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    Safety of Patient Mobilization and Rehabilitation in the ICU: Systematic Review with Meta-Analysis.
    Ann Am Thorac Soc 2017 Feb 23. Epub 2017 Feb 23.
    Johns Hopkins University, Pulmonary & Critical Care Medicine, Baltimore, Maryland, United States ;
    Background: Early mobilization and rehabilitation of patients in intensive care units (ICU) may improve physical function, and reduce the duration of delirium, mechanical ventilation and ICU length of stay. However, safety concerns are an important barrier to widespread implementation.

    Objective: To synthesize safety data regarding patient mobilization and rehabilitation in the ICU, including falls, removal of endotracheal tubes (ETT), removal or dysfunction of intravascular catheters, removal of other catheters/tubes, cardiac arrest, hemodynamic changes and desaturation. Read More

    An experimental study on the impacts of inspiratory and expiratory muscles activities during mechanical ventilation in ARDS animal model.
    Sci Rep 2017 Feb 23;7:42785. Epub 2017 Feb 23.
    Respiratory Mechanics Lab, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
    In spite of intensive investigations, the role of spontaneous breathing (SB) activity in ARDS has not been well defined yet and little has been known about the different contribution of inspiratory or expiratory muscles activities during mechanical ventilation in patients with ARDS. In present study, oleic acid-induced beagle dogs' ARDS models were employed and ventilated with the same level of mean airway pressure. Respiratory mechanics, lung volume, gas exchange and inflammatory cytokines were measured during mechanical ventilation, and lung injury was determined histologically. Read More

    The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation among patients undergoing transcatheter aortic valve implantation in Germany.
    Eur J Health Econ 2017 Feb 22. Epub 2017 Feb 22.
    Department of Cardiology and Angiology I, Heart Center Freiburg University, Freiburg, Germany.
    Background: The impact of various post-procedural complications after transcatheter aortic valve implantation (TAVI) on resource use and their consequences in the German reimbursement system has still not been properly quantified.

    Methods: In a retrospective observational study, we use data from the German DRG statistic on patient characteristics and in-hospital outcomes of all isolated TAVI procedures in 2013 (N = 9147). The impact of post-procedural complications on reimbursement, length of stay and mechanical ventilation was analyzed using both unadjusted and risk-adjusted linear and logistic regression analyses. Read More

    Ten-Year Temporal Trends in Medical Complications After Acute Intracerebral Hemorrhage in the United States.
    Stroke 2017 Feb 22. Epub 2017 Feb 22.
    From the Department of Neurology, University of Miami Miller School of Medicine, FL.
    Background And Purpose: Data on medical complications after intracerebral hemorrhage (ICH) are sparse. We assessed trends in the prevalence of urinary tract infection, pneumonia, sepsis, deep venous thrombosis (DVT), pulmonary embolism, acute renal failure (ARF), and acute myocardial infarction after ICH in the United States.

    Methods: A total of 575 211 adult ICH cases were identified from the 2004 to 2013 Nationwide Inpatient Sample. Read More

    Comparison of PESI, echocardiogram, CTPA, and NT-proBNP as risk stratification tools in patients with acute pulmonary embolism.
    Indian Heart J 2017 Jan - Feb;69(1):68-74. Epub 2016 Aug 1.
    Department of Cardiology, SVIMS, Tirupati, Andhra Pradesh, India.
    Objective: The aim of this study is to prospectively assess the diagnostic accuracy of pulmonary embolism severity index, echocardiogram, computed tomography pulmonary angiogram (CTPA), and N-terminal pro b-type natriuretic peptide (NT-proBNP) for predicting adverse events in acute pulmonary embolism patients.

    Methods: Thirty consecutive acute pulmonary embolism patients were included in this study. Combined adverse events consisted of in-hospital death or use of escalation of care including cardiopulmonary resuscitation, mechanical ventilation, vasopressor therapy, or secondary thrombolysis during hospital stay. Read More

    Inhalation therapy in patients with tracheostomy: a guide to clinicians.
    Expert Rev Respir Med 2017 Mar 20;11(3):201-208. Epub 2017 Feb 20.
    a Department of Respiratory Therapy , Georgia State University , Atlanta , GA , USA.
    Introduction: Inhalation therapy has become a popular procedure for the treatment of patients with tracheostomy. However, clinicians are faced with many challenges during inhalation therapy because of the many factors affecting aerosol therapy to this patient population, and the lack of literature providing guidance in this area of research. Areas covered: The purpose of this paper is to describe the factors affecting aerosol drug delivery to patients with tracheostomy and to explain how to optimize inhalation therapy through device selection, interface selection and delivery technique in this patient population. Read More

