Flow Controlled Ventilation in Thoracic Surgery
Positive-Pressure RespirationIntrinsicThis trial investigates effects of individualized (by compliