Search results for "Ventilator-Associated"

Mechanical ventilation alters the development of staphylococcus aureus pneumonia in rabbit

2016

Ventilator-associated pneumonia (VAP) is common during mechanical ventilation (MV). Beside obvious deleterious effects on muco-ciliary clearance, MV could adversely shift the host immune response towards a pro-inflammatory pattern through toll-like receptor (TLRs) up-regulation. We tested this hypothesis in a rabbit model of Staphylococcus aureus VAP. Pneumonia was caused by airway challenge with S. aureus, in either spontaneously breathing (SB) or MV rabbits (n = 13 and 17, respectively). Pneumonia assessment regarding pulmonary and systemic bacterial burden, as well as inflammatory response was done 8 and 24 hours after S. aureus challenge. In addition, ex vivo stimulations of whole blood…

Quantification of atelectatic lung volumes in two different porcine models of ARDS.

2006

BACKGROUND: Cyclic recruitment during mechanical ventilation contributes to ventilator associated lung injury. Two different pathomechanisms in acute respiratory distress syndrome (ARDS) are currently discussed: alveolar collapse vs persistent flooding of small airways and alveoli. We compare two different ARDS animal models by computed tomography (CT) to describe different recruitment and derecruitment mechanisms at different airway pressures: (i) lavage-ARDS, favouring alveolar collapse by surfactant depletion; and (ii) oleic acid ARDS, favouring alveolar flooding by capillary leakage. METHODS: In 12 pigs [25 (1) kg], ARDS was randomly induced, either by saline lung lavage or oleic acid (…

Measurement of gas transport kinetics in high-frequency oscillatory ventilation (HFOV) of the lung using hyperpolarized 3He magnetic resonance imaging

2010

PURPOSE: To protect the patient with acute respiratory distress syndrome from ventilator associated lung injury (VALI) high-frequency oscillatory ventilation (HFOV) is used. Clinical experience has proven that HFOV is an efficient therapy when conventional artificial ventilation is insufficient. However, the optimal settings of HFOV parameters, eg, tidal volumes, pressure amplitudes and frequency for maximal lung protection, and efficient gas exchange are not established unambiguously. METHODS: In this work magnetic resonance imaging (MRI) with hyperpolarized (3)He was employed to visualize the redistribution of gas within the cadaver pig lung during HFOV. The saturated slice method was use…

Impact of Health Care−Associated Infection in Patients with Aneurysmal Subarachnoid Hemorrhage

2018

In the era of antibiotics, nosocomial infections are still uncontrollable and represent a problem with a problematic solution. The terms nosocomial and health care−associated infections are both used for disease, absent at the time of admission, acquired by patients under medical care in the hospital or other health care facilities. Recently, the term health care−associated infection (HAI) has been introduced for the type of infection caused by a prolonged hospital stay, and it accounts for a significant risk factor for severe health issues leading to death. HAIs can occur during health care delivery for other diseases and even after patient discharge. Invasive devices such as catheters and…

Analysis and modulation of the inflammatory response through lung agression related to bacterial infection and mechanical ventilation

2015

Despite major advances since decades in the management of ventilated patients, ventilator-associated pneumonia (VAP) continues to complicate the course of approximately 28% of the patients receiving mechanical ventilation (MV). Among patients hospitalized in intensive care units, the risk of pneumonia is 3- to 10- fold increased in MV patients. However, MV is often the only way to care for critically ill patients with respiratory failure. It has now been clearly demonstrated that MV, in particular adverse ventilatory strategies could activate lung cells, thus leading to a proinflammatory response, even in the absence of pathogen. This is the biotrauma paradigm, which accounts, at least in p…

Ventilator-Associated Lung Injury Superposed to Oleic Acid Infusion or Surfactant Depletion: Histopathological Characteristics of Two Porcine Models …

2009

<i>Background:</i> The pathophysiological concept of acute lung injury (ALI) in combination with ventilator-associated lung injury (VALI) is still unclear. We characterized the histopathological features of intravenous injection of oleic acid (OAI) and lung lavage (LAV) combined with VALI. <i>Methods:</i> Pigs were randomized to the control, LAV or OAI group and ventilated by pressure-controlled ventilation. Measurements included: haemodynamics, spirometry, blood gas analysis, lung wet-to-dry weight ratio (W/D), total protein content in broncho-alveolar lavage fluid (BALF), and lung pathological description and scoring. <i>Results:</i> Five hours after lu…

Healthcare-Associated Pneumonia and Multidrug Resistant Bacteria: Do We Have a Convincing Answer?

2014

Ventilator-associated Pneumonia and MRSA ST398, Italy

2010

To the Editor: Methicillin-resistant Staphylococcus aureus (MRSA) sequence type (ST)398 has become increasingly common in livestock, particularly pigs, in some countries in Europe, such as Spain and Germany (1). In Italy, prevalences as high as 14% and 21.6% in pig-breeding facilities and meat-processing sites, respectively, have been recently reported (1). Possible association of MRSA in animals with infection in humans has been investigated. One study showed a strong relationship between contact with pigs or calves and carriage by persons having direct contact with animals and families of persons who handle animals (2). Moreover, an MRSA prevalence >11.9% has been described by de Boer et …

Antimicrobial de-escalation in the critically ill patient and assessment of clinical cure : the DIANA study

2020

© 2020 The Author(s).

Spatial and temporal heterogeneity of ventilator-associated lung injury after surfactant depletion.

2008

Volutrauma and atelectrauma have been proposed as mechanisms of ventilator-associated lung injury, but few studies have compared their relative importance in mediating lung injury. The objective of our study was to compare the injury produced by stretch (volutrauma) vs. cyclical recruitment (atelectrauma) after surfactant depletion. In saline-lavaged rabbits, we used high tidal volume, low respiratory rate, and low positive end-expiratory pressure to produce stretch injury in nondependent lung regions and cyclical recruitment in dependent lung regions. Tidal changes in shunt fraction were assessed by measuring arterial Po2 oscillations. After ventilating for times ranging from 0 to 6 h, lu…