    Patient emulator: a tool for testing mechanical ventilation therapies.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:4321-4324
    Several modes of mechanical ventilation are clinically available. The differences among them in terms of efficacy and patient outcomes are not clear yet. Testing and comparison of mechanical ventilation modes via human or animal trials is a very challenging and costly process. Read More

    Cardiovascular interactions assessed via conditional joint transfer entropy in patients developing atrial fibrillation after coronary artery bypass graft surgery.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:2937-2940
    Assigned the universe of knowledge Ω as composed by one target and two exogenous signals, the conditional joint transfer entropy (CJTE), assessing the amount of information jointly transferred from the two sources to the target that can be uniquely linked to one of the two sources, was found useful to study cardiovascular control. We propose the assessment of CJTE from systolic arterial pressure (SAP) and respiration (R) to heart period (HP) conditioned on R (CJTESAP, R→HP|R) along the baroreflex, and from HP and R to SAP conditioned on R (CJTEHP, R→SAP|R) along the feedforward mechanical pathway, in 134 patients undergoing coronary artery bypass graft surgery before (PRE) and after (POST) the induction of general anesthesia. In this group 38 patients developed atrial fibrillation (AF) after surgery, while the remaining individuals did not (noAF, n=96). Read More

    Noninvasive estimation of alveolar pressure.
    Conf Proc IEEE Eng Med Biol Soc 2016 Aug;2016:2721-2724
    This paper presents an algorithm for noninvasive estimation of alveolar pressure in mechanically ventilated patients who are spontaneously breathing. Continual monitoring of alveolar pressure is desirable to prevent ventilator-induced lung injury and to assess the intrinsic positive end-expiratory pressure (PEEPi), which is a parameter of clinical relevance in respiratory care and difficult to measure noninvasively. The algorithm is based on a physiological model of the respiratory system and, as such, it also provides insight into the respiratory mechanics of the patient under mechanical ventilation. Read More

    Mechanical Efficiency in Chronic Obstructive Pulmonary Disease.
    J Cardiopulm Rehabil Prev 2017 Mar;37(2):146-153
    Institute of Human Movement and Sports, Fontys University of Applied Sciences, Eindhoven, the Netherlands (Mr Gosens and Drs Oomen and Borghouts); Department of Human Movement Sciences, Maastricht University, Maastricht, the Netherlands (Mr Gosens and Dr Hesselink); Radboudumc, Department of Pulmonary Diseases, Nijmegen, the Netherlands (Dr van't Hul); and Revant, Rehabilitation Centre, Breda, the Netherlands (Dr van't Hul).
    Purpose: The primary aims of this study were (1) to evaluate whole-body mechanical efficiency (ME) in a large group of chronic obstructive pulmonary disease (COPD) patients with a wide range of degrees of illness and (2) to examine how ME in COPD is related to absolute work rate and indices of disease severity during exercise testing.

    Methods: A total of 569 patients (301 male patients; GOLD stage I: 28, GOLD stage II: 166, GOLD stage III: 265, and GOLD stage IV: 110) with chronic obstructive pulmonary disease (COPD) were included in the data analysis. Individual maximal workload (watt), peak minute ventilation ((Equation is included in full-text article. Read More

    Intravenous vitamin C as adjunctive therapy for enterovirus/rhinovirus induced acute respiratory distress syndrome.
    World J Crit Care Med 2017 Feb 4;6(1):85-90. Epub 2017 Feb 4.
    Alpha A Fowler III, Rajiv Malhotra, Orlando Debesa, Ramesh Natarajan, Bernard J Fisher, Aamer Syed, Christine DeWilde, Anna Priday, Division of Pulmonary Disease and Critical Care Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, United States.
    We report a case of virus-induced acute respiratory distress syndrome (ARDS) treated with parenteral vitamin C in a patient testing positive for enterovirus/rhinovirus on viral screening. This report outlines the first use of high dose intravenous vitamin C as an interventional therapy for ARDS, resulting from enterovirus/rhinovirus respiratory infection. From very significant preclinical research performed at Virginia Commonwealth University with vitamin C and with the very positive results of a previously performed phase I safety trial infusing high dose vitamin C intravenously into patients with severe sepsis, we reasoned that infusing identical dosing to a patient with ARDS from viral infection would be therapeutic. Read More

    Comparison of inhaled milrinone, nitric oxide and prostacyclin in acute respiratory distress syndrome.
    World J Crit Care Med 2017 Feb 4;6(1):74-78. Epub 2017 Feb 4.
    Martin Albert, Departments of Intensive Care and Medicine, Hôpital du Sacré-Coeur, de Montréal Research Center, Université de Montréal, Montréal H4J 1C5, Canada.
    Aim: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS).

