1,041 results match your criteria Barotrauma and Mechanical Ventilation


Individualized positive end-expiratory pressure setting in patients with severe acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation.

Perfusion 2020 Aug 10:267659120946728. Epub 2020 Aug 10.

Department of Critical Care Medicine, The Third Central Clinical College of Tianjin Medical University, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin, China.

Background: Patients with acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation benefit from higher positive end-expiratory pressure combined with conventional ventilation during the early extracorporeal membrane oxygenation period. The role of incremental positive end-expiratory pressure titration in patients with severe acute respiratory distress syndrome supported with veno-venous extracorporeal membrane oxygenation remains unclear. This study aimed to determine the preferred method for setting positive end-expiratory pressure in patients with severe acute respiratory distress syndrome on veno-venous extracorporeal membrane oxygenation support. Read More

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http://dx.doi.org/10.1177/0267659120946728DOI Listing

Case Report: Pneumothorax and Pneumomediastinum as Uncommon Complications of COVID-19 Pneumonia-Literature Review.

Am J Trop Med Hyg 2020 Jul 23. Epub 2020 Jul 23.

Diagnostic Imaging Service, Hospital II LNC Luis Negreiros Vega ESSALUD, Lima, Peru.

As the COVID-19 pandemic progresses, awareness of uncommon presentations of the disease increases. Such is the case with pneumothorax and pneumomediastinum. Recent evidence suggested that these can occur in the context of COVID-19 pneumonia, even in the absence of mechanical ventilation-related barotrauma. Read More

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http://dx.doi.org/10.4269/ajtmh.20-0815DOI Listing

Ventilation, oxidative stress and risk of brain injury in preterm newborn.

Ital J Pediatr 2020 Jul 23;46(1):100. Epub 2020 Jul 23.

Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.

Preterm infants have an increased risk of cognitive and behavioral deficits and cerebral palsy compared to term born babies. Especially before 32 weeks of gestation, infants may require respiratory support, but at the same time, ventilation is known to induce oxidative stress, increasing the risk of brain injury. Ventilation may cause brain damage through two pathways: localized cerebral inflammatory response and hemodynamic instability. Read More

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http://dx.doi.org/10.1186/s13052-020-00852-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376314PMC

[Tracheostoma valves and their associated risks].

Authors:
P Kress K Pfeiffer

HNO 2020 Jul 20. Epub 2020 Jul 20.

Abteilung Medizinprodukte, Bundesinstitut für Arzneimittel und Medizinprodukte, Kurt-Georg-Kiesinger-Allee 3, Bonn, 53175, Deutschland.

Tracheostoma valves have proven to be very effective for voice restoration in patients with a tracheotomy or laryngectomy. Nevertheless, in recent years there have been a number of reports about life-threatening incidents with tracheostoma valves. An analysis of these incidents and the commercially available tracheostoma valves, their functions and limitations enables typical risk situations to be derived. Read More

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http://dx.doi.org/10.1007/s00106-020-00905-1DOI Listing

Vaping Cannabis Butane Hash Oil Leads to Severe Acute Respiratory Distress Syndrome-A Case of EVALI in a Teenager With Hypertrophic Cardiomyopathy.

J Intensive Care Med 2020 Jul 20:885066620941004. Epub 2020 Jul 20.

Division of Pediatric Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, CA, USA.

A 17-year-old with severe hypertrophic cardiomyopathy (HCM) presented to the emergency department with symptoms of cough, shortness of breath, chest pain, and tactile fevers. She was initially admitted to the cardiac floor, and later transferred to the cardiothoracic intensive care unit on day 5 of illness with deterioration over the next week from BiLevel positive airway pressure to endotracheal intubation. The patient met criteria for severe acute respiratory distress syndrome (ARDS). Read More

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http://dx.doi.org/10.1177/0885066620941004DOI Listing

High Incidence of Barotrauma in Patients with COVID-19 Infection on Invasive Mechanical Ventilation.

Radiology 2020 Jul 1:202352. Epub 2020 Jul 1.

From the Department of Radiology, NYU Grossman School of Medicine, New York, NY (G.M., C.Z., L.A., M.W., D.M.M., W.H.M.), NYU Grossman School of Medicine, New York, NY (N.R.), Department of Pathology, NYU Grossman School of Medicine, New York, NY (K.M.T.), and NYU Langone Health, New York, NY (G.M., C.Z., N.R., L.A., M.W., D.M.M., K.M.T., W.H.M.).

