Journal of thoracic disease
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Electromagnetic navigation bronchoscopy (ENB) is emerging as a useful new technique for diagnosing small pulmonary peripheral lesions (SPPLs). However, the accuracy and efficiency of ENB have not been investigated in Asian populations where the differential diagnoses for SPPLs may be different. To analyze this question, this study included patients who received diagnostic ENB followed by surgery for the excision of SPPLs. ⋯ These data suggested that ENB was an accurate and efficient procedure to sample and diagnose SPPLs in the Asian population. It appeared that ENB had a high percentage of successful results in both navigating and aiding in the diagnosis of SPPLs in the Asian population.
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A compression-ventilation (C:V) ratio of 30:2 is recommended for adult cardiopulmonary resuscitation (CPR) by the current American Heart Association (AHA) guidelines. However, continuous chest compression (CCC) is an alternative strategy for CPR that minimizes interruption especially when an advanced airway exists. In this study, we investigated the effects of 30:2 mechanical CPR when compared with CCC in combination with regular ventilation in a porcine model. ⋯ There was no difference in hemodynamic efficacy and gas exchange during and after resuscitation, therefore identical 72 h survival with intact neurologic function was observed in both VC and CCC groups. However, the incidence of rib fracture increases during the mechanical CPR strategy of CCC combined with regular ventilations.
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Goal-directed therapy confers a strong prognosis in patients undergoing major cardiac or noncardiac surgery. The present study investigated whether intraoperative goal-directed fluid restriction (GDFR) using stroke volume variation (SVV) and cardiac index could improve oxygenation and postoperative outcome in patients undergoing one-lung ventilation (OLV). ⋯ The GDFR protocol based on SVV and cardiac index applied in patients undergoing OLV improves intraoperative pulmonary oxygenation. It can also reduce the postoperative complications and length of hospital stay. However, the GDFR strategy cannot reduce the local or systemic inflammation.
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Critically ill patients with severe acute respiratory failure due to malignant airway stenosis often require emergency intubation and mechanical ventilation. Urgent intervention is necessary for the survival of such patients. The aim of this study was to determine the efficacy and outcomes of airway stenting in patients with malignant airway stenosis requiring emergency intubation. ⋯ Airway stenting facilitates extubation in critically ill patients with malignant central airway stenosis. It plays an important role as a bridge to additional tumor-specific therapies, especially in chemoradiotherapy-naïve patients.
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Although intercostal nerve injury is one of the major causes for post-thoracotomy pain, the exact mechanisms are still unclear. We sought to evaluate the electro-physiological changes of intercostal nerve injury after thoracotomy in a sheep model. ⋯ Our experiment provides electro-physiological evidence for intercostal nerve injury after thoracotomy. The injury is primarily attributed to mechanical compression caused by the rib retractor.