Search results for "positive end-expiratory pressure"

showing 10 items of 21 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
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Mechanical ventilation parameters in critically ill COVID-19 patients: a scoping review

2021

Abstract Background The mortality of critically ill patients with COVID-19 is high, particularly among those receiving mechanical ventilation (MV). Despite the high number of patients treated worldwide, data on respiratory mechanics are currently scarce and the optimal setting of MV remains to be defined. This scoping review aims to provide an overview of available data about respiratory mechanics, gas exchange and MV settings in patients admitted to intensive care units (ICUs) for COVID-19-associated acute respiratory failure, and to identify knowledge gaps. Main text PubMed, EMBASE, and MEDLINE databases were searched from inception to October 30, 2020 for studies providing at least one v…

ARDSmedicine.medical_specialtyCritical Illnessmedicine.medical_treatmentReviewRespiratory physiologyCritical Care and Intensive Care MedicineHypoxemia03 medical and health sciencesMechanical ventilation0302 clinical medicineIntensive careFraction of inspired oxygenmedicineHumansIntensive care unitMechanical ventilation.Positive end-expiratory pressureMechanical ventilationRespiratory Distress SyndromeIntensive care unitsCoronavirus disease 2019Acute respiratory distress syndromebusiness.industrylcsh:Medical emergencies. Critical care. Intensive care. First aidCOVID-19030208 emergency & critical care medicinelcsh:RC86-88.9medicine.diseaseRespiration Artificial030228 respiratory systemEmergency medicineRespiratory Mechanicsmedicine.symptombusinessCohort studyCritical Care
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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
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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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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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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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Protective intraoperative ventilation with higher versus lower levels of positive end-expiratory pressure in obese patients (PROBESE): study protocol…

2017

Background Postoperative pulmonary complications (PPCs) increase the morbidity and mortality of surgery in obese patients. High levels of positive end-expiratory pressure (PEEP) with lung recruitment maneuvers may improve intraoperative respiratory function, but they can also compromise hemodynamics, and the effects on PPCs are uncertain. We hypothesized that intraoperative mechanical ventilation using high PEEP with periodic recruitment maneuvers, as compared with low PEEP without recruitment maneuvers, prevents PPCs in obese patients. Methods/design The PRotective Ventilation with Higher versus Lower PEEP during General Anesthesia for Surgery in OBESE Patients (PROBESE) study is a multice…

MaleLung DiseasesTime Factors[SDV]Life Sciences [q-bio]Respiratory Medicine and Allergymedicine.medical_treatmentRESPIRATORY-DISTRESS-SYNDROMEMedicine (miscellaneous)HemodynamicsMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuver; Medicine (miscellaneous); Pharmacology (medical)LAPAROSCOPIC BARIATRIC SURGERYLung DiseaseBody Mass Indexlaw.inventionPositive-Pressure RespirationStudy Protocol0302 clinical medicineMechanical ventilationClinical ProtocolsRandomized controlled trialRisk Factors030202 anesthesiologylawMedicine and Health SciencesClinical endpointAnesthesiaPharmacology (medical)Respiratory function030212 general & internal medicineLungLungmedicin och allergi2. Zero hungerlcsh:R5-920ddc:617Positive end-expiratory pressurerespiratory systemOperative3. Good healthTreatment OutcomeRecruitment maneuverTIDAL VOLUMESResearch DesignMechanical ventilation Positive end-expiratory pressure Recruitment maneuver Obesity Postoperative pulmonary complicationSurgical Procedures OperativeAnesthesiaBreathingFemaleErratumlcsh:Medicine (General)ALVEOLAR RECRUITMENT MANEUVERHumancirculatory and respiratory physiologymedicine.medical_specialtyTime FactorMechanical ventilation ; Obesity ; Positive end-expiratory pressure ; Postoperative pulmonary complication ; Recruitment maneuverAnesthesia GeneralLung injuryMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuver; Body Mass Index; Clinical Protocols; Female; Humans; Intraoperative Care; Lung; Lung Diseases; Male; Obesity; Positive-Pressure Respiration; Protective Factors; Research Design; Risk Factors; Time Factors; Treatment Outcome; Anesthesia General; Surgical Procedures Operative; Medicine (miscellaneous); Pharmacology (medical)NOGENERAL-ANESTHESIADRIVING PRESSURE03 medical and health sciencesmedicineHumansddc:610ObesityClinical ProtocolGeneralProtective FactorPositive end-expiratory pressurePOSTOPERATIVE PULMONARY COMPLICATIONSMechanical ventilationSurgical ProceduresIntraoperative CareINTERNATIONAL CONSENSUSbusiness.industryRisk FactorProtective FactorsSurgeryMechanical ventilation; Obesity; Positive end-expiratory pressure; Postoperative pulmonary complication; Recruitment maneuverrespiratory tract diseasesbusinessPostoperative pulmonary complicationLUNG INJURY
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Noninvasive Ventilatory Assistance During Exercise for Patients with Kyphoscoliosis

