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 ...

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 ...

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 ...

PURPOSE: This study evaluated the soft tissue change of the upper airway after maxillomandibular advancement (MMA) using computational fluid dynamics. MATERIALS AND METHODS: 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 ...

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 ...

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, ...

To determine how the OSA patient's pathophysiologic traits predict the success of the treatment aimed at stabilization or increase in respiratory motor outputs, we studied 26 patients with OSA (AHI 42±5 events/hour with 92% of apnea were obstructive), who were treated with O2 supplementation, an isocapnic rebreathing system in which ...

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 ...

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, ...

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 ...

OBJECTIVE: 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. METHODS: We performed a 2-group, parallel, randomized controlled trial. The primary outcome was time until fit for discharge. Secondary outcomes were partial pressure ...

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 ...

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 ...

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 ...

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 ...

While transbronchoscopic air insufflation has been described in refractory atelectasis as a therapy without any serious complications, 3 cases of gastric rupture during the same procedure have been reported when it was used to support tracheal intubation by employing the jet of oxygen from the wall pipeline. Here, we report ...

We investigated the hypothesis that the oropharyngeal leak pressure would differ between the GuardianCPV™ and the LMA Supreme™ in anaesthetised patients. We randomly assigned 120 patients to receive either the GuardianCPV or the LMA Supreme for airway management. Oropharyngeal leak pressure was measured during cuff inflation from 0 to 40 ml ...

The Pentax Airway Scope (AWS) is a video laryngoscope designed to facilitate tracheal intubation with a high-resolution image. The Pentax AWS has been reported to cause less hemodynamic stress than the Macintosh laryngoscope. The aims of this study are to investigate the differences in hemodynamic responses and norepinephrine concentrations to ...

BACKGROUND: The cuff pressure for optimal airway sealing with first-generation laryngeal mask airway has been shown to be 40 cm H2 O in children. Currently, there are no data regarding the ideal intracuff pressure for the laryngeal mask airway Supreme (Supreme) in children. OBJECTIVES: To compare the clinical performance of the ...

Background: T-piece has been widely used as T-piece trial to identify patients who are ready for extubation but it is seldom used as a weaning tool. Our objective was to investigate the effects of breathing via T-piece on gas exchange as compared to continuous positive airway pressure with pressure support ...

BackgroundBubble continuous positive airway pressure (B-CPAP) is frequently used in spontaneously breathing infants with lung disease. Often, the B-CPAP systems lack pressure alarms and pressure release valves. We observed a large volume of condensate in the exhalation limb of a patient circuit and conducted a series of experiments to test ...

OBJECTIVES:: To calculate an index (termed Pmusc/Eadi index) relating the pressure generated by the respiratory muscles (Pmusc) to the electrical activity of the diaphragm (Eadi), during assisted mechanical ventilation and to assess if the Pmusc/Eadi index is affected by the type and level of ventilator assistance. The Pmusc/Eadi index was ...

BACKGROUND: There are multiple techniques for face-mask (FM) ventilation. To our knowledge, the one-handed vs. two-handed C-E technique has been compared in children and adults, but no studies have compared the various two-handed methods. OBJECTIVE: To compare the effectiveness of mask seal using three different FM techniques on a model ...

The current standard of care for patients suffering from acute respiratory distress syndrome (ARDS) is ventilation with a tidal volume of 6 ml/kg predicted body weight (PBW), but variability remains in the tidal volumes that are actually used. This study aims to identify patient scenarios for which there is discordance between ...

ABSTRACT Oxygenation during high-frequency oscillatory ventilation is secured by a high level of mean airway pressure. Our objective was to identify a pressure difference between the airway opening of the respiratory circuit and the trachea during application of different oscillatory frequencies. Six female Pietrain pigs (57.1 ± 3.6 kg) were first ...

This study focused on examination of ventilation rates in classrooms with two different types of ventilation systems: natural and mechanical. Carbon dioxide (CO2) measurements were conducted in primary schools of Portugal characterized by natural ventilation and compared to Finland where mechanical ventilation is the norm. The winter period was selected ...

Noninvasive ventilation (NIV) is a technique of mechanical ventilation which does not require invasive airway management, i.e. intubation or tracheostomy. In emergency medicine Continuous Positive Airway Pressure (CPAP) is used often. A new method of NIV is Impedance Threshold Device (ITD). Breathing through an ITD is utilized to raise blood ...

OBJECTIVES:: Nasal continuous positive airway pressure (NCPAP) is an established treatment for respiratory distress in neonates. Most modern ventilators are able to provide NCPAP. There have been no large studies examining the properties of NCPAP delivered by ventilators. The aim of this study was to compare pressure stability and imposed ...

Obstructive sleep apnoea-hypopnoea syndrome is associated independently with an increase in cardiovascular risk factors and is associated with self-reported lack of exercise. We aimed to investigate the utility of the incremental shuttle walk test in routine clinical practice to monitor physical capacity of patients with obstructive sleep apnoea-hypopnoea syndrome and ...

ABSTRACT: Study Design. Prospective study on intraoperative blood loss during lumbar spine surgery.Objective. To evaluate the relationship between airway pressure change due to the patient's prone position and intraoperative blood loss during lumbar spine surgery.Summary of the Background Data. A prone position may increase abdominal pressure. Changes in abdominal pressure ...

Previous studies showed that treatment of obstructive sleep apnea syndrome (OSAS) with continuous positive airway pressure (CPAP) significantly reduced the blood pressure (BP) in hypertensive patients. We investigated the predictors of BP change in normotensive patients with OSAS who underwent CPAP. A total of 24 patients with OSAS (19 male; ...

Traditionally, Continuous Positive Airway Pressure (CPAP) and Bilevel Positive Airway Pressure (BiPAP) devices have been used to treat patients in acute respiratory failure. However they require an electric power source, are relatively large in size, and may be difficult to use in prehospital settings. The recently introduced Boussignac CPAP system ...

Background: Forces applied on oropharyngeal soft tissues by direct laryngoscopy may cause damage to the patients. The aim of this study was to measure the forces applied during the manoeuvres to achieve glottis visualization and tracheal intubation, comparing direct laryngoscopy and videolaryngoscopy in vivo. Methods: Thirty adult patients (ASA physical ...

Synchronization of spontaneous breathing with breaths supplied by the ventilator is essential for providing optimal ventilation to patients on mechanical ventilation. Some ventilation techniques such as Adaptive Support Ventilation (ASV), Proportional Assist Ventilation (PAV), and Neurally Adjusted Ventilatory Assist (NAVA) are designed to address this problem. In PAV, the pressure ...

BACKGROUND: Maintaining blood pressure (BP) and heart rate (HR) after laryngoscopy and tracheal intubation has always been a concern for anesthesiologists. Opioids can attenuate or stop an increase in these two parameters if administered with proper doses or targets in target-controlled infusion (TCI). Remifentanil and sufentanil are widely used for ...

Hypoxic brain damage might explain persistent sleepiness in some continuous positive airway pressure-compliant obstructive sleep apnoea called residual excessive sleepiness. Although continuous positive airway pressure may not be fully efficient in treating this symptom, wake-promoting drug prescription in residual excessive sleepiness is no longer allowed by the European Medicines Agency. ...

A 4-year-old girl with bilateral vocal fold palsy was successfully decannulated from tracheotomy after seven laryngeal procedures. But an important stridor and dyspnea recurred 13 months after decannulation. Nocturnal gas exchange was normal but her daytime work of breathing was increased by fourfold, without any beneficial effect of nasal noninvasive ...

Introduction:Noninvasive Ventilation (NIV) is usually applied using Bi-Level Positive Airway Pressure (Bi-PAP) devices and many of these devices use a single-limb patient circuit with an integrated leak port to purge the circuit of exhaled carbon dioxide. Sometimes, bronchodilator therapy is indicated in pediatric patients. However, there have been no forthcoming ...

OSAHS is a common disease with many factors related to the etiology. Airflow plays an important role in the pathogenesis of OSAHS. Previous research has not yielded a sufficient understanding of the relationship between airflow in upper airway and the pathophysiology of OSAHS. Therefore, a better understanding of the flow ...

The performances of 2 noninvasive CPAP systems (high flow and low flow air-entrainment masks) were compared to the Boussignac valve in 3 different scenarios. Scenario 1: pneumatic lung simulator with a tachypnea pattern (tidal volume 800 mL at 40 breaths/min). Scenario 2: Ten healthy subjects studied during tidal breaths and ...

Background: The forced oscillation technique (FOT) and multiple breath nitrogen washout (MBNW) are non-invasive tests that are potentially sensitive to peripheral airways, with MBNW indices being especially sensitive to heterogeneous changes in ventilation. Objective: To study methacholine-induced changes in the lung periphery of asthmatic patients and determine how changes in ...

OBJECTIVES: This study sought to test the effects of rostral fluid displacement from the legs on transpharyngeal resistance (R(ph)), minute volume of ventilation (V(min)), and partial pressure of carbon dioxide (PCO(2)) in men with heart failure (HF) and either obstructive (OSA) or central sleep apnea (CSA). BACKGROUND: Overnight rostral fluid ...

ABSTRACT: INTRODUCTION: Protective ventilation using limited airway pressures and ventilation may result in moderate and prolonged hypercapnic acidosis, as often observed in critically ill patients. Because allow of moderate and prolonged hypercapnia may be considered as a protective measure for the lungs, we hypothesized that moderate and prolonged hypercapnic acidosis ...

Tracheal stenosis used to be a complication of tracheostomy. Prior to the introduction of mechanical ventilation for treatment of respiratory failure, although the incidence of post intubation tracheal stenosis has markedly decreased with the advent of large volume, low pressure cuffs, it still occurs, commonly in patients after prolonged intubation. ...

IMPORTANCE Patients requiring prolonged mechanical ventilation (>21 days) are commonly weaned at long-term acute care hospitals (LTACHs). The most effective method of weaning such patients has not been investigated. OBJECTIVE To compare weaning duration with pressure support vs unassisted breathing through a tracheostomy collar in patients transferred to an LTACH ...

PURPOSE: The purpose of this study was to compare the dose-related effects of fentanyl on systemic hemodynamics, hormone release and cardiac output in response to endotracheal intubation in patients with and without hypertension. METHODS: Forty-five patients without hypertension and 45 patients with hypertension (total 90 patients) undergoing elective general surgical, ...

Highly blood soluble gases exchange with the bronchial circulation in the airways. On inhalation, air absorbs highly soluble gases from the airway mucosa and equilibrates with the blood before reaching the alveoli. Highly soluble gas partial pressure is identical throughout all alveoli. At the end of exhalation, the partial pressure ...

STUDY OBJECTIVE: Cricoid pressure may negatively affect laryngeal view and compromise airway patency, according to previous studies of direct laryngoscopy, endoscopy, and radiologic imaging. In this study, we assess the effect of cricoid pressure on laryngeal view with a video laryngoscope, the Pentax-AWS. METHODS: This cross-sectional survey involved 50 American ...

The aim of this study was to compare ventilation parameters during mechanical ventilation using Laryngeal Mask Airway (LMA), Laryngeal Tube (LT), and Peri-Laryngeal Airway Cobra (PLA). In a prospective, randomised controlled trial, 90 patients undergoing general anaesthesia for elective surgery were divided into three subgroups. The settings of controlled ventilation ...

Background. Automatic tube compensation (ATC) has been developed to overcome the imposed work of breathing due to artificial airways during spontaneous breathing trials (SBTs). Objectives. This study aimed to assess extubation outcome after an SBT (spontaneous breathing trial) with ATC compared with pressure support ventilation (PSV) and to determine the ...