998 results match your criteria Barotrauma and Mechanical Ventilation


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 02 18. Epub 2019 Feb 18.

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
February 2019

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
4 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
Publisher Site
http://dx.doi.org/10.1186/s13613-019-0492-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338613PMC
January 2019
8 Reads

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

Authors:
Jeremy R Beitler

Curr Opin Crit Care 2019 Feb;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
5 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
4 Reads

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

J Crit Care 2019 Apr 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
11 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
10 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 Nov 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
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http://dx.doi.org/10.1186/s12871-018-0631-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240288PMC
November 2018
12 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
8 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
9 Reads

Intraoperative use of low volume ventilation to decrease postoperative mortality, mechanical ventilation, lengths of stay and lung injury in adults without acute lung injury.

Cochrane Database Syst Rev 2018 07 9;7:CD011151. Epub 2018 Jul 9.

Department of Anesthesiology, Faculty of Medicine, University of Sherbrooke, Sherbrooke, Quebec, Canada.

Background: Since the 2000s, there has been a trend towards decreasing tidal volumes for positive pressure ventilation during surgery. This an update of a review first published in 2015, trying to determine if lower tidal volumes are beneficial or harmful for patients.

Objectives: To assess the benefit of intraoperative use of low tidal volume ventilation (less than 10 mL/kg of predicted body weight) compared with high tidal volumes (10 mL/kg or greater) to decrease postoperative complications in adults without acute lung injury. Read More

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http://dx.doi.org/10.1002/14651858.CD011151.pub3DOI Listing
July 2018
20 Reads

Severe Progressive Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus.

Case Rep Crit Care 2018 7;2018:9790459. Epub 2018 Jun 7.

Department of Anesthesiology, Kansai Medical University Hospital, Osaka, Japan.

Diffuse alveolar hemorrhage (DAH) refers to the effusion of blood into the alveoli due to damaged pulmonary microvasculature. The ensuing alveolar collapse can lead to severe hypoxemia with poor prognosis. In these cases, it is crucial to provide respiratory care for hypoxemia in addition to treating the underlying disease. Read More

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http://dx.doi.org/10.1155/2018/9790459DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6011174PMC
June 2018
8 Reads

[Effects of airway management team in the treatment of severely mass burn patients combined with inhalation injury].

Zhonghua Shao Shang Za Zhi 2018 Jun;34(6):354-359

Department of Burns and Plastic Surgery, the Third People's Hospital of Wuxi City, Wuxi 214041, China.

To explore and analyze the effects of airway management team (AMT) in the treatment of severely mass burn patients combined with inhalation injury. The clinical data of 58 severely burned patients combined with inhalation injury hospitalized in our unit from January 2012 to August 2014, conforming to the inclusion criteria, were retrospectively analyzed. According to whether airway management was implemented by AMT or not, patients hospitalized from January 2012 to July 2014 were divided into control group (=27), while patients in Kunshan factory aluminum dust explosion accident hospitalized on 2nd August 2014 were divided into observation group (=31). Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2018.06.008DOI Listing
June 2018
12 Reads

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

Zhonghua Shao Shang Za Zhi 2018 Jun;34(6):332-338

Burn Institute, the First Affiliated Hospital of PLA General Hospital, Beijing 100048, China.

To summarize the measures and experience of treatment in mass extremely severe burn patients. The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. Read More

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http://dx.doi.org/10.3760/cma.j.issn.1009-2587.2018.06.004DOI Listing
June 2018
20 Reads

Permissive Hypercapnia, Alveolar Recruitment and Low Airway Pressure (PHARLAP): a protocol for a phase 2 trial in patients with acute respiratory distress syndrome.

Crit Care Resusc 2018 06;20(2):139-149

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

Background: Mechanical ventilation is a life-saving intervention that maintains gas exchange in patients with acute respiratory distress syndrome (ARDS); however, it is associated with high mortality and it may augment, or even initiate, lung injury. An open lung ventilation strategy that combines alveolar recruitment manoeuvres with individually titrated positive end-expiratory pressure (PEEP) and targeting lower tidal volumes, or driving pressures by a permissive approach to hypercapnia, may reduce the lung injury associated with mechanical ventilation. This protocol reports the rationale, study design and analysis plan of the Permissive Hypercapnia, Alveolar Recruitment and Low Airway Pressure (PHARLAP) trial. Read More

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June 2018
7 Reads
2.154 Impact Factor

Comparison of the Peak Inspiratory Pressure and Lung Dynamic Compliance between a Classic Laryngeal Mask Airway and an Endotracheal Tube in Children Under Mechanical Ventilation.

