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Engström Joakim - - 2013
Daily routine ventilator-filter exchange interrupts the integrity of the ventilator circuit. We hypothesized that this might reduce positive airway pressure in mechanically ventilated ICU patients, inducing alveolar collapse and causing impaired oxygenation and compliance of the respiratory system (CRS). 40 consecutive ICU patients (PaO2/FIO2 ratio ≤ 300 mm Hg), mechanically ...
Rizkalla Nicole A NA Department of Anesthesiology and Critical Care Medicine, The Children's Hospital of Philadelphia, Philadelphia, - - 2013
High-frequency percussive ventilation (HFPV) in pediatrics has been described predominantly in burned patients. We aimed to describe its effectiveness and safety in noninhalational pediatric acute respiratory failure (ARF). We conducted an observational study in a tertiary care pediatric intensive care unit on 31 patients with ARF failing conventional ventilation transitioned ...
Wootton David M - - 2013
Rationale: Computational fluid dynamics (CFD) analysis may quantify the severity of anatomical airway restriction in obstructive sleep apnea syndrome (OSAS) better than anatomical measurements alone. However, optimal CFD model endpoints to characterize or assess OSAS have not been determined. Objectives: To model upper airway fluid dynamics using CFD and investigate ...
Carter Eleanor L - - 2013
Ventilation-associated pneumonia (VAP) is the commonest nosocomial infection in intensive care. Implementation of a VAP prevention care bundle is a proven method to reduce its incidence. The UK care bundle recommends maintenance of the tracheal tube cuff pressure at 20 to 30 cmH2O with 4-hourly pressure checks and use of tracheal ...
Kim Min-Soo MS Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul 120-752, Republic of - - 2013
This single-center, prospective, randomized, double-blind, 2-arm, parallel group comparison trial was performed to establish whether the adult-sized laryngeal mask airway (LMA) Classic (The Laryngeal Mask Company Ltd, Henley-on-Thames, UK) could be used safely without any consideration of cuff hyperinflation when a cuff of the LMA Classic was inflated using half ...
Barjaktarevic Igor - - 2013
Endotracheal intubation is difficult in patients with hypoxemic respiratory failure who deteriorate despite treatment with noninvasive positive pressure ventilation (NIPPV). Maintaining NIPPV during intubation may prevent alveolar derecruitment and deterioration in gas exchange. We report a case series of 10 nonconsecutive patients with NIPPV failure who were intubated via a ...
Chantzara G - - 2013
Background: Pharyngolaryngeal discomfort is a significant complication following the use of laryngeal mask airway (LMA). The present study aimed to investigate the relation of LMA cuff pressure and the occurrence of pharyngolaryngeal discomfort during spontaneous ventilation (SV), pressure support (PSV) and pressure control ventilation (PCV). Methods: 120 patients, ASA I-III, ...
Sasano Nobuko - - 2013
Percutaneous transtracheal ventilation (PTV) can be life-saving in a cannot ventilate, cannot intubate situation. The aim of this study was to investigate the efficacy of PTV by measuring tidal volumes (VTs) and airway pressure (Paw) in high-flow oxygen ventilation and manual ventilation using a model lung. We examined 14G, 16G, ...
Birkenfeld Falk F Institute of Anatomy, Christian-Albrechts University, Kiel, - - 2013
The aim of the study was to evaluate the leakage of liquid past the cuffs of tracheal tubes in fresh frozen human heads. Six truncated fresh frozen heads were used and intubated with 8.0 mm endotracheal tubes. The intracuff pressures tested were 30 and 100 cmH2O. Subsequently, 20 ml of ...
Marjanovic Nicolas - - 2013
In the absence of endotracheal intubation, the manual bag-valve is the most frequently used ventilation technique during resuscitation. The efficiency of other devices has been poorly studied. The bench-test study described here was designed to evaluate the effectiveness of an automatic, manually-triggered system, and to compare it with manual bag ...
Efe Esra Mercanooglu EM Department of Anesthesiology and Reanimation, Ankara University Medical Faculty, Ankara, Turkey. Electronic address: - - 2014
The aim of this randomized, prospective and double blinded study is to investigate effects of different esmolol use on hemodynamic response of laryngoscopy, endotracheal intubation and sternotomy in coronary artery bypass graft surgery. After approval of local ethics committee and patients' written informed consent, 45 patients were randomized into three ...
Patel Shreya - - 2013
Uncuffed endotracheal tubes are still preferred over cuffed tubes in certain situations in pediatric anesthesia. Inaccurately sized uncuffed endotracheal tubes may lead to inadequate ventilation or tracheal mucosal damage during anesthesia. Endotracheal tube size in children is usually assessed by measuring the audible leak pressure; if the fit of the ...
