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Results 501 - 550 of 2139
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Schmidt Gregory A - - 2012
PURPOSE OF REVIEW: Through shared anatomy, pressures, and endothelial connections, the respiratory and cardiovascular systems affect each other in complex but clinically important ways. RECENT FINDINGS: Lung injury has clinically important circulatory effects, especially with regards to right ventricular function. Mechanical ventilation and PEEP produce a host of circulatory consequences, ...
Cinnella Gilda - - 2012
BACKGROUND:: The authors tested the hypothesis that during laparoscopic surgery, Trendelenburg position and pneumoperitoneum may worsen chest wall elastance, concomitantly decreasing transpulmonary pressure, and that a protective ventilator strategy applied after pneumoperitoneum induction, by increasing transpulmonary pressure, would result in alveolar recruitment and improvement in respiratory mechanics and gas exchange. ...
Klein K U - - 2012
BACKGROUND: Cyclic alveolar recruitment and derecruitment play a role in the pathomechanism of acute lung injury and may lead to arterial partial pressure of oxygen (PaO(2) ) oscillations within the respiratory cycle. It remains unknown, however, if these PaO(2) oscillations are transmitted to the microcirculation. The present study investigates if ...
Höstman S - - 2012
BACKGROUND: Ventilation with low tidal volumes reduces mortality in acute respiratory distress syndrome. A further reduction of tidal volumes might be beneficial, and it is known that apneic oxygenation (no tidal volumes) with arteriovenous CO(2) removal can keep acid-base balance and oxygenation normal for at least 7 h in an acute ...
Liu Y H - - 2012
BACKGROUND: /st>Percutaneous transtracheal ventilation (PTV) via a jet ventilator (PTJV) is considered a rescue technique in difficult airway management. However, whether a conventional ventilator can generate adequate ventilation via PTV is not known. Our goal was to evaluate the tidal volume (V(T)) generated by a conventional ventilator during simulated PTV ...
Smith Bradford J BJ Vermont Lung Center, University of Vermont College of Medicine, 149 Beaumont Avenue, HSRF 228, Burlington, VT 05405-0075, - - 2013
Management of ALI/ARDS involves supportive ventilation at low tidal volumes (V t) to minimize the rate at which ventilator induced lung injury (VILI) develops while the lungs heal. However, we currently have few details to guide the minimization of VILI in the ALI/ARDS patient. The goal of the present study ...
Freitas F G R - - 2012
BACKGROUND: /st>The applicability of pulse pressure variation (ΔPP) to predict fluid responsiveness using lung-protective ventilation strategies is uncertain in clinical practice. We designed this study to evaluate the accuracy of this parameter in predicting the fluid responsiveness of septic patients ventilated with low tidal volumes (TV) (6 ml kg(-1)). METHODS: ...
Rydman Riikka - - 2012
BACKGROUND: Right ventricular (RV) involvement in pulmonary embolism (PE) is an ominous sign. The aim of this study was to investigate the extent to which the d-dimer level or simplified PE severity index (sPESI) indicates RV dysfunction in patients with preserved systemic arterial pressure. METHODS: Right ventricular function was studied ...
Duchateau Paul - - 2012
BACKGROUND. We measured tidal volume (VT) delivered from ICU ventilators after adding an external filter to the expiratory limb of the breathing circuit. This latter may protect the expiratory valve from water saturation in case of nebulisation and the environnement in case of lung infection with multi-drug-resistant micro-organisms or H1N1 ...
Lu Q - - 2012
OBJECTIVEC: Randomized trials fail to demonstrate a decrease in mortality when high Positive End-Expiratory Pressure (PEEP) is applied to patients with acute respiratory distress syndrome. Use of PEEP in all patients without taking into consideration specific lung morphology, potential for recruitment and risk of lung hyperinflation could be one of ...
Vegh T - - 2012
BACKGROUND: The ideal tidal volume (VT) during one-lung ventilation (OLV) remains controversial. High tidal volumes may increase the incidence of postoperative lung injury after thoracic surgery. There is nonetheless little evidence that the use of low tidal volume during OLV will fail to provide adequate arterial oxygenation. We evaluated the ...
Casserly Brian - - 2012
BACKGROUND: "Optimal" mean airway pressure (MAP) during high-frequency oscillatory ventilation (HFOV) can be defined as the pressure that allows for maximal alveolar recruitment while minimizing alveolar overdistension. Choosing a MAP near or just below the point of maximal curvature (PMC) of the volume-pressure characteristics of the lung can serve as ...
