Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “VENTILATION”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 757 records · Page 42Linked to original sources
PubMed1977

Prevention of tracheal injuries in prolonged ventilation. Laboratory and clinical observations on the use of self-inflating cuffs on ventilating tubes.

We have previously described the design for a new self-inflating cuff for use on endotracheal and tracheostomy tubes. The pressure characteristics of this new cuff have been reported. The present report presents our experience with this self-inflating cuff in over 200 laboratory observations demonstrating its effectiveness in preventing tracheal damage. Tracheostomy tubes mounted with self-inflating cuffs were kept in the dogs for six weeks without causing tracheal ulceration. Our clinical experience in 52 patients is also described. Endotracheal, nasotracheal, and tracheostomy tubes were used intraoperatively and for long periods of ventilation. No tracheal damage could be shown at postmortem examination in two patients dying of their disease, 10 and 25 days after continuous ventilation.

Animals↗
PubMed1989

Negative pressure ventilation. Effects on ventilation during sleep in normal subjects.

Negative pressure ventilation (NPV) is used for ventilatory support of patients with respiratory failure due to neuromuscular disorders and thoracic deformities, and to provide ventilatory muscle rest for patients with severe chronic airflow limitation. To determine whether NPV would result in episodes of upper airway obstruction during sleep, we studied five normal subjects on two consecutive nights with the first night serving as a control and NPV being administered on the second night. Ventilators were adjusted so as to reduce the peak phasic diaphragm electromyogram signal by at least 50 percent. All subjects demonstrated an increase in the total number of apneas + hypopneas per hour on NPV control nights. Although differences were not significant, there was a tendency to develop decreased sleep efficiency, sleep fragmentation and altered sleep architecture with NPV. We conclude that nocturnal NPV can induce sleep apneas and impair sleep quality in normal subjects.

Adult↗
PubMed1999

New strategies for mechanical ventilation. Lung protective ventilation.

Although research is ongoing, and there are no definitive data to mandate the final answer to the question of which ventilation strategies result in the most optimal outcomes, the consensus of clinicians today suggests that we limit FIO2 to nontoxic levels, limit ventilating pressures and volumes, and use PEEP levels adequate to recruit alveoli and prevent tidal collapse. The critical care nurse must remain vigilant in his or her review of current literature to maintain knowledge of the current recommendations for optimal MV strategies.

Critical Care↗
PubMed1999

Detection of secretory immunoglobulin A (SIgA) in saliva of ventilated and non-ventilated preterm neonates.

The very young preterm neonate has multiple immune deficiencies which may increase his or her vulnerability to infection. Secretory Immunoglobulin A (SIgA) plays an important role in the protection of epithelial surfaces exposed to the external environment; nevertheless controversy exists with regards to the ontogeny of SIgA in newborns and especially the preterm neonate. The objective was to investigate if SIgA could be detected in the saliva of very/extremely low birthweight neonates (V/ELBW). A total of 707 samples which were collected twice daily (morning and afternoon) for three consecutive days were obtained from sixty-eight preterm neonates (mean gestational age 28 weeks; conceptional age ranged from 25-35 weeks). A repeated measures design was used. Total concentration of SIgA was determined from unstimulated saliva by an Enzyme Linked Immunosorbant Assay technique. Results indicated that SIgA was detectable in the early postnatal period in the saliva of both ventilated preterms who were receiving intravenous total parenteral nutrition (TPN) and non-ventilated preterms. A 3-way repeated measures Analysis of Variance (ANOVA) showed no significant effect from 'before' and 'after' samples during a period of spontaneous activity, time and day of sampling. A significant effect of mode of nutrition was found; neonates who were receiving expressed breast milk had significantly higher concentrations of SIgA than those infants receiving TPN (df=3, F=14.27, p<0.0001). These results have implications for the care of the preterm neonate in intensive care.

Journal Article↗
PubMed2003

Sequential non-invasive mechanical ventilation following short-term invasive mechanical ventilation in COPD induced hypercapnic respiratory failure.

