Articles: mechanical-ventilation.
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Case Reports
Use of awake proning to avoid invasive ventilation in a patient with severe COVID-19 pneumonitis.
A 60-year-old man with swab-positive COVID-19 and extensive ground-glass change seen on CT imaging was successfully managed on our COVID-19 high-dependency unit with only low-flow oxygen and strict awake proning instructions. He was successfully weaned off oxygen entirely without any requirement for non-invasive or invasive ventilation and made a recovery to be discharged home after an 18-day hospital stay.
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Paediatric anaesthesia · Aug 2020
Multicenter Study Observational StudyVentilation in pediatric anesthesia: A French multicenter prospective observational study (PEDIAVENT).
Protective ventilation is now a standard of care in adults. However, management of ventilation is heterogeneous in children and little is known regarding the mechanical ventilation parameters actually used during pediatric anesthesia. ⋯ Ventilatory practices in children were heterogenous, and a large proportion of children were not ventilated as it is currently recommended by some experts.
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Paediatric anaesthesia · Aug 2020
Randomized Controlled TrialDependency of respiratory system mechanics on positive end-expiratory pressure and recruitment maneuvers in lung healthy pediatric patients - a randomized crossover study.
The lungs of pediatric patients are subjected to tidal derecruitment during mechanical ventilation and in contrast to adult patients this unfavorable condition cannot be resolved with small c increases. This raises the question if higher end-expiratory pressure increases or recruitment maneuvers may resolve tidal derecruitment in pediatric patients. ⋯ We conclude that contrary to our hypothesis, PEEP up to 7 cmH2 O is not sufficient to resolve tidal derecruitment and that recruitment maneuvers may be dispensable in mechanically ventilated pediatric patients.
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J Clin Monit Comput · Aug 2020
Comparative StudyA comparison of controlled ventilation with a noninvasive ventilator versus traditional mask ventilation.
After induction, but before intubation, many general anesthesia patients are manually bag-mask ventilated. The objective of this study was to determine the efficacy of bag-mask ventilation (MkV) of an anesthetized patient versus mask ventilation using a noninvasive ventilator (NIV). We hypothesized that feedback-controlled, mask ventilation via NIV is more efficacious and safer. ⋯ It can deliver more optimal tidal volumes with the operator utilizing only one hand. The airway pressures are fixed at safe limits during a period where the goal is to reach a maximal level of oxygenation prior to intubation. Over-ventilation or over-pressurization of the airway is not a concern with NIV since the pressures are maintained well within safe thresholds to avoid injury.
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Long-term mechanical ventilation with hyperoxia can induce lung injury. General anesthesia is associated with a very high incidence of hyperoxaemia, despite it usually lasts for a relatively short period of time. It remains unclear whether short-term mechanical ventilation with hyperoxia has an adverse impact on or cause injury to the lungs. The present study aimed to assess whether short-term mechanical ventilation with hyperoxia may cause lung injury in rats and whether deferoxamine (DFO), a ferrous ion chelator, could mitigate such injury to the lungs and explore the possible mechanism. ⋯ Mechanical ventilation with hyperoxia for 4 h induced oxidative injury of the lungs, accompanied by a dramatic reduction in the concentrations of SP-C and SP-D. DFO could mitigate such injury by lowering XOD activity and elevating GR activity.