Articles: mechanical-ventilation.
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Significant psychological impacts, including post-traumatic stress disorder (PTSD), have been associated with patients under sedation in intensive care units (ICUs). However, it remains unknown if and how sedation is related to post-ICU psychological outcomes. This literature review explores the relationships between sedation, the depth of sedation and psychological disorders. ⋯ To ensure subject relevance pre-2006, non-English and paediatric-based research was excluded. Findings highlighted that reduced sedation levels did not significantly reduce the outcome of PTSD, yet reduced ICU length of stay and length of mechanical ventilation (MV) were both associated with lighter sedation. Further research is recommended into more specific factual and delusional memories post ICU in relation to the level of sedation and to psychological distress.
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Am. J. Physiol. Lung Cell Mol. Physiol. · Jul 2014
Autophagy in pulmonary macrophages mediates lung inflammatory injury via NLRP3 inflammasome activation during mechanical ventilation.
The inflammatory response is a primary mechanism in the pathogenesis of ventilator-induced lung injury. Autophagy is an essential, homeostatic process by which cells break down their own components. We explored the role of autophagy in the mechanisms of mechanical ventilation-induced lung inflammatory injury. ⋯ Pharmacological inhibition of autophagy also significantly attenuated the inflammatory responses caused by lung hyperinflation. The activation of autophagy in macrophages mediates early lung inflammation during mechanical ventilation via NLRP3 inflammasome signaling. Inhibition of autophagy activation in lung macrophages may therefore provide a novel and promising strategy for the prevention and treatment of ventilator-induced lung injury.
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Pediatric pulmonology · Jul 2014
Randomized Controlled Trial Comparative StudyA prospective, randomized, controlled study of NIPPV versus nCPAP in preterm and term infants with respiratory distress syndrome.
To evaluate whether nasal intermittent positive pressure ventilation (NIPPV) compared with nasal continuous positive airway pressure (nCPAP) decreases the requirement for endotracheal ventilation in preterm and term infants with respiratory distress syndrome (RDS). ⋯ Treatment with NIPPV compared with nCPAP decreased the need for endotracheal ventilation and increased favorable outcome in preterm and term infants with RDS.
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Am. J. Physiol. Lung Cell Mol. Physiol. · Jul 2014
Mechanical ventilation causes airway distension with proinflammatory sequelae in mice.
The pathogenesis of ventilator-induced lung injury has predominantly been attributed to overdistension or mechanical opening and collapse of alveoli, whereas mechanical strain on the airways is rarely taken into consideration. Here, we hypothesized that mechanical ventilation may cause significant airway distension, which may contribute to the pathological features of ventilator-induced lung injury. C57BL/6J mice were anesthetized and mechanically ventilated at tidal volumes of 6, 10, or 15 ml/kg body wt. ⋯ Mechanical ventilation causes a rapid, pronounced, and reversible distension of upper airways in mice that is associated with an increase in functional dead space. Upper airway distension is most pronounced at moderate tidal volumes, whereas higher tidal volumes redistribute preferentially to the alveolar compartment. Airway distension triggers proinflammatory responses and may thus contribute relevantly to ventilator-induced pathologies.
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Eur J Cardiothorac Surg · Jul 2014
Outcomes in patients requiring mechanical ventilation following pneumonectomy.
The aim of this study was to clarify the outcomes of patients who require post-pneumonectomy mechanical ventilation (PPMV). ⋯ Our findings suggest that continued PPMV patients may have a rate of weaning at hospital dismissal and OS comparable to reintubated PPMV patients. A lower fraction of inhaled oxygen and less positive fluid balance may be favoured managements in reintubated PPMV patients.