Search results for " Positive-Pressure Respiration"

showing 9 items of 9 documents

Pressure support ventilation + sigh in acute hypoxemic respiratory failure patients: Study protocol for a pilot randomized controlled trial, the PROT…

2018

Background Adding cyclic short sustained inflations (sigh) to assisted ventilation yields optimizes lung recruitment, decreases heterogeneity and reduces inspiratory effort in patients with acute hypoxemic respiratory failure (AHRF). These findings suggest that adding sigh to pressure support ventilation (PSV) might decrease the risk of lung injury, shorten weaning and improve clinical outcomes. Thus, we conceived a pilot trial to test the feasibility of adding sigh to PSV (the PROTECTION study). Methods PROTECTION is an international randomized controlled trial that will be conducted in 23 intensive care units (ICUs). Patients with AHRF who have been intubated from 24 h to 7 days and under…

procedurePressure supportTime Factorsgenetic structuresbreathingmedicine.medical_treatmentMedicine (miscellaneous)Pilot Projects[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tractintensive care unitlaw.inventionPositive-Pressure RespirationStudy Protocol0302 clinical medicineMechanical ventilationRandomized controlled triallawtime factorClinical endpointpatient safetyMulticenter Studies as TopicPharmacology (medical)030212 general & internal medicinerandomized controlled trial (topic)Intervention study; Mechanical ventilation; Positive-pressure ventilation; Pressure support; Recruitment; Sigh; Ventilator-induced lung injury; Weaning; Feasibility Studies; Humans; Hypoxia; Intubation Intratracheal; Lung; Multicenter Studies as Topic; Pilot Projects; Positive-Pressure Respiration; Recovery of Function; Respiratory Insufficiency; Time Factors; Treatment Outcome; Randomized Controlled Trials as Topic; Medicine (miscellaneous); Pharmacology (medical)HypoxiaLungpathophysiologyendotracheal intubationRandomized Controlled Trials as TopicVentilator-induced lung injurylcsh:R5-920Intervention studyadultpilot studyfeasibility studytreatment outcome Feasibility Studie3. Good healthTreatment OutcomeAnesthesiapositive end expiratory pressureBreathingmulticenter study (topic)oxygenationRecruitmentlcsh:Medicine (General)Respiratory Insufficiencyrespiratory tract intubationcirculatory and respiratory physiologyHumanextubationPressure support ventilationWeaningLung injuryArticleSpontaneous breathing trialNO03 medical and health sciencesIntensive care[SDV.MHEP.PHY]Life Sciences [q-bio]/Human health and pathology/Tissues and Organs [q-bio.TO]medicineIntubation IntratrachealHumanscontrolled studyPilot ProjectSightreatment failureMechanical ventilationhypoxemiapressure support ventilationtreatment durationbusiness.industrylung inflationrespiratory failureconvalescenceRecovery of Functionmajor clinical studymortalitywater acute respiratory failurehospital dischargeIntratracheal030228 respiratory systemrandomized controlled trialFeasibility StudiesbusinessPositive-pressure ventilationIntubationclinical protocol
researchProduct

Individualized versus fixed positive end-expiratory pressure for intraoperative mechanical ventilation in obese patients: a secondary analysis

2021

Background General anesthesia may cause atelectasis and deterioration in oxygenation in obese patients. The authors hypothesized that individualized positive end-expiratory pressure (PEEP) improves intraoperative oxygenation and ventilation distribution compared to fixed PEEP. Methods This secondary analysis included all obese patients recruited at University Hospital of Leipzig from the multicenter Protective Intraoperative Ventilation with Higher versus Lower Levels of Positive End-Expiratory Pressure in Obese Patients (PROBESE) trial (n = 42) and likewise all obese patients from a local single-center trial (n = 54). Inclusion criteria for both trials were elective laparoscopic abdominal…

Pulmonary Atelectasismedicine.medical_treatment[SDV]Life Sciences [q-bio]AtelectasisPositive-Pressure Respiration03 medical and health sciences0302 clinical medicine030202 anesthesiologyInterquartile rangemedicineTidal VolumeHumansObesity10. No inequalityPEEPPositive end-expiratory pressureTidal volumeComputingMilieux_MISCELLANEOUS2. Zero hungerMechanical ventilationbusiness.industryRespirationEnvironmental air flowOxygenationrespiratory systemmedicine.disease3. Good healthrespiratory tract diseasesAnesthesiology and Pain MedicineAnesthesiaArtificialBreathingbusinesstherapeutics030217 neurology & neurosurgeryHumans; Obesity; Positive-Pressure Respiration; Pulmonary Atelectasis; Respiration Artificial; Tidal Volumecirculatory and respiratory physiology
researchProduct

Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protoc…

2019

Background: Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM. Methods: PROTHOR is an international, multicenter, randomized, controlled, assessor-blinded, two-arm trial initiated by investigators of the PROtective VEntilation NETwork. In total, 2378 patients will be randomly assigned to one of two diffe…

one-lung ventilationIntraoperative ComplicationMedicine (miscellaneous)Thoracic Surgical Procedurerecruitment maneuverOrvostudományokrespiratory systemThoracic Surgical ProceduresKlinikai orvostudományokthoracic surgeryrespiratory tract diseasesPositive-Pressure RespirationMechanical ventilation; one-lung ventilation; positive end-expiratory pressure; postoperative pulmonary complication; recruitment maneuver; thoracic surgery; Humans; Intraoperative Complications; One-Lung Ventilation; Positive-Pressure Respiration; Research Design; Sample Size; Thoracic Surgical Procedures; Randomized Controlled Trials as TopicMechanical ventilationResearch DesignSample SizeHumansPharmacology (medical)postoperative pulmonary complicationIntraoperative ComplicationsMechanical ventilation; one-lung ventilation; positive end-expiratory pressure; postoperative pulmonary complication; recruitment maneuver; thoracic surgery; Medicine (miscellaneous); Pharmacology (medical)Humanpositive end-expiratory pressureRandomized Controlled Trials as Topic
researchProduct

High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised con…

2014

BACKGROUND: The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H(2)O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression and lung injury from overdistension. We tested the hypothesis that a high level of positive end-expiratory pressure with recruitment manoeuvres protects against postoperative pulmonary complications in patients at risk of complications who are receiving mechanical ventilation with low tidal volumes during general anaesthesia for open abdominal surgery. METHODS: In this randomised controlled tri…

Lung DiseasesMalemedicine.medical_specialtymedicine.medical_treatmentSettore MED/41 - AnestesiologiaAtelectasisAnesthesia GeneralLung injuryArticlePositive-Pressure Respirationabdominal surgery PEEPPostoperative ComplicationsDouble-Blind MethodRisk FactorsAbdomenTidal VolumemedicineHumansGeneral anaesthesiaPEEP; recruitment manoeuvres; abdominal surgeryPositive end-expiratory pressureTidal volumeAgedMechanical ventilationbusiness.industryGeneral Medicinerespiratory systemmedicine.diseaseCardiac surgerySurgeryAbdomen Aged Double-Blind Method Humans Lung Diseases Positive-Pressure Respiration Postoperative Complications Risk Factors Tidal Volume Treatment OutcomeTreatment OutcomeSurgical Procedures OperativeAnesthesiaFemalebusinessAbdominal surgeryThe Lancet
researchProduct

Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) with Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications…

2019

Importance: An intraoperative higher level of positive end-expiratory positive pressure (PEEP) with alveolar recruitment maneuvers improves respiratory function in obese patients undergoing surgery, but the effect on clinical outcomes is uncertain. Objective: To determine whether a higher level of PEEP with alveolar recruitment maneuvers decreases postoperative pulmonary complications in obese patients undergoing surgery compared with a lower level of PEEP. Design, Setting, and Participants: Randomized clinical trial of 2013 adults with body mass indices of 35 or greater and substantial risk for postoperative pulmonary complications who were undergoing noncardiac, nonneurological surgery un…

