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Zacharias Dimitriadis - - 2011
BACKGROUND: Respiratory muscle strength is an important part of lung function. The assessment of the ability of respiratory muscles to generate force is important for recognizing respiratory muscle weakness not only in pathological populations, but also in healthy people. The main purpose of this study was to assess the test-retest ...
Grippo Antonello - - 2011
OBJECTIVE: Respiratory-related evoked potentials (RREP) elicited by transmural pressure in obstructive sleep apnoea (OSA) subjects have reported conflicting data. Different features of pressure stimuli and/or in the timing of stimuli application seem to account for these contradictory results. The negative expiratory pressure (NEP) technique, highly reproducible in terms of rise ...
Tang Fang - - 2011
To compare the effectiveness of various ventilation modes during suspension laryngoscopy and to investigate risk factors associated with CO(2) retention in high-frequency jet ventilation (HFJV). Part I: Randomized controlled study; Part II: Outcomes research. In Part I, saturation of peripheral oxygen, partial pressure of carbon dioxide (PaCO(2) )(,) and pH ...
Kumar Mala - - 2011
To evaluate the role of Unsynchronized Nasal Intermittent Positive Pressure Ventilation (NIPPV) in prevention of extubation failure in mechanically ventilated preterm neonates weighing less than 2,000 g. This randomized controlled trial was conducted in the neonatal intensive care unit of a tertiary care teaching hospital. Preterm neonates weighing less than ...
Polglase Graeme R - - 2011
Early postnatal events may play a critical role in the development of cardio-respiratory diseases of prematurity. While the exact mechanism is unknown, capillary leakage resulting in increased interstitial fluid volume has been postulated to play a critical role. We investigated the effects of capillary leakage, induced by a volume load, ...
Lowhagen K - - 2011
In acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), recruitment manoeuvres (RMs) are used frequently. In pigs with induced ALI, superior effects have been found using a slow moderate-pressure recruitment manoeuvre (SLRM) compared with a vital capacity recruitment manoeuvre (VICM). We hypothesized that the positive recruitment effects of SLRM could ...
Ludwig Corinna - - 2011
Intermittent positive-pressure breathing is thought to avoid atelectasis and improve pulmonary function after major lung resections. Since no clear scientific data was available to confirm this, our objective was to determine whether atelectasis can be avoided and if postoperative lung function is improved. Prospective analysis was carried out in 135 ...
Pelosi Paolo - - 2011
This article discusses the methods available to evaluate chest wall mechanics and the relationship between intraabdominal pressure (IAP) and chest wall mechanics during general anaesthesia in normal and obese individuals, as well as in acute lung injury/acute respiratory distress syndrome. The interactions between the abdominal and thoracic compartments pose a ...
Magder Sheldon - - 2011
Interactions between the heart and lungs are magnified in patients undergoing mechanical ventilation and the consequences of these interactions always need to be considered when managing ventilated patients. In patients with normal lungs and normal cardiovascular function monitoring needs are minimal, but when oxygenation and cardiac function are compromised careful ...
Modrykamien Ariel - - 2011
Acute respiratory distress syndrome (ARDS) results in collapse of alveoli and therefore poor oxygenation. In this article, we review airway pressure release ventilation (APRV), a mode of mechanical ventilation that may be useful when, owing to ARDS, areas of the lungs are collapsed and need to be reinflated ("recruited"), avoiding ...
Oprea Adriana Dana - - 2011
The adjustable pressure-limiting (APL) valve controls airway pressure during manual ventilation. Failure of the APL valve during induction of anesthesia may occur, and the anesthesiologist must be aware of solutions for this occurrence.
Marini John J - - 2011
To present an updated discussion of those aspects of controlled positive pressure breathing and retained spontaneous regulation of breathing that impact the management of patients whose tissue oxygenation is compromised by acute lung injury. The recent introduction of ventilation techniques geared toward integrating natural breathing rhythms into even the earliest ...
Bouferrache Koceila - - 2011
To reiterate the effects of positive pressure ventilation on right ventricular (RV) function in acute respiratory distress syndrome (ARDS), to explain in which conditions acute cor pulmonale (ACP) may worsen prognosis, and to define an approach to protection of the right ventricle. In unselected populations of ARDS patients, large studies ...
van Dijk Pim - - 2011
Spontaneous otoacoustic emissions can be detected as peaks in the Fourier spectrum of a microphone signal recorded from the ear canal. The height, center frequency, and spectral width of SOAE peaks changed when a static pressure was applied to the ear canal. Most commonly, with either increasing or decreasing static ...