OBJECTIVE: To estimate the feasibility and the efficacy of early extubation and sequential non-invasive mechanical ventilation (MV) in chronic obstructive pulmonary disease (COPD) with exacerbated hypercapnic respiratory failure. METHODS: Twenty-two intubated COPD patients with severe hypercapnic respiratory failure due to pulmonary infection (pneumonia or purulent bronchitis) were involved in the study. At the time of pulmonary infection control window (PIC window) appeared, when pulmonary infection had been significantly controlled (resolution of fever and decrease in purulent sputum, radiographic infiltrations, and leukocytosis) after the antibiotic and the comprehensive therapy, the early extubation was conducted and followed by non-invasive MV via facial mask immediately in 11 cases (study group). Other 11 COPD cases with similar clinical characteristics who continuously received invasive MV after PIC window were recruited as control group. RESULTS: All patients had similar clinical characteristics and gas exchange before treatment, as well as the initiating time and all indices at the time of the PIC window. For study group and control group, the duration of invasive MV was (7.1 +/- 2.9) vs (23.0 +/- 14.0) days, respectively, P < 0.01. The total duration of ventilatory support was (13 +/- 7) vs (23 +/- 14) days, respectively, P < 0.05. The incidence of ventilator associated pneumonia (VAP) were 0/11 vs 6/11, respectively, P < 0.01. The duration of intensive care unit (ICU) stay was (13 +/- 7) vs (26 +/- 14) days, respectively, P < 0.05. CONCLUSIONS: In COPD patients requiring intubation and MV for pulmonary infection and hypercapnic respiratory failure, early extubation followed by non-invasive MV initiated at the point of PIC window significantly decreases the invasive and total durations of ventilatory support, the risk of VAP, and the duration of ICU stay.

Adult↗
PubMed1992

Kinin metabolism in the perfused ventilated rat lung. II: Influence of ventilation, perfusion, and perfusate composition variation on bradykinin metabolism in uninjured lung.

Bradykinin metabolism by peptidases of the pulmonary endothelium has been investigated in the previously uninjured, ventilated, and asanguinously perfused rat lung. The influence of short-duration (up to 20 min) abnormal ventilation and perfusion conditions on bradykinin metabolism was assessed. Neither variation of the oxygen concentration (0 to 45%) nor omission of carbon dioxide in the ventilatory gas altered bradykinin metabolism significantly. Tidal volume variation did not alter bradykinin metabolism, and exclusion of one lung from the perfusion circuit reduced the capacity to degrade bradykinin proportionately. Acidification of the perfusion medium to pH 5 did not alter bradykinin metabolism. Acetylsalicylic acid in the perfusate protected the lung from an otherwise irreversible pressure increase associated with high-dose bradykinin perfusion. Endotoxin and hydrogen peroxide in the perfusate did not alter bradykinin metabolism. However, ammonia in the ventilatory gas caused immediate pulmonary edema, diminished lung capacity to metabolize bradykinin and altered the pattern of bradykinin metabolic products. The pulmonary endothelium itself, in the absence of blood, maintains its capacity to metabolize bradykinin under an extraordinary range of conditions.

Amino Acid Sequence↗
PubMed2005

[Clinical comparative study of airway pressure release ventilation and continuous positive airway pressure ventilation].

OBJECTIVE: To evaluate the effects of airway pressure release ventilation (APRV) and continuous positive airway pressure (CPAP) on hemodynamics, lung mechanics and oxygen metabolism index. METHODS: Fifteen ARDS cases ventilated and monitored by the pulse contour method (PiCCO) were randomized into APRV group and CPAP group, then lung recruitment maneuver (RM) was executed every 4 hours. In APRV group, Phigh was 35 cm H(2)O (1 cm H(2)O=0.098 kPa) and Plow was set at lower inflection point (LIP) of the static pressure-volume (P-V) curve. In CPAP group, CPAP was also 35 cm H(2)O. The duration of RM in both groups was 40 seconds. Before and after RM the parameters of lung mechanics, oxygen metabolism index and hemodynamics were monitored and compared. RESULTS: (1) In APRV group cardiac index (CI) was decreased slightly during RM with shorter duration than CPAP group. (2) The parameters of lung mechanics and oxygenation were improved significantly in both groups, and they were better in APRV group than CPAP group. CONCLUSION: In APRV group sedation can be abstained during RM, and the hemodynamics were hardly disturbed. Improvement of lung mechanics and oxygenation is much better with APRV than CPAP mode.