Tanaffos 2017 Jun;16(4):289-294

Department of Pediatric Anesthesia, Shahid Beheshti University of Medical Science, Tehran, Iran.

Background: The present study was performed with the aim of comparing the peak inspiratory pressure and lung dynamic compliance between a classic laryngeal mask airway (LMA) and an endotracheal tube in children under mechanical ventilation.

Materials And Methods: In this study, 30 children aged 1 to 7 years with a physical condition of ASA I-II who were admitted for operations to repair inguinal hernias, hydroceles, or hypospadias were randomly enrolled. After induction of anesthesia, the appropriate laryngeal mask was used for each patient and they were placed under pressure-controlled mechanical ventilation. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5971760PMC
June 2017
6 Reads

Influence of xenon on pulmonary mechanics and lung aeration in patients with healthy lungs.

Br J Anaesth 2018 Jun 13;120(6):1394-1400. Epub 2018 Apr 13.

Department of Anaesthesiology, Düsseldorf University Hospital, Düsseldorf, Germany.

Background: The anaesthetic xenon shows potent organ-protective properties. Due to high density and dynamic viscosity, peak inspiratory pressure (P) increases during xenon application. Thus, barotrauma may counteract organ protection. Read More

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http://dx.doi.org/10.1016/j.bja.2018.02.064DOI Listing
June 2018
5 Reads

Effectiveness of dexmedetomidine versus propofol on extubation times, length of stay and mortality rates in adult cardiac surgery patients: a systematic review and meta-analysis.

JBI Database System Rev Implement Rep 2018 May;16(5):1220-1239

School of Nurse Anesthesia, Texas Christian University, Fort Worth, USA.

Objective: To determine the effects of dexmedetomidine versus propofol on extubation time, intensive care unit (ICU) length of stay, total hospital length of stay and in-hospital mortality rates in cardiac surgery patients.

Introduction: Recovery from cardiovascular surgery involves weaning from mechanical ventilation. Mechanical ventilation decreases the work of breathing for patients by inhaling oxygen and exhaling carbon dioxide via a ventilator or breathing machine. Read More

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http://dx.doi.org/10.11124/JBISRIR-2017-003488DOI Listing
May 2018
6 Reads

Evidence Regarding the Use of Bubble Continuous Positive Airway Pressure in the Extremely Low Birth-Weight Infant: Benefits, Challenges, and Implications for Nursing Practice.

Authors:
Samantha Alessi

Adv Neonatal Care 2018 Jun;18(3):199-207

University of Pennsylvania, Philadelphia.

Background: Gentle ventilation with optimal oxygenation is integral to prevention of chronic lung disease in the extremely low birth-weight (ELBW) infant. Various types of noninvasive ventilation are used in neonatal intensive care units worldwide. Bubble continuous positive airway pressure (BCPAP) has been in use in newborn intensive care since 1975. Read More

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http://dx.doi.org/10.1097/ANC.0000000000000509DOI Listing
June 2018
14 Reads

Molecular Mechanisms of Ventilator-Induced Lung Injury.

Chin Med J (Engl) 2018 May;131(10):1225-1231

Department of Anesthesiology, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, China.

Objective: Mechanical ventilation (MV) has long been used as a life-sustaining approach for several decades. However, researchers realized that MV not only brings benefits to patients but also cause lung injury if used improperly, which is termed as ventilator-induced lung injury (VILI). This review aimed to discuss the pathogenesis of VILI and the underlying molecular mechanisms. Read More

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http://Insights.ovid.com/crossref?an=00029330-201805200-0001
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http://dx.doi.org/10.4103/0366-6999.226840DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5956775PMC
May 2018
6 Reads

High frequency jet ventilation during endolaryngeal surgery: Risk factors for complications.

Auris Nasus Larynx 2018 Oct 17;45(5):1047-1052. Epub 2018 Jan 17.