    Methods: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients. Read More

    Electrical impedance tomography and trans-pulmonary pressure measurements in a patient with extreme respiratory drive.
    Respir Med Case Rep 2017 17;20:141-144. Epub 2017 Jan 17.
    Department of Adult Intensive Care Medicine, Erasmus MC - University Medical Center, 's Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
    Preserving spontaneous breathing during mechanical ventilation prevents muscle atrophy of the diaphragm, but may lead to ventilator induced lung injury (VILI). We present a case in which monitoring of trans-pulmonary pressure and ventilation distribution using Electrical Impedance Tomography (EIT) provided essential information for preventing VILI. Read More

    Assessment of Bohr and Enghoff Dead Space Equations in Mechanically Ventilated Children.
    Respir Care 2017 Feb 21. Epub 2017 Feb 21.
    Centre Hospitalier Universitaire Sainte-Justine and the Division of Pediatric Critical Care Medicine, Department of Pediatrics, Université de Montréal, Montréal, Quebec, Canada.
    Background: Recent findings suggest that using alveolar PCO2 (PACO2 ) estimated by volumetric capnography in the Bohr equation instead of PaCO2 (Enghoff modification) could be appropriate for the calculation of physiological dead space to tidal volume ratio (VD/VT Bohr and VD/VT Enghoff, respectively). We aimed to describe the relationship between these 2 measurements in mechanically ventilated children and their significance in cases of ARDS.

    Methods: From June 2013 to December 2013, mechanically ventilated children with various respiratory conditions were included in this study. Read More

    Can body mass index predict clinical outcomes for patients with acute lung injury/acute respiratory distress syndrome? A meta-analysis.
    Crit Care 2017 Feb 22;21(1):36. Epub 2017 Feb 22.
    Departments of Respiratory Diseases, West China School of Medicine and West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, Sichuan, China.
    Background: The effects of body mass index (BMI) on the prognosis of acute respiratory distress syndrome (ARDS) are controversial. We aimed to further determine the relationship between BMI and the acute outcomes of patients with ARDS.

    Methods: We searched the Pubmed, Embase, Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and ISI Web of Science for trials published between 1946 and July 2016, using "BMI" or "body mass index" or "overweight" or "obese" and "ARDS" or "ALI" or "acute respiratory distress syndrome" or "acute lung injury", without limitations on publication type or language. Read More

    Suspicion of respiratory tract infection with multidrug-resistant Enterobacteriaceae: epidemiology and risk factors from a Paediatric Intensive Care Unit.
    BMC Infect Dis 2017 Feb 21;17(1):163. Epub 2017 Feb 21.
    Dept. of Paediatrics, Pediatric Infectious Diseases, Immunology & Pneumology/Cystic fibrosis, University Children's Hospital Tübingen, Hoppe-Seyler Str. 1, Tübingen, 72076, Germany.
    Background: Multidrug-resistant (MDR) infections are a serious concern for children admitted to the Paediatric Intensive Care Unit (PICU). Tracheal colonization with MDR Enterobacteriaceae predisposes to respiratory infection, but underlying risk factors are poorly understood. This study aims to determine the incidence of children with suspected infection during mechanical ventilation and analyses risk factors for the finding of MDR Enterobacteriaceae in tracheal aspirates. Read More

    Use of the injection test to indicate the oesophageal balloon position in patients without spontaneous breathing: a clinical feasibility study.
    J Int Med Res 2017 Feb 17;45(1):320-331. Epub 2017 Jan 17.
    1 Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
    Objective To investigate the clinical feasibility of the injection test for balloon placement during oesophageal pressure measurement in patients without spontaneous breathing. Methods The injection test was performed in 12 mechanically ventilated patients under deep sedation and paralysis. During withdrawal of the balloon from the stomach and air injection into the gastric lumen of the catheter, the presence of the injection test wave in the balloon pressure tracing indicated that the whole balloon was positioned above the lower oesophageal sphincter (LES). Read More

