Search results for "Atelectasi"
showing 10 items of 39 documents
Software zur automatischen Quantifizierung von Belüftungszuständen bei akutem Lungenversagen in dynamischen CT-Aufnahmen der Lunge1
2001
Purpose: Density measurements in dynamic CT image series of the lungs allow one to quantify ventilated, hyperinflated, and atelectatic pulmonary compartments with high temporal resolution. Fast automatic segmentation of lung parenchyma and a subsequent evaluation of it's respective density values are a prerequisite for any clinical application of this technique. Material and Methods: For automatic lung segmentation in thoracic CT scans, an algorithm was developed which uses (a) different density masks, and (b) anatomic knowledge to differentiate heart, diaphragm and chest wall from ventilated and atelectatic lung parenchyma. With Animal Care Committee approval, the automated technique was t…
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…
Ultrasonography of the Lung.
2019
High diagnostic accuracy, increasing clinical experience and technical improvements are good reasons to consider lung ultrasound (US) for the assessment of pleural and pulmonary diseases. In the emergency room and in intensive care, it is well acknowledged, but application in other settings is rare. The aim of this review is to update potential users in general radiology about the diagnostic scope of lung US and to encourage more frequent use of this generally underestimated lung imaging modality. Literature review was done independently by the two authors in MEDLINE (via PubMed) covering a time span from 2002 until 2017 using free text and Medical Subject Headings/MeSH. Article selection …
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…
Effect of chest compressions only during experimental basic life support on alveolar collapse and recruitment
2007
Summary Aim The importance of ventilatory support during cardiac arrest and basic life support is controversial. This experimental study used dynamic computed tomography (CT) to assess the effects of chest compressions only during cardiopulmonary resuscitation (CCO-CPR) on alveolar recruitment and haemodynamic parameters in porcine model of ventricular fibrillation. Materials and methods Twelve anaesthetized pigs (26±1kg) were randomly assigned to one of the following groups: (1) intermittent positive pressure ventilation (IPPV) both during basic life support and advanced cardiac life support, or (2) CCO during basic life support and IPPV during advanced cardiac life support. Measurements w…
Quantification of Lung Volume at Different Tidal Volumes and Positive End-Expiratory Pressures in a Porcine Model by Using Retrospective Respiratory …
2008
PURPOSE: This feasibility study in healthy animals should prove the concept that it is possible to quantitatively assess the effects of different ventilatory settings on the lung parenchyma during ongoing ventilation in respiratory gated 4-dimensional (D)-computed tomography (CT). For this purpose, the influence of different tidal volumes and positive end-expiratory pressure (PEEP) on quantitative assessment of lung volumes (LVs) and lung compartments was analyzed. METHODS: Five anesthetized and ventilated (20 breaths/min, inspiratory/expiratory ratio of 1:2) healthy pigs underwent 16-row multidetector CT with retrospective respiratory gating using a noncontact charge-coupled device camera …
Non-invasive ventilation in postoperative patients: A systematic review
2010
Background: Postoperative pulmonary complications, generally defined as any pulmonary abnormality occurring in the postoperative period, are still a significant issue in clinical practice increasing hospital length of stay, morbidity and mortality. Non-invasive ventilation (NIV), primarily applied in cardiogenic pulmonary edema, decompensated COPD and hypoxemic pulmonary failure, is nowadays also used in perioperative settings. Objective: Investigate the application and results of preventive and therapeutic NIV in postsurgical patients. Design: A systematic review. Data sources: Medical literature databases were searched for articles about "clinical trials," "randomized controlled trials" a…
Easy removal of a large mucus plug with a flexible paediatric bronchoscope after administration of rhDNase (Pulmozyme).
2006
Mucoid impaction and plastic bronchitis are relatively rare disorders affecting patients of any age. Here we report the case of mucoid impaction developing in a four-year-old child as a complication of pneumonic infection treated four weeks prior. p.a. chest X-ray and fiberoptic bronchoscopy showed atelectasis and the location of a mucus cast in the left upper lobe. After extraction of the cast via the suction channel of the bronchoscope had failed, we administered 2.5 mg of undiluted recombinant human deoxyribonuclease (rhDNase) instilled directly over the affected area of occlusion for 15 minutes. This mucolytic agent mobilized the cast by reducing viscoelasticity and adherence of mucus. …
Understanding Primary Ciliary Dyskinesia: Experience From a Mediterranean Diagnostic Reference Centre
2020
Background: Due to the lack of a gold standard diagnostic test, reference centres with experienced personnel and costly procedures are needed for primary ciliary dyskinesia (PCD) diagnostics. Diagnostic flowcharts always start with clinical symptoms. Therefore, the aim of this work is to define differential clinical criteria so that only patients clinically compatible with PCD are referred to reference centres. Materials and methods: 18 variables from 476 Mediterranean patients with clinically suspicious PCD were collected. After analysing cilia function and ultrastructure, 89 individuals were diagnosed with PCD and 387 had a negative diagnosis. Simple logistic regression analysis, consider…
Visualization of alveolar recruitment in a porcine model of unilateral lung lavage using3He-MRI
2009
BACKGROUND: In the acute respiratory distress syndrome potentially recruitable lung volume is currently discussed. (3)He-magnetic resonance imaging ((3)He-MRI) offers the possibility to visualize alveolar recruitment directly. METHODS: With the approval of the state animal care committee, unilateral lung damage was induced in seven anesthetized pigs by saline lavage of the right lungs. The left lung served as an intraindividual control (healthy lung). Unilateral lung damage was confirmed by conventional proton MRI and spiral-CT scanning. The total aerated lung volume was determined both at a positive end-expiratory pressure (PEEP) of 0 and 10 mbar from three-dimensionally reconstructed (3)H…