granda, Milano, - - 2014
An increased alveolar-arterial oxygen tension difference is frequent in anesthetized patients. In this study, we evaluated the effect on the lung of anesthesia, muscle paralysis, and a brief course of mechanical ventilation. Lung diffusion for carbon monoxide (DLCO), including pulmonary capillary blood volume (Vc) and conductance of the alveolar-capillary membrane ...
El-Tahan Mohamed R MR Department of Anesthesiology, King Fahd Hospital of the University of Dammam, Dammam, Saudi Arabia, P.O. 40289, Al Khubar 31952, Saudi Arabia. Electronic address: - - 2014
A novel method in the management of refractory severe hypoxemia during one-lung ventilation (OLV) in a patient who presented with myasthenia gravis, asthma, a symptomatic mediastinal mass, hiatal hernia, and a moderate pericardial effusion is presented. The patient was scheduled for excision of a large anterior mediastinal mass and creation ...
Stahl C A CA Department of Anesthesiology and Intensive Care Medicine, University Medical Center Freiburg, Freiburg, - - 2014
It has been proposed that the analysis of positive end-expiratory pressure (PEEP)-induced volume changes can quantify alveolar recruitment. The potential of a lung to be recruited is expected to be high in acute respiratory distress syndrome (ARDS), where collapsed lung tissue is very common. The volume change that is beyond ...
Hess Dean R DR Respiratory Care Services, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts. - - 2014
Respiratory mechanics refers to the expression of lung function through measures of pressure and flow. From these measurements, a variety of derived indices can be determined, such as volume, compliance, resistance, and work of breathing. Plateau pressure is a measure of end-inspiratory distending pressure. It has become increasingly appreciated that ...
Boussuges Alain A UMR-MD2, French Armed Biomedical Research Institute, IRBA, Brétigny sur Orge, and Aix-Marseille University, Marseille, France (Drs Boussuges, Bessereau, Coulange, and Rossi). Electronic address: - - 2014
The glossopharyngeal insufflation maneuver (lung packing) is largely performed by competitive breath-hold divers to improve their performance, despite observational evidence of fainting and loss of consciousness in the first seconds of apnea. We describe here the time course of hemodynamic changes, induced by breath-holding with and without lung packing, in ...
Mrazkova Hana H 3rd Department of Surgery, University Hospital Motol and 1st Medical School, Charles University in Prague, Prague, Czech Republic. Electronic address: - - 2014
Lifesaving therapy for patients with end-stage lung disease is lung transplantation. However, there are not enough available donors. A relatively new method of transplantation from non-heart-beating donors (NHBDs) allows the treatment of the lung outside the body and could increase the number of suitable lungs. We have focused on hypercapnic ...
Hamedani Hooman H From the Department of Radiology (H.H., S.J.K., M.I., Y.X., K.E., B.H., H.S., D.G., W.G., R.R.R.), Department of Anesthesiology and Critical Care (M.C.), and Pulmonary, Allergy and Critical Care Division (M.D.R.), University of Pennsylvania, 308 Stemmler Hall, 3450 Hamilton Walk, Philadelphia, PA - - 2014
Purpose To assess the ability of helium 3 ((3)He) magnetic resonance (MR) imaging of regional alveolar partial pressure of oxygen ( Pao2 alveolar partial pressure of oxygen ) to depict smoking-induced functional alterations and to compare its efficacy to that of current diagnostic techniques. Materials and Methods This study was ...
Davis Daniel P - - 2014
Abstract Background: Inadvertent hyperventilation is associated with poor outcomes from traumatic brain injury (TBI). Hypocapnic cerebral vasoconstriction is well described and causes an immediate and profound decrease in cerebral perfusion. The hemodynamic effects of positive-pressure ventilation (PPV) remain incompletely understood but may be equally important, particularly in the hypovolemic patient ...
de Prost Nicolas N Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts Medical Intensive Care Unit, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France - - 2014
PET with (18)F-FDG allows for noninvasive assessment of regional lung metabolism reflective of neutrophilic inflammation. This study aimed at determining during early acute lung injury whether local (18)F-FDG phosphorylation rate and volume of distribution were sensitive to the initial regional inflammatory response and whether they depended on the mechanism of ...
Marhong Jonathan J Interdepartmental Division of Critical Care Medicine, University of Toronto and the Department of Medicine, University Health Network and Mount Sinai Hospital, Toronto, Ontario, - - 2014
Hypercapnia and hypocapnia commonly complicate conditions that are present in critically ill patients. Both conditions have important physiologic effects that may impact the clinical management of these patients. For instance, hypercapnia results in bronchodilation and enhanced hypoxic vasoconstriction, leading to improved ventilation/perfusion matching. Hypocapnia reduces cerebral blood volume through arterial ...
Duyndam Anita A Erasmus MC - Sophia Children's Hospital, Rotterdam, The - - 2014
To evaluate to what extent physicians on a paediatric intensive care unit (PICU) adhered to a newly implemented ventilation algorithm. PICUs worldwide use different ventilators with a wide variety of ventilation modes. We developed an algorithm, as part of a larger protocol, for choice of ventilation mode at time of ...
