Search results for "end-expiratory pressure"

showing 10 items of 22 documents

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
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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…

ResuscitationAnatomy and PhysiologyEmergency and Critical CareRespiratory rateResuscitationmedicine.medical_treatmentCardiologylcsh:Medicine030204 cardiovascular system & hematologyGeneral Biochemistry Genetics and Molecular Biology03 medical and health sciences0302 clinical medicineNeuroinflammationmedicineCardiopulmonary resuscitationRespiratory MedicinePositive end-expiratory pressureTidal volumePigMultiple inert gas elimination techniquebusiness.industryGeneral Neurosciencelcsh:R030208 emergency & critical care medicineGeneral MedicineGas ExchangeVentilationOxygenationAnesthesiaBreathingPulmonary shuntmedicine.symptomMIGETGeneral Agricultural and Biological SciencesbusinessTranslational MedicineBi-levelPeerJ
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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
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Individualized versus fixed positive end-expiratory pressure for intraoperative mechanical ventilation in obese patients: a secondary analysis

2021

Background General anesthesia may cause atelectasis and deterioration in oxygenation in obese patients. The authors hypothesized that individualized positive end-expiratory pressure (PEEP) improves intraoperative oxygenation and ventilation distribution compared to fixed PEEP. Methods This secondary analysis included all obese patients recruited at University Hospital of Leipzig from the multicenter Protective Intraoperative Ventilation with Higher versus Lower Levels of Positive End-Expiratory Pressure in Obese Patients (PROBESE) trial (n = 42) and likewise all obese patients from a local single-center trial (n = 54). Inclusion criteria for both trials were elective laparoscopic abdominal…

Pulmonary Atelectasismedicine.medical_treatment[SDV]Life Sciences [q-bio]AtelectasisPositive-Pressure Respiration03 medical and health sciences0302 clinical medicine030202 anesthesiologyInterquartile rangemedicineTidal VolumeHumansObesity10. No inequalityPEEPPositive end-expiratory pressureTidal volumeComputingMilieux_MISCELLANEOUS2. Zero hungerMechanical ventilationbusiness.industryRespirationEnvironmental air flowOxygenationrespiratory systemmedicine.disease3. Good healthrespiratory tract diseasesAnesthesiology and Pain MedicineAnesthesiaArtificialBreathingbusinesstherapeutics030217 neurology & neurosurgeryHumans; Obesity; Positive-Pressure Respiration; Pulmonary Atelectasis; Respiration Artificial; Tidal Volumecirculatory and respiratory physiology
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Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protoc…

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 diffe…

one-lung ventilationIntraoperative ComplicationMedicine (miscellaneous)Thoracic Surgical Procedurerecruitment maneuverOrvostudományokrespiratory systemThoracic Surgical ProceduresKlinikai orvostudományokthoracic surgeryrespiratory tract diseasesPositive-Pressure RespirationMechanical ventilation; one-lung ventilation; positive end-expiratory pressure; postoperative pulmonary complication; recruitment maneuver; thoracic surgery; Humans; Intraoperative Complications; One-Lung Ventilation; Positive-Pressure Respiration; Research Design; Sample Size; Thoracic Surgical Procedures; Randomized Controlled Trials as TopicMechanical ventilationResearch DesignSample SizeHumansPharmacology (medical)postoperative pulmonary complicationIntraoperative ComplicationsMechanical ventilation; one-lung ventilation; positive end-expiratory pressure; postoperative pulmonary complication; recruitment maneuver; thoracic surgery; Medicine (miscellaneous); Pharmacology (medical)Humanpositive end-expiratory pressureRandomized Controlled Trials as Topic
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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…

Lung DiseasesMalemedicine.medical_specialtymedicine.medical_treatmentSettore MED/41 - AnestesiologiaAtelectasisAnesthesia GeneralLung injuryArticlePositive-Pressure Respirationabdominal surgery PEEPPostoperative ComplicationsDouble-Blind MethodRisk FactorsAbdomenTidal VolumemedicineHumansGeneral anaesthesiaPEEP; recruitment manoeuvres; abdominal surgeryPositive end-expiratory pressureTidal volumeAgedMechanical ventilationbusiness.industryGeneral Medicinerespiratory systemmedicine.diseaseCardiac surgerySurgeryAbdomen Aged Double-Blind Method Humans Lung Diseases Positive-Pressure Respiration Postoperative Complications Risk Factors Tidal Volume Treatment OutcomeTreatment OutcomeSurgical Procedures OperativeAnesthesiaFemalebusinessAbdominal surgeryThe Lancet
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Acute respiratory distress syndrome in traumatic brain injury: how do we manage it?