Cedborg Anna I Hårdemark - - 2013
Intact pharyngeal function and coordination of breathing and swallowing are essential for airway protection and to avoid respiratory complications. Postoperative pulmonary complications caused by residual effects of neuromuscular-blocking agents occur more frequently in the elderly. Moreover, elderly have altered pharyngeal function which is associated with increased risk of aspiration. The ...
Kill Clemens - - 2013
Mechanical ventilation with an automated ventilator is recommended during cardiopulmonary resuscitation with a secured airway. We investigated the influence of intermittent positive-pressure ventilation, bilevel ventilation, and the novel ventilator mode chest compression synchronized ventilation, a pressure-controlled ventilation triggered by each chest compression, on gas exchange, hemodynamics, and return of spontaneous ...
Maitra Souvik - - 2013
Laryngeal mask airway (LMA) Supreme is a newly introduced single-use supraglottic device, which shares common features of both the LMA Pro-Seal and the intubating LMA (ILMA). Clinical studies have compared the safety and efficacy of the LMA Supreme over the 'gold standard' LMA Pro-Seal in different patient populations. However, the ...
Wilson Emily V - - 2013
Ventilation during neonatal resuscitation is typically initiated with a face mask, but may be ineffective due to leak or obstruction. To compare leak using three methods of mask hold. Medical and nursing staff regularly involved in neonatal resuscitation used the three holds (two-point, two-handed, spider) on a manikin in a ...
Sinderby Christer - - 2013
The aim of this study was to validate an automated, objective and standardized algorithm for quantifying and displaying patient-ventilator interaction. Using a new method to detect patient-ventilator synchrony, the present study re-analyzed previously acquired and published data from 24 mechanically ventilated adult patients (Colombo et al., Crit Care Med. 2011 ...
Wong David T - - 2013
Excessive supraglottic airway cuff pressure increases postoperative pharyngolaryngeal symptoms such as sore throat, dysphonia, and dysphagia. A new supraglottic airway, AES Ultra CPV™ (CPV), has a built-in intracuff pressure indicator. We hypothesized that using the CPV would reduce postoperative symptoms when compared with the LMA Classic™ (LMA) without intracuff pressure ...
Bach John Robert - - 2013
Mechanically assisted coughing is the combination of mechanical insufflation-exsufflation to the airways in conjunction with an exsufflation-timed abdominal thrust. It has permitted in-home long-term survival of respirator-dependent users of continuous noninvasive intermittent positive pressure ventilatory support in the United States since shortly after it became available in 1952. By contrast, ...
Talikoti Anand T - - 2013
Endotracheal intubation is sine quo non for safe conduct of general anaesthesia. Pregabalin, an anticonvulsant drug is being studied for control of haemodynamic response to laryngoscopy and intubation. Some authors have found that pregabalin 150 mg orally attenuates the haemodynamic response to laryngoscopy. The purpose of the present study was ...
Gilstrap Daniel - - 2013
Assisted/supported modes of mechanical ventilation offer significant advantages over controlled modes in terms of ventilator muscle function/recovery and patient comfort (and sedation needs). However, assisted/supported breaths must interact with patient demands during all three phases of breath delivery: trigger, target and cycle. Synchronous interactions match ventilator support with patient demands; ...
Fava Cristiano - - 2013
Continuous positive airway pressure (cPAP) is considered the therapy of choice for obstructive sleep apnea (OSA), but the extent to which it can reduce blood pressure (BP) is still under debate.We undertook a systematic review and meta-analysis of randomized controlled trials (RCTs) to quantify the effect size of the reduction ...
Qaseem Amir - - 2013
The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of obstructive sleep apnea (OSA) in adults. This guideline is based on published literature from 1966 to September 2010 that was identified by using MEDLINE, the Cochrane Central Register of ...
Liesching Timothy - - 2013
Studies have shown different clinical outcomes of noninvasive positive pressure ventilation (NPPV) from those of continuous positive airway pressure (CPAP). We evaluated whether bilevel positive airway pressure (BPAP) more rapidly improves dyspnea, ventilation, and acidemia without increasing the myocardial infarction (MI) rate compared to continuous positive pressure ventilation (CPAP) in ...
Vasconcelos Renata Dos S - - 2013
Background: The digital Auto-Trak™ system is a technology capable of automatically adjusting the triggering and cycling mechanisms during pressure support ventilation (PSV). Objective: To compare Auto-Trak with conventional settings in terms of patient-ventilator synchrony and discomfort. Methods: Twelve healthy volunteers underwent PSV via the mouth by breathing through an endotracheal ...