Background We observed a high number of patients with COVID-19 pneumonia who had barotrauma related to invasive mechanical ventilation at our institution. Purpose To determine if the rate of barotrauma in patients with COVID-19 infection was greater than other patients requiring invasive mechanical ventilation at our institution. Methods In this retrospective study, clinical and imaging data of patients seen between 03/01/2020 and 04/06/2020 who tested positive for COVID-19 and experienced barotrauma associated with invasive mechanical ventilation were compared to patients without COVID-19 infection during the same period. Read More

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http://dx.doi.org/10.1148/radiol.2020202352DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7336751PMC

Detection and Management of Intraoperative Pneumothorax during Laparoscopic Cholecystectomy.

Case Rep Anesthesiol 2020 7;2020:9273903. Epub 2020 Apr 7.

Department of General Surgery, Farwaniya Hospital, Sabah Al Nasser, Kuwait.

Intraoperative pneumothorax is a rare but potentially lethal complication during general anesthesia. History of lung disease, barotrauma, and laparoscopic surgery increase the risk of developing intraoperative pneumothorax. The diagnosis during surgery could be difficult because the signs are often nonspecific. Read More

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http://dx.doi.org/10.1155/2020/9273903DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7166272PMC

[Large Pneumothorax in a Sleep Apnea Patient with CPAP without Previously Known Lung and Thoracic Diseases - a Case Report].

Pneumologie 2020 Apr 9;74(4):217-221. Epub 2020 Apr 9.

Bereich Pneumologie, Medizinische Klinik I, Universitätsklinikum "Carl Gustav Carus", Technische Universität Dresden.

CPAP is the most common treatment for obstructive sleep apnea.Serious complications from this treatment are very rare. Pneumothorax following lung barotrauma under CPAP therapy has been described in case reports only in patients with pre-existing lung and thoracic diseases. Read More

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http://dx.doi.org/10.1055/a-1108-3004DOI Listing

Development of a tension pneumomediastinum during mechanical ventilation of a young Irish Wolfhound.

J Vet Emerg Crit Care (San Antonio) 2020 May 8;30(3):342-346. Epub 2020 Mar 8.

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO.

Objective: To report the development of a tension pneumomediastinum during mechanical ventilation of a young Irish Wolfhound with aspiration pneumonia.

Case Summary: A 9-month-old intact female Irish Wolfhound was presented for clinical signs consistent with aspiration pneumonia. Evaluation of her pedigree and clinical signs prompted suspicion of Irish Wolfhound rhinitis bronchopneumonia syndrome as a contributing factor. Read More

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http://dx.doi.org/10.1111/vec.12927DOI Listing

Validation of neuromuscular blocking agent use in acute respiratory distress syndrome: a meta-analysis of randomized trials.

Crit Care 2020 02 17;24(1):54. Epub 2020 Feb 17.

Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China.

Background: We aimed to synthesize up-to-date trials to validate the effects of neuromuscular blocking agent (NMBA) use in patients with moderate-to-severe acute respiratory distress syndrome (ARDS).

Methods: Several databases including PubMed, EMBASE, Web of Science, and Cochrane Central Register were searched up to November 14, 2019. All randomized trials investigating the use of NMBAs in patients with moderate-to-severe ARDS and reporting mortality data were included in the meta-analysis. Read More

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http://dx.doi.org/10.1186/s13054-020-2765-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7027110PMC
February 2020

[The effect of a breathing trainer on relieving airway pressure caused by active cough in patients with mechanical ventilation].

Zhonghua Jie He He Hu Xi Za Zhi 2020 Feb;43(2):136-139

State Key Laboratory of Respiratory Diseases, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.

To explore the effect of a breathing trainer on relieving the peak airway pressure caused by forced exhalation at the end of deep inspiration, gentle coughing at the end of calm inspiration and forced coughing at the end of deep inspiration in patients undergoing mechanical ventilation. From July to September 2018, 15 patients undergoing mechanical ventilation were selected from the First Affiliated Hospital of Guangzhou Medical University, including 5 patients with invasive ventilation (3 with tracheotomy and 2 with endotracheal intubation), and 10 patients with non-invasive ventilation through mask. The patients included 14 males and 1 female, aging 48-79 years, with an average age of (68±10) years. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1001-0939.2020.02.012DOI Listing
February 2020

Dexamethasone treatment for the acute respiratory distress syndrome: a multicentre, randomised controlled trial.

Lancet Respir Med 2020 03 7;8(3):267-276. Epub 2020 Feb 7.

Biostatistics Research Unit, Hospital Universitario Dr Negrín, Las Palmas de Gran Canaria, Spain.

Background: There is no proven specific pharmacological treatment for patients with the acute respiratory distress syndrome (ARDS). The efficacy of corticosteroids in ARDS remains controversial. We aimed to assess the effects of dexamethasone in ARDS, which might change pulmonary and systemic inflammation and result in a decrease in duration of mechanical ventilation and mortality. Read More

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http://dx.doi.org/10.1016/S2213-2600(19)30417-5DOI Listing

Neuromuscular blockade in acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials.