Istanbul University, Istanbul Faculty of Medicine, Department of Anaesthesiology, Turkey. Electronic address:

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http://dx.doi.org/10.1016/j.anl.2017.12.003DOI Listing
October 2018
9 Reads

An unusual case of infective pneumocephalus: case report of pneumocephalus exacerbated by continuous positive airway pressure.

BMC Emerg Med 2018 01 18;18(1). Epub 2018 Jan 18.

Department of Medicine, Korle Bu Teaching Hospital, P.O. Box KB77, Accra, Ghana.

Background: Pneumocephalus, illustrated by air in the cranial vault is relatively infrequent and generally associated with neurosurgery, trauma, meningitis and barotrauma. However cases of spontaneous non-traumatic pneumocephalus remain rare. While the relationship between continuous positive airway pressure (CPAP) and atraumatic pneumocephalus has been previously reported, to our knowledge the rare presentation associated with sinus wall osteomyelitis has never been described. Read More

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http://dx.doi.org/10.1186/s12873-018-0154-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774152PMC
January 2018
9 Reads

Invasive versus non-invasive ventilation for acute respiratory failure in neuromuscular disease and chest wall disorders.

Cochrane Database Syst Rev 2017 Dec 4;12:CD008380. Epub 2017 Dec 4.

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

Background: Acute respiratory failure is a common life-threatening complication of acute onset neuromuscular diseases, and may exacerbate chronic hypoventilation in patients with neuromuscular disease or chest wall disorders. Standard management includes oxygen supplementation, physiotherapy, cough assistance, and, whenever needed, antibiotics and intermittent positive pressure ventilation. Non-invasive mechanical ventilation (NIV) via nasal, buccal or full-face devices has become routine practice in many centres. Read More

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http://dx.doi.org/10.1002/14651858.CD008380.pub2DOI Listing
December 2017
34 Reads

Pneumopericardium in the Neonate.

Neonatal Netw 2017 Nov;36(6):368-373

Pneumopericardium occurs when air accumulates in the pericardial sac surrounding the heart and is one of the rarest forms of air leaks in neonates. Because of various advances in neonatal care, including gentler modes of ventilation, surfactant replacement, and antenatal steroids, the incidence of pneumopericardium has decreased. Despite the decrease in incidence of pneumopericardium, most cases arise in premature infants with a history of respiratory distress and mechanical ventilation. Read More

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http://dx.doi.org/10.1891/0730-0832.36.6.368DOI Listing
November 2017
5 Reads

Multi-Drug-Resistant Gram-Negative Infections in Deployment-Related Trauma Patients.

Surg Infect (Larchmt) 2017 Apr 24;18(3):357-367. Epub 2017 Feb 24.

2 Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland.

Background: The contribution of multi-drug-resistant gram-negative bacilli infections (MDRGN-I) in patients with trauma is not well described. We present characteristics of MDRGN-Is among military personnel with deployment-related trauma (2009-2014).

Patients And Methods: Data from the Trauma Infectious Disease Outcomes Study were assessed for infectious outcomes and microbial recovery. Read More

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https://www.liebertpub.com/doi/10.1089/sur.2017.002
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http://dx.doi.org/10.1089/sur.2017.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5393413PMC
April 2017
13 Reads

Neurally adjusted ventilatory assist compared to other forms of triggered ventilation for neonatal respiratory support.

Cochrane Database Syst Rev 2017 10 27;10:CD012251. Epub 2017 Oct 27.

Division of Asthma, Allergy and Lung Biology, MRC Centre for Allergic Mechanisms in Asthma, King's College London, Bessemer Road, London, UK.

Background: Effective synchronisation of infant respiratory effort with mechanical ventilation may allow adequate gas exchange to occur at lower peak airway pressures, potentially reducing barotrauma and volutrauma and development of air leaks and bronchopulmonary dysplasia. During neurally adjusted ventilatory assist ventilation (NAVA), respiratory support is initiated upon detection of an electrical signal from the diaphragm muscle, and pressure is provided in proportion to and synchronous with electrical activity of the diaphragm (EADi). Compared to other modes of triggered ventilation, this may provide advantages in improving synchrony. Read More

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http://dx.doi.org/10.1002/14651858.CD012251.pub2DOI Listing
October 2017
10 Reads

Lung Recruitment Maneuvers for Adult Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.

