Search results for "Positive-Pressure Respiration"

showing 10 items of 54 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
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

Impact of hypertonic saline nebulisation combined with oscillatory positive expiratory pressure on sputum expectoration and related symptoms in cysti…

2018

Abstract Objective To evaluate the impact of combining nebulised hyaluronic acid plus hypertonic saline (HA + HS) with oscillatory positive expiratory pressure (oscillatory-PEP) on sputum expectoration and related symptoms in adults with cystic fibrosis (CF). Design Randomised crossover trial. Setting Seven centres. Participants Twenty-two outpatients with CF. Interventions Usual care (HA + HS followed by autogenic drainage) and combined therapy (HA + HS with oscillatory-PEP followed by autogenic drainage]. Each treatment was performed for 5 days. Main outcome measures Sputum expectoration was measured during the nebulisation period (primary outcome), during autogenic drainage and for 24 ho…

AdultMale030506 rehabilitationAdolescentCystic FibrosisPhysical Therapy Sports Therapy and RehabilitationCystic fibrosisPulmonary function testingPositive-Pressure RespirationYoung Adult03 medical and health sciences0302 clinical medicineAdministration InhalationmedicineHumansSingle-Blind Method030212 general & internal medicineHyaluronic AcidAdverse effectSaline Solution HypertonicCross-Over Studiesbusiness.industryNebulizers and VaporizersSputummedicine.diseaseCombined Modality TherapyCrossover studyConfidence intervalRespiratory Function TestsHypertonic salineClinical trialAnesthesiaSputumFemalemedicine.symptom0305 other medical sciencebusinessPhysiotherapy
researchProduct

Effect of Lung Recruitment and Titrated Positive End-Expiratory Pressure (PEEP) vs Low PEEP on Mortality in Patients With Acute Respiratory Distress …

2017

Importance The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. Objective To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. Design, Setting, and Participants Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. Interventions An experimental strat…

AdultMaleARDSmedicine.medical_specialtyacure respitatory distress syndromemedicine.medical_treatmentmechanical ventilationlaw.inventionPositive-Pressure Respiration03 medical and health sciences0302 clinical medicineRandomized controlled triallawIntensive careTidal VolumemedicineHumansTreatment FailureARDS ventilation PEEPMED/41 - ANESTESIOLOGIAPEEPTidal volumePositive end-expiratory pressureAgedintensive careMechanical ventilationRespiratory Distress Syndromebusiness.industryHazard ratioPneumothorax030208 emergency & critical care medicineGeneral MedicineMiddle Agedmedicine.diseaseSurgeryIntensive Care UnitsEditorial030228 respiratory systemPneumothoraxAnesthesiaFemaleARDSbusiness
researchProduct

Tidal Volume Estimation during Helmet Noninvasive Ventilation: an Experimental Feasibility Study

2019

AbstractWe performed a bench (BS) and human (HS) study to test the hypothesis that estimation of tidal volume (VT) during noninvasive helmet pressure support ventilation (nHPSV) would be possible using a turbine driven ventilator (TDV) coupled with an intentional leak single-limb vented circuit. During the BS a mannequin was connected to a lung simulator (LS) and at different conditions of respiratory mechanics, positive end expiratory pressure (PEEP) levels and leaks (30, 50 and 80 L/min). All differences were within the 95% limits of agreement (LoA) in all conditions in the Bland-Altman plot. The overall bias (difference between VT measured by TDV and LS) was 35 ml (95% LoA 10 to 57 ml), …

AdultMaleLeakmedicine.medical_specialtylcsh:MedicineSettore MED/41 - AnestesiologiaPressure support ventilationTherapeuticsRespiratory physiologyManikinsArticlePositive-Pressure Respiration03 medical and health sciences0302 clinical medicineInternal medicineHealthy volunteersTidal VolumemedicineHumanslcsh:SciencePositive end-expiratory pressureTidal volumeMouthpieceVentilators Mechanicalacute respiratory failureMultidisciplinarybusiness.industrylcsh:RhelmetReproducibility of Resultsnoninvasive ventilation030208 emergency & critical care medicineEquipment DesignHealthy Volunteers030228 respiratory systemPreclinical researchRespiratory MechanicsCardiologyFeasibility Studieslcsh:QFemaleHead Protective DevicesNoninvasive ventilationbusinessScientific Reports
researchProduct

Chest wall mechanics during pressure support ventilation.

2005

Introduction During pressure support ventilation (PSV) a part of the breathing pattern is controlled by the patient, and synchronization of respiratory muscle action and the resulting chest wall kinematics is a valid indicator of the patient's adaptation to the ventilator. The aim of the present study was to analyze the effects of different PSV settings on ventilatory pattern, total and compartmental chest wall kinematics and dynamics, muscle pressures and work of breathing in patients with acute lung injury. Method In nine patients four different levels of PSV (5, 10, 15 and 25 cmH2O) were randomly applied with the same level of positive end-expiratory pressure (10 cmH2O). Flow, airway ope…

AdultMaleResearchMiddle AgedPressure support ventilation; Chest; Respiratory musclesPressure support ventilationPositive-Pressure RespirationRespiratory musclesRespiratory MechanicsChestHumansFemaleRespiratory InsufficiencyThoracic WallAged
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

The AVL-mode: a safe closed loop algorithm for ventilation during total intravenous anesthesia.

