Search results for " Tidal volume"

showing 9 items of 9 documents

Do ventilatory parameters influence outcome in patients with severe acute respiratory infection? Secondary analysis of an international, multicentre1…

2021

Purpose: To investigate the possible association between ventilatory settings on the first day of invasive mechanical ventilation (IMV) and mortality in patients admitted to the intensive care unit (ICU) with severe acute respiratory infection (SARI). Materials and methods: In this pre-planned sub-study of a prospective, multicentre observational study, 441 patients with SARI who received controlled IMV during the ICU stay were included in the analysis. Results: ICU and hospital mortality rates were 23.1 and 28.1%, respectively. In multivariable analysis, tidal volume and respiratory rate on the first day of IMV were not associated with an increased risk of death; however, higher driving pr…

ARDSSoins intensifs réanimationmedicine.medical_treatmentAirway pressuresPEEP positive end-expiratory pressureCritical Care and Intensive Care Medicinelaw.inventionHypoxemiaCohort StudiesPositive-Pressure RespirationMechanical ventilationSARI severe acute respiratory infectionlawHospital MortalityProspective StudiesIQR interquartile rangesProspective cohort studyRCT randomized controlled trialTidal volumeSOFA Sequential Organ Failure AssessmentSAPS Simplified Acute Physiology ScoreIntensive care unitVCV volume-controlled ventilationHIV human immunodeficiency virusIntensive Care UnitsIC GLOSSARI Intensive Care Global Study on Severe Acute Respiratory Infectionmedicine.symptomCohort studyLOS length of staymedicine.medical_specialtyVt tidal volumeCOPD Chronic obstructive pulmonary diseaseNYHA New York Heart Association.PCV pressure-controlled ventilationArticleInternal medicineICU Intensive Care UnitSIMV Synchronized intermittent mandatory ventilationmedicineTidal VolumeHumansDP driving pressurePEEPARDS acute respiratory distress syndromeMechanical ventilationbusiness.industryOdds ratioPneumoniaPlateau pressuremedicine.diseaseRespiration ArtificialVILI ventilator induced lung injuryCI confidence intervalOR odds ratioIMV invasive mechanical ventilationCPAP continuous positive airway pressureARDSbusinessSD standard deviationECMO extracorporeal membrane oxygenationPBW predicted body weightPplat plateau pressure
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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
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Sex difference and intra-operative tidal volume: Insights from the LAS VEGAS study

2021

BACKGROUND: One key element of lung-protective ventilation is the use of a low tidal volume (V(T)). A sex difference in use of low tidal volume ventilation (LTVV) has been described in critically ill ICU patients. OBJECTIVES: The aim of this study was to determine whether a sex difference in use of LTVV also exists in operating room patients, and if present what factors drive this difference. DESIGN, PATIENTS AND SETTING: This is a posthoc analysis of LAS VEGAS, a 1-week worldwide observational study in adults requiring intra-operative ventilation during general anaesthesia for surgery in 146 hospitals in 29 countries. MAIN OUTCOME MEASURES: Women and men were compared with respect to use o…

AdultMalemedicine.medical_specialtyIntra operativehealth care facilities manpower and services[SDV]Life Sciences [q-bio]Critical IllnessLas Vegas StudyArticle03 medical and health sciences0302 clinical medicine030202 anesthesiologyInternal medicineTidal VolumemedicineHumansGeneral anaesthesiaLungTidal volumeAdult; Critical Illness; Female; Humans; Lung; Male; Tidal Volume; Respiration Artificial; Sex CharacteristicsSex CharacteristicsLas vegasbusiness.industryRespirationrespiratory failure sexrespiratory systemSex differenceRespiration Artificialrespiratory tract diseasesAnesthesiology and Pain Medicine030228 respiratory systemRelative riskArtificialCohortBreathingFemaleObservational studybusinessintra-operative tidal volumecirculatory and respiratory physiology
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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
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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
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Epidemiological characteristics, practice of ventilation, and clinical outcome in patients at risk of acute respiratory distress syndrome in intensiv…

2016

Background Scant information exists about the epidemiological characteristics and outcome of patients in the intensive care unit (ICU) at risk of acute respiratory distress syndrome (ARDS) and how ventilation is managed in these individuals. We aimed to establish the epidemiological characteristics of patients at risk of ARDS, describe ventilation management in this population, and assess outcomes compared with people at no risk of ARDS. Methods PRoVENT (PRactice of VENTilation in critically ill patients without ARDS at onset of ventilation) is an international, multicentre, prospective study undertaken at 119 ICUs in 16 countries worldwide. All patients aged 18 years or older who were rece…