Aged↗
PubMed1986

[Normofrequent jet ventilation (N20/02 mixture). I. Anesthesiologic principles and experiences using the jet ventilation method].

Report on normo-frequent jet ventilation using N2O/O2 mixture for endolaryngeal and tracheal diagnostic and surgical procedures. Presentation of a system of flexible and rigid sounds. Choice of sounds and driving pressures permits adaptation to different physiological and pathological conditions. Possible methodical complications and their prophylaxis are pointed out. Cardiac arrhythmias occur caused by manipulations only and independent of jet ventilation. Therefore authors recommend continuous ECG monitoring during endolaryngeal manipulations under general anaesthesia too.

Anesthesia, Inhalation↗
PubMed1984

[Ventilation using jet-ventilation during fiber-optic bronchoscopy in children under 5 years old. Apropos of 100 case reports].

The authors report an original procedure for respiratory assistance during flexible bronchoscopy in infants and toddlers. The injector is directly connected with the operating channel of the bronchoscope. Ventilation parameters are pre-regulated before introducing the fiberscope into the respiratory tree. Insufflation volumes are restricted to 5 ml/kg at the tip of the bronchoscope, on a basis of 40 to 60 cycles per minute, according to children's age. A venturi effect may occur as discrepancy between bronchi and the size of the fiberscope does exist. For evaluating this effect, gas flow is measured through tracheal tubes selected in accordance to the size of the respiratory tree of the infant. This evaluation demonstrates that tidal volumes are comprised within 5 and 10 ml/kg. The procedure of jet-ventilation was performed on 100 infants under general anaesthesia with curarization. Baro-traumatic accidents did not occur, despite poor physical conditions in many cases. The procedure was safe for the infants and convenient for the physicians. In this way, it could be recommended for flexible bronchoscopy in infants and toddlers with poor condition or when excessive duration of the examination could be required (diagnostic or therapeutic procedures associated).

Anesthesia, General↗
PubMed1976

The Penlon Oxford ventilator. A new ventilator for adult or paediatric use.

A pneumatically powered lung ventilator for anaesthesia and intensive care of both adult and paediatric patients is described. The design criteria were selected to produce a small machine with high power, simple to control, sterilise and service. Laboratory and clinical results are presented andprocedure for clinical use of the controls suggested.

Adult↗
PubMed1990

Gas trapping during high frequency positive pressure ventilation using conventional ventilators.

Inspiratory and expiratory volumes were measured in 51 preterm infants with respiratory distress syndrome (RDS), when comparing two ventilator rates, 60 and 120 breaths/min. Gas trapping was not demonstrated at rates of 60, but in 11 infants at 120 breaths/min and this was more common in the paralysed infants and those more mature than 31 weeks gestational age (P less than 0.05). The median change in functional residual capacity resulting from gas trapping was 3.8 ml/kg. We conclude rates of 120 breaths/min can be used in the majority of non-paralysed infants without gas trapping but should be avoided in paralysed infants more mature than 31 weeks.

High-Frequency Ventilation↗
PubMed2006

High-frequency jet ventilation in interventional bronchoscopy: factors with predictive value on high-frequency jet ventilation complications.