    Coupling Effect of Double Lungs on a VCV Ventilator with Automatic Secretion Clearance Function.
    IEEE/ACM Trans Comput Biol Bioinform 2017 Feb 16. Epub 2017 Feb 16.
    For patients with mechanical ventilation, secretions in airway are harmful and sometimes even mortal, it's of great significance to clear secretion timely and efficiently. In this paper, a new secretion clearance method for VCV (volume-controlled ventilation) ventilator is put forward, and a secretion clearance system with a VCV ventilator and double lungs is designed. Furthermore, the mathematical model of the secretion clearance system is built and verified via experimental study. Read More

    Pathogenic Link Between Postextubation Pneumonia and Ventilator-Associated Pneumonia: An Experimental Study.
    Anesth Analg 2017 Feb 17. Epub 2017 Feb 17.
    From the *Anesthesia Center for Critical Care Research, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; †Department of Health Science, School of Medicine and Surgery, University of Milan-Bicocca, Milan, Italy; ‡Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milano, Italy; §Department of Anesthesia, Medstar-Georgetown University Hospital, Washington, DC; and ‖Pulmonary and Critical Care Medicine Branch, Section of Pulmonary and Cardiac Assist Devices, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
    Background: The presence of an endotracheal tube is the main cause for developing ventilator-associated pneumonia (VAP), but pneumonia can still develop in hospitalized patients after endotracheal tube removal (postextubation pneumonia [PEP]). We hypothesized that short-term intubation (24 hours) can play a role in the pathogenesis of PEP. To test such hypothesis, we initially evaluated the occurrence of lung colonization and VAP in sheep that were intubated and mechanically ventilated for 24 hours. Read More

    Pulmonary outcomes following specialized respiratory management for acute cervical spinal cord injury: a retrospective analysis.
    Spinal Cord 2017 Feb 21. Epub 2017 Feb 21.
    Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA, USA.
    Study Design: Retrospective analysis.

    Objectives: To identify multivariate interactions of respiratory function that are sensitive to spinal cord injury level and pharmacological treatment to promote strategies that increase successful liberation from mechanical ventilation.

    Setting: United States regional spinal cord injury (SCI) treatment center. Read More

    Stress echocardiography in patients who experienced mechanical ventilation weaning failure.
    J Crit Care 2017 Jan 18;39:66-71. Epub 2017 Jan 18.
    Harefield Hospital Intensive Care Unit, Royal Brompton and Harfield NHS Foundation Trust, UK.
    Introduction: Critically ill patients may suffer varying degrees of temporary myocardial dysfunction during respiratory weaning that could play an important role in weaning failure.

    Objectives: In this study, we tried to assess the existence of temporary diastolic dysfunction during respiratory weaning.

    Methods: Inclusion period is from 2006 to 2015. Read More

    Hyperoxia and hypertonic saline in patients with septic shock (HYPERS2S): a two-by-two factorial, multicentre, randomised, clinical trial.
    Lancet Respir Med 2017 Feb 14. Epub 2017 Feb 14.
    Institut für anesthesiologische Pathophysiologie und Verfahrensentwicklung, Universitätklinikum Ulm, Ulm, Germany.
    Background: There is insufficient research into the use of mechanical ventilation with increased inspiratory oxygen concentration (FiO2) and fluid resuscitation with hypertonic saline solution in patients with septic shock. We tested whether these interventions are associated with reduced mortality.

    Methods: This two-by-two factorial, multicentre, randomised, clinical trial (HYPERS2S) recruited patients aged 18 years and older with septic shock who were on mechanical ventilation from 22 centres in France. Read More

    Intrabronchial Pneumonectomy for Vanishing Lung Syndrome: First Reported Case.
    Ann Thorac Surg 2017 Mar;103(3):e277-e279
    Department of Surgery, University of Tennessee College of Medicine, Chattanooga, Tennessee.
    Vanishing lung syndrome is a clinical presentation of giant bullous emphysema associated with significant morbidity and mortality. We present a case of a 50-year-old white woman with vanishing lung syndrome who presented with a spontaneous secondary pneumothorax and an uncontrolled bronchopleural fistula. The large bronchopleural fistula was initially controlled with a double-lumen endotracheal tube and a tube thoracostomy. Read More

