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Revista Brasileira de Terapia Intensiva 2017To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. (Review)
Review
OBJECTIVE:
To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique.
METHODS:
Search, selection, and analysis of all original articles on variable ventilation, without restriction on the period of publication and language, available in the electronic databases LILACS, MEDLINE®, and PubMed, by searching the terms "variable ventilation" OR "noisy ventilation" OR "biologically variable ventilation".
RESULTS:
A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies.
CONCLUSION:
Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation.
Topics: Animals; Humans; Lung Diseases; Lung Injury; Pulmonary Gas Exchange; Respiration, Artificial; Respiratory Function Tests; Respiratory Mechanics
PubMed: 28444076
DOI: 10.5935/0103-507X.20170012 -
Respiratory Care Jun 2017Inhaled medications are the mainstay of therapy for many pediatric pulmonary diseases. Device and delivery technique selection is key to improving lung deposition of... (Review)
Review
Inhaled medications are the mainstay of therapy for many pediatric pulmonary diseases. Device and delivery technique selection is key to improving lung deposition of inhaled drugs. This paper will review the subject in relationship to several pediatric clinical situations: acute pediatric asthma, transnasal aerosol delivery, delivery through tracheostomies, and delivery during noninvasive and invasive mechanical ventilation. This review will focus on the pediatric age group and will not include neonates.
Topics: Administration, Inhalation; Aerosols; Asthma; Child; Humans; Respiration, Artificial
PubMed: 28546371
DOI: 10.4187/respcare.05298 -
Respiratory Care Jul 2021Despite its life-saving nature, invasive mechanical ventilation does not come without risk, and the avoidance of invasive mechanical ventilation is the primary goal of... (Review)
Review
Despite its life-saving nature, invasive mechanical ventilation does not come without risk, and the avoidance of invasive mechanical ventilation is the primary goal of noninvasive respiratory support. Noninvasive respiratory support in the form of continuous or bi-level positive airway pressure were considered the only viable options to accomplish this for many years. Innovation and research have led to high-flow nasal cannula being added to the list of specialized therapies clinically shown to reduce escalation of care and intubation rates in patients presenting with acute respiratory failure. The amount of research being performed in this clinical space is impressive, to say the least, and it is rapidly evolving. It is the responsibility of the clinicians trained to use these therapies in the management of respiratory failure to understand the currently available evidence, benefits, and risks associated with the type of noninvasive respiratory support being used to treat our patients.
Topics: Cannula; Humans; Noninvasive Ventilation; Respiration, Artificial; Respiratory Insufficiency
PubMed: 34210742
DOI: 10.4187/respcare.09247 -
Emergencias : Revista de La Sociedad... Feb 2021
Topics: Emergency Service, Hospital; Humans; Noninvasive Ventilation; Respiration, Artificial
PubMed: 33496391
DOI: No ID Found -
Paediatric Anaesthesia Feb 2022Extraordinary progress has been made during the past few decades in the development of anesthesia machines and ventilation techniques. With unprecedented precision and... (Review)
Review
Extraordinary progress has been made during the past few decades in the development of anesthesia machines and ventilation techniques. With unprecedented precision and performance, modern machines for pediatric anesthesia can deliver appropriate mechanical ventilation for children and infants of all sizes and with ongoing respiratory diseases, ensuring very small volume delivery and compensating for circuit compliance. Along with highly accurate monitoring of the delivered ventilation, modern ventilators for pediatric anesthesia also have a broad choice of ventilation modalities, including synchronized and assisted ventilation modes, which were initially conceived for ventilation weaning in the intensive care setting. Despite these technical advances, there is still room for improvement in pediatric mechanical ventilation. There is a growing effort to minimize the harm of intraoperative mechanical ventilation of children by adopting the protective ventilation strategies that were previously employed only for prolonged mechanical ventilation. More than ever, the pediatric anesthesiologist should now recognize that positive-pressure ventilation is potentially a harmful procedure, even in healthy children, as it can contribute to both ventilator-induced lung injury and ventilator-induced diaphragmatic dysfunction. Therefore, careful choice of the ventilation modality and its parameters is of paramount importance to optimize gas exchange and to protect the lungs from injury during general anesthesia. The present report reviews the novel ventilation techniques used for children, discussing the advantages and pitfalls of the ventilation modalities available in modern anesthesia machines, as well as innovative ventilation modes currently under development or research. Several innovative strategies and devices are discussed. These novel modalities are likely to become part of the armamentarium of the pediatric anesthesiologist in the near future and are particularly relevant for challenging ventilation scenarios.