J Intensive Care 2020 28;8:12. Epub 2020 Jan 28.

2Medical Intensive Care Unit, North Hospital, APHM, Marseille, France.

Background: Neuromuscular blocking agent (NMBA) has been proposed by medical guidelines for early severe acute respiratory distress syndrome (ARDS) because of its survival benefits. However, new studies have provided evidence contradicting these results.

Method: A search was performed of the Pubmed, Scopus, Clinicaltrials. Read More

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http://dx.doi.org/10.1186/s40560-020-0431-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6986163PMC
January 2020

Neuromuscular blockers in the acute respiratory distress syndrome: A meta-analysis.

PLoS One 2020 21;15(1):e0227664. Epub 2020 Jan 21.

Department of Anesthesiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.

Background: The effects of neuromuscular blocking agents (NMBAs) on adult patients with acute respiratory distress syndrome (ARDS) remain unclear. We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate its effect on mortality.

Methods: We searched the Cochrane (Central) database, Medline, Embase, the Chinese Biomedical Literature Database (SinoMed), WanFang data and ClinicalTrials from inception to June 2019, with language restriction to English and Chinese. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0227664PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6974254PMC
April 2020
3.234 Impact Factor

Efficacy of continuous positive airway pressure in casualties suffering from primary blast lung injury: A modeling study.

Conf Proc IEEE Eng Med Biol Soc 2019 07;2019:4965-4968

Primary blast lung injury is the most important component of a multisystem syndrome of injury that results from exposure to an explosive shockwave. The majority of such casualties require ventilation in an intensive care unit. We describe the use of a novel primary blast lung injury simulator to evaluate the potential efficacy of continuous positive airway pressure in 6 in silico casualties over 24 hours after injury. Read More

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http://dx.doi.org/10.1109/EMBC.2019.8857613DOI Listing

[Comparison of pressure-controlled volume-guaranteed ventilation and volume-controlled ventilation in obese patients during gynecologic laparoscopic surgery in the Trendelenburg position].

Rev Bras Anestesiol 2019 Nov - Dec;69(6):553-560. Epub 2019 Dec 10.

Mugla Sıtkı Kocman University, Department of Anesthesiology and Reanimation, Mugla, Turquia.

Background And Objectives: The aim of this study was to investigate the efficacy of the pressure-controlled, volume-guaranteed (PCV-VG) and volume-controlled ventilation (VCV) modes for maintaining adequate airway pressures, lung compliance and oxygenation in obese patients undergoing laparoscopic hysterectomy in the Trendelenburg position.

Methods: Patients (104) who underwent laparoscopic gynecologic surgery with a body mass index between 30 and 40kg.m were randomized to receive either VCV or PCV-VG ventilation. Read More

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http://dx.doi.org/10.1016/j.bjan.2019.09.003DOI Listing

Patient self-inflicted lung injury and positive end-expiratory pressure for safe spontaneous breathing.

Curr Opin Crit Care 2020 Feb;26(1):59-65

Department of Anesthesiology and Intensive Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan.

Purpose Of Review: The potential risks of spontaneous effort and their prevention during mechanical ventilation is an important concept for clinicians and patients. The effort-dependent lung injury has been termed 'patient self-inflicted lung injury (P-SILI)' in 2017. As one of the potential strategies to render spontaneous effort less injurious in severe acute respiratory distress syndrome (ARDS), the role of positive end-expiratory pressure (PEEP) is now discussed. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000691DOI Listing
February 2020
2.617 Impact Factor

Vaporized perfluorocarbon inhalation attenuates primary blast lung injury in canines by inhibiting mitogen-activated protein kinase/nuclear factor-κB activation and inducing nuclear factor, erythroid 2 like 2 pathway.

Toxicol Lett 2020 Feb 3;319:49-57. Epub 2019 Nov 3.

Department of Respiration, First Medical Center of Chinese PLA General Hospital, Beijing City, People's Republic of China. Electronic address:

Blast lung injury is associated with high morbidity and mortality. Vaporized perfluorocarbon (PFC) inhalation has been reported to attenuate acute respiratory distress syndrome in humans and animal models. However, the effect of vaporized PFC on blast lung injury is still unknown. Read More

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http://dx.doi.org/10.1016/j.toxlet.2019.10.019DOI Listing
February 2020
1 Read

Gas in coronary artery: A case of fatal decompression sickness evaluated by computed tomography.

Undersea Hyperb Med 2019 Sep - Dec - Fourth Quarter;46(5):633-634

Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Izunokuni City, Shizuoka, Japan.

A 54-year-old man suffered a leg cramp while diving in the ocean at a depth of 20 meters. He began to surface, with his ascent based on a decompression table. He lost consciousness at the surface and was rescued by a nearby boat. Read More

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November 2019
1 Read

Pulmonary Barotrauma Following Nasal High-Flow Therapy in a Patient with Bronchiolitis Obliterans Syndrome.

