Articles: mechanical-ventilation.
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Pediatric pulmonology · Aug 2015
Positional effects on lung mechanics of ventilated preterm infants with acute and chronic lung disease.
The role of prone position in preterm infants has not been completely clarified. We investigated prone versus supine posture-related changes in respiratory system resistance (Rrs) and reactance (Xrs) measured by the Forced Oscillation Technique (FOT) in mechanically ventilated preterm newborns. ⋯ On short-term basis, prone positioning does not offer significant advantages in lung mechanics in mechanically ventilated infants with RDS, while it is associated with lower Rrs values in patients with evolving BPD.
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Patients with systemic sclerosis (SSc) are prone to disease-specific or treatment-related life-threatening complications that may warrant intensive care unit (ICU) admission. We assessed the characteristics and current outcome of patients with SSc admitted to the ICU. ⋯ This study provides reliable prognostic data in patients with SSc who required ICU admission. The devastating outcome of invasive mechanical ventilation in patients with SSc requires a reappraisal of indications for ICU admission and early identification of patients likely to benefit from noninvasive ventilation.
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To assess the use and clinical impact of tracheostomy in burn patients. ⋯ Tracheostomy may be a safe procedure in burn patients and is not associated with higher rates of mortality or respiratory infection. Tracheostomy patients showed longer mechanical ventilation times and higher morbidity, probably not attributable to tracheostomy.
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Pediatric pulmonology · Aug 2015
Case ReportsSurvival of a child with spinal muscular atrophy and acute respiratory distress syndrome.
Spinal muscular atrophy (SMA), a lower motor neuron anterior horn cell disease, causes significant respiratory morbidity and mortality in children. Acute respiratory distress syndrome (ARDS) accounts for 1-4% of all Pediatric Intensive Care Unit (PICU) admissions. ⋯ He improved with meticulous management of mechanical ventilation, airway clearance, fluid/nutrition, and sedation/analgesia. He was successfully extubated after 14 days of invasive mechanical ventilation and discharged home after a 20 day hospitalization.
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Am. J. Respir. Crit. Care Med. · Aug 2015
Controlled Clinical TrialMechanical Stress Induces Lung Fibrosis via Midkine Signaling Pathway.
Lung-protective ventilatory strategies have been widely used in patients with acute respiratory distress syndrome (ARDS), but the ARDS mortality rate remains unacceptably high and there is no proven pharmacologic therapy. ⋯ Mechanical stretch can induce an epithelial-mesenchymal transition phenotype mediated by the MK-Notch2-angiotensin-converting enzyme signaling pathway, contributing to lung remodeling. The MK pathway is a potential therapeutic target in the context of ARDS-associated lung fibrosis.