Rittayamai Nuttapol - - 2013
To compare the short term benefit of high-flow nasal oxygen cannula (HFNC) with non-rebreathing mask in terms of change of dyspnea, physiologic variables, and patient comfort in subjects after endotracheal extubation. A randomized cross-over study was conducted in a 10-bed respiratory care unit in a university hospital. Seventeen mechanically ventilated ...
Wood Fiona E - - 2013
Face mask ventilation provides respiratory support to newly born or sick infants. It is a challenging technique and difficult to ensure that an appropriate tidal volume is delivered because large and variable leaks occur between the mask and face; airway obstruction may also occur. Technique is more important than the ...
van Vonderen Jeroen J - - 2013
Background: During mask ventilation, the mask volume can vary as it is pressurized or when it is squeezed. The change in volume of the mask may affect tidal volumes delivered and difference in inspired (Vti) and expired tidal volumes (Vte). Objectives: To investigate whether hand squeeze and distensibility of the ...
Kuo Alexander S - - 2013
To quantify inspiratory flow resistance of instrumented single-lumen and double-lumen endotracheal tubes. Bench-top in vitro experiments. Laboratory of a university hospital. In vitro lung simulator. A lung simulator was ventilated mechanically via several single- and double-lumen endotracheal tubes (ETT) that were instrumented with adult and pediatric bronchoscopes as well as ...
Derosa Savino - - 2013
Little is known about the small airways dysfunction in acute respiratory distress syndrome (ARDS). By computed tomography (CT) imaging in a porcine experimental model of early ARDS, we aimed at studying the location and magnitude of peripheral airway closure and alveolar collapse under high and low distending pressures and high ...
Ferdowsali Kameron - - 2013
Airway pressure release ventilation (APRV) is a mode of ventilation that has been around since the 1980s and was originally viewed as a type of continuous positive pressure mode of ventilation. Conceptually, APRV can be thought of as a type of inverse-ratio, pressure-controlled, intermittent mandatory ventilation during which the maintenance ...
Cerqueira Manoel Luiz de ML - - 2013
To evaluate the effects of physiotherapeutic respiratory maneuvers on cerebral and cardiovascular hemodynamics and blood gas variables. A descriptive, longitudinal, prospective, nonrandomized clinical trial that included 20 critical patients with severe craniocerebral trauma who were receiving mechanical ventilation and who were admitted to the intensive care unit. Each patient was ...
Wongsritrang Krongthong - - 2013
To compare the clinical outcomes and determine the difference in therapeutic pressure between Automatic positive airway pressure (APAP) and polysomnography manual titration. Fifty patients of obstructive sleep apnea (OSA), moderate to severe cases, were randomized into two groups of intervention: 95-percentile pressure derived from APAP titration and an optimal pressure ...
Johnson Pamela L PL 1 David Read Laboratory, University of Sydney , Sydney, NSW Australia - - 2013
Acute mountain sickness (AMS) is very common at altitudes above 2500 m. There are few treatment options in the field where electricity availability is limited, and medical assistance or oxygen is unavailable or difficult to access. Positive airway pressure has been used to treat AMS at 3800 m. We hypothesized ...
Pitts Teresa - - 2013
Airway protection is the prevention and/or removal of material by behaviors, such as cough and swallow. We tested the hypothesis that cough and swallow, in response to aspiration, are a "meta-behavior" and thus are coordinated and have alterations in excitability to respond to aspiration risk and maintain homeostasis. Anesthetized animals ...
Vagheggini Guido - - 2013
Neurally adjusted ventilatory assist (NAVA) is a mode of ventilation wherein the delivered assistance is proportional to diaphragm electrical activity (EAdi) throughout inspiration. We assessed the physiologic response to varying levels of NAVA and pressure support ventilation (PSV) in 13 tracheostomised patients with prolonged weaning. Each patient randomly underwent 8 ...
Hartdorff Caroline M - - 2013
To assess the feasibility, stability and predictability of pCO2 measurement (PETCO2) using a main stream capnograph in a high frequency oscillatory ventilation circuit. A commercially available capnograph was mounted into a high frequency oscillatory ventilator patient circuit, adjustable CO2 flow was introduced into an artificial lung and the output of ...