Am J Case Rep 2019 Nov 4;20:1619-1622. Epub 2019 Nov 4.

Department of Clinical Engineering, Suzuka University of Medical Science, Suzuka, Mie, Japan.

BACKGROUND Pulmonary barotrauma is considered as complication of the use of positive-pressure ventilations. Nasal high-flow therapy is increasingly being used as an alternative to them. Nasal high-flow therapy rarely causes pulmonary barotrauma probably because airway pressures are lower when compared with invasive mechanical ventilation. Read More

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http://dx.doi.org/10.12659/AJCR.918580DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6858625PMC
November 2019

Bedside troubleshooting during venovenous extracorporeal membrane oxygenation (ECMO).

J Thorac Dis 2019 Sep;11(Suppl 14):S1698-S1707

In this review, we discuss common difficulties that clinicians may encounter while managing patients treated with venovenous (VV) extracorporeal membrane oxygenation (ECMO). ECMO is an increasingly important tool for managing severe respiratory failure that is refractory to conventional therapies. Its overall goal is to manage respiratory failure-induced hypoxemia and hypercarbia to allow "lung rest" and promote recovery. Read More

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http://dx.doi.org/10.21037/jtd.2019.04.81DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6783727PMC
September 2019

Acute respiratory failure: nonintubation assist methods for the acutely deteriorating patient.

Curr Opin Crit Care 2019 12;25(6):591-596

CHU de Poitiers, Médecine Intensive Réanimation, Poitiers.

Purpose Of Review: Noninvasive ventilation is strongly recommended in acute hypercapnic respiratory failure, whereas high-flow nasal oxygen therapy could be an alternative in de novo respiratory failure.

Recent Findings: High-flow nasal oxygen may improve the outcome of patients de novo respiratory failure as compared with standard oxygen. Its success within 2 h after initiation is well predicted by a ROX index (ratio of SpO2/FiO2 to respiratory rate) greater than 4. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000670DOI Listing
December 2019
3 Reads

Airway Pressure Release Ventilation in Adult Patients With Acute Hypoxemic Respiratory Failure: A Systematic Review and Meta-Analysis.

Crit Care Med 2019 12;47(12):1794-1799

Department of Intensive Care, Fiona Stanley Hospital, Perth, WA, Australia.

Objectives: To evaluate the efficacy and safety of airway pressure release ventilation in critically ill adults with acute hypoxemic respiratory failure.

Data Sources: A systematic literature search of MEDLINE via PUBMED, EMBASE, the Cochrane Library, published conference proceedings and abstracts, reference lists of eligible studies and review articles, and hand searches of relevant journals and trial registers.

Study Selection: Eligible studies included randomized controlled trials published between years 2000 and 2018, comparing airway pressure release ventilation to any ventilation mode, in critically ill adults with acute hypoxemic respiratory failure and reporting at least one mortality outcome. Read More

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http://dx.doi.org/10.1097/CCM.0000000000003972DOI Listing
December 2019
7 Reads

Acute Respiratory Distress Syndrome Novel Therapies.

Crit Care Nurs Q 2019 Oct/Dec;42(4):411-416

Division of Pulmonary-Critical Care, Allegheny General Hospital, Allegheny Health Network, Pittsburgh, Pennsylvania.

Acute respiratory distress syndrome (ARDS) was first described in 1967. Since then, several landmark studies have been published that have greatly influenced the way we diagnose and treat patients with ARDS. Despite extensive research and advancements in ventilator strategies, moderate-severe ARDS has been associated with high mortality rates. Read More

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http://dx.doi.org/10.1097/CNQ.0000000000000281DOI Listing
December 2019
6 Reads

Surfactant therapy in premature babies: SurE or InSurE.

Pediatr Pulmonol 2019 11 19;54(11):1747-1752. Epub 2019 Aug 19.

Department of Neonatology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Background: Preterm infants with respiratory distress syndrome (RDS) requiring surfactant therapy have been traditionally receiving surfactant by intubation surfactant and extubation technique (InSurE), which comprises of tracheal intubation, surfactant administration, and extubation. However, more recently noninvasive methods like least invasive surfactant therapy or minimally invasive surfactant therapy have been reported to be successful. These methods, avoid intubation thus minimize airway trauma and avoid barotrauma. Read More

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http://dx.doi.org/10.1002/ppul.24479DOI Listing
November 2019
6 Reads

Current Use of Neuromuscular Blocking Agents in Intensive Care Units.

Turk J Anaesthesiol Reanim 2019 Aug 24;47(4):273-281. Epub 2019 Jan 24.

Clinic of Anaesthesiology and Reanimation, Türkiye Yüksek İhtisas Training and Research Hospital, Ankara, Turkey.