Lung DiseasesMalemedicine.medical_treatmentAtelectasisLung Disease01 natural sciencesBody Mass IndexHypoxemiaPositive-Pressure RespirationPostoperative Complications0302 clinical medicinePEEP postoperative complications obese patientsAnesthesiaRespiratory function030212 general & internal medicineTidal volumeGeneral MedicineMiddle AgedPleural Diseasesrespiratory systemAdult; Anesthesia General; Body Mass Index; Female; Humans; Lung Diseases; Male; Middle Aged; Obesity; Pleural Diseases; Positive-Pressure Respiration; Postoperative Complications; Pulmonary Atelectasis; Respiratory Insufficiency; Surgical Procedures Operative; Tidal Volume; Treatment Outcome; Intraoperative CareOperative3. Good healthTreatment OutcomePneumothoraxSurgical Procedures OperativeAnesthesiaFemalemedicine.symptomRespiratory Insufficiencypsychological phenomena and processesHumancirculatory and respiratory physiologyAdultPulmonary AtelectasisAnesthesia GeneralNO03 medical and health sciencesmental disordersTidal VolumemedicineHumansPleural DiseaseObesity0101 mathematicsGeneralPositive end-expiratory pressureMechanical ventilationSurgical ProceduresIntraoperative CarePulmonary Atelectasibusiness.industry010102 general mathematicsmedicine.diseaserespiratory tract diseasesRespiratory failurePostoperative Complicationbusiness
researchProduct

Intraoperative positive end-expiratory pressure and postoperative pulmonary complications: a patient-level meta-analysis of three randomised clinical…

2022

BACKGROUND: High intraoperative PEEP with recruitment manoeuvres may improve perioperative outcomes. We re-examined this question by conducting a patient-level meta-analysis of three clinical trials in adult patients at increased risk for postoperative pulmonary complications who underwent non-cardiothoracic and non-neurological surgery. METHODS: The three trials enrolled patients at 128 hospitals in 24 countries from February 2011 to February 2018. All patients received volume-controlled ventilation with low tidal volume. Analyses were performed using one-stage, two-level, mixed modelling (site as a random effect; trial as a fixed effect). The primary outcome was a composite of postoperati…

AdultLung Diseases*PEEP*postoperative pulmonary complicationsmechanical ventilationPositive-Pressure RespirationsurgeryAnesthesiology and Pain MedicinePostoperative ComplicationsTidal Volume*surgeryHumanspostoperative pulmonary complicationsPostoperative Period*mechanical ventilationmechanical ventilation; PEEP; postoperative pulmonary complications; surgery; Adult; Humans; Lung; Postoperative Complications; Postoperative Period; Randomized Controlled Trials as Topic; Tidal Volume; Lung Diseases; Positive-Pressure RespirationLungPEEPRandomized Controlled Trials as Topic
researchProduct

Kinetics of plasma biomarkers of inflammation and lung injury in surgical patients with or without postoperative pulmonary complications

2017

Background Postoperative pulmonary complications (PPCs) are common after major abdominal surgery. The kinetics of plasma biomarkers could improve identification of patients developing PPCs, but the kinetics may depend on intraoperative ventilator settings. Objective To test whether the kinetics of plasma biomarkers are capable of identifying patients who will develop PPCs, and whether the kinetics depend on the intraoperative level of positive end-expiratory pressure (PEEP). Design A preplanned substudy of a randomised controlled trial. Setting Operation room of five centres. Patients Two hundred and forty-two adult patients scheduled for abdominal surgery at risk of developing PPCs. Interv…

AdultMalemedicine.medical_specialtyInflammationLung injuryGastroenterologyArticlelaw.inventionPositive-Pressure Respiration03 medical and health sciencesPostoperative Complications0302 clinical medicineRandomized controlled trial030202 anesthesiologylawInternal medicinemedicineHumansInflammationLungReceiver operating characteristicbusiness.industryLung InjuryAnesthesiology and Pain Medicinemedicine.anatomical_structure030228 respiratory systemAnesthesiaAdult; Biomarkers; Female; Humans; Inflammation; Inflammation Mediators; Lung Injury; Male; Positive-Pressure Respiration; Postoperative Complications; Anesthesiology and Pain MedicineBiomarker (medicine)FemaleInflammation Mediatorsmedicine.symptombusinessBiomarkersAbdominal surgeryBlood samplingEuropean Journal of Anaesthesiology
researchProduct

Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol…

2017

Background Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multice…

MaleLung DiseasesTime Factors[SDV]Life Sciences [q-bio]Respiratory Medicine and Allergymedicine.medical_treatmentRESPIRATORY-DISTRESS-SYNDROMEMedicine (miscellaneous)HemodynamicsMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuver; Medicine (miscellaneous); Pharmacology (medical)LAPAROSCOPIC BARIATRIC SURGERYLung DiseaseBody Mass Indexlaw.inventionPositive-Pressure RespirationStudy Protocol0302 clinical medicineMechanical ventilationClinical ProtocolsRandomized controlled trialRisk Factors030202 anesthesiologylawMedicine and Health SciencesClinical endpointAnesthesiaPharmacology (medical)Respiratory function030212 general & internal medicineLungLungmedicin och allergi2. Zero hungerlcsh:R5-920ddc:617Positive end-expiratory pressurerespiratory systemOperative3. Good healthTreatment OutcomeRecruitment maneuverTIDAL VOLUMESResearch DesignMechanical ventilation Positive end-expiratory pressure Recruitment maneuver Obesity Postoperative pulmonary complicationSurgical Procedures OperativeAnesthesiaBreathingFemaleErratumlcsh:Medicine (General)ALVEOLAR RECRUITMENT MANEUVERHumancirculatory and respiratory physiologymedicine.medical_specialtyTime FactorMechanical ventilation ; Obesity ; Positive end-expiratory pressure ; Postoperative pulmonary complication ; Recruitment maneuverAnesthesia GeneralLung injuryMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuver; Body Mass Index; Clinical Protocols; Female; Humans; Intraoperative Care; Lung; Lung Diseases; Male; Obesity; Positive-Pressure Respiration; Protective Factors; Research Design; Risk Factors; Time Factors; Treatment Outcome; Anesthesia General; Surgical Procedures Operative; Medicine (miscellaneous); Pharmacology (medical)NOGENERAL-ANESTHESIADRIVING PRESSURE03 medical and health sciencesmedicineHumansddc:610ObesityClinical ProtocolGeneralProtective FactorPositive end-expiratory pressurePOSTOPERATIVE PULMONARY COMPLICATIONSMechanical ventilationSurgical ProceduresIntraoperative CareINTERNATIONAL CONSENSUSbusiness.industryRisk FactorProtective FactorsSurgeryMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuverrespiratory tract diseasesbusinessPostoperative pulmonary complicationLUNG INJURY
researchProduct

Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protoc…

2018

Postoperative pulmonary complications (PPC) may result in longer duration of in-hospital stay and even mortality. Both thoracic surgery and intraoperative mechanical ventilation settings add considerably to the risk of PPC. It is unclear if one-lung ventilation (OLV) for thoracic surgery with a strategy of intraoperative high positive end-expiratory pressure (PEEP) and recruitment maneuvers (RM) reduces PPC, compared to low PEEP without RM.PROTHOR is an international, multicenter, randomized, controlled, assessor-blinded, two-arm trial initiated by investigators of the PROtective VEntilation NETwork. In total, 2378 patients will be randomly assigned to one of two different intraoperative me…

Positive-Pressure RespirationMechanical ventilation; one-lung ventilation; positive end-expiratory pressure; postoperative pulmonary complication; recruitment maneuver; thoracic surgery; Humans; Intraoperative Complications; One-Lung Ventilation; Positive-Pressure Respiration; Research Design; Sample Size; Thoracic Surgical Procedures; Randomized Controlled Trials as TopicResearch DesignSample SizeHumansCorrectionThoracic Surgical ProceduresIntraoperative ComplicationsOne-Lung VentilationRandomized Controlled Trials as TopicTrials
researchProduct