Song Seok Young SY Department of Anesthesiology and Pain Medicine, Catholic University of Daegu School of Medicine, Daegu, - - 2014
The purpose of this study was to investigate the changes in airway pressure and arterial oxygenation between ventilation modes during one-lung ventilation (OLV) in patients undergoing thoracic surgery. We enrolled 27 patients for thoracic surgery with OLV in the lateral decubitus position. The subjects received various modes of ventilation in ...
Del Bo' Cristian C Università degli Studi di Milano, Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Milano, Italy. - - 2014
Cigarette smoking causes oxidative stress, hypertension and endothelial dysfunction. Polyphenol-rich foods may prevent these conditions. We investigated the effect of a single serving of fresh-frozen blueberry intake on peripheral arterial function and arterial stiffness in young smokers. Sixteen male smokers were recruited for a 3-armed randomized-controlled study with the following ...
Zhu Bing B Respiratory Technology, Woolcock Institute of Medical Research - - 2014
Abstract There are a multitude of formulation factors to consider when developing a solution-based pressurized metered dose inhaler (pMDI). Evaluation of these variables and their underpinning driving force has been performed over the years. Key components, including formulation composition and device design, play significant roles in determining the aerosol performance ...
Pouzou Jane G JG Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, - - 2014
Shipbuilding involves intensive welding activities within enclosed and confined spaces, and although ventilation is commonly used in the industry, its use and effectiveness has not been adequately documented. Workers engaged in welding in enclosed or confined spaces in two shipyards were observed for their use of ventilation and monitored for ...
Huynh Trang T Division of Newborn Medicine, Department of Pediatrics, New York Presbyterian Hospital, New York, - - 2014
Delivery room cardiopulmonary resuscitation is rare. Recent evidence suggests that effective ventilation may be compromised during chest compressions (CC). To determine whether trained neonatal personnel can assess effective ventilation during CC in the setting of changing lung compliance. Neonatal providers (n=30) provided CC using a 3:1 CC to ventilation ratio ...
Uzawa Yoshihiro Y Department of Rehabilitation, Kameda Medical Center. Electronic address: - - 2014
Lung volume changes involve the recruitment of collapsed alveoli and the expansion of already opened alveoli. This study aimed to determine the alveolar recruitment function by using a mathematical model from a Pressure-Volume curve (P-V curve). We assumed a lung model as VL=R(P)V0f(P), where R recruitment function is the fraction ...
Kollisch-Singule Michaela M Department of General Surgery, SUNY Upstate Medical University, Syracuse, - - 2014
Improper mechanical ventilation can exacerbate acute lung damage, causing a secondary ventilator-induced lung injury (VILI). We hypothesized that VILI can be reduced by modifying specific components of the ventilation waveform (mechanical breath), and we studied the impact of airway pressure release ventilation (APRV) and controlled mandatory ventilation (CMV) on the ...
Fischer Hendrik Stefan HS Department of Neonatology, Charité Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany, - - 2014
Nasal high-frequency oscillation ventilation (nHFOV) is a non-invasive ventilation mode that applies an oscillatory pressure waveform to the airways using a nasal interface. nHFOV has been shown to facilitate carbon dioxide expiration, but little is known about its use in neonates. In a questionnaire-based survey, we assessed nHFOV use in ...
Kollisch-Singule Michaela M Department of General Surgery, State University of New York Upstate Medical University, - - 2014
Improper mechanical ventilation settings can exacerbate acute lung injury by causing a secondary ventilator-induced lung injury. It is therefore important to establish the mechanism by which the ventilator induces lung injury to develop protective ventilation strategies. It has been postulated that the mechanism of ventilator-induced lung injury is the result ...
Mayhew Philipp D PD Departments of Surgical and Radiological Sciences, University of California-Davis, Davis, - - 2014
To document a technique for one-lung ventilation (OLV) in cats and evaluate the effect of low-pressure carbon dioxide insufflation and OLV (OLV-CDI) on cardiorespiratory variables in cats. Prospective randomized study. Cats (n = 6). General anesthesia was induced using a standardized anesthetic protocol. A thermodilution catheter was placed into the pulmonary artery ...
Suehiro Koichi K Department of Anesthesiology, Osaka City University Graduate School of Medicine, 1-5-7 Asahimachi, Abenoku, Osaka City, Osaka, 545-8586, Japan, - - 2014
This study was aimed at comparing the cardiac output (CO) measured by the Vigileo™-FloTrac™ system with that estimated by the thermodilution pulmonary artery catheter (PAC) during one-lung ventilation (OLV) and determining the reliability of this system in tracking phenylephrine-induced CO changes during OLV. Sixteen patients scheduled for descending aorta replacement ...
Strnad Matej M aCenter for Emergency Medicine, Community Health Center Maribor bMedical Faculty cFaculty of Health Sciences, University of Maribor, Maribor, - - 2014
The aim of this pilot study was to determine the usefulness of prehospital lung ultrasound in monitoring the effectiveness of treatment with continuous positive airway pressure (CPAP) versus standard therapy in patients with acute decompensated heart failure (ADHF). Twenty patients with ADHF were enrolled in this prospective, observational study. They ...
Berger David - - 2014
IntroductionAssist in unison to the patient¿s inspiratory neural effort and feedback- controlled limitation of lung distension with neurally adjusted ventilatory assist (NAVA) may reduce the negative effects of mechanical ventilation on right ventricular function.MethodsHeart-lung interaction was evaluated in 10 intubated patients with impaired cardiac function using esophageal balloons, pulmonary artery ...
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