Zannin Emanuela - - 2012
ABSTRACT: INTRODUCTION: It is well established that during mechanical ventilation of patients with acute respiratory distress syndrome cyclic recruitment/derecruitment and overdistension are potentially injurious for lung tissues. We evaluated whether the forced oscillatory technique (FOT) could be used to guide the ventilator settings in order to minimize cyclic lung recruitment/derecruitment ...
Ambrosio Aline M - - 2012
BACKGROUND:: In acute lung injury positive end-expiratory pressure (PEEP) and recruitment maneuver are proposed to optimize arterial oxygenation. The aim of the study was to evaluate the impact of such a strategy on lung histological inflammation and hyperinflation in pigs with acid aspiration-induced lung injury. METHODS:: Forty-seven pigs were randomly ...
McNamara Patrick J - - 2012
OBJECTIVES:: Persistent pulmonary hypertension of the newborn is a common problem with significant morbidity and mortality. Inhaled nitric oxide is the standard care, but up to 40% of neonates are nonresponders. Milrinone is a phosphodiesterase III inhibitor which increases the bioavailability of cyclic adenosine monophosphate and has been shown to ...
Engel Monique - - 2012
BACKGROUND: Recruitment manoeuvres are widely used in clinical practice to open the lung and prevent lung injury by derecruitment, although the evidence is still discussed. In this study two different recruitment manoeuvres were compared to no recruitment manoeuvres (control) in ventilated sheep with acute respiratory distress syndrome (ARDS), induced by ...
Jensen Morten Hasselstrøm - - 2012
Abstract Background: Chronic obstructive pulmonary disease (COPD) affects millions of people worldwide. A complication of COPD is exacerbations that result in increased utilization of healthcare services, readmissions to the hospital, and a decline in health-related quality of life. Home telehealth has been shown both to improve health-related quality of life ...
Radicioni M - - 2012
Experience with terlipressin (TP) in the neonatal field is scarce. We describe the effects of TP on pulmonary circulation, studied with echocardiography, in an asphyxiated septic cooled infant with pulmonary hypertension (PH) who developed catecholamine-resistant hypotension and exacerbation of PH shortly after the beginning of the rewarming. TP was added ...
Kim Sh - - 2012
Prolonged inspiratory to expiratory (I:E) ratio ventilation may have both positive and negative effects on respiratory mechanics and oxygenation during one-lung ventilation (OLV), but definitive information is currently lacking. We therefore compared the effects of volume-controlled ventilation with I:E ratios of 1:1 and 1:2 on respiratory mechanics and oxygenation during ...
Fan Xiao-Fang - - 2012
To explore the effects of safflower injection on prevention and treatment of hypoxic pulmonary hypertension and clarify the function of the endoplasmic reticulum stress apoptosis pathway during the process. Thirty male SD rats were randomly grouped as normal control group, hypoxia-hypercapnia group and hypoxia+safflower group. The latter two groups were ...
Charalampopoulos Athanasios - - 2012
Pulmonary hypertension (PH) is defined as an increase in mean pulmonary arterial pressure > or = 25 mmHg at rest as assessed invasively by right heart catheterisation. It can affect patients at any age and presents with non-specific symptoms. Accurate diagnosis is important as while PH is a potentially lethal ...
De Meester Pieter - - 2012
Elevated pulmonary artery systolic pressure (PASP) causes functional tricuspid valve insufficiency (TI). However, the differential contribution of pressure load and right ventricular (RV) dilatation is not well established. The study aim was to evaluate both variables in relation to TI. A cross-sectional study was performed of consecutive transthoracic echocardiographic studies ...
Simon Bruce - - 2012
Despite the prevalence and recognized association of pulmonary contusion and flail chest (PC-FC) as a combined, complex injury pattern with interrelated pathophysiology, the mortality and morbidity of this entity have not improved during the last three decades. The purpose of this updated EAST practice management guideline was to present evidence-based ...
Bräunlich Jens J Department of Respiratory Medicine, University of Leipzig, Leipzig, Germany. - - 2013
A high flow of air applied by large bore nasal cannulae has been suggested to improve symptoms of chronic respiratory insufficiency. In pediatric patients, nasal high-flow (nHF) ventilation was similarly effective compared to noninvasive ventilation with a face mask. The aim of this study was to describe changes in respiratory ...
Iversen N K - - 2012
Recent advances of nanotechnology in clinical settings have spurred the development of various complex engineered nanoparticles (NPs). NPs share characteristics with ultrafine particles (UFPs; <1 μm) that can cross the pulmonary epithelium and disturb cardiovascular functions. Since these particles are injected directly into the blood stream, it is imperative to ...
