Search results for "mechanical ventilation."
showing 10 items of 179 documents
Correction to: When kidneys and lungs suffer together
2019
A significant interaction between kidneys and lungs has been shown in physiological and pathological conditions. The two organs can both be targets of the same systemic disease (eg., some vasculitides). Moreover, loss of normal function of either of them can induce direct and indirect dysregulation of the other one. Subjects suffering from COPD may have systemic inflammation, hypoxemia, endothelial dysfunction, increased sympathetic activation and increased aortic stiffness. As well as the exposure to nicotine, all the foresaid factors can induce a microvascular damage, albuminuria, and a worsening of renal function. Renal failure in COPD can be unrecognized since elderly and frail patients…
An international perspective on hospitalized patients with viral community-acquired pneumonia
2019
Background Who should be tested for viruses in patients with community acquired pneumonia (CAP), prevalence and risk factors for viral CAP are still debated. We evaluated the frequency of viral testing, virus prevalence, risk factors and treatment coverage with oseltamivir in patients admitted for CAP. Methods Secondary analysis of GLIMP, an international, multicenter, point-prevalence study of hospitalized adults with CAP. Testing frequency, prevalence of viral CAP and treatment with oseltamivir were assessed among patients who underwent a viral swab. Univariate and multivariate analysis was used to evaluate risk factors. Results 553 (14.9%) patients with CAP underwent nasal swab. Viral CA…
Recurrent wheezing during the first 3 years of life in a birth cohort of moderate-to-late preterm infants.
2019
Background Data addressing short- and long-term respiratory morbidity in moderate-late preterm infants are limited. We aim to determine the incidence of recurrent wheezing and associated risk and protective factors in these infants during the first 3 years of life. Methods Prospective, multicenter birth cohort study of infants born at 32+0 to 35+0 weeks' gestation and followed for 3 years to assess the incidence of physician-diagnosed recurrent wheezing. Allergen sensitization and pulmonary function were also studied. We used multivariate mixed-effects models to identify risk factors associated with recurrent wheezing. Results A total of 977 preterm infants were enrolled. Rates of recurrent…
Mitochondrial dysfunction and host immune response during pneumococcal pneumonia : impact of mechanical ventilation?
2020
Lung damage induced by mechanical ventilation (MV) worsens the prognosis of pneumonia. Mitochondrial dysfunctions could account for such deleterious effects. Accordingly, data obtained from both in vitro and in vivo experimental studies, as well as in ventilated patients with acute respiratory distress syndrome, show that mitochondrial alarmins, especially mitochondrial DNA, are released in the alveolar compartment as a result of the cyclic stretch, and could thus represent one link between the mechanical insult and the sterile inflammation leading to VILI (ventilator-induced lung injury). In rabbits, we show herein that adverse and prolonged MV worsens the prognosis of pneumococcal pneumon…
Protective ventilation with high versus low positive end-expiratory pressure during one-lung ventilation for thoracic surgery (PROTHOR): study protoc…
2018
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.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 different intraoperative me…
Investigation of Inspiratory Pressure-Volume Curves on Mechanically Ventilated Patients Using Least Square Polynomial Fit
1988
Abstract An on-line method for the registration of pressure volume 1 oops TrT mechanically ventilated patients was developed using a personal computer with analog/digital interface. A third order polynomial function was fitted to the measured inspiratory pressure volume pairs. The significance of the fitting procedure was calculated using regression ANOVA. The inflection point of the pressure-volume curve was determinated by calculating the root of the second derivative of the polynomial. The method was teseted on 20 patients without major pulmonary dysfunction and on 6 patients with severe ARDS.
Influence of inspiration to expiration ratio on cyclic recruitment and derecruitment of atelectasis in a saline lavage model of acute respiratory dis…
2015
OBJECTIVE Cyclic recruitment and derecruitment of atelectasis can occur during mechanical ventilation, especially in injured lungs. Experimentally, cyclic recruitment and derecruitment can be quantified by respiration-dependent changes in PaO2 (ΔPaO2), reflecting the varying intrapulmonary shunt fraction within the respiratory cycle. This study investigated the effect of inspiration to expiration ratio upon ΔPaO2 and Horowitz index. DESIGN Prospective randomized study. SETTING Laboratory investigation. SUBJECTS Piglets, average weight 30 ± 2 kg. INTERVENTIONS At respiratory rate 6 breaths/min, end-inspiratory pressure (Pendinsp) 40 cm H2O, positive end-expiratory pressure 5 cm H2O, and FIO2…
New evidence in one-lung ventilation
2017
Mechanical ventilation in thoracic surgery has undergone significant changes in recent years due to the implementation of the protective ventilation. This review will analyze recent ventilatory strategies in one-lung ventilation. A MEDLINE research was performed using Mesh term "One-Lung Ventilation" including randomized clinical trials, metanalysis, reviews and systematic reviews published in the last 6 years. Search was performed on 21st March 2017. A total of 75 articles were initially found. After title and abstract review 14 articles were included. Protective ventilation is not simply synonymous of low tidal volume ventilation, but it also includes routine use of PEEP and alveolar recr…
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…
Outcome of acute hypoxaemic respiratory failure: insights from the LUNG SAFE Study
2020
BackgroundCurrent incidence and outcome of patients with acute hypoxaemic respiratory failure requiring mechanical ventilation in the intensive care unit (ICU) are unknown, especially for patients not meeting criteria for acute respiratory distress syndrome (ARDS).MethodsAn international, multicentre, prospective cohort study of patients presenting with hypoxaemia early in the course of mechanical ventilation, conducted during four consecutive weeks in the winter of 2014 in 459 ICUs from 50 countries (LUNG SAFE). Patients were enrolled with arterial oxygen tension/inspiratory oxygen fraction ratio ≤300 mmHg, new pulmonary infiltrates and need for mechanical ventilation with a positive end-e…