Neuromuscular blocking agents can be used for purposes such as eliminating ventilator-patient dyssynchrony, facilitating gas exchange by reducing intra-abdominal pressure and improving chest wall compliance, reducing risk of lung barotrauma, decreasing contribution of muscles to oxygen consumption by preventing shivering and limiting elevations in intracranial pressure caused by airway stimulation in patients supported with mechanical ventilation in intensive care units. Adult Respiratory Distress Syndrome (ARDS), status asthmaticus, increased intracranial pressure and therapeutic hypothermia following ventricular fibrillation-associated cardiac arrest are some of clinical conditions that can be sustained by neuromuscular blockade. Appropriate indication and clinical practice have gained importance considering side effects such as ICU-acquired weakness, masking seizure activity and longer durations of hospital and ICU stays. Read More

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http://dx.doi.org/10.5152/TJAR.2019.33269DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6645848PMC
August 2019
7 Reads

Assessment of Therapeutic Interventions and Lung Protective Ventilation in Patients With Moderate to Severe Acute Respiratory Distress Syndrome: A Systematic Review and Network Meta-analysis.

JAMA Netw Open 2019 07 3;2(7):e198116. Epub 2019 Jul 3.

Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada.

Importance: A number of interventions are available to manage patients with moderate to severe acute respiratory distress syndrome (ARDS). However, the associations of currently available ventilatory strategies and adjunctive therapies with mortality are uncertain.

Objectives: To compare and rank different therapeutic strategies to identify the best intervention associated with a reduction in mortality in adult patients with moderate to severe ARDS. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2019.8116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6669780PMC
July 2019
5 Reads

Maximal Recruitment Open Lung Ventilation in Acute Respiratory Distress Syndrome (PHARLAP). A Phase II, Multicenter Randomized Controlled Clinical Trial.

Am J Respir Crit Care Med 2019 12;200(11):1363-1372

Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Victoria, Australia.

Open lung ventilation strategies have been recommended in patients with acute respiratory distress syndrome (ARDS). To determine whether a maximal lung recruitment strategy reduces ventilator-free days in patients with ARDS. A phase II, multicenter randomized controlled trial in adults with moderate to severe ARDS. Read More

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http://dx.doi.org/10.1164/rccm.201901-0109OCDOI Listing
December 2019
4 Reads
12.996 Impact Factor

Applied Uses of Extracorporeal Membrane Oxygenation Therapy.

Cureus 2019 Jul 17;11(7):e5163. Epub 2019 Jul 17.

Pulmonary Medicine, Marshall University School of Medicine, Huntington, USA.

Extracorporeal membrane oxygenation (ECMO) therapy has been around since the 1970s and has completely changed how critical care physicians view supportive therapy for certain patients. ECMO therapy is a supportive therapy provided by a mechanical extracorporeal circuit that is able to directly oxygenate and remove carbon dioxide from the blood. By performing this, ECMO can provide cardiac, respiratory, or combined cardiopulmonary supportive therapy in cases of failure. Read More

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http://dx.doi.org/10.7759/cureus.5163DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6639062PMC
July 2019
5 Reads

Effect of lung recruitment and titrated positive end-expiratory pressure (PEEP) low PEEP on patients with moderate-severe acute respiratory distress syndrome: a systematic review and meta-analysis of randomized controlled trials.

Ther Adv Respir Dis 2019 Jan-Dec;13:1753466619858228

Surgical Intensive Care Unit, Beijing Chao-Yang Hospital, Capital Medical University, 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.

Background: Setting a positive end-expiratory pressure (PEEP) on patients with acute respiratory distress syndrome (ARDS) receiving mechanical ventilation has been an issue of great contention. Therefore, we aimed to determine effects of lung recruitment maneuver (RM) and titrated PEEP low PEEP on adult patients with moderate-severe ARDS.

Methods: Data sources and study selection proceeded as follows: PubMed, Ovid, EBSCO, and Cochrane Library databases were searched from 2003 to May 2018. Read More

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http://dx.doi.org/10.1177/1753466619858228DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611025PMC
November 2019
10 Reads

Traumatic subcutaneous emphysema after liposuction.

Arch Craniofac Surg 2019 Jun 20;20(3):199-202. Epub 2019 Jun 20.

Department of Plastic and Reconstructive Surgery, Busan Paik Hospital, Inje University School of Medicine, Busan, Korea.

Traumatic subcutaneous emphysema, which is the infiltration of air into subcutaneous tissues due to trauma, is caused by various factors such as chest and/or abdominal trauma, facial fractures, and barotrauma caused by mechanical ventilation. In this case report, a 32-year-old woman developed traumatic subcutaneous emphysema after undergoing abdominal liposuction at a local clinic. She was subsequently admitted to Busan Paik Hospital, and with early diagnosis and conservative treatment, she was discharged on the seventh day of hospitalization with no complications. Read More

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http://dx.doi.org/10.7181/acfs.2018.02355DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6615419PMC
June 2019
6 Reads

Five-year single center experience on surfactant treatment in preterm infants with respiratory distress syndrome: LISA vs INSURE.