STUDY OBJECTIVE: To evaluate the incidence and impact on clinical outcome of complications observed during high-frequency jet ventilation (HFJV) at interventional bronchoscopy and to identify the perioperative factors that may be associated to an increased incidence of such complications. DESIGN: Observational retrospective, study with an observational prospective validation of the statistically significant associations. SETTING: University hospital. PATIENTS: The retrospective study involved 276 patients who underwent an interventional rigid bronchoscopy during general anesthesia and HFJV. Forty consecutive patients were accrued for the prospective validation group. INTERVENTIONS/MEASUREMENTS: Information recorded included patient medical history and perioperative complications observed at HFJV-managed bronchoscopic procedures and their impact on clinical outcome until hospital discharge. MAIN RESULTS: At least one complication was detected in 38% of retrospective patients and 55% of prospective patients. Most frequent complications were hypercapnia, hypoxemia, and hemodynamic instability, but just one case of barotrauma in the retrospective group. Despite the high incidence, these complications were transient and did not increase hospital stay, whereas technical failure to widen airway lumen was associated with an adverse prognosis. Several clinical parameters showed a significant association with complications in the univariate analysis. However, the multivariate analysis only evidenced two independent predictive factors: the ASA physical status scale and baseline oxygen saturation. CONCLUSIONS: Classification in ASA physical status IV group and a baseline oxygen saturation of 95% or less independently predicted the development of complications during interventional rigid bronchoscopy with HFJV.

Anesthesia, General↗
PubMed2006

Noninvasive positive pressure ventilation prevents postoperative pulmonary complications in chronic ventilators users.

OBJECTIVE: To evaluate the postoperative pulmonary complications and the long-term impact on pulmonary function of different surgical procedures with general anaesthesia in chronic respiratory failure (CRF) patients who were using noninvasive positive pressure ventilation (NPPV). DESIGN: We retrospectively studied 20 stable patients on NPPV for CRF secondary to: kyphoscoliosis (eight), morbid obesity (six), thoracoplasty (four), neuromuscular diseases (two), who underwent surgical procedures with general anaesthesia, between January 1998 and December 2003. MATERIAL AND METHODS: The variables studied were: type of surgery, hours of orotracheal intubation, hours of stay in the postsurgical reanimation unit (PRU), postoperative pulmonary complications and days of hospital stay. These results were compared with those obtained in patients without respiratory pathology and who were submitted to the same type of surgical interventions during the study period. All patients were tested for: arterial blood gases, forced vital capacity (FVC) and forced expiratory volume in 1s (FVE1). These tests were carried out both prior to surgical intervention and 12 months after this intervention, and the use of medical assistance resources the year prior to and the year after the surgical intervention were also analysed. RESULTS: Sixteen patients were using NPPV at home at the time of the intervention and four patients were adapted to NPPV before surgery. The surgical procedures were: gastroplasty: six; mastectomy: five; septoplasty: three; hip prosthesis: two; cholecystectomy: one; Gasserian ganglion thermocoagulation: one; hysterectomy: one; and endoscopic retrograde cholangiopancreatography (ERCP): one. The mean postoperative intubation time was 3.8+/-3.2h, and only one patient remained intubated for more than 12h. The mean stay in the PRU was 19+/-9h (vs 19+/-6h in the general population, p>0.05). The days of hospital stay for the different pathologies were in the majority of cases greater than in the general population. We did not find significant differences on comparing the arterial blood gases, in pulmonary function or in use of assistance resources between the year previous to and the year following the surgical intervention. CONCLUSIONS: In high-risk patients with chronic respiratory failure as a consequence of a restrictive lung pathology, NPPV can play an important role to confront surgical procedure with general anaesthesia with greater security. To obtain these results, it was fundamental to coordinate between the Pulmonary Services and the Anaesthesia Services as well as to follow up jointly in the PRU.

Anesthesia, General↗
PubMed1999

Proportional assist ventilation in low birth weight infants with acute respiratory disease: A comparison to assist/control and conventional mechanical ventilation.