Richard J C M - - 2013
Pressure preset ventilation (PPV) modes with set inspiratory time can be classified according to their ability to synchronize pressure delivery with patient's inspiratory efforts (i-synchronization). Non-i-synchronized (like airway pressure release ventilation, APRV), partially i-synchronized (like biphasic airway pressure), and fully i-synchronized modes (like assist-pressure control) can be distinguished. Under identical ...
Li Hui - - 2013
Whether bilevel positive airway pressure (BiPAP) is advantageous compared with continuous positive airway pressure (CPAP) in acute cardiogenic pulmonary edema (ACPO) remains uncertain. The aim of the meta-analysis was to assess potential beneficial and adverse effects of CPAP compared with BiPAP in patients with ACPO. Randomized controlled trials comparing the ...
Al-Hegelan Mashael - - 2013
The overarching goal of positive pressure mechanical ventilation is to provide adequate gas exchange support while not causing harm. Indeed, positive pressure mechanical ventilators are only support technologies, not therapeutic technologies. As such they cannot be expected to "cure" disease; they can only "buy time" for other therapies (including the ...
De Jarnett Dewi - - 2013
Airway management in the morbidly obese, anesthetized patient can be especially challenging. Difficulties in fiberoptic intubation (FOI) can be experienced due to alterations in airway anatomy associated with morbid obesity and the effects of anesthesia. The loss of upper airway muscle tone that occurs during anesthesia compromises the structure of ...
Gonsaga Ricardo Alessandro Teixeira - - 2013
To evaluate gasometric differences of severe trauma patients requiring intubation in prehospital care. Patients requiring airway management were submitted to collection of arterial blood samples at the beginning of pre-hospital care and at arrival at the Emergency Room. We analyzed: Glasgow Coma Scale, respiratory rate, arterial pH, arterial partial pressure ...
Schädler Dirk - - 2013
To describe the principles and the first clinical application of a novel prototype automated weaning system called Evita Weaning System (EWS). EWS allows an automated control of all ventilator settings in pressure controlled and pressure support mode with the aim of decreasing the respiratory load of mechanical ventilation. Respiratory load ...
Hung Kuo-Chuan - - 2013
Insertion of a medical instrument into the esophagus may affect tracheal tube pressure. This study evaluated the potential effect of a calibrating orogastric tube insertion on tracheal cuff pressure in patients undergoing laparoscopic bariatric surgery. Adult patients who were scheduled for elective bariatric surgery requiring insertion of a calibrating orogastric ...
Vignaux Laurence - - 2013
To document the prevalence of asynchrony events during noninvasive ventilation in pressure support in infants and in children and to compare the results with neurally adjusted ventilatory assist. Prospective randomized cross-over study in children undergoing noninvasive ventilation. The study was performed in a PICU. From 4 weeks to 5 years. ...
Chanques G - - 2013
Background: High-flow-oxygen-therapy is provided by various techniques and patient interfaces, resulting in various inspired-fraction of oxygen (FiO2) and airway-pressure levels. However, tracheal measurements have never been performed Methods: Three oxygen-delivery-devices were evaluated: 1) standard-high-flow-oxygen-facemask with reservoir-bag, 2) Optiflow™-high-flow-nasal-cannulae and 3) Boussignac™-oxygen-therapy-system. Main judgment criteria were airway-pressure and FiO2 measured in ...
Hardison Lewis S LS - - 2013
Phosgene is a rare exposure with strong clinical implications. We report a phosgene exposure that resulted in the patient's death. A 58 year-old man arrived to the emergency department 1 hour after exposure to phosgene with complaints of a sore throat. Initial vital signs were blood pressure 175/118 mmHg, heart ...
Kam Karen - - 2013
Congenital central hypoventilation syndrome (CCHS) is a rare disorder of autonomic dysregulation, characterized by alveolar hypoventilation especially during sleep. As a result, lifelong ventilatory assistance is necessary in these patients. Many infants and children initially require positive pressure ventilation via tracheostomy for support. Associated complications and psychosocial pressure may prompt ...
Pinzon Anelise Dentzien - - 2013
To describe the effects of high-frequency oscillatory ventilation (HFOV) as a rescue ventilatory support in pediatric patients with acute respiratory distress syndrome (ARDS). Twenty-five children (1 month < age < 17 years) admitted to a university hospital pediatric intensive care unit (ICU) with ARDS and submitted to HFOV for a ...
Murphy Caitriona - - 2013
The purpose of this Continuing Professional Development module is to describe anatomic and physiologic challenges in obese patients, review their effects on oxygenation and airway management, and propose strategies for perioperative management. The combination of excess adipose tissue deposition, increased oxygen consumption, reduced lung volumes, and increased airway resistance in ...
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