Early Hum Dev 2019 08 20;135:32-36. Epub 2019 Jun 20.

Division of Neonatology, Health Sciences University, Zekai Tahir Burak Maternity Education and Research Hospital, Ankara, Turkey.

Background: Surfactant administration traditionally involved endotracheal intubation and mechanical ventilation, which is associated with a risk of barotrauma and volutrauma.

Objective: To compare the morbidity and mortality rates between LISA-treated and INSURE-treated premature babies with respiratory distress syndrome (RDS).

Methods: We assessed retrospectively the medical records of preterm infants who were born at 25 to 29 weeks of gestation and were administered surfactant initially either with LISA or INSURE method over a five-year period. Read More

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http://dx.doi.org/10.1016/j.earlhumdev.2019.06.004DOI Listing
August 2019
36 Reads

Changes in ventilator settings and ventilation-induced lung injury in burn patients-A systematic review.

Burns 2020 06 12;46(4):762-770. Epub 2019 Jun 12.

Laboratory of Experimental Intensive Care and Anesthesiology (L·E·I·C·A), Amsterdam Universitair Medische Centra, Amsterdam, The Netherlands; Department of Intensive Care, Amsterdam Universitair Medische Centra, Amsterdam, The Netherlands.

Objective: Ventilation strategies aiming at prevention of ventilator-induced lung injury (VILI), including low tidal volumes (V) and use of positive end-expiratory pressures (PEEP) are increasingly used in critically ill patients. It is uncertain whether ventilation practices changed in a similar way in burn patients. Our objective was to describe applied ventilator settings and their relation to development of VILI in burn patients. Read More

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http://dx.doi.org/10.1016/j.burns.2019.05.015DOI Listing
June 2020
25 Reads

Effect of Apneic Oxygenation on Tracheal Oxygen Levels, Tracheal Pressure, and Carbon Dioxide Accumulation: A Randomized, Controlled Trial of Buccal Oxygen Administration.

Anesth Analg 2019 06;128(6):1154-1159

From the Department of Anaesthesia and Pain Medicine, Royal Perth Hospital, Perth, Australia.

Background: Apneic oxygenation via the oral route using a buccal device extends the safe apnea time in most but not all obese patients. Apneic oxygenation techniques are most effective when tracheal oxygen concentrations are maintained >90%. It remains unclear whether buccal oxygen administration consistently achieves this goal and whether significant risks of hypercarbia or barotrauma exist. Read More

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http://dx.doi.org/10.1213/ANE.0000000000003810DOI Listing
June 2019
6 Reads

[The Critically Ill Obese Patient: Too Big to Fail?]

Anasthesiol Intensivmed Notfallmed Schmerzther 2019 Apr 12;54(4):256-266. Epub 2019 Apr 12.

Worldwide, currently more than 1.9 billion adults are overweight, 650 million of them are obese. Hereby they pose a significant burden on the budget of the health system and on the workload of intensive care units. Read More

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http://www.thieme-connect.de/DOI/DOI?10.1055/a-0636-2735
Publisher Site
http://dx.doi.org/10.1055/a-0636-2735DOI Listing
April 2019
22 Reads

PO oscillations induce lung injury and inflammation.

Crit Care 2019 Mar 27;23(1):102. Epub 2019 Mar 27.

Department of Anesthesia, General Intensive Care and Pain Management, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.

Background: Mechanical ventilation can lead to ventilator-induced lung injury (VILI). In addition to the well-known mechanical forces of volutrauma, barotrauma, and atelectrauma, non-mechanical mechanisms have recently been discussed as contributing to the pathogenesis of VILI. One such mechanism is oscillations in partial pressure of oxygen (PO) which originate in lung tissue in the presence of within-breath recruitment and derecruitment of alveoli. Read More

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http://dx.doi.org/10.1186/s13054-019-2401-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6438034PMC
March 2019
10 Reads

Computational Modeling of Primary Blast Lung Injury: Implications for Ventilator Management.

Mil Med 2019 03;184(Suppl 1):273-281

Department of Anesthesia, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA.

Primary blast lung injury (PBLI) caused by exposure to high-intensity pressure waves is associated with parenchymal tissue injury and severe ventilation-perfusion mismatch. Although supportive ventilation is often required in patients with PBLI, maldistribution of gas flow in mechanically heterogeneous lungs may lead to further injury due to increased parenchymal strain and strain rate, which are difficult to predict in vivo. In this study, we developed a computational lung model with mechanical properties consistent with healthy and PBLI conditions. Read More

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http://dx.doi.org/10.1093/milmed/usy305DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6515895PMC
March 2019
90 Reads

A Case of Pneumomediastinum and Pneumoperitoneum with Concurrent Massive Subcutaneous Emphysema due to Repositioning of a Tracheostomy Tube.