Ann Am Thorac Soc 2017 Oct;14(Supplement_4):S304-S311

1 Interdepartmental Division of Critical Care Medicine.

Rationale: In patients with acute respiratory distress syndrome (ARDS), lung recruitment maneuvers (LRMs) may prevent ventilator-induced lung injury and improve survival.

Objectives: To summarize the current evidence in support of the use of LRMs in adult patients with ARDS and to inform the recently published American Thoracic Society/European Society of Intensive Care Medicine/Society of Critical Care Medicine clinical practice guideline on mechanical ventilation in ARDS.

Methods: We conducted a systematic review and meta-analysis of randomized trials comparing mechanical ventilation strategies with and without LRMs. Read More

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http://dx.doi.org/10.1513/AnnalsATS.201704-340OTDOI Listing
October 2017
36 Reads

Higher PEEP versus Lower PEEP Strategies for Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.

Ann Am Thorac Soc 2017 Oct;14(Supplement_4):S297-S303

11 Interdivisional Department of Critical Care, University of Toronto, Toronto, Ontario, Canada.

Rationale: Higher positive end-expiratory pressure (PEEP) levels may reduce atelectrauma, but increase over-distention lung injury. Whether higher PEEP improves clinical outcomes among patients with acute respiratory distress syndrome (ARDS) is unclear.

Objectives: To compare clinical outcomes of mechanical ventilation strategies using higher PEEP levels versus lower PEEP strategies in patients with ARDS. Read More

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http://dx.doi.org/10.1513/AnnalsATS.201704-338OTDOI Listing
October 2017
46 Reads

High-Frequency Oscillation for Adult Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.

Ann Am Thorac Soc 2017 Oct;14(Supplement_4):S289-S296

1 Interdepartmental Division of Critical Care Medicine.

Rationale: By minimizing tidal lung strain and maintaining alveolar recruitment, high-frequency oscillatory ventilation (HFOV) may protect against ventilator-induced lung injury.

Objectives: To summarize the current evidence in support of the use of HFOV in adult patients with acute respiratory distress syndrome.

Methods: We conducted a systematic review and meta-analysis of randomized trials comparing mortality rates with the use of HFOV versus conventional mechanical ventilation for adult patients with acute respiratory distress syndrome. Read More

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http://dx.doi.org/10.1513/AnnalsATS.201704-341OTDOI Listing
October 2017
43 Reads

Rescue therapeutic strategy combining ultra-protective mechanical ventilation with extracorporeal CO2 removal membrane in near-fatal asthma with severe pulmonary barotraumas: A case report.

Medicine (Baltimore) 2017 Oct;96(41):e8248

aDepartment of Respiratory and Critical Care Medicine, Schaffner Hospital, Lens bIntensive Care Unit, Arras Hospital, Arras, France.

Rationale: Mechanical ventilation of severe acute asthma is still considered a challenging issue, mainly because of the gas trapping phenomenon with the potential for life-threatening barotraumatic pulmonary complications.

Patient Concerns: Herein, we describe 2 consecutive cases of near-fatal asthma for whom the recommended protective mechanical ventilation approach using low tidal volume of 6 mL/kg and small levels of PEEP was rapidly compromised by giant pneumomediastinum with extensive subcutaneousemphysema.

Diagnoses: Near fatal asthma. Read More

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http://dx.doi.org/10.1097/MD.0000000000008248DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5662316PMC
October 2017
6 Reads

Effect of Lung Recruitment and Titrated Positive End-Expiratory Pressure (PEEP) vs Low PEEP on Mortality in Patients With Acute Respiratory Distress Syndrome: A Randomized Clinical Trial.

JAMA 2017 10;318(14):1335-1345

Cardio-Pulmonary Department, Pulmonary Division, Heart Institute (Incor), University of São Paulo, São Paulo, Brazil.

Importance: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain.

Objective: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy.

Design, Setting, And Participants: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. Read More

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http://dx.doi.org/10.1001/jama.2017.14171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5710484PMC
October 2017
190 Reads
35.289 Impact Factor

Intubation Barotrauma and/or CPR Causing Tension Pneumoperitoneum.

Del Med J 2016 Jul;88(7):218-220

Background: Review the radiologic findings and clinical significance of tension pneumoperitoneum.