1994

The Adaptive Lung Ventilation Controller (ALV-Controller) represents a new approach to closed loop control of ventilation. It is based on a pressure controlled ventilation mode. Adaptive lung ventilation signifies automatic breath by breath adaptation of breathing patterns to the lung mechanics of an individual patient. The specific goals are to minimize work of breathing, to maintain a preset alveolar ventilation and to prevent the occurrence of intrinsic PEEP. We ventilated 5 patients undergoing major abdominal procedures using ALV. ALV was tolerated well in all patients. Alveolar ventilation was preset between 5500 and 6500 ml/min. Serial dead space (Vds) and respiratory time constant (r…

Artificial ventilationAdultRespiratory ratemedicine.medical_treatmentMedicine (miscellaneous)Critical Care and Intensive Care MedicinePositive-Pressure Respiration IntrinsicWork of breathingBreathing patternControl theoryMedicineHumansAgedVentilators MechanicalTotal intravenous anesthesiabusiness.industryLung mechanicsdigestive oral and skin physiologyrespiratory systemRespiration Artificialrespiratory tract diseasesRespiratory Function TestsAnesthesiaBreathingAnesthesia IntravenousRespiratory MechanicsbusinessAlgorithmsInternational journal of clinical monitoring and computing
researchProduct

The Association of Intraoperative driving pressure with postoperative pulmonary complications in open versus closed abdominal surgery patients – a po…

2021

Abstract Background It is uncertain whether the association of the intraoperative driving pressure (ΔP) with postoperative pulmonary complications (PPCs) depends on the surgical approach during abdominal surgery. Our primary objective was to determine and compare the association of time–weighted average ΔP (ΔPTW) with PPCs. We also tested the association of ΔPTW with intraoperative adverse events. Methods Posthoc retrospective propensity score–weighted cohort analysis of patients undergoing open or closed abdominal surgery in the ‘Local ASsessment of Ventilatory management during General Anaesthesia for Surgery’ (LAS VEGAS) study, that included patients in 146 hospitals across 29 countries.…

Driving pressure; Laparoscopic surgery; Laparoscopy; PEEP; Perioperative ventilation; Pneumoperitoneum; Protective ventilation; Respiratory mechanics;Lung DiseasesMaleLaparoscopic surgery[SDV]Life Sciences [q-bio]medicine.medical_treatmentLaparoscopic surgeryCohort StudiesPositive-Pressure RespirationPostoperative Complications0302 clinical medicinePneumoperitoneum030202 anesthesiologyPneumoperitoneumAbdomenClinical endpointPerioperative ventilationMiddle Aged3. Good healthDriving pressure Laparoscopic surgery Laparoscopy PEEP Perioperative ventilation Pneumoperitoneum Protective ventilation Respiratory mechanicsDriving pressureFemaleResearch ArticleCohort studyProtective ventilationAdultmedicine.medical_specialtyAnestesi och intensivvårdRespiratory mechanicsAnesthesia GeneralNOlcsh:RD78.3-87.303 medical and health sciencesmedicineHumansPropensity ScoreAdverse effectPEEPAgedRetrospective StudiesDriving pressure; Laparoscopic surgery; Laparoscopy; PEEP; Perioperative ventilation; Pneumoperitoneum; Protective ventilation; Respiratory mechanicsAnesthesiology and Intensive Carebusiness.industryKirurgi030208 emergency & critical care medicineOdds ratiomedicine.diseaseRespiration ArtificialSurgeryAnesthesiology and Pain Medicinelcsh:AnesthesiologyRelative riskSurgeryLaparoscopyDriving pressure ; Laparoscopic surgery ; Laparoscopy ; PEEP ; Perioperative ventilation ; Pneumoperitoneum ; Protective ventilation ; Respiratory mechanics.businessAbdominal surgery
researchProduct

Gastric insufflation pressure, air leakage and respiratory mechanics in the use of the laryngeal mask airway (LMA) in children.

2004

Summary Background : The objective of the present study was to evaluate the prelaryngeal position of the laryngeal mask airway (LMATM) in children, and to determine the influence of mask positioning on gastric insufflation and oropharyngeal air leakage. Methods : A total of 100 children, 3–11 years old, scheduled for surgical procedures in the supine position under general anaesthesia were studied. After clinically satisfactory LMA placement, tidal volumes were increased stepwise until air entered the stomach, airway pressure exceeded 30 cmH2O, or air leakage from the mask seal prevented further increases in tidal volume. LMA position in relation to the laryngeal entrance was verified using…

Larynxmedicine.medical_specialtySupine positionOropharynxRespiratory physiologyMascaraLaryngeal MasksIntermittent Positive-Pressure VentilationPositive-Pressure RespirationLaryngeal mask airwaymedicineTidal VolumeHumansGeneral anaesthesiaChildTidal volumebusiness.industryAirStomachSurgeryAnesthesiology and Pain Medicinemedicine.anatomical_structureBronchoscopesAnesthesiaChild PreschoolPediatrics Perinatology and Child HealthRespiratory MechanicsEquipment FailureAirwaybusinessPaediatric anaesthesia
researchProduct