    Non anti-coagulant factors associated with filter life in continuous renal replacement therapy (CRRT): a systematic review and meta-analysis.
    BMC Nephrol 2017 Feb 20;18(1):69. Epub 2017 Feb 20.
    School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
    Background: Optimising filter life and performance efficiency in continuous renal replacement therapy has been a focus of considerable recent research. Larger high quality studies have predominantly focussed on optimal anticoagulation however CRRT is complex and filter life is also affected by vascular access, circuit and management factors. We performed a systematic search of the literature to identify and quantify the effect of vascular access, circuit and patient factors that affect filter life and presented the results as a meta-analysis. Read More

    [Clinical application of Acutegastrointestinal injury grading system assocaited with clinical severity outcome in critically ill patients: a multi-center prospective, observational study].
    Zhonghua Yi Xue Za Zhi 2017 Feb;97(5):325-331
    Department of Intensive Care Medicine, Zhejiang Provincial People's Hospital, Huzhou 310014, China.
    Objective: To investigate the feasibility of utilizing the current acute gastrointestinal injury(AGI) grading system, and explore the association of severity of AGI grade with clinical outcome in critically ill patients. Methods: The adult patients from 14 general ICUs in Zhejiang Province with an expected admission to ICU for at least 24 h were recruited, and all clinical, laboratory, and survival data were prospectively collected. The AGI grade was daily assessed based on GIsymptoms, feeding details and organ dysfunctionon the first week of admission to ICU. Read More

    Exhaled Breath Metabolomics for the Diagnosis of Pneumonia in Intubated and Mechanically-Ventilated Intensive Care Unit (ICU)-Patients.
    Int J Mol Sci 2017 Feb 19;18(2). Epub 2017 Feb 19.
    Department of Intensive Care, Academic Medical Centre, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
    The diagnosis of hospital-acquired pneumonia remains challenging. We hypothesized that analysis of volatile organic compounds (VOCs) in exhaled breath could be used to diagnose pneumonia or the presence of pathogens in the respiratory tract in intubated and mechanically-ventilated intensive care unit patients. In this prospective, single-centre, cross-sectional cohort study breath from mechanically ventilated patients was analysed using gas chromatography-mass spectrometry. Read More

    Affection of the Respiratory Muscles in Combined Complex I and IV Deficiency.
    Open Neurol J 2017 26;11:1-6. Epub 2017 Jan 26.
    Institute of Clinical Chemistry, Academic Hospital München-Schwabing, Germany.
    Objectives: Combined complex I+IV deficiency has rarely been reported to manifest with the involvement of the respiratory muscles.

    Case Report: A 45y male was admitted for hypercapnia due to muscular respiratory insufficiency. He required intubation and mechanical ventilation. Read More

    Effect of nebulized budesonide on respiratory mechanics and oxygenation in acute lung injury/acute respiratory distress syndrome: Randomized controlled study.
    Saudi J Anaesth 2017 Jan-Mar;11(1):9-14
    Department of Clinical Pathology, Qena University Hospital, South Valley University, Qena, Egypt.
    Background: We tested the hypothesis that nebulized budesonide would improve lung mechanics and oxygenation in patients with early acute lung injury (ALI) and/or acute respiratory distress syndrome (ARDS) during protective mechanical ventilation strategy without adversely affecting systemic hemodynamics.

    Methods: Patients with ALI/ARDS were included and assigned into two groups; budesonide group (30 cases) in whom 1 mg-2 ml budesonide suspension was nebulized through the endotracheal tube and control group (30 cases) in whom 2 ml saline (placebo) were nebulized instead of budesonide. This regimen was repeated every 12 h for three successive days alongside with constant ventilator settings in both groups. Read More

    Floating of the lobes of mosquito (Aedes togoi) larva for respiration.
    Sci Rep 2017 Feb 20;7:43050. Epub 2017 Feb 20.
    Department of Mechanical Engineering, Pohang University of Science and Technology, Pohang Gyeongbuk, Republic of Korea.
    Mosquito (Aedes togoi) larva has to float its siphon on the water surface to breathe air. To elucidate the floating mechanism of the siphon, morphological structures, especially the flap-like lobes and spiracle of the siphon, were observed. Wettability and dynamic behavior of the lobes on the water surface were also experimentally examined. Read More

