Search results for "breathing"
showing 10 items of 319 documents
German Thoracic Research Scholarship 1996: lung volume reduction for endstage pulmonary emphysema at the Washington University of St. Louis.
1998
The Thoracic Research Scholarship 1996 of the German Society for Thoracic and Cardiovascular Surgery enabled me to visit Barnes Hospital at the Washington University of St. Louis, USA, from May to July 1996. At that center Prof. J. D. Cooper has established lung-volume reduction surgery as a successful surgical treatment for patients with endstage pulmonary emphysema. The operation is performed using left-sided double-lumen intubation. After opening of the chest and pleura and starting single-lung ventilation the less diseased parts of the second lung collapse due to absorption atelectasis whereas the more diseased portion of the lung stays hyperinflated. Linear staplers buttressed with bov…
Patient-Ventilator Asynchronies: Clinical Implications and Practical Solutions
2020
Mechanical ventilation is a supportive treatment commonly applied in critically ill patients. Whenever the patient is spontaneously breathing, the pressure applied to the respiratory system depends on the sum of the pressure generated by the respiratory muscles and the pressure generated by the ventilator. Patient-ventilator interaction is of utmost importance in spontaneously breathing patients, and thus the ventilator should be able to adapt to patient's changes in ventilatory demand and respiratory mechanics. Nevertheless, a lack of coordination between patient and ventilator due to a mismatch between neural and ventilator timing throughout the respiratory cycle may make weaning difficul…
Sleep apnoea and metabolic dysfunction.
2013
Obstructive sleep apnoea (OSA) is a highly prevalent condition often associated with central obesity. In the past few years, several studies have analysed the potential independent contribution of OSA to the pathogenesis of metabolic abnormalities, including type 2 diabetes, the metabolic syndrome and non-alcoholic fatty liver disease. New perspectives in OSA patient care have been opened by the promotion of lifestyle interventions, such as diet and exercise programmes that could improve both OSA and the metabolic profile. The rich clinical literature on this subject, together with the growing amount of data on pathophysiological mechanisms provided by animal studies using the chronic inter…
Ventilator Settings to Avoid Nuisance Alarms During Mouthpiece Ventilation
2016
BACKGROUND: A recent study found that activation of disconnection and low-pressure alarms is common during mouthpiece ventilation and may represent a major limitation to its use. The aim of this bench study was: (1) to investigate the technical aspects that can influence the setting of the ventilator during mouthpiece ventilation and (2) to provide a practical setting strategy to avoid the alarm activation. METHODS: Eight life-support ventilators able to deliver volume controlled ventilation were tested in a bench study using a single-limb non-vented circuit configuration connected to a standard mouthpiece. Disconnection and apnea alarm were turned off or set at the least sensitive setting.…
Advances in Pulmonary Medicine: Research and Innovations
2019
This book discusses a wide range of investigations and practice-oriented advances in pulmonary medicine and critical care. Pulmonary diseases are a major cause of hospitalization and mortality, affecting millions of people worldwide. Addressing a range of topics, including chronic obstructive pulmonary disease, sleep apnea, and lung cancer, the book offers insights into the disease mechanisms and risk factors, along with practical aspects concerning the maintenance of quality of life, adherence to therapy, and palliative treatment and care. Further, it explores diagnostic and treatment approaches to respiratory dysfunction and respiratory failure, highlighting the beneficial effects of good…
Application of latent class analysis in assessing the awareness, attitude, practice and satisfaction of paediatricians on sleep disorder management i…
2020
Aim To identify subgroups regarding paediatricians’ awareness, attitude, practice and satisfaction about management of Sleep-Disordered Breathing (SDB) in Italy using Latent Class Analysis (LCA). Methods A cross-sectional study was conducted on a large sample of Italian paediatricians. Using a self-administered questionnaire, the study collected information on 420 Paediatric Hospital Paediatricians (PHPs) and 594 Family Care Paediatricians (FCPs). LCA was used to discover underlying response patterns, thus allowing identification of respondent groups with similar awareness, attitude, practice and satisfaction. A logistic regression model was used to investigate which independent variables i…
Survey of neonatal respiratory support use in very preterm infants in Italy
2012
Background: Respiratory support in very preterm infants is often a life-saving procedure and several techniques are available. There is lack of data on the current use of these techniques. Methods and aim: We analyzed a cohort of infants <30 weeks gestation or < 1501 g birth weight, enrolled in the Italian Neonatal Network in 2009 and 2010 (n = 8297, mean gestation = 29.3 weeks, mean birth weight = 1089 g) to ascertain the use of several techniques. We also conducted a questionnaire survey of all neonatal units adhering to the Italian Neonatal Network, inquiring about preferred methods of respiratory support. Results: Conventional ventilation was used in 53% of these infants, high frequency…
Functional MR imaging of pulmonary ventilation using hyperpolarized noble gases.
2000
The current status of experimental and clinical applications for functional MR imaging of pulmonary ventilation using hyperpolarized noble gases are reviewed. 3-helium (3He) and 129-xenon (129Xe) can be hyperpolarized by optical pumping techniques such as spin exchange or metastability exchange in sufficient amounts. This process leads to an artificial, non-equilibrium increase of the density of excited nuclei which represents the source of the MR signal. Those hyperpolarized gases are administered mostly via inhalation, and will fill airways and airspaces allowing for ventilation imaging. Recent human studies concentrate on imaging the airways and airspaces with high spatial resolution. N…
Bi-Level ventilation decreases pulmonary shunt and modulates neuroinflammation in a cardiopulmonary resuscitation model
2020
Background Optimal ventilation strategies during cardiopulmonary resuscitation are still heavily debated and poorly understood. So far, no convincing evidence could be presented in favour of outcome relevance and necessity of specific ventilation patterns. In recent years, alternative models to the guideline-based intermittent positive pressure ventilation (IPPV) have been proposed. In this randomized controlled trial, we evaluated a bi-level ventilation approach in a porcine model to assess possible physiological advantages for the pulmonary system as well as resulting changes in neuroinflammation compared to standard measures. Methods Sixteen male German landrace pigs were anesthetized a…
Resuscitation with room air instead of 100% oxygen prevents oxidative stress in moderately asphyxiated term neonates.
2001
Background. Traditionally, asphyxiated newborn infants have been ventilated using 100% oxygen. However, a recent multinational trial has shown that the use of room air was just as efficient as pure oxygen in securing the survival of severely asphyxiated newborn infants. Oxidative stress markers in moderately asphyxiated term newborn infants resuscitated with either 100% oxygen or room air have been studied for the first time in this work. Methods. Eligible term neonates with perinatal asphyxia were randomly resuscitated with either room air or 100% oxygen. The clinical parameters recorded were those of the Apgar score at 1, 5, and 10 minutes, the time of onset of the first cry, and the tim…