MalePediatricsARDSmedicine.medical_treatmentlaw.inventionPositive-Pressure Respiration0302 clinical medicinelawRisk FactorsPrevalenceventilator–induced lung injuryProspective StudiesHospital MortalityProspective cohort studyTidal volumeeducation.field_of_studyRespiratory Distress SyndromeAcute respiratory distress syndrometidal volumeARDS critically ill ventilationMiddle AgedIntensive care unitIntensive Care UnitsCritical IllneFemaleHumanPulmonary and Respiratory Medicinemedicine.medical_specialtyCritical IllnessPopulationIntensive Care UnitLung injurymechanical ventilationNO03 medical and health sciencesIntensive caremedicineAcute respiratory distress syndrome mechanical ventilation ventilator–induced lung injury tidal volume positive end–expiratory pressureHumansMED/41 - ANESTESIOLOGIAeducationAgedMechanical ventilationbusiness.industryRisk FactorRespiratory Distress Syndrome Adult030208 emergency & critical care medicinemedicine.diseaseRespiration ArtificialMechanical ventilation Acute respiratory failure Acute respiratory distress syndromeProspective Studie030228 respiratory systemEmergency medicinepositive end–expiratory pressurebusiness
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Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications:LAS VEGAS - An observationa…

2017

BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative venti…

MalePediatricsInternationalityRESPIRATORY-DISTRESS-SYNDROME0302 clinical medicinePostoperative Complications030202 anesthesiologyRisk FactorsEpidemiologyABDOMINAL-SURGERY80 and overMedicine and Health SciencesGeneral anaesthesiaAnesthesiaEND-EXPIRATORY-PRESSUREBERLIN DEFINITION030212 general & internal medicineProspective StudiesProspective cohort studyLungAged 80 and overFramingham Risk ScoreIncidence (epidemiology)RespirationMiddle AgedTreatment OutcomeArtificialFemalePRACTICE PATTERNSHumanmedicine.medical_specialtymechanical ventilation ; prospective observational study ; Intensive careAnesthesia GeneralNONCARDIOTHORACIC SURGERYNOAged; Aged 80 and over; Anesthesia General; Cross-Sectional Studies; Female; Humans; Intraoperative Care; Lung; Male; Middle Aged; Postoperative Complications; Prospective Studies; Respiration Disorders; Respiration Artificial; Risk Factors; Tidal Volume; Treatment Outcome; Internationality; Anesthesiology and Pain MedicineACUTE LUNG INJURY03 medical and health sciencesGENERAL-ANESTHESIAInternal medicinemedicineJournal ArticleTidal VolumeHumansMED/41 - ANESTESIOLOGIAGeneralAgedCross-Sectional StudieIntraoperative Carebusiness.industryRisk FactorRespiration DisorderRespiration DisordersRespiration ArtificialConfidence intervalPROTECTIVE MECHANICAL VENTILATIONProspective StudieAnesthesiology and Pain MedicineCross-Sectional StudiesRelative riskMAJOR NONCARDIAC SURGERYPostoperative ComplicationbusinessAbdominal surgery
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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
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Effectiveness and safety of a new helmet CPAP configuration allowing tidal volume monitoring in patients with COVID-19.

2021

Abstract Background High generated tidal volumes (Vt) have been correlated with higher risk of self-induced lung injury and worse clinical outcome. This study aimed to evaluate the effectiveness and safety of a new helmet continuous positive airway pressure delivered (h-CPAP) configuration allowing Vt monitoring in patients affected by COVID-19. Methods This prospective observational study was performed in the respiratory intermediate care unit of University Hospital in Turin, Italy, between March 24th, and June 15th, 2020. Included patients were treated with CPAP via a single-limb intentional leak configuration by a turbine-driven ventilator, provided with a dedicated patch. Effectiveness …

Pulmonary and Respiratory MedicineLeakTidal volume monitoringmedicine.medical_specialtyCoronavirus disease 2019 (COVID-19)List of abbreviations: ARF Acute respiratory failuremedicine.medical_treatmentLung injuryTidal volumeVt Tidal volumeCPAPMedicineIn patientContinuous positive airway pressureTidal volumeHelmetCPAP Continuous positive airway pressureRICU Respiratory intermediate care unitbusiness.industryCOVID-19ICU Intensive care unitEmergency medicineHFNT High flow nasal therapyObservational studyOriginal ArticleTDVs turbine-driven ventilatorsbusinessPulmonology
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