Search results for "ventilation"

Managing Persistent Hypoxemia: what is new?

2017

Mechanical ventilation is the standard life-support technique for patients with severe acute respiratory failure. However, some patients develop persistent and refractory hypoxemia because their lungs are so severely damaged that they are unable to respond to the application of high inspired oxygen concentration and high levels of positive end-expiratory pressure. In this article, we review current knowledge on managing persistent hypoxemia in patients with injured lungs.

Inhaled amikacin versus placebo to prevent ventilator-associated pneumonia: the AMIKINHAL double-blind multicentre randomised controlled trial protoc…

2021

IntroductionPre-emptive inhaled antibiotics may be effective to reduce the occurrence of ventilator-associated pneumonia among critically ill patients. Meta-analysis of small sample size trials showed a favourable signal. Inhaled antibiotics are associated with a reduced emergence of antibiotic resistant bacteria. The aim of this trial is to evaluate the benefit of a 3-day course of inhaled antibiotics among patients undergoing invasive mechanical ventilation for more than 3 days on the occurrence of ventilator-associated pneumonia.Methods and analysisAcademic, investigator-initiated, parallel two group arms, double-blind, multicentre superiority randomised controlled trial. Patients invasi…

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…

Rapid systematic review shows that using a high-flow nasal cannula is inferior to nasal continuous positive airway pressure as first-line support in …

2017

Aim We reviewed using a high-flow nasal cannula (HFNC) as first-line support for preterm neonates with, or at risk of, respiratory distress. Methods This rapid systematic review covered biomedical databases up to June 2017. We included randomised controlled trials (RCTs) published in English. The reference lists of the studies and relevant reviews we included were also screened. We performed the study selection, data extraction, study quality assessment, meta-analysis and quality of evidence assessment following the Grading of Recommendations Assessment, Development and Evaluation system. Results Pooled results from six RCTs covering 1227 neonates showed moderate-quality evidence that HFNC …

Supraglottic airway devices for surfactant treatment: systematic review and meta-analysis

2019

Objective: To compare surfactant administration via supraglottic airway device (SAD) vs. nasal CPAP alone or INSURE. Study design: A systematic search of PubMed, EMBASE, SCOPUS, Cochrane Central Register of Controlled Trials and Clinicaltrials.gov was performed. Articles meeting inclusion criteria (RCT, surfactant administration via SAD, laryngeal mask, I-gel) were assessed Results: Five RCTs were eligible. Surfactant administration via SAD reduced the need for intubation/mechanical ventilation (RR 0.57, 95%CI 0.38–0.85) and short-term oxygen requirements (MD −8.00, 95%CI −11.09 to −4.91) compared to nCPAP alone. Surfactant administration via SAD reduced the need for intubation/mechanical v…

Is COVID‐19 infection more severe in kidney transplant recipients?

2021

International audience; There are no studies which have compared the risk of severe Covid-19 and related mortality between transplant recipients and non-transplant patients. We enrolled two groups of patients hospitalized for Covid-19, i.e., kidney transplant recipients from the French Registry of Solid Organ Transplant (n=306) and a single-center cohort of non-transplant patients (n=795). An analysis was performed among subgroups matched for age and risk factors for severe Covid-19 or mortality. Severe Covid-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death.Transplant recipients were younger and had more comorbidities compared to…

Intentional interruptions during compression only CPR: a way to increase adherence to CPR and compressions' quality?

2021

The influence of the decompressive operation on the intracranial pressure and the pressure-volume relation in patients with severe head injuries.

1978

Measurements of intracranial pressure by ventricular catheter were performed in 47 patients with severe head injuries. Thirty-three patients with decompressive operations such as osteoclastic craniotomy and dilatation by means of duraplastic have been compared with 14 patients with closed heads with regard to volume pressure response (intracranial elasticity). This was determined either by intraventricular injection of 2 ml saline or by drainage of cerebrospinal fluid. The examination clearly shows that patients with closed heads have a much higher intracranial elasticity than patients who have decompressive operations, so that in the first group minor differences of the intracranial volume…

Elemental and microbiota content in indoor and outdoor air using recuperation unit filters

2021

Detection and quantification of engineered nanomaterials in environmental systems require precise knowledge of the elemental composition, association, and ratios in homologous natural nanomaterials (NNMs). Here, we characterized soil NNMs at the single particle level using single particle-inductively coupled plasma-time of flight-mass spectrometer (SP-ICP-TOF-MS) in order to identify the elemental purity, composition, associations, and ratios within NNMs. Elements naturally present as a major constituent in NNMs such as Ti, and Fe occurred predominantly as pure/single metals, whereas elements naturally present at trace levels in NNMs occurred predominantly as impure/multi-metal NNMs such as…

Soluzioni per la ventilazione naturale e precetti igienici nell’edilizia ospedaliera tra Ottocento e Novecento

2016

La ventilazione, il riscaldamento e raffrescamento, il soleggiamento divennero, tra Ottocento e Novecento, strumenti imprescindibili per garantire la salubrità dell’aria e degli ambienti, sia nel caso di risanamento di edifici esistenti, sia nella realizzazione di nuove costruzioni. La tipologia degli ospedali era, al pari delle scuole, teatri, mercati quella in cui i sistemi di ventilazione finalizzati all’igiene dell’aria erano studiati con più accuratezza. Si ricorreva ad ingegnosi espedienti che consentivano di mantenere nello stabilimento sanitario quelle condizioni che garantissero il comfort ambientale, evitando l’entrata di aria dai padiglioni delle malattie infettive; particolare i…