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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 ...
Qi D Y - - 2013
Background: Cardiovascular response to laryngoscopy and tracheal intubation may be harmful in surgical patients with cardiovascular and cerebral diseases. The efficacy of intravenous lidocaine on attenuating the hemodynamic changes remains controversial. This systematic review aims to determine the efficacy of lidocaine versus placebo. Methods: PubMed, Embase and Cochrane Library databases ...
Rubini Alessandro - - 2013
This study was designed to investigate the possible effects of acute hyperbaric hyperoxia on respiratory mechanics of anaesthetised, positive-pressure ventilated rats. We measured respiratory mechanics by the end-inflation occlusion method in nine rats previously acutely exposed to hyperbaric hyperoxia in a standard fashion. The method allows the measurements of respiratory ...
Tuzcu Kasim - - 2013
This study aimed to compare the effects of remifentanil and esmolol on the elevation of intraocular pressure (IOP) and hemodynamic response. After approval of the institutional Ethics Committee and obtaining informed consent, 60 adult patients with American Society of Anesthesiologists I-II status undergoing elective, nonophthalmic surgery were included in the ...
Sundberg Johan - - 2013
Acoustic and aerodynamic properties of the voice source and vocal tract have been extensively analyzed during the last half century. Corresponding investigations of the subglottal system are rare but can be assumed to be relevant to voice production. In the present exploratory study, subglottal pressure was recorded in a male ...
Arslan Ilker Burak - - 2013
ObjectiveThis study was designed to evaluate the effectiveness of topical lidocaine in attenuating the laryngeal reflex and blunting hemodynamic response by inhibition of the superior laryngeal nerve in laryngeal microsurgery, which would be helpful in preventing potential complications.Study DesignA prospective, randomized, double-blind study.SettingTertiary medical center.Subjects and MethodsFifty-four patients requiring glottic ...
Phillips Justin P - - 2013
Photoplethysmographic (PPG) signals were recorded from the fingers of 16 healthy volunteers with periods of timed and forced respiration. The aim of this pilot study was to compare estimations of arterial oxygen saturation (SpO2) recorded using a dedicated pulse oximetry system while subjects were breathing regularly with and without a ...
Dow Douglas E - - 2013
Reliable information from patient monitors enhances treatment for critically ill patients. Redundant sources for information would aid identification of faulty sensors and leads, and improve presentation of physiological data. Respiratory information can be obtained from several sources, including airway pressure and central venous pressure (CVP). CVP signals have been analyzed ...
Kaczka David W - - 2013
Lung inflation has been shown to dilate airways by altering the mechanical equilibrium between opposing airway and parenchymal forces. However, it is not known how heterogeneously such dilation occurs throughout the airway tree. In six anesthetized dogs, we measured the diameters of five to six central airway segments using high ...
Carteaux Guillaume - - 2013
During proportional assist ventilation with load-adjustable gain factors, peak respiratory muscle pressure can be estimated from the peak airway pressure and the percentage of assistance (gain). Adjusting the gain can, therefore, target a given level of respiratory effort. This study assessed the clinical feasibility of titrating proportional assist ventilation with ...
Chanques Gerald - - 2013
OBJECTIVES:: Breath-stacking asynchrony during assist-control-mode ventilation may be associated with increased tidal volume and alveolar pressure that could contribute to ventilator-induced lung injury. Methods to reduce breath stacking have not been well studied. The objective of this investigation was to evaluate 1) which interventions were used by managing clinicians to ...
Massery Mary - - 2013
Maintenance of upright posture involves complex neuromotor processes that include control of thoracic and abdominal pressures. Control of airflow by glottal structures is a primary determinant of thoracic pressure and may have a role in control of postural stability. This study aimed to investigate the effect of modulation of airway ...
Hawkes G A - - 2013
Assessment of effective ventilation in neonatal mask ventilation can be difficult. This study aims to determine whether manual ventilation with a T-piece resuscitator containing an inline CO2 detector (either a Pedi-Cap® CO2 detector or a Neo-StatCO2 <Kg® CO2 detector connected to a facemask) facilitates effective positive pressure ventilation compared to no ...
Fleck Robert J - - 2013
IMPORTANCE Positive pressure air is used during basic life support to provide respirations and applied as continuous positive airway pressure to maintain a patent airway during sleep or anesthesia. These functions are more critical in children with obstructive sleep apnea, who often have smaller airway dimensions and increased airway collapsibility. ...