Cureus 2019 Jan 14;11(1):e3881. Epub 2019 Jan 14.

Internal Medicine, Brookdale University Hospital Medical Center, New York, USA.

Tracheostomy is a common procedure seen in critically ill patients that require long term ventilatory support. As with all airway access procedures, tracheotomy with prolonged tracheal tube placement comes with possible risks such as tracheal scarring, tracheal rupture, pneumothorax, tracheoesophageal fistula among others. Another possible complication, though rare, is escape of free air into the surrounding tissue, as well as pneumomediastinum (PM). Read More

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http://dx.doi.org/10.7759/cureus.3881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6420328PMC
January 2019
10 Reads

Effect of Titrating Positive End-Expiratory Pressure (PEEP) With an Esophageal Pressure-Guided Strategy vs an Empirical High PEEP-Fio2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial.

JAMA 2019 03;321(9):846-857

Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.

Importance: Adjusting positive end-expiratory pressure (PEEP) to offset pleural pressure might attenuate lung injury and improve patient outcomes in acute respiratory distress syndrome (ARDS).

Objective: To determine whether PEEP titration guided by esophageal pressure (PES), an estimate of pleural pressure, was more effective than empirical high PEEP-fraction of inspired oxygen (Fio2) in moderate to severe ARDS.

Design, Setting, And Participants: Phase 2 randomized clinical trial conducted at 14 hospitals in North America. Read More

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http://dx.doi.org/10.1001/jama.2019.0555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6439595PMC
March 2019
26 Reads

Pulmonary Barotrauma Including Huge Pulmonary Interstitial Emphysema in an Adult with Status Asthmaticus: Diagnostic and Therapeutic Challenges.

Eur J Case Rep Intern Med 2018 25;5(5):000823. Epub 2018 May 25.

Medical Intensive Care Unit, Farhat Hached Hospital, Sousse, Tunisia.

Introduction: Pulmonary interstitial emphysema is a rare finding defined as abnormal air collection inside the lung interstitial tissues. Described more frequently in ventilated new-borns, pulmonary interstitial emphysema is an uncommon barotrauma-related complication in adults. Management and clinical sequelae are poorly described. Read More

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https://www.ejcrim.com/index.php/EJCRIM/article/view/823
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http://dx.doi.org/10.12890/2018_000823DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6346923PMC
May 2018
40 Reads

Feasibility of an alternative, physiologic, individualized open-lung approach to high-frequency oscillatory ventilation in children.

Ann Intensive Care 2019 Jan 18;9(1). Epub 2019 Jan 18.

Department of Paediatrics, Division of Paediatric Critical Care Medicine, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Huispost CA 80, P.O. Box 30.001, 9700 RB, Groningen, The Netherlands.

Background: High-frequency oscillatory ventilation (HFOV) is a common but unproven management strategy in paediatric critical care. Oscillator settings have been traditionally guided by patient age and/or weight rather than by lung mechanics, thereby potentially negating any beneficial effects. We have adopted an open-lung HFOV strategy based on a corner frequency approach using an initial incremental-decremental mean airway pressure titration manoeuvre, a high frequency (8-15 Hz), and high power to initially target a proximal pressure amplitude (∆P) of 70-90 cm HO, irrespective of age or weight. Read More

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https://annalsofintensivecare.springeropen.com/articles/10.1
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http://dx.doi.org/10.1186/s13613-019-0492-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338613PMC
January 2019
33 Reads

Bedside respiratory physiology to detect risk of lung injury in acute respiratory distress syndrome.

Authors:
Jeremy R Beitler

Curr Opin Crit Care 2019 02;25(1):3-11

Division of Pulmonary, Allergy, and Critical Care Medicine, Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons, New York, New York, USA.

Purpose Of Review: The most effective strategies for treating the patient with acute respiratory distress syndrome center on minimizing ventilation-induced lung injury (VILI). Yet, current standard-of-care does little to modify mechanical ventilation to patient-specific risk. This review focuses on evaluation of bedside respiratory mechanics, which when interpreted in patient-specific context, affords opportunity to individualize lung-protective ventilation in patients with acute respiratory distress syndrome. Read More

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http://dx.doi.org/10.1097/MCC.0000000000000579DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402876PMC
February 2019
12 Reads

Lobectomy with ECMO Support in an Infant Who Developed Pulmonary Interstitial Emphysema Following Repair of Hypoplastic Aortic Arch.