Case Report: Imaging case presented to radiology during patient's prolonged and complicated hospital stay.

Conclusions: Tension pneumoperitoneum associated with barotrauma is a rare, but potentially life threatening complication of mechanical ventilation. Read More

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July 2016
18 Reads

Low Tidal Volume versus Non-Volume-Limited Strategies for Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.

Ann Am Thorac Soc 2017 Oct;14(Supplement_4):S271-S279

2 Interdivisional Department of Critical Care and.

Rationale: Trials investigating use of lower tidal volumes and inspiratory pressures for patients with acute respiratory distress syndrome (ARDS) have shown mixed results.

Objectives: To compare clinical outcomes of mechanical ventilation strategies that limit tidal volumes and inspiratory pressures (LTV) to strategies with tidal volumes of 10 to 15 ml/kg among patients with ARDS.

Methods: This is a systematic review and meta-analysis of clinical trials investigating LTV mechanical ventilation strategies. Read More

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http://dx.doi.org/10.1513/AnnalsATS.201704-337OTDOI Listing
October 2017
41 Reads

Driving pressure and mechanical power: new targets for VILI prevention.

Ann Transl Med 2017 Jul;5(14):286

Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Göttingen, Germany.

Several factors have been recognized as possible triggers of ventilator-induced lung injury (VILI). The first is pressure (thus the 'barotrauma'), then the volume (hence the 'volutrauma'), finally the cyclic opening-closing of the lung units ('atelectrauma'). Less attention has been paid to the respiratory rate and the flow, although both theoretical considerations and experimental evidence attribute them a significant role in the generation of VILI. Read More

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http://dx.doi.org/10.21037/atm.2017.07.08DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5537108PMC
July 2017
26 Reads

Ventrain: from theory to practice. Bridging until re-tracheostomy.

BMJ Case Rep 2017 Aug 16;2017. Epub 2017 Aug 16.

Department of Trauma Surgery, Hamad Medical Corporation, Doha, Qatar.

Imminent upper airway obstruction due to life-threatening tracheal stenosis of any cause is challenging. A 77-year-old woman, with a history of temporal tracheostomy for prolonged mechanical ventilation, presented with life-threatening tracheal stenosis to the emergency department. After failed intubation with a 5. Read More

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http://casereports.bmj.com/lookup/doi/10.1136/bcr-2017-22040
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http://dx.doi.org/10.1136/bcr-2017-220403DOI Listing
August 2017
18 Reads

Inhalation injury caused by cornstarch dust explosion in intubated patients-A single center experience.

Burns 2018 02 24;44(1):134-139. Epub 2017 Jul 24.

Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Respiratory Therapy, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Respiratory Therapy, Chang Gung University, College of Medicine, Taoyuan, Taiwan. Electronic address:

Background: Around 10%-20% of burned patients have inhalation injuries, and the severity of these injuries is correlated with mortality. Fiberoptic bronchoscopy is an important tool for the early diagnosis of inhalation injury. This study investigated correlations between the severity of inhalation injury and outcomes of patients involved in a cornstarch dust explosion in northern Taiwan in 2015. Read More

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http://dx.doi.org/10.1016/j.burns.2017.06.011DOI Listing
February 2018
7 Reads

Successful rescue combination of extracorporeal membrane oxygenation, high-frequency oscillatory ventilation and prone positioning for the management of severe methicillin-resistant Staphylococcus aureus pneumonia complicated by pneumothorax: a case report and literature review.

BMC Pulm Med 2017 Jul 20;17(1):103. Epub 2017 Jul 20.

Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Key Laboratory of Respiratory and Pulmonary Circulation, Beijing Chao-Yang Hospital, Capital Medical University, No. 8 Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China.

Background: To describe the experience of combination therapy with extracorporeal membrane oxygenation(ECMO), high-frequency oscillatory ventilation(HFOV) and prone positioning in treating severe respiratory failure caused by community acquired methicillin resistant Staphylococcus aureus(CA-MRSA).

Case Presentation: A 30-year-old female presented with fever and dyspnea for 3 days. She was diagnosed CA-MRSA pneumonia complicated by severe respiratory failure, pneumothorax and neutropenia. Read More

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http://bmcpulmmed.biomedcentral.com/articles/10.1186/s12890-
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http://dx.doi.org/10.1186/s12890-017-0445-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5520331PMC
July 2017
9 Reads

Mechanical ventilation practice in Egyptian pediatric intensive care units.