Topics: Anesthesia, General; Child; Humans; Infant; Lung; Positive-Pressure Respiration; Respiration, Artificial; Ventilators, Mechanical
PubMed: 34837438
DOI: 10.1111/pan.14344 -
Anesthesiology Dec 2017
Topics: Humans; Interactive Ventilatory Support; Respiration, Artificial; Ventilators, Mechanical
PubMed: 29016378
DOI: 10.1097/ALN.0000000000001921 -
Anesthesiology Oct 2022
Topics: Humans; Intraoperative Care; Positive-Pressure Respiration; Respiration, Artificial; Tidal Volume
PubMed: 36137258
DOI: 10.1097/ALN.0000000000004366 -
Critical Care (London, England) Aug 2022Pulmonary microbial diversity may be influenced by biotic or abiotic conditions (e.g., disease, smoking, invasive mechanical ventilation (MV), etc.). Specially, invasive... (Review)
Review
Pulmonary microbial diversity may be influenced by biotic or abiotic conditions (e.g., disease, smoking, invasive mechanical ventilation (MV), etc.). Specially, invasive MV may trigger structural and physiological changes in both tissue and microbiota of lung, due to gastric and oral microaspiration, altered body posture, high O inhalation-induced O toxicity in hypoxemic patients, impaired airway clearance and ventilator-induced lung injury (VILI), which in turn reduce the diversity of the pulmonary microbiota and may ultimately lead to poor prognosis. Furthermore, changes in (local) O concentration can reduce the diversity of the pulmonary microbiota by affecting the local immune microenvironment of lung. In conclusion, systematic literature studies have found that invasive MV reduces pulmonary microbiota diversity, and future rational regulation of pulmonary microbiota diversity by existing or novel clinical tools (e.g., lung probiotics, drugs) may improve the prognosis of invasive MV treatment and lead to more effective treatment of lung diseases with precision.
Topics: Humans; Lung; Microbiota; Respiration, Artificial; Ventilator-Induced Lung Injury
PubMed: 35996150
DOI: 10.1186/s13054-022-04126-6 -
Respiratory Care Mar 2023Intermittent mandatory ventilation (IMV) is one kind of breath sequence used to classify a mode of ventilation. IMV is defined as the ability for spontaneous breaths... (Review)
Review
Intermittent mandatory ventilation (IMV) is one kind of breath sequence used to classify a mode of ventilation. IMV is defined as the ability for spontaneous breaths (patient triggered and patient cycled) to exist between mandatory breaths (machine triggered or machine cycled). Over the course of more than a century, IMV has evolved into 4 distinct varieties, each with its own advantages and disadvantages in serving the goals of mechanical ventilation (ie, safety, comfort, and liberation). The purpose of this paper is to describe the evolution of IMV, review relevant supporting evidence, and discuss the rationales for each of the 4 varieties. Also included is a brief overview of the background information required for a proper perspective of the purpose and design of the innovations. Understanding these different forms of IMV is essential to recognizing the similarities and differences among many dozens of different modes of ventilation. This recognition is important for clinical application, education of caregivers, and research in mechanical ventilation.
Topics: Humans; Intermittent Positive-Pressure Ventilation; Respiration, Artificial; Respiration
PubMed: 36195349
DOI: 10.4187/respcare.10184 -
Anesthesia and Analgesia Nov 2022
Topics: Humans; Respiration, Artificial; Tidal Volume; Positive-Pressure Respiration; Intraoperative Care
PubMed: 36269986
DOI: 10.1213/ANE.0000000000006158