Braz J Cardiovasc Surg 2018 Sep-Oct;33(5):528-530

Department of Surgery; Division of Cardiothoracic Surgery; Pediatric and Congenital Cardiac Surgery Section Jackson Memorial Hospital - University of Miami Miller School of Medicine, Miami, USA.

Pulmonary interstitial emphysema (PIE) is a common problem in premature neonates with respiratory distress syndrome. This condition is often related to barotrauma caused by mechanical ventilation or continuous positive airway pressure applied to low birth weight neonates. The clinical diagnosis can be challenging. Read More

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http://dx.doi.org/10.21470/1678-9741-2018-0135DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257528PMC
March 2019
16 Reads

Recruitment manoeuvres for adults with acute respiratory distress syndrome receiving mechanical ventilation: a systematic review and meta-analysis.

J Crit Care 2019 04 3;50:1-10. Epub 2018 Nov 3.

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, 100020, China. Electronic address:

Purpose: To determine if recruitment manoeuvres (RMs) would decrease 28-day mortality of patients with acute respiratory distress syndrome (ARDS) compared with standard care.

Materials And Methods: Relevant randomized controlled trials (RCTs) published prior to April 26, 2018 were systematically searched. The primary outcome was mortality. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08839441183096
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http://dx.doi.org/10.1016/j.jcrc.2018.10.033DOI Listing
April 2019
31 Reads

Modes of Neonatal Ventilation: Breathe Deeply!

Authors:
Shawn Hughes

Crit Care Nurs Clin North Am 2018 Dec;30(4):523-531

NICU Respiratory Care Services, Charlotte R. Bloomberg Children's Center, Neonatal Intensive Care Unit, Johns Hopkins Hospital, 8th Floor, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address:

The art and science of neonatal ventilation continue to evolve with advances in technology and as a result of evidenced based research. Although some historically administered therapies remain such as nasal continuous positive airway pressure, newer therapies have emerged in the neonatal intensive care unit such as pressure regulated volume control and neurally adjusted ventilatory assist. The challenge for clinicians continues to be which mode will support the patient's medical diagnosis with minimal barotrauma or lung injury. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S08995885183097
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http://dx.doi.org/10.1016/j.cnc.2018.07.008DOI Listing
December 2018
35 Reads

Higher PEEP improves outcomes in ARDS patients with clinically objective positive oxygenation response to PEEP: a systematic review and meta-analysis.

BMC Anesthesiol 2018 11 17;18(1):172. Epub 2018 Nov 17.

Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, China.

Background: Mortality in patients with acute respiratory distress syndrome (ARDS) remains high. These patients require mechanical ventilation strategies that include high positive end-expiratory pressure (PEEP). It remains controversial whether high PEEP can improve outcomes for ARDS patients, especially patients who show improvement in oxygenation in response to PEEP. Read More

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https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s1
Publisher Site
http://dx.doi.org/10.1186/s12871-018-0631-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240288PMC
November 2018
49 Reads

Surfactant, steroids and non-invasive ventilation in the prevention of BPD.

Semin Perinatol 2018 11 2;42(7):444-452. Epub 2018 Oct 2.

Section of Neonatal-Perinatal Medicine, Department of Pediatrics, St. Christopher's Hospital for Children, Drexel University College of Medicine, 160 East Erie Avenue, Philadelphia, PA 19134, United States. Electronic address:

Bronchopulmonary dysplasia (BPD) is a complex disorder with multiple factors implicated in its etiopathogenesis. Despite the scientific advances in the field of neonatology, the incidence of BPD has remained somewhat constant due to increased survival of extremely premature infants. Surfactant deficiency in the immature lung, exposure to invasive mechanical ventilation leading to volutrauma, barotrauma and lung inflammation are some of the critical contributing factors to the pathogenesis of BPD. Read More

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http://dx.doi.org/10.1053/j.semperi.2018.09.006DOI Listing
November 2018
25 Reads

[Analysis on treatment of extremely severe burn patients with severe inhalation injury in August 2nd Kunshan factory aluminum dust explosion accident].

Zhonghua Shao Shang Za Zhi 2018 Jul;34(7):455-458

Department of Burns and Plastic Surgery, the First Affiliated Hospital of Soochow University, Suzhou 215000, China.

To summarize the measures and experience in diagnosis and treatment of extremely severe burn patients with severe inhalation injury in dust explosion accident. The medical records of 13 patients with extremely severe burn complicated with severe inhalation injury in August 2nd Kunshan factory aluminum dust explosion accident who were treated at the First Affiliated Hospital of Soochow University (hereinafter referred to as our hospital) on August 2nd, 2014, were retrospectively analyzed. All the patients were transferred to our hospital 3-8 hours after injury under the condition of inhalation of pure oxygen. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2018.07.007DOI Listing
July 2018
19 Reads