Formenti Paolo - - 2011
PURPOSE: A quantitative measure of the airway pressure-time tracing during passive inflation [stress index (SI)] has been suggested as an indicator of tidal lung recruitment and/or overinflation. If reliable, this simple index could help guide positive end-expiratory pressure (PEEP) and tidal volume selection. The compartment surrounding the lungs should impact ...
da Silva Ramos F J - - 2011
BACKGROUND: /st> The functional haemodynamic variables pulse pressure variation (PPV), stroke volume variation (SVV), and systolic pressure variation (SPV) are widely used to assess haemodynamic status. However, it is not known how these perform during acute lung injury (ALI). This study evaluated the effects of different ventilatory strategies on haemodynamic ...
Kondili Eumorfia - - 2011
BACKGROUND: In mechanically ventilated patients with chronic obstructive pulmonary disease (COPD) the response of expiratory resistance (RrsE) to bronchodilators is virtually unknown. The aim of this study was to examine the effect of inhaled salbutamol on RrsE, and the correlation of salbutamol-induced changes in RrsE with corresponding changes in end-inspiratory ...
Carvalho Alysson R - - 2011
In acute lung injury (ALI), pressure support ventilation (PSV) may improve oxygenation compared with pressure-controlled ventilation (PCV), and benefit from random variation of pressure support (noisy PSV). We investigated the effects of PCV, PSV, and noisy PSV on gas exchange as well as the distribution of lung aeration and perfusion ...
Reifferscheid Florian - - 2011
SUMMARY AT A GLANCE: Posture-dependent redistribution of regional ventilation was determined by electrical impedance tomography in healthy subjects during spontaneous tidal breathing and vital capacity manoeuvres. The ventilation distribution patterns within two examined chest cross-sections were dissimilar. The reproducibility of findings was good which is essential for future clinical follow-up ...
Piraino Tom - - 2011
A 45 yr old female was admitted to our ICU with severe ascites, and septic shock due to an obstructive ureteric stone. Despite an increase in FiO₂ to 1.0, high PEEP levels, and multiple recruitment maneuvers, it was challenging to obtain an SpO₂ > 85% after the patient was turned. ...
Spieth Peter M - - 2011
OBJECTIVES:: To explore whether 1) conventional pressure support ventilation improves lung function and attenuates the pulmonary inflammatory response compared to pressure-controlled ventilation and 2) random variation of pressure support levels (noisy pressure support ventilation) adds further beneficial effects to pressure support ventilation. DESIGN:: Three-arm, randomized, experimental study. SETTING:: University hospital ...
Grooms David A - - 2011
The ARDSnet low tidal volume protocol is considered the standard of care for patients who develop Acute Respiratory Distress Syndrome (ARDS). The protocol is built on the foundation of low tidal volume ventilation, use of a combined PEEP and FIO₂ table, and managing end alveolar inspiratory pressure by limiting plateau ...
Liao Kuang-Ming - - 2011
Objective Double-triggering (DT) is a frequent type of patient-ventilator dyssynchrony with potentially severe consequences such as alveolar overdistention or the generation of auto-PEEP. However, the first breath of DT could be patient triggered (DT-P), auto triggered (DT-A) or ventilator triggered (DT-V). The aim of this investigation was to differentiate these ...
Silva Pedro L - - 2011
OBJECTIVE:: To investigate the effects of the rate of airway pressure increase and duration of recruitment maneuvers on lung function and activation of inflammation, fibrogenesis, and apoptosis in experimental acute lung injury. DESIGN:: Prospective, randomized, controlled experimental study. SETTING:: University research laboratory. SUBJECTS:: Thirty-five Wistar rats submitted to acute lung ...
Bellani Giacomo G Department of Experimental Medicine (DIMS), University of Milan-Bicocca, Via Cadore 48, 20052 Monza (MB) - - 2011
During acute lung injury (ALI), mechanical ventilation can aggravate inflammation by promoting alveolar distension and cyclic recruitment-derecruitment. As an estimate of the intensity of inflammation, metabolic activity can be measured by positron emission tomography imaging of [(18)F]fluoro-2-deoxy-D-glucose. To assess the relationship between gas volume changes induced by tidal ventilation and ...