2007

The goal was to determine whether noninvasive ventilatory assistance (NIV) could facilitate exercise performance and benefit physiologic parameters for eight hypercapnic kyphoscoliosis patients using a cycloergometer for 6-min periods at a constant power (20 W). The exercise protocols were performed in random order while breathing unaided (spontaneous breathing test or SBT) and also while receiving NIV (NIV test or NIVT). The NIV was pressure support (15 cm H2O) plus positive end expiratory pressure (PEEP) (4 cm H2O) via a nasal mask. Of the compared parameters, heart rate was not significantly different, but acidosis (pH = 7.32 +/- 0.04 vs. 7.36 +/- 0.04), hypoxia (PaO2 = 61.5 +/- 15.9 vs.…

MalePilot ProjectsPhysical Therapy Sports Therapy and RehabilitationPressure support ventilationHypercapniaPositive-Pressure RespirationHeart ratemedicineHumansKyphosisExerciseKyphoscoliosisPositive end-expiratory pressureAcidosisbusiness.industryRehabilitationMasksMiddle AgedHypoxia (medical)medicine.diseaseScoliosisAnesthesiaExercise TestBreathingFemalemedicine.symptombusinessHypercapniaAmerican Journal of Physical Medicine & Rehabilitation
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Protective Mechanical Ventilation during General Anesthesia for Open Abdominal Surgery Improves Postoperative Pulmonary Function

2013

Abstract Background: The impact of intraoperative ventilation on postoperative pulmonary complications is not defined. The authors aimed at determining the effectiveness of protective mechanical ventilation during open abdominal surgery on a modified Clinical Pulmonary Infection Score as primary outcome and postoperative pulmonary function. Methods: Prospective randomized, open-label, clinical trial performed in 56 patients scheduled to undergo elective open abdominal surgery lasting more than 2 h. Patients were assigned by envelopes to mechanical ventilation with tidal volume of 9 ml/kg ideal body weight and zero-positive end-expiratory pressure (standard ventilation strategy) or tidal vol…

Malemedicine.medical_specialtymedicine.medical_treatmentAnesthesia GeneralLung DiseaseFollow-Up StudiePulmonary function testingPositive-Pressure RespirationProtective Mechanical VentilationAbdomenTidal VolumeMedicineRespiratory functionPostoperative PeriodTidal volumePositive end-expiratory pressureAgedRespiratory Function TestMechanical ventilationIntraoperative CareLungbusiness.industryOxygenationRespiration ArtificialSurgeryClinical trialProspective StudieTreatment OutcomeAnesthesiology and Pain Medicinemedicine.anatomical_structureAnesthesiaBreathingFemalePostoperative ComplicationbusinessHumanAbdominal surgery
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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…

Positive-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 TopicResearch DesignSample SizeHumansCorrectionThoracic Surgical ProceduresIntraoperative ComplicationsOne-Lung VentilationRandomized Controlled Trials as TopicTrials
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