Respiratory Care Year in Review 2013: Airway Management, Noninvasive Monitoring, and Invasive Mechanical Ventilation

Durbin, Charles G.; Blanch, Lluís; Fan, Eddy; Hess, Dean

doi:10.4187/respcare.03199

Cited by 6 publications

(4 citation statements)

References 79 publications

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“…In ALI and ARDS, permissive hypercapnia 45,46 is preferred over strict normoventilation, and hypercapnic acidosis may also affect inflammation and oxygenation. 47,48 Avoidance of 1.0 Fio 2 , as performed in previous studies, 12 may also have influenced the results because of the time-dependent impact of oxygen on pulmonary damage and mortality.…”

Section: Discussionmentioning

confidence: 99%

Sevoflurane Abolishes Oxygenation Impairment in a Long-Term Rat Model of Acute Lung Injury

Kellner

Müller

Piegeler

et al. 2017

Anesthesia &Amp; Analgesia

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BACKGROUND Patients experiencing acute lung injury (ALI) often need mechanical ventilation for which sedation may be required. In such patients, usually the first choice an intravenously administered drug. However, growing evidence suggests that volatile anesthetics such as sevoflurane are a valuable alternative. In this study, we evaluate pulmonary and systemic effects of long-term (24-hour) sedation with sevoflurane compared with propofol in an in vivo animal model of ALI. METHODS Adult male Wistar rats were subjected to ALI by intratracheal lipopolysaccharide (LPS) application, mechanically ventilated and sedated for varying intervals up to 24 hours with either sevoflurane or propofol. Vital parameters were monitored, and arterial blood gases were analyzed. Inflammation was assessed by the analysis of bronchoalveolar lavage fluid (BALF), cytokines (monocyte chemoattractant protein-1 [MCP-1], cytokine-induced neutrophil chemoattractant protein-1 [CINC-1], interleukin , IL-12/12a, transforming growth factor-, and IL-10) in blood and lung tissue and inflammatory cells. The alveolocapillary barrier was indirectly assessed by wet-to-dry ratio, albumin, and total protein content in BALF. Results are presented as mean ± standard deviation. RESULTS After 9 hours of ventilation and sedation, oxygenation index was higher in the LPS/sevoflurane (LPS-S) than in the LPS/propofol group (LPS-P) and reached 400 ± 67 versus 262 ± 57 mm Hg after 24 hours (P < .001). Cell count in BALF in sevoflurane-treated animals was lower after 18 hours (P = .001) and 24 hours (P < .001) than in propofol controls. Peak values of CINC-1 and IL-6 in BALF were lower in LPS-S versus LPS-P animals (CINC-1: 2.7 ± 0.7 vs 4.0 ± 0.9 ng/mL; IL-6: 9.2 ± 2.3 vs 18.9 ± 7.1 pg/mL, both P < .001), whereas IL-10 and MCP-1 did not differ. Also messenger RNAs of CINC-1, IL-6, IL-12a, and IL-10 were significantly higher in LPS-P compared with LPS-S. MCP-1 and transforming growth factor-showed no differences. Wet-to-dry ratio was lower in LPS-S (5.4 ± 0.2 vs 5.7 ± 0.2, P = .016). Total protein in BALF did not differ between P-LPS and S-LPS groups. CONCLUSIONS Long-term sedation with sevoflurane compared with propofol improves oxygenation and attenuates the inflammatory response in LPS-induced ALI. Our findings suggest that sevoflurane may improve lung function when used for sedation in patients with ALI. Bacterial lipopolysaccharides (LPSs) are complex glycolipids found on the outer membrane of Gram-negative bacteria 10 and have been utilized to examine in vitro and in vivo inflammatory responses. [10][11][12] Other markers of ALI include endothelial barrier disruption, recruitment and transmigration of neutrophils, and development of a protein-and neutrophil-rich (noncardiogenic) pulmonary edema. [13][14][15][16] According to current guidelines, intravenous propofol, midazolam, and dexmedetomidine are recommended for sustained sedation in critically ill patients. 17,18 However, since the introduction of the Anaesthetic Conserving Device (AnaConDa; S...