Kitaoka Hiroko - - 2011
SUMMARY AT A GLANCE: Airflow simulation with computational fluid dynamics by the use of a 4D lobule model revealed that frequency dependence of respiratory resistance measured by impulse oscillometry is an index of the alveolar pressure inequality caused by heterogeneous changes in the intra-pulmonary airway and/or the lung parenchyma. ABSTRACT: ...
Wheeler Kevin I - - 2011
Aim:  The Dräger Babylog 8000plus ventilator (Dräger Medical Systems, Lübeck, Germany) can provide both conventional and high-frequency ventilation (HFV). Dräger recommends specific circuits for each of these modes. We investigated the performance of the Babylog ventilator in HFV mode when used with the recommended circuits for both conventional and HFV. ...
Veres Jan - - 2011
Background: A new device was developed to deliver high-frequency jet ventilation via a laryngeal mask airway (LMA). We investigated its use during flexible fiberoptic bronchoscopy in anesthetized patients. Methods: Thirty adults were studied during interventional bronchoscopy. After facemask ventilation, the Veres adapter was connected to a size 4 or 5 ...
Srivastava Neena - - 2011
Glucocorticoids and its receptor are known to be involved in the dysregulation of hormone and lipid levels. Therefore, we evaluated the association of Bcl1 gene polymorphism of glucocorticoids receptor (GCR) gene variant with hormone and lipid levels in Northern Indians obese. A total of 435 obese and non-obese age matched ...
Cremona George - - 2011
Lung volume reduction surgery (LVRS) improves lung function, respiratory symptoms, and exercise tolerance in selected patients with chronic obstructive pulmonary disease, who have heterogeneous emphysema. However, the reported effects of LVRS on gas exchange are variable, even when lung function is improved. To clarify how LVRS affects gas exchange in ...
Sanchez-Lorente David - - 2011
We describe a useful salvage method for hypoxaemia during one-lung ventilation (OLV) in functionally impaired patients during a sleeve bronchial reconstruction. When dependent-lung OLV strategies for hypoxaemia fail during bronchial anastomosis (increasing the oxygen administration to fraction of inspired oxygen (FiO(2)) 1 and positive end-expiratory pressure (PEEP), recruitment strategy and ...
Lackner Helmut Karl - - 2011
We studied the synchronization of heart rate, blood pressure and respiration in the sympathetic and parasympathetic branches of the autonomic nervous system during a cancellation test of attention and during mental arithmetic tasks. The synchronization was quantified by the index γ, which has been adopted from the analysis of weakly ...
Ishikawa Seiji - - 2011
PURPOSE: We previously showed that compression of the nondependent lung during one-lung ventilation (OLV) in patients undergoing esophagectomy improves arterial oxygenation but impairs cardiac output (CO) and systemic oxygen delivery (DO(2)). The objective of this study was to test the hypothesis that the combination of nondependent lung compression and ephedrine ...
Seah Adrian S - - 2011
Management of patients with acute lung injury (ALI) rests on achieving a balance between the gas exchanging benefits of mechanical ventilation and the exacerbation of tissue damage in the form of ventilator-induced lung injury (VILI). Optimizing this balance requires an injury cost function relating injury progression to the measurable pressures, ...
Kapetanakis Theodoros - - 2011
There is mounting experimental evidence that hypercapnic acidosis protects against lung injury. However, it is unclear if acidosis per se rather than hypercapnia is responsible for this beneficial effect. Therefore, we sought to evaluate the effects of hypercapnic (respiratory) versus normocapnic (metabolic) acidosis in an ex vivo model of ventilator-induced ...
Macintyre Neil R - - 2011
Assisted (interactive) breathing is generally preferred to controlled breaths in patients on mechanical ventilators. Assisted breaths allow the patient's respiratory muscles to be used, and ventilatory muscle atrophy can be prevented. Moreover, the respiratory drive of the patient does not have to be aggressively blunted. However, interactive breaths need to ...
Slim Ahmad M - - 2011
Background. Airway pressure release ventilation (APRV) is a mode of mechanical ventilation that theoretically believed to improve cardiac output by lowering right atrial pressure. However, hemodynamic parameters have never been formally assessed. Methods. Seven healthy swine were intubated and sedated. A baseline assessment of conventional ventilation (assist control) and positive ...