Moraes Davi J A - - 2012
Why should researchers in charge of basic and clinical investigation of hypertension also pay attention to respiration? More than its primary role to orchestrate the diaphragm, chest, and abdominal muscle contraction and relaxation, essential for O(2) and CO(2) pulmonary exchanges, the brain stem respiratory network is also precise and timely ...
West John B - - 2012
Abstract Medical problems occur at high altitude because of the low inspired PO2 which in turn is caused by the reduced barometric pressure. The classical physiological responses to high altitude include hyperventilation, polycythemia, hypoxic pulmonary vasoconstriction increased intracellular oxidative enzymes, and increased capillary density in muscle. However with the discovery ...
Regli Adrian - - 2012
ABSTRACT: INTRODUCTION: Intra-abdominal hypertension (IAH) causes atelectasis, reduces lung volumes and increases respiratory system elastance. Positive end-expiratory pressure (PEEP) in the setting of IAH and healthy lungs improves lung volumes but not oxygenation. However, critically ill patients with IAH often suffer from acute lung injury (ALI). This study therefore examined ...
Klein K U KU Department of Anaesthesiology, Medical Center of the Johannes Gutenberg-University, Mainz, Germany. - - 2013
Cyclic recruitment and derecruitment (R/D) play a key role in the pathomechanism of acute lung injury (ALI) leading to respiration-dependent oscillations of arterial partial pressure of oxygen (Pa(O(2))). These Pa(O(2)) oscillations could also be forwarded to the cerebral microcirculation. In 12 pigs, partial pressure of oxygen was measured in the ...
Miedema Martijn - - 2012
OBJECTIVE: To monitor regional changes in end-expiratory lung volume (EELV), tidal volumes, and their ventilation distribution during different levels of nasal continuous positive airway pressure (nCPAP) and nasal biphasic positive airway pressure (BiPAP) in stable preterm infants. STUDY DESIGN: By using electrical impedance tomography and respiratory inductive plethysmography, we measured ...
Corley Amanda - - 2012
PURPOSE: Endotracheal suctioning causes significant lung derecruitment. Closed suction (CS) minimizes lung volume loss during suction, and therefore, volumes are presumed to recover more quickly postsuctioning. Conflicting evidence exists regarding this. We examined the effects of open suction (OS) and CS on lung volume loss during suctioning, and recovery of ...
Ballard-Croft Cherry - - 2012
Our original venovenous perfusion-induced systemic hyperthermia (vv-PISH) system appeared to significantly improve the survival of patients with lung cancer, but was too complex with numerous dialysis problems. We tested a simplified vv-PISH circuit that includes the Avalon Elite (Avalon Laboratories, LLC, Rancho Dominguez, CA) double lumen cannula, a modified heat ...
Dupont Matthias - - 2012
Right ventricular (RV) dysfunction frequently occurs and independently prognosticates in left-sided heart failure. It is not clear which RV afterload measure has the greatest impact on RV function and prognosis. We examined the determinants, prognostic role, and response to treatment of pulmonary arterial capacitance (PAC, ratio of stroke volume over ...
Solevåg Anne L - - 2012
ABSTRACT: BACKGROUND: In newborn resuscitation the recommended rate of chest compressions should be 90 per minute and 30 ventilations should be delivered each minute, aiming at achieving a total of 120 events per minute. However, this recommendation is based on physiological plausibility and consensus rather than scientific evidence. With focus ...
Cao Jie J - - 2012
BACKGROUND: -Cardiac hemodynamics affect pulmonary vascular pressure and flow but little is known of the effects of hemodynamics on lung perfusion at the tissue level. We sought to investigate the relationship between hemodynamic abnormalities in patients with left heart failure and global and regional lung perfusion using lung perfusion quantitation ...
James Mollie M - - 2012
The treatment of respiratory failure requiring mechanical ventilation has advanced significantly over the last 20 years. The goal of therapy in patients with acute respiratory distress syndrome should be to optimize oxygenation while minimizing the risk of ventilator-induced lung injury and providing adequate ventilation. Appropriate use of ventilation modes and ...
Wrobel Jeremy P - - 2012
PURPOSE: Recent studies have suggested that pretransplant secondary pulmonary hypertension (PHT) may be associated with worse outcomes following lung transplantation. We sought to determine whether COPD patients with secondary PHT have inferior intensive care outcomes following lung transplantation. METHODS: This is a single-center, retrospective analysis of all lung transplant recipients ...