    Prospective, randomised, controlled study evaluating early modification of oral microbiota following admission to the intensive care unit and oral hygiene with chlorhexidine.
    J Glob Antimicrob Resist 2017 Feb 18;8:159-163. Epub 2017 Feb 18.
    School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil.
    Objectives: Chlorhexidine (CHX) is the most commonly used oral hygiene product for the prevention of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation (MV). The change in dental plaque (DP) microbiota following CHX use in patients under MV has not been described previously. The aim of this study was to evaluate the incidence of pathogenic bacteria associated with VAP and the coverage of DP within the oral cavity in patients administered CHX. Read More

    Indoor air pollutants, ventilation rate determinants and potential control strategies in Chinese dwellings: A literature review.
    Sci Total Environ 2017 Feb 16. Epub 2017 Feb 16.
    School of Mechanical Engineering, Tongji University, Shanghai, PR China.
    After nearly twenty years of rapid modernization and urbanization in China, huge achievements have transformed the daily lives of the Chinese people. However, unprecedented environmental consequences in both indoor and outdoor environments have accompanied this progress and have triggered public awareness and demands for improved living standards, especially in residential environments. Indoor pollution data measured for >7000 dwellings (approximately 1/3 were newly decorated and were tested for volatile organic compound (VOC) measurements, while the rest were tested for particles, phthalates and other semi-volatile organic compounds (SVOCs), moisture/mold, inorganic gases and radon) in China within the last ten years were reviewed, summarized and compared with indoor concentration recommendations based on sensory or health end-points. Read More

    Extracorporeal membrane oxygenation (ECMO) in adults with acute respiratory distress syndrome (ARDS): A 6-year experience and case-control study.
    Heart Lung 2017 Feb 16. Epub 2017 Feb 16.
    ICU, Hospital General Universitario "Gregorio Marañón", Madrid, Spain.
    Purpose: To evaluate the development of an extracorporeal membrane oxygenation (ECMO) program for the treatment of acute respiratory distress syndrome (ARDS) in adults.

    Methods: a) Descriptive study of 15 cases treated since the program approval from 2010 to 2016. b) Case-control study matching the 15 ECMO cases with the 52 severe ARDS treated between 2005 and 2011 in which alternative rescue treatments (prone ventilation, tracheal gas insufflation (TGI) and/or the administration of inhaled nitric oxide (iNO)) were used. Read More

    Drainage of pleural effusion improves diaphragmatic function in mechanically ventilated patients.
    Crit Care Resusc 2017 Mar;19(1):64-70
    Department of Anaesthetics and Intensive Care, Ospedale San Paolo - Polo Universitario, ASST Santi Paolo e Carlo, Milan, Italy.
    Background: Pleural effusion adversely affects the pressuregenerating capacity of the diaphragm. It uncouples the lung and chest wall, which may result in diaphragmatic dysfunction. Information on the effects of effusion drainage on diaphragmatic function is limited, but several studies report relief of dyspnoea after drainage, which was attributed to improved diaphragmatic mechanics, even if this issue was never formally addressed. Read More

    Autophagy Activation by Rapamycin Before Hypoxia-Reoxygenation Reduces Endoplasmic Reticulum Stress in Alveolar Epithelial Cells.
    Cell Physiol Biochem 2017 Jan 17;41(1):79-90. Epub 2017 Jan 17.
    Background: To determine potential effects of autophagy activation on hypoxia-reoxygenation (H/R) induced damage of a rat alveolar epithelial cell line.

    Methods: CCL149 cells were subjected to autophagy agonist (rapamycin, Rap), autophagy inhibitor (3-methyladenine, 3-MA) or PBS for 1 h before H/R treatment for 2 h, 4 h and 6 h. The optimal concentration of Rap (150 nM, 200 nM and 250 nM) or 3-MA (5 mM, 10 mM and 15 mM) was obtained from MTT assay. Read More

    The Burden of Respiratory Disease in Very-Low-Birth-Weight Infants: Changes in Perinatal Care and Outcomes in a Decade in Spain.
    Neonatology 2017 Feb 18;112(1):30-39. Epub 2017 Feb 18.
    Division of Neonatology, CHUI Materno-Infantil, Las Palmas de Gran Canaria, Spain.
    Background: Advances in perinatal care have led to a significant reduction in morbidity and mortality among very-low-birth-weight (VLBW) infants. Much of this progress is related to the prevention and management of respiratory disease.