Thakur Nikhil A - - 2013
Airway obstruction by wound hematoma is a serious adverse event associated with anterior cervical spine surgery. Although intrinsic airway edema is the most plausible pathophysiologic mechanism of obstruction, we hypothesized that extrinsic compression of the trachea by a hematoma can result in airway occlusion at an angle to the sagittal ...
Cortes-Puentes Gustavo A - - 2013
Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) may complicate monitoring of pulmonary mechanics owing to their impact on the respiratory system. However, recommendations for mechanical ventilation of patients with IAH/ACS and the interpretation of thoracoabdominal interactions remain unclear. Our study aimed to characterize the influence of elevated intra-abdominal pressure ...
Saikia Bhaskar - - 2013
Airway malacia is uncommon condition having symptoms similar to common respiratory illnesses. Any child having persistent wheeze during infancy should be evaluated for airway malacia. The authors report a case of isolated severe bilateral bronchomalacia managed with tracheostomy and continuous positive pressure ventilation.
Hwang J Y - - 2013
BACKGROUND: /st>Current tracheal tubes (TTs) cannot guarantee a perfect seal against pulmonary aspiration of upper airway secretions. The purpose of this study was to investigate whether a gel layer between the tracheal tube with double cuffs (Double cuffs) prevents fluid leakage past TT cuffs. METHODS: /st>In vitro fluid leakage tests ...
Kim Yong Beom - - 2013
PURPOSE: This prospective, randomized trial was designed to assess whether the i-gel supraglottic airway device is suitable for volume-controlled ventilation while applying positive end-expiratory pressure (PEEP) of 5 cmH2O under general anesthesia. It was believed that this device might improve arterial oxygenation. METHODS: Forty adult patients (aged 20-60 years) scheduled for elective ...
Choi Ji Ho - - 2013
The aims of the present study were twofold. We sought to compare two methods of titrating the level of continuous positive airway pressure (CPAP) - auto-adjusting titration and titration using a predictive equation - with full-night manual titration used as the benchmark. We also investigated the reliability of the two ...
Rafiei Mohammad Reza - - 2013
Increased intra-abdominal pressure (IAP) results in dysfunction of vital organs. The aim of the present study was to evaluate the effect of mechanical ventilation mode on IAP. In a cohort study, a total of 60 patients aged 20-70 years who were admitted to the ICU and underwent mechanical ventilation were ...
Taghavi Sharven - - 2013
Prehospital intubation does not result in a survival advantage in patients experiencing penetrating trauma, yet resistance to immediate transportation to facilitate access to definitive care remains. An animal model was developed to determine whether intubation provides a survival advantage during severe hemorrhagic shock. We hypothesized that intubation would not provide ...
Garguilo Marine M University of Versailles Saint-Quentin-en-Yvelines, Versailles, - - 2013
Communication is a major issue for patients with tracheostomy who are supported by mechanical ventilation. The use of positive end-expiratory pressure (PEEP) may restore speech during expiration; however, the optimal PEEP level for speech may vary individually. We aimed to improve speech quality with an individually adjusted PEEP level delivered ...
Sittitavornwong Somsak S Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL 35294, USA. - - 2013
This study evaluated the soft tissue change of the upper airway after maxillomandibular advancement (MMA) using computational fluid dynamics. Eight patients with obstructive sleep apnea syndrome who required MMA were recruited into this study. All participants underwent pre- and postoperative computed tomography and then MMA by a single oral and ...
Hopper Kate - - 2013
Respiratory failure may occur due to hypoventilation or hypoxemia. Regardless of the cause, emergent anesthesia and intubation, accompanied by positive pressure ventilation, may be necessary and life saving. Long-term mechanical ventilation requires some specialized equipment and knowledge; however, short-term ventilation can be accomplished without the use of an intensive care ...
Greising Sarah M SM Department of Physiology and Biomedical Engineering, Mayo Clinic, College of Medicine, 200 First Street SW, Rochester, MN 55905, - - 2013
The diaphragm muscle (DIAm) is responsible for breathing and determines the ability to generate both ventilatory and non-ventilatory behaviors. Size limitations of the mouse make transdiaphragmatic pressure (Pdi) measurement using a dual balloon system untenable. Adult C57BL/6J mice (n=8) and C57BL/6×129 (n=9), underwent Pdi measurements using solid-state pressure catheters spanning ...
