Search results for " ventilation"

Acute Hypoxemic Respiratory Failure in Immunocompromised Patients: Taking Aggressive Measures to Identify Etiology

2019

MRI of Pulmonary Ventilation

2008

Gas imaging has opened the new field of direct imaging of pulmonary ventilation by MRI. The use of hyperpolarised 3He gas for MRI of the lung has been pioneered by a number of groups worldwide. Due to the enormous progress in the fields of hyperpolarisation technology, administration of hyperpolarised 3He, MR hardware, and MR pulse sequences significant progress has been made and the translation into the clinical arena has been accomplished. This chapter gives an overview of the technical methods for HP 3He MRI for human lung imaging, focusing on gas polarisation methods, background physics, MRI hardware considerations, MRI pulse sequence considerations, safety considerations for imaging in…

Airway assessment by four-phase rhinomanometry in septal surgery

2011

PURPOSE OF REVIEW This article updates the state of the art in functional ventilation tests of the nasal airway. Multidisciplinary international cooperation has led within the last years to the development of four-phase rhinomanometry (4PR) by eradicating the errors of the 'classic' rhinomanometry. RECENT FINDINGS Physical experiments, mathematical models and comprehensive statistical analyses implicate that the nasal breath consists of four phases of different diagnostic importance. Presuming the motility of the nasal entrance, it is necessary to depict the elastic behavior within the rhinomanometric curve, as well as to use new parameters for the clinical evaluation of the nasal obstructi…

Physiopathological rationale of using high-flow nasal therapy in the acute and chronic setting: A narrative review

2019

Abstract Chronic lung disease and admissions due to acute respiratory failure (ARF) are becoming increasingly common. Consequently, there is a growing focus on optimizing respiratory support, particularly non-invasive respiratory support, to manage these conditions. High flow nasal therapy (HFNT) is a noninvasive technique where humidified and heated gas is delivered through the nose to the airways via small dedicated nasal prongs at flows that are higher than the rates usually applied during conventional oxygen therapy. HFNT enables to deliver different inspired oxygen fractions ranging from 0.21 to 1. Despite having only recently become available, the use of HFNT in the adult population i…

Managing Persistent Hypoxemia: what is new?

2017

Mechanical ventilation is the standard life-support technique for patients with severe acute respiratory failure. However, some patients develop persistent and refractory hypoxemia because their lungs are so severely damaged that they are unable to respond to the application of high inspired oxygen concentration and high levels of positive end-expiratory pressure. In this article, we review current knowledge on managing persistent hypoxemia in patients with injured lungs.

Inhaled amikacin versus placebo to prevent ventilator-associated pneumonia: the AMIKINHAL double-blind multicentre randomised controlled trial protoc…

2021

IntroductionPre-emptive inhaled antibiotics may be effective to reduce the occurrence of ventilator-associated pneumonia among critically ill patients. Meta-analysis of small sample size trials showed a favourable signal. Inhaled antibiotics are associated with a reduced emergence of antibiotic resistant bacteria. The aim of this trial is to evaluate the benefit of a 3-day course of inhaled antibiotics among patients undergoing invasive mechanical ventilation for more than 3 days on the occurrence of ventilator-associated pneumonia.Methods and analysisAcademic, investigator-initiated, parallel two group arms, double-blind, multicentre superiority randomised controlled trial. Patients invasi…

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

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 differe…

Rapid systematic review shows that using a high-flow nasal cannula is inferior to nasal continuous positive airway pressure as first-line support in …

2017

Aim We reviewed using a high-flow nasal cannula (HFNC) as first-line support for preterm neonates with, or at risk of, respiratory distress. Methods This rapid systematic review covered biomedical databases up to June 2017. We included randomised controlled trials (RCTs) published in English. The reference lists of the studies and relevant reviews we included were also screened. We performed the study selection, data extraction, study quality assessment, meta-analysis and quality of evidence assessment following the Grading of Recommendations Assessment, Development and Evaluation system. Results Pooled results from six RCTs covering 1227 neonates showed moderate-quality evidence that HFNC …

Supraglottic airway devices for surfactant treatment: systematic review and meta-analysis

2019

Objective: To compare surfactant administration via supraglottic airway device (SAD) vs. nasal CPAP alone or INSURE. Study design: A systematic search of PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov was performed. Articles meeting inclusion criteria (RCT, surfactant administration via SAD, laryngeal mask, I-gel) were assessed Results: Five RCTs were eligible. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.57, 95%CI 0.38–0.85) and short-term oxygen requirements (MD −8.00, 95%CI −11.09 to −4.91) compared to nCPAP alone. Surfactant administration via SAD reduced the need for intubation/mechanical v…

Is COVID‐19 infection more severe in kidney transplant recipients?

2021

International audience; There are no studies which have compared the risk of severe Covid-19 and related mortality between transplant recipients and non-transplant patients. We enrolled two groups of patients hospitalized for Covid-19, i.e., kidney transplant recipients from the French Registry of Solid Organ Transplant (n=306) and a single-center cohort of non-transplant patients (n=795). An analysis was performed among subgroups matched for age and risk factors for severe Covid-19 or mortality. Severe Covid-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death.Transplant recipients were younger and had more comorbidities compared to…