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Section: Discussionmentioning

confidence: 99%

Sevoflurane Abolishes Oxygenation Impairment in a Long-Term Rat Model of Acute Lung Injury

Kellner

Müller

Piegeler

et al. 2017

Anesthesia &Amp; Analgesia

View full text Add to dashboard Cite

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“…Secretion clearance is usually used to keep the respiratory tract clear and to improve alveolar ventilation and patients' breathe function. Thus, secretion clearance is one of the most important nursing interventions of ventilated patients' respiratory tract 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Classification of Sputum Sounds Using Artificial Neural Network and Wavelet Transform

Shi¹,

Wang²,

Niu³

et al. 2018

Int. J. Biol. Sci.

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Sputum sounds are biological signals used to evaluate the condition of sputum deposition in a respiratory system. To improve the efficiency of intensive care unit (ICU) staff and achieve timely clearance of secretion in patients with mechanical ventilation, we propose a method consisting of feature extraction of sputum sound signals using the wavelet transform and classification of sputum existence using artificial neural network (ANN). Sputum sound signals were decomposed into the frequency subbands using the wavelet transform. A set of features was extracted from the subbands to represent the distribution of wavelet coefficients. An ANN system, trained using the Back Propagation (BP) algorithm, was implemented to recognize the existence of sputum sounds. The maximum precision rate of automatic recognition in texture of signals was as high as 84.53%. This study can be referred to as the optimization of performance and design in the automatic technology for sputum detection using sputum sound signals.

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“…New recommendations put forward aggressive chest compression. It was reported that stopping compression and slowing it down would lead to fast and continuous deterioration of coronary perfusion pressure (25). This situation was considered by researchers during training.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Repeated Basic Life Support Training on Teachers’ Knowledge and Skill Levels: A Quasi-experimental Study

Gümüş¹,

Keloğlan²,

Doğan³

et al. 2020

Eurasian J Emerg Med

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Aim:The purpose of this study is to research the effect of repeated theoretical and practical up to date basic life support (BLS) training that provides teachers the opportunity to improve knowledge and skill levels. Materials and Methods:This research was a pre-test, post-test, quasi-experimental study. The scope of the study included 65 teachers who participated in theoretical and practical up to date BLS training thirty days apart. A survey form including 19 questions was administered to determine pre-test and post-test theoretical knowledge about BLS. Skill level in BLS was assessed via BLS simulator model in terms of the followings; correct hand positioning, correct head positioning, sufficient depth and frequency of chest compressions.Results: A significant difference was found between pre-test level of knowledge before BLS training and post-test after the second training session (p<0.05). The levels of competence for correct hand positioning (38.2% vs 61.8%; p=0.001), correct head positioning (27.6% vs 72.4%; p=0.006) and adequate compression frequency (35.0% vs 65.0%; p=0.005) increased and excessive compression rate (40.0% vs 60.0%; p=0.005) rose when pre-test and post-test levels were compared. Conclusion:Promoting teachers' up to date BLS knowledge and skills with continuous training is beneficial. Repeated BLS training showed that the ability of the participants to develop adequate compression frequency with correct hand and head positioning was increased.

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Respiratory Care Year in Review 2013: Airway Management, Noninvasive Monitoring, and Invasive Mechanical Ventilation

Cited by 6 publications

References 79 publications

Sevoflurane Abolishes Oxygenation Impairment in a Long-Term Rat Model of Acute Lung Injury

Sevoflurane Abolishes Oxygenation Impairment in a Long-Term Rat Model of Acute Lung Injury

Classification of Sputum Sounds Using Artificial Neural Network and Wavelet Transform

The Effects of Repeated Basic Life Support Training on Teachers’ Knowledge and Skill Levels: A Quasi-experimental Study

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