OBJECTIVES: To compare the physiologic efficacy and safety aspects of proportional assist (PA), assist/control (A/C), and intermittent mandatory ventilation (IMV) in very low birth weight infants with acute respiratory illness and to test the hypothesis that ventilatory pressure requirements are lower and arterial oxygenation is improved during PA when compared with IMV or A/C at an equivalent inspired oxygen fraction. STUDY DESIGN: Randomized, 3-period, crossover design. METHODS: Thirty-six infants were stratified by birth weight (600 to 750, 751 to 900, and 901 to 1200 g) and exposed to consecutive 45-minute epochs of the 3 modalities in a sequence chosen at random. Tidal volumes of 4 to 6 mL/kg were targeted during A/C and IMV. The IMV rate was matched to the rate during an A/C test period. PA was adjusted to unload the resistance of the endotracheal tube and the disease-related increase in lung elastic recoil. RESULTS: Compared with A/C and IMV, PA maintained similar arterial oxygenation with lower airway and transpulmonary pressures (15% to 44% reduction depending on the index variable). The oxygenation index decreased by 28% during PA. No adverse events were observed. The number and severity of apneic episodes and periods of arterial oxygen desaturations were similar with the 3 modes. Similar results were obtained within each birth weight subgroup. CONCLUSIONS: PA safely maintains gas exchange with smaller transpulmonary pressure changes compared with A/C and IMV. It may therefore offer a way of reducing the incidence of chronic lung disease in low birth weight infants.

Acute Disease↗
PubMed1997

[Liquid ventilation: a new mode of ventilation in neonatology?].

Liquid ventilation is based on perfluorocarbons capacity to transport O2 and CO2. Almost 30 years of experimental studies have shown its feasibility and high performances. Results of the first clinical applications in severe neonatal respiratory failure are encouraging. Results of larger randomized and controlled studies, actually in preparation, are awaited with interest.

Animals↗
PubMed1972

The control by ventilation of airborne bacterial transfer between hospital patients, and its assessment by means of a particle tracer. II. Ventilation in subdivided isolation units.

Values are deduced for the efficiency of isolation against airborne particulates, e.g. micro-organisms, of a variety of ventilation systems. The calculated values show reasonable correspondence with the limited experimental data available. Much better control and indication of the air flow is necessary if high degrees of isolation are required.

Air Microbiology↗
PubMed1979

A portable electronic 'calling device' as an aid to 'weaning' ventilator-dependent tetraplegic patients from intermittent positive pressure ventilation.

An electronic calling device has been developed. It is easily portable and can be operated by the severely paralysed tetraplegic patient in order to attract attention. The patient can operate the sensor either during artificial ventilation or when breathing spontaneously via the tracheostomy tube at a stage prior to the insertion of a speaking tube.

Adolescent↗
PubMed2003

Comparison of impedance minute ventilation and direct measured minute ventilation in a rate adaptive pacemaker.

Respiration rate (RR) and minute ventilation (MV) provide important clinical information on the state of the patient. This study evaluated the accuracy of determining these using a pacemaker impedance sensor. In 20 patients who were previously implanted with a Guidant PULSAR MAX group of pacemakers, the telemetered impedance sensor waveform was recorded simultaneously with direct volume respiration waveforms as measured by a pneumatometer. Patients underwent 30 minutes of breathing tests while supine and standing, and a 10-minute ergonometer bicycle exercise test at a workload of 50 W. Breathing tests included regular and rapid-shallow breathing sequences. RR was determined by a computerized algorithm, from impedance and respiration signals. The mean RR by impedance was 21.3 +/- 7.7 breaths/min, by direct volume was 21.1 +/- 7.6 breaths/min, range 7-66, the mean difference of RR measured by the impedance sensor, as compared with the true measurement, being 0.2 +/- 2.1 breaths/min. During the entire exercise, the mean correlation coefficient between impedance (iMV) and direct measured MV was 0.96 +/- 0.03, slope 0.13 +/- 0.05 L/Omega and range 0.07-0.26 L/Omega. Bland-Altman limits of agreement were +/- 4.6 L/min for MV versus iMV with each patient calibrated separately. The correlation coefficient for iMV versus MV over the entire 10 minutes of exercise, including the initial 4 minutes of exercise, was 0.99. The transthoracic impedance sensor of an implanted pacemaker can accurately detect respiration parameters. There was a large variation between subjects in the iMV versus MV slope during a bicycle exercise test, whereas for each subject, the slope was stable during submaximal bicycle exercise.

Adult↗