Clavieras Noémie - - 2013
BACKGROUND:: Intellivent is a new full closed-loop controlled ventilation that automatically adjusts both ventilation and oxygenation parameters. The authors compared gas exchange and breathing pattern variability of Intellivent and pressure support ventilation (PSV). METHODS:: In a prospective, randomized, single-blind design crossover study, 14 patients were ventilated during the weaning phase, ...
Pedrosa Rodrigo P - - 2013
ABSTRACT BACKGROUND: Obstructive sleep apnea is extremely common among patients with resistant hypertension. However, the impact of the treatment of obstructive sleep apnea with continuous positive airway pressure on blood pressure in patients with resistant hypertension is not well established. METHODS: In the present study, 40 patients with confirmed resistant ...
Xie Ailiang A James B. Skatrud Laboratory of Pulmonary and Sleep Medicine, William S. Middleton Memorial Veterans Affairs Hospital, Madison, WI 53705, USA. - - 2013
To determine how the obstructive sleep apnea (OSA) patient's pathophysiological traits predict the success of the treatment aimed at stabilization or increase in respiratory motor outputs, we studied 26 newly diagnosed OSA patients [apnea-hypopnea index (AHI) 42 ± 5 events/h with 92% of apneas obstructive] who were treated with O2 ...
Muller Matthew D MD Penn State Hershey Heart and Vascular Institute, Pennsylvania State University College of Medicine, Hershey, PA 17033, - - 2013
Tactile stimulation of the oropharynx (TSO) elicits the gag reflex and increases heart rate (HR) and mean arterial pressure (MAP) in anesthetized patients. However, the interaction between upper-airway defense reflexes and the sympathetic nervous system has not been investigated in conscious humans. In Experiment 1, beat-by-beat measurements of HR, MAP, ...
Hester Doug - - 2013
Prolonged time during endotracheal tube placement has been associated with poor outcomes, including cardiac arrest and death. For this reason, the accurate measurement of the duration of intubation time is an important metric in studies that evaluate interventions to improve airway outcomes. In the current study we correlated the gaps ...
Al Jaaly Emad E Cardiothoracic Surgery, Hammersmith Hospital, Imperial College NHS Trust, London, United - - 2013
We compared the efficacy of noninvasive ventilation with bilevel positive airway pressure added to usual care versus usual care alone in patients undergoing coronary artery bypass grafting. We performed a 2-group, parallel, randomized controlled trial. The primary outcome was time until fit for discharge. Secondary outcomes were partial pressure of carbon ...
Baba Atsushi - - 2013
OBJECTIVE: The purpose of this study was to show the effects of the tra gas insufflation (TGI) technique on gas exchange using helium-oxygen mixtures during high-frequency oscillatory ventilation (HFOV). We hypothesized that a helium-oxygen mixture delivered into the trachea using the TGI technique (0.3 L/min) would enhance gas exchange during ...
Pichot C C Department of Physiology, University of Lyon, EA 4612: Neurocardiology, Lyon, - - 2013
Acute respiratory distress syndrome (ARDS) is associated with a high mortality linked primarily to co-morbidities (sepsis, cardiac failure, multiple organ failure, etc.). When the lung is the single failing organ, quick resolution of ARDS should skip some complications arising from a prolonged stay in the critical care unit. In severe ...
Osborn Alexander J - - 2013
OBJECTIVES/HYPOTHESIS: To test whether a simple inexpensive device that dynamically minimizes endotracheal cuff pressure throughout the respiratory cycle reduces endotracheal cuff pressure-related subglottic injury. STUDY DESIGN: Hypoxic animal model with one control and one experimental group. METHODS: Twelve S. scrofa domesticus piglets (14-16kg) were intubated with standard endotracheal tubes and ...
Jiang Nancy - - 2013
OBJECTIVES/HYPOTHESIS: The purpose of this study was to evaluate the efficacy of a novel teaching tool to improve health care providers' ability to inflate tracheostomy tube cuffs to the appropriate pressure. STUDY DESIGN: Single-blinded, randomized, controlled trial. METHODS: Subjects were randomized to a control and study group. The control group ...
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