Electron Physician 2017 May 25;9(5):4370-4377. Epub 2017 May 25.

MD, Associate Professor, Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.

Introduction: Mechanical ventilation is one of the indispensable tools in pediatric intensive care units. Few studies addressed the epidemiology of pediatric patients on mechanical ventilation and the frequently used modes of ventilation. This is the first study to describe the practice of mechanical ventilation (MV) in Egyptian pediatric intensive care units (PICUs). Read More

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http://dx.doi.org/10.19082/4370DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5498702PMC
May 2017
8 Reads

The future of mechanical ventilation: lessons from the present and the past.

Crit Care 2017 Jul 12;21(1):183. Epub 2017 Jul 12.

Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany.

The adverse effects of mechanical ventilation in acute respiratory distress syndrome (ARDS) arise from two main causes: unphysiological increases of transpulmonary pressure and unphysiological increases/decreases of pleural pressure during positive or negative pressure ventilation. The transpulmonary pressure-related side effects primarily account for ventilator-induced lung injury (VILI) while the pleural pressure-related side effects primarily account for hemodynamic alterations. The changes of transpulmonary pressure and pleural pressure resulting from a given applied driving pressure depend on the relative elastances of the lung and chest wall. Read More

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http://dx.doi.org/10.1186/s13054-017-1750-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508674PMC
July 2017
9 Reads

Is middle ear pressure affected by continuous positive airway pressure use?

Laryngoscope 2017 11 12;127(11):2443-2445. Epub 2017 Jul 12.

Department of Otolaryngology-Head and Neck Surgery, New York-Presbyterian/Weill Cornell Medical College, New York, New York, U.S.A.

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http://dx.doi.org/10.1002/lary.26752DOI Listing
November 2017
5 Reads

Effect of frequency on pressure cost of ventilation and gas exchange in newborns receiving high-frequency oscillatory ventilation.

Pediatr Res 2017 Dec 26;82(6):994-999. Epub 2017 Jul 26.

Obstetric and Pediatric Department, Neonatal Intensive Care Unit, Fondazione MBBM-ASST, Monza, Italy.

BackgroundWe hypothesized that ventilating at the resonant frequency of the respiratory system optimizes gas exchange while limiting the mechanical stress to the lung in newborns receiving high-frequency oscillatory ventilation (HFOV). We characterized the frequency dependence of oscillatory mechanics, gas exchange, and pressure transmission during HFOV.MethodsWe studied 13 newborn infants with a median (interquartile range) gestational age of 29. Read More

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http://dx.doi.org/10.1038/pr.2017.151DOI Listing
December 2017
53 Reads

[Noninvasive ventilation: general characteristics, indications, and review of the literature].

G Ital Cardiol (Rome) 2017 Jun;18(6):496-504

Divisione di Cardiologia, Ospedale "Garibaldi-Nesima", Catania - Past President ANMCO.

Noninvasive ventilation (NIV), including both continuous and bilevel positive airway pressure, plays a pivotal role in the treatment of acute respiratory failure secondary to acute heart failure. For an appropriate use of NIV, it is essential to consider the underlying pathophysiological principles, the differences between the different modes of ventilation, the main indications, contraindications and complications. The aim of this review is also to give practical guidance on how and when to start NIV at the bedside, how to monitor the response and how to choose the most appropriate interface. Read More

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http://dx.doi.org/10.1714/2700.27610DOI Listing
June 2017
11 Reads

[A Meta analysis of the efficacy of high-frequency oscillatory ventilation versus conventional mechanical ventilation for treating pediatric acute respiratory distress syndrome].

Zhongguo Dang Dai Er Ke Za Zhi 2017 Apr;19(4):430-435

Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

Objective: To systematically assess the clinical efficacy of high-frequency oscillatory ventilation (HFOV) and conventional mechanical ventilation (CMV) for treating pediatric acute respiratory distress syndrome (ARDS).