Gentile Michael A - - 2011
Patient-ventilator interaction is a key element in optimizing mechanical ventilation. The change from inspiration to expiration is a crucial point in the mechanically ventilated breath, and is termed "cycling." Patient-ventilator asynchrony may occur if the flow at which the ventilator cycles to exhalation does not coincide with the termination of ...
Hodgson Carol L - - 2011
Recruitment maneuvers (RMs) can expand collapsed alveoli in ventilated patients. The optimal method for delivering RMs is unknown. Purpose: To evaluate the safety and the respiratory and hemodynamic effects of a staircase recruitment maneuver (SRM) with decremental positive end expiratory pressure (PEEP) titration and the consequences of desaturation during the ...
Blakeman Thomas - - 2011
To evaluate the SAVe simplified automated ventilator in a laboratory setting to determine performance characteristics, accuracy of tidal volume delivery at various lung compliance, and battery life at sea level and at altitude. Three SAVe ventilators were used for the evaluation. Each ventilator was attached to a test lung with ...
Burns Karen E A - - 2011
Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are life threatening clinical conditions seen in critically ill patients with diverse underlying illnesses. Lung injury may be perpetuated by ventilation strategies that do not limit lung volumes and airway pressures. We conducted a systematic review and meta-analysis of randomized ...
Albaiceta Guillermo M - - 2011
Ventilator-induced lung injury (VILI) consists of tissue damage and a biological response resulting from the application of inappropriate mechanical forces to the lung parenchyma. The current paradigm attributes VILI to overstretching due to very high-volume ventilation (volutrauma) and cyclic changes in aeration due to very low-volume ventilation (atelectrauma); however, this ...
Papaioannou Vasilios E - - 2011
Separation from mechanical ventilation is a difficult task, whereas conventional predictive indices have not been proven accurate enough, so far. A few studies have explored changes of breathing pattern variability for weaning outcome prediction, with conflicting results. In this study, we tried to assess respiratory complexity during weaning trials, using ...
Grant Caroline A - - 2011
Electrical impedance tomography (EIT) has been shown to be able to distinguish both ventilation and perfusion. With adequate filtering the regional distributions of both ventilation and perfusion and their relationships could be analysed. Several methods of separation have been suggested previously, including breath holding, electrocardiograph (ECG) gating and frequency filtering. ...
De Backer Daniel - - 2011
Respiratory-associated variations in stroke volume and pulse pressure are frequently used to predict the response to fluid administration. However, it has been demonstrated that low tidal volume ventilation may limit their use in patients with acute respiratory distress syndrome (ARDS). In this issue, a trial investigates the value of pulse ...
Schifelbain Luciele Medianeira - - 2011
Echocardiographic, electrocardiographic and other cardiorespiratory variables can change during weaning from mechanical ventilation. To analyze changes in cardiac function, using Doppler echocardiogram, in critical patients during weaning from mechanical ventilation, using two different weaning methods: pressure support ventilation and T-tube; and comparing patient subgroups: success vs. failure in weaning. Randomized ...
Mattingley Jennifer S - - 2011
This small observational study was motivated by our belief that scaling the tidal volume in mechanically ventilated patients to the size of the injured lung is safer and more 'physiologic' than scaling it to predicted body weight, i.e. its size before it was injured. We defined Total Lung Capacity (TLC) ...
Lakhal Karim - - 2011
Fluid responsiveness prediction is of utmost interest during acute respiratory distress syndrome (ARDS), but the performance of respiratory pulse pressure variation (ΔRESPPP) has scarcely been reported. In patients with ARDS, the pathophysiology of ΔRESPPP may differ from that of healthy lungs because of low tidal volume (Vt), high respiratory rate, ...
Fanelli Vito - - 2011
Low tidal volume (VT 6 ml/predicted body weight) pressure limited (plateau pressure <30 cmH2O) protective ventilation as proposed by the ARDS Network was associated with an improvement in mortality and is considered the gold standard for acute respiratory distress syndrome (ARDS) ventilation strategies. Limiting plateau pressure minimizes ventilator-induced lung injury ...
Henzler Dietrich - - 2011
Partial ventilatory support modalities are ill defined and different perceptions about these modes might depend on geographic region. Exemplary on two recent publications investigating airway pressure release ventilation (APRV) in an adult ICU population, the question is investigated whether research in ventilation modes can be performed with the current definitions. ...
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