    Objectives: To evaluate changes in perinatal care and its influence on respiratory morbidity and mortality among VLBW infants in Spain in 2 consecutive periods (2002-2006 and 2007-2011). Read More

    [Condition and consequences of zinc metabolic disorder in patients with neurosurgical pathology requiring intensive care].
    Wiad Lek 2016 ;69(6):726-729
    Higher State Educational Institution of Ukraine" Ukrainian Medical Stomatological Academy", Poltava, Ukraine.
    Introduction: diseases that require neurosurgical intervention for many years constitute the major cause of disability and death in the world. These patients develop the disorder of zinc supply which is a universal bioregulator. The aim of the research is the assessment of zinc metabolism and effects of its disorder in patients with neurosurgical disorders that require intensive care. Read More

    Noninvasivepositive pressure ventilation vsinvasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure in cancer patients.
    J Crit Care 2017 Jan 20;39:56-61. Epub 2017 Jan 20.
    Department of Critical Care, University of Texas MD Anderson Cancer Center, Houston, TX.
    Purpose: The objective was to describe the characteristics and outcomes of critically ill cancer patients who received noninvasive positive pressure ventilation (NIPPV) vs invasive mechanical ventilation as first-line therapy for acute hypoxemic respiratory failure.

    Material And Methods: A retrospective cohort study of consecutive adult intensive care unit (ICU) cancer patients who received either conventional invasive mechanical ventilation or NIPPV as first-line therapy for hypoxemic respiratory failure.

    Results: Of the 1614 patients included, the NIPPV failure group had the greatest hospital length of stay, ICU length of stay, ICU mortality (71. Read More

    [Risk factors related with ventilator-associated pneumonia in a neonatal intensive care therapy].
    Rev Med Inst Mex Seguro Soc 2017 ;55 Suppl 1:S72-S79
    Departamento de Neonatología, Terapia Intensiva Neonatal, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
    Background: Ventilator-associated pneumonia (VAP) represents the second cause of nosocomial infections and it is associated with greater morbility, duration of mechanical ventilation (MV), and hospital stay. The objective was to determine factors related with VAP in neonates.

    Methods: Analytical transversal study including newborns admitted already intubated with at least 48 hours of MV or who were intubated in Neonatal Therapy. Read More

    [Zinc phosphide poisoning in pediatric patients from a Toxicology Center at Mexico City].
    Rev Med Inst Mex Seguro Soc 2017 ;55 Suppl 1:S44-S52
    Departamento Clínico de Toxicología, Hospital General "Dr. Gaudencio González Garza", Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, Ciudad de México, México.
    Background: Zinc phosphide is a chemical compound that is frequently used as a rodenticide; it is a highly toxic product that is widely used, among other spaces, at home. Given that it is a highly commercialized pesticide and that there is no antidote, it is mandatory to establish favorably the clinical manifestations of the intoxication. The aim was to describe the epidemiological and clinical profile of children intoxicated with zinc phosphide attended in a toxicological center of a tertiary referral hospital. Read More

    Relationship between pre-anesthetic and intra-anesthetic airway resistance in patients undergoing general anesthesia: A prospective observational study.
    PLoS One 2017 17;12(2):e0172421. Epub 2017 Feb 17.
    Department of Anesthesiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
    Surgery patients in Japan undergo routine spirometry testing prior to general anesthesia. The use of a flow sensor during general anesthesia has recently become common. However, it is not certain whether the information derived from flow-volume curves is being adequately used for mechanical ventilation management during general anesthesia. Read More

    Volume Controlled Ventilation Does Not Prevent Injurious Inflation During Spontaneous Effort.
    Am J Respir Crit Care Med 2017 Feb 17. Epub 2017 Feb 17.
    Osaka University Hospital, Intensive Care Unit, Suita, Osaka, Japan ;
    Rationale: Spontaneous breathing during mechanical ventilation increases transpulmonary pressure and tidal volume, and worsens lung injury. Intuitively, controlling tidal volume and transpulmonary pressure might limit injury from added spontaneous effort.