Methods: Data from randomized controlled trials comparing HFOV and CMV in the treatment of pediatric ARDS published before July 2016 were collected from the Cochrane Library, PubMed, Medline, CNKI, and Wanfang Data. Literature screening, data extraction, and quality assessment were performed by two independent reviewers according to the inclusion and exclusion criteria. Read More

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April 2017
7 Reads

Bedside Breath-Wise Visualization of Bronchospasm by Electrical Impedance Tomography Could Improve Perioperative Patient Safety: A Case Report.

A A Case Rep 2017 Jun;8(12):316-319

From the *Pediatric Intensive Care Unit, Hospital Universitario La Paz, Madrid, ES, Spain; †Department of Pediatrics, Medical School, Universidad Autónoma de Madrid, ES, Spain; ‡Swisstom AG, Medical Research, Landquart, CH, Switzerland; and §Pediatric Anestesia and Reanimation Unit, Hospital Universitario La Paz, Madrid, ES, Spain.

Bronchospasm appears in up to 4% of patients with obstructive lung disease or respiratory infection undergoing general anesthesia. Clinical examination alone may miss bronchospasm. As a consequence, subsequent (mis)treatment and ventilator settings could lead to pulmonary hyperinflation, hypoxia, hypercapnia, hypotension, patient-ventilator asynchrony, volutrauma, or barotrauma. Read More

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http://dx.doi.org/10.1213/XAA.0000000000000499DOI Listing
June 2017
12 Reads

Rationale, study design and analysis plan of the lung imaging morphology for ventilator settings in acute respiratory distress syndrome study (LIVE study): Study protocol for a randomised controlled trial.

Anaesth Crit Care Pain Med 2017 Oct 18;36(5):301-306. Epub 2017 Mar 18.

Department of Perioperative Medicine, University Hospital of Clermont-Ferrand, 1, place Lucie-Aubrac, 63003 Clermont-Ferrand, France; Université Clermont-Auvergne, CNRS, Inserm, GReD, 63000 Clermont-Ferrand, France. Electronic address:

Different acute respiratory distress syndrome (ARDS) phenotypes may explain controversial results in clinical trials. Lung-morphology is one of the ARDS-phenotypes and physiological studies suggest different responses in terms of positive-end-expiratory-pressure (PEEP) and recruitment-manoeuvres (RM) according to loss of aeration. To evaluate whether tailored ventilator regimens may impact ARDS outcomes, our group has designed a randomised-clinical-trial of ventilator settings according to lung morphology in moderate-to-severe ARDS (LIVE study). Read More

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http://dx.doi.org/10.1016/j.accpm.2017.02.006DOI Listing
October 2017
19 Reads

Effect of Intensive vs Moderate Alveolar Recruitment Strategies Added to Lung-Protective Ventilation on Postoperative Pulmonary Complications: A Randomized Clinical Trial.

JAMA 2017 04;317(14):1422-1432

Cardio-Pulmonary Department, Pulmonary Division, Heart Institute (Incor), Hospital Das Clínicas da FMUSP, University of São Paulo, São Paulo, Brazil.

Importance: Perioperative lung-protective ventilation has been recommended to reduce pulmonary complications after cardiac surgery. The protective role of a small tidal volume (VT) has been established, whereas the added protection afforded by alveolar recruiting strategies remains controversial.

Objective: To determine whether an intensive alveolar recruitment strategy could reduce postoperative pulmonary complications, when added to a protective ventilation with small VT. Read More

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http://dx.doi.org/10.1001/jama.2017.2297DOI Listing
April 2017
38 Reads

Severity of Hypoxemia and Effect of High-Frequency Oscillatory Ventilation in Acute Respiratory Distress Syndrome.

Am J Respir Crit Care Med 2017 09;196(6):727-733

6 Interdepartmental Division of Critical Care Medicine.

Rationale: High-frequency oscillatory ventilation (HFOV) is theoretically beneficial for lung protection, but the results of clinical trials are inconsistent, with study-level meta-analyses suggesting no significant effect on mortality.

Objectives: The aim of this individual patient data meta-analysis was to identify acute respiratory distress syndrome (ARDS) patient subgroups with differential outcomes from HFOV.

Methods: After a comprehensive search for trials, two reviewers independently identified randomized trials comparing HFOV with conventional ventilation for adults with ARDS. Read More

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http://dx.doi.org/10.1164/rccm.201609-1938OCDOI Listing
September 2017
24 Reads