2017

Abstract: Traumatic brain injury (TBI) is an important cause of morbidity and mortality worldwide. TBI patients frequently suffer from lung complications and acute respiratory distress syndrome (ARDS), which is associated with poor clinical outcomes. Moreover, the association between TBI and ARDS in trauma patients is well recognized. Mechanical ventilation of patients with a concomitance of acute brain injury and lung injury can present significant challenges. Frequently, guidelines recommending management strategies for patients with traumatic brain injuries come into conflict with what is now considered best ventilator practice. In this review, we will explore the strategies of the best …

Pulmonary and Respiratory Medicinemedicine.medical_specialtyARDSTraumatic brain injurymedicine.medical_treatmentReview ArticleLung injury03 medical and health sciencesAcute respiratory distress syndrome (ARDS); Extra corporeal membrane oxygenation (ECMO); Positive end expiratory pressure (PEEP); Traumatic brain injury (TBI); Pulmonary and Respiratory Medicine0302 clinical medicineTraumatic brain injury (TBI); acute respiratory distress syndrome (ARDS); extra corporeal membrane oxygenation (ECMO); positive end expiratory pressure (PEEP)medicineExtracorporeal membrane oxygenationTraumatic brain injury (TBI)Intensive care medicinePositive end-expiratory pressureMechanical ventilationpositive end expiratory pressure (PEEP)Lungbusiness.industryextra corporeal membrane oxygenation (ECMO)acute respiratory distress syndrome (ARDS)030208 emergency & critical care medicinemedicine.diseaseProne positionmedicine.anatomical_structurebusiness030217 neurology & neurosurgeryJournal of thoracic disease
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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…

Lung DiseasesMalemedicine.medical_treatmentAtelectasisLung Disease01 natural sciencesBody Mass IndexHypoxemiaPositive-Pressure RespirationPostoperative Complications0302 clinical medicinePEEP postoperative complications obese patientsAnesthesiaRespiratory function030212 general & internal medicineTidal volumeGeneral MedicineMiddle AgedPleural Diseasesrespiratory systemAdult; Anesthesia General; Body Mass Index; Female; Humans; Lung Diseases; Male; Middle Aged; Obesity; Pleural Diseases; Positive-Pressure Respiration; Postoperative Complications; Pulmonary Atelectasis; Respiratory Insufficiency; Surgical Procedures Operative; Tidal Volume; Treatment Outcome; Intraoperative CareOperative3. Good healthTreatment OutcomePneumothoraxSurgical Procedures OperativeAnesthesiaFemalemedicine.symptomRespiratory Insufficiencypsychological phenomena and processesHumancirculatory and respiratory physiologyAdultPulmonary AtelectasisAnesthesia GeneralNO03 medical and health sciencesmental disordersTidal VolumemedicineHumansPleural DiseaseObesity0101 mathematicsGeneralPositive end-expiratory pressureMechanical ventilationSurgical ProceduresIntraoperative CarePulmonary Atelectasibusiness.industry010102 general mathematicsmedicine.diseaserespiratory tract diseasesRespiratory failurePostoperative Complicationbusiness
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Sigh in Patients With Acute Hypoxemic Respiratory Failure and ARDS

2021

Background Sigh is a cyclic brief recruitment maneuver: previous physiologic studies showed that its use could be an interesting addition to pressure support ventilation to improve lung elastance, decrease regional heterogeneity, and increase release of surfactant. Research Question Is the clinical application of sigh during pressure support ventilation (PSV) feasible? Study Design and Methods We conducted a multicenter noninferiority randomized clinical trial on adult intubated patients with acute hypoxemic respiratory failure or ARDS undergoing PSV. Patients were randomized to the no-sigh group and treated by PSV alone, or to the sigh group, treated by PSV plus sigh (increase in airway pr…

Pulmonary and Respiratory MedicineARDSbusiness.industryPressure support ventilationCritical Care and Intensive Care Medicinemedicine.diseaseSpontaneous breathing triallaw.invention03 medical and health sciences0302 clinical medicine030228 respiratory systemRandomized controlled triallawAnesthesiaBreathingMedicine030212 general & internal medicineCardiology and Cardiovascular MedicinebusinessRespiratory minute volumePositive end-expiratory pressureTidal volumeChest
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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…

medicine.medical_specialtyone-lung ventilationMedicine (miscellaneous)recruitment maneuverVentilaciólaw.invention03 medical and health sciencesStudy Protocol0302 clinical medicineMechanical ventilationRandomized controlled triallawmedicinePharmacology (medical)030212 general & internal medicinePositive end-expiratory pressureTòrax2. Zero hungerProtocol (science)lcsh:R5-920Cirurgiabusiness.industryrespiratory systemOne lung ventilationthoracic surgery3. Good healthrespiratory tract diseasesProtective ventilationCardiothoracic surgeryAnesthesiapostoperative pulmonary complicationlcsh:Medicine (General)business030217 neurology & neurosurgerypositive end-expiratory pressure
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