    Objectives: To test the hypothesis that during spontaneous effort in injured lungs, tidal volume and transpulmonary pressure limitation by volume-controlled ventilation results in less injurious patterns of inflation. Read More

    Telemedicine in chronic obstructive pulmonary disease.
    Breathe (Sheff) 2016 Dec;12(4):350-356
    Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Lumezzane, Italy.
    : Telemedicine is a medical application of advanced technology to disease management. This modality may provide benefits also to patients with chronic obstructive pulmonary disease (COPD). Different devices and systems are used. Read More

    My night on call in Poland.
    Breathe (Sheff) 2016 Sep;12(3):291-292
    Uniwersyteckie Centrum Kliniczne im prof. Kornela Gibińskiego Śląskiego Uniwersytetu Medycznego, Katowice, Poland.
    I am a young doctor who graduated from the Medical University of Silesia in 2014. After 13 months of postgraduate training, passing a state examination and successful completion of the admission process I made a decision to specialise in Respiratory Medicine. I started working in a large clinical hospital that provides junior doctors with excellent opportunities for training and career development. Read More

    Effectiveness of new sedation and rehabilitation methods for critically ill patients receiving mechanical ventilation.
    J Phys Ther Sci 2017 Jan 30;29(1):138-143. Epub 2017 Jan 30.
    Department of Critical Care Medical Center, Hakodate Municipal Hospital, Japan.
    [Purpose] The purpose of this study was to investigate the effects of new sedation management methods and cooperation between nurses and physical therapists on the duration of mechanical ventilation and hospitalization. [Subjects and Methods] Patients who had been treated at the study hospital 2 years before and after the implementation of the new methods were analyzed retrospectively and classified into a "control group" and an "intervention group", respectively. Both groups were analyzed and subsequently compared regarding the effects of the new sedation and cooperative rehabilitation. Read More

    [A comparison of leak compensation in six acute care ventilators during non-invasive ventilation].
    Zhonghua Jie He He Hu Xi Za Zhi 2017 Feb;40(2):90-97
    Department of Respiratory Medicine, the General Hospital of People's Liberation Army, Beijing 100853, China.
    Objective: To compare the ability of leak compensation in 6 medical ventilators during non-invasive ventilation. Methods: Six medical ventilators were selected, including 3 non-invasive ventilators (V60, Flexo and Stellar150), and 3 invasive ventilators(Avea, Servo I and BellaVist). Using a lung simulator, the ability of leak compensation was evaluated during triggering and cycling in 2 respiratory mechanics conditions (high airway resistance condition and high elastance resistance condition), and each condition was performed under 2 PEEP levels (4, and 8 cmH(2)O, 1 mmHg=0. Read More

    Contributing Factors for Morbidity and Mortality in Patients with Organophosphate Poisoning on Mechanical Ventilation: A Retrospective Study in a Teaching Hospital.
    J Clin Diagn Res 2016 Dec 1;10(12):UC18-UC20. Epub 2016 Dec 1.
    Postgraduate Student, Department of Anaesthesiology, Mahadevappa Rampure Medical College/Rajiv Gandhi University of Health Sceinces , Kalaburagi, Karnataka, India .
    Introduction: One of the most common causes of poisoning in agricultural based developing countries like India is due to Organophosphorus (OP) compound. Its widespread use and easy availability has increased the likelihood of poisoning with these compounds.

    Aim: To study the morbidity and mortality in patients with acute OP poisoning requiring mechanical ventilation. Read More

    Precautionary Measures for Successful Open Heart Surgery in G6PD Deficient Patient- A Case Report.
    J Clin Diagn Res 2016 Dec 1;10(12):PD11-PD12. Epub 2016 Dec 1.
    Assistant Professor, Department of Cardiothoracic and Vascular Surgery, Advanced Cardiac Center, Post Graduate Institute of Medical Education and Research , Sector 12, Chandigarh, India .
    Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is among the most common enzymatic disorders of red blood cells. Cardiac surgeries on this group of individuals are associated with an additional risk in terms of impaired oxygenation, prolonged ventilation and increased risk of haemolysis. These patients have a very low threshold for haemolysis due to oxidative stress. Read More

    Argon does not affect cerebral circulation or metabolism in male humans.
    PLoS One 2017 16;12(2):e0171962. Epub 2017 Feb 16.
    Department of Anaesthesiology, Critical Care, Emergency Medicine and Pain Therapy, Klinikum Oldenburg, Medical Campus University of Oldenburg, Oldenburg, Germany.
    Objective: Accumulating data have recently underlined argon´s neuroprotective potential. However, to the best of our knowledge, no data are available on the cerebrovascular effects of argon (Ar) in humans. We hypothesized that argon inhalation does not affect mean blood flow velocity of the middle cerebral artery (Vmca), cerebral flow index (FI), zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe), resistance area product (RAP) and the arterio-jugular venous content differences of oxygen (AJVDO2), glucose (AJVDG), and lactate (AJVDL) in anesthetized patients. Read More

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