Bonderman D - - 2012
Precapillary pulmonary hypertension (PH) is diagnosed when mean pulmonary arterial pressure (mPAP) equals or exceeds 25 mmHg and the pulmonary capillary wedge pressure (PCWP) is equal or lower than 15 mmHg. Because both parameters can only be derived from invasive hemodynamic assessment, right heart catheter (RHC) is still a gold ...
Antoniou Theofani - - 2012
OBJECTIVE: The purpose of this study was to evaluate the hemodynamic effects of inhaled nitric oxide (NO) plus aerosolized iloprost in patients with pulmonary hypertension/right ventricular dysfunction after cardiac surgery. DESIGN: A retrospective study. SETTING: A single center. PARTICIPANTS: Eight consecutive patients with valve disease and postextracorporeal circulation (ECC) pulmonary ...
Rodriguez Pablo O - - 2012
BACKGROUND: Selection of positive end expiratory pressure (PEEP) associated with the best compliance of the respiratory system during decremental PEEP titration can be used for the treatment of patients suffering from acute respiratory distress syndrome (ARDS). We describe changes in transpulmonary pressure (Ptp) and gas exchange during a decremental PEEP ...
Tehrani Fleur T - - 2012
A system for automatic control of the fraction of inspired oxygen (F(IO2)), and positive end-expiratory pressure (PEEP) for patients on mechanical ventilation is presented. In this system, F(IO2) is controlled by using two interacting mechanisms; a fine control mechanism and a fast stepwise procedure used when patient's oxygen saturation level ...
Luján Manel - - 2012
BACKGROUND: New home ventilators are able to provide clinicians data of interest through built-in-software. Monitoring of tidal volume is a key point in the assessment of the efficacy of home mechanical ventilation. OBJECTIVE: To assess the reliability of the tidal volume (VT) provided by five ventilators in a bench test. ...
Strunden Mike S - - 2012
PURPOSE: The endothelial glycocalyx (GLX) is pivotal to vascular barrier function. We investigated the consequences of GLX degradation on pulmonary microvascular perfusion and, prompted by evidence that hydroxyethyl starch (HES) improves microcirculation, studied the effects of two HES preparations during GLX diminution. METHODS: C57 BL/6 black mice lungs were explanted ...
Leuchte Hanno H - - 2012
Background: Pulmonary hypertension (PH) of various causes leads to a poor prognosis. Pulmonary vasoreactivity testing during right heart catheterization (RHC) has prognostic and therapeutic consequences. Objective: To characterize the acute hemodynamic response to short-term oxygen supplementation (SHOT) in adult PH patients and its impact on prognosis. Methods: After a stable ...
Leme Silva P - - 2012
Recent data show an alarming increasing trend in obesity around the world. Mechanical ventilation in this population requires specific ventilatory settings due to the mechanical and inflammatory alterations observed in obesity. In this line, end-expiratory lung volume is decreased, leading to impairment in the mechanics of the respiratory system, lung ...
Kunugiyama Sujen K - - 2012
High-frequency percussive ventilation (HFPV) has been used for patients with severe respiratory compromise refractory to conventional mechanical ventilation. It frequently results in equivalent or improved oxygenation and ventilation at lower peak pressures than conventional ventilation, thus minimizing secondary ventilator-associated lung injury. The only ventilator currently available that delivers HFPV is ...
Fletcher Alexander M - - 2012
The best method of hemodynamic monitoring to guide the resuscitation and management of the critically ill patient is unclear. The evaluated article presents data from a prospective randomized controlled trial that recruited 120 shocked patients (n = 60 in each arm) to compare volume-limited versus pressure-limited hemodynamic management. Patients were ...
Yeung Jonathan C - - 2012
The evaluation of donor lungs by normothermic ex vivo acellular perfusion has improved the safety of organ utilization. However, this strategy requires a critical re-evaluation of the parameters used to assess lungs during ex vivo perfusion compared with those traditionally used to evaluate the donor lung in vivo. Using a ...
Swenson Erik R - - 2012
High-altitude pulmonary edema (HAPE), a not uncommon form of acute altitude illness, can occur within days of ascent above 2500 to 3000 m. Although life-threatening, it is avoidable by slow ascent to permit acclimatization or with drug prophylaxis. The critical pathophysiology is an excessive rise in pulmonary vascular resistance or ...
Bang Jae Ouk - - 2012
The use of positive end expiratory pressure (PEEP) in patients with acute lung injury (ALI) improves arterial oxygenation by alleviating pulmonary shunting, helping the respiratory muscles to decrease the work of breathing, decreasing the rate of infiltrated and atelectatic tissues, and increasing functional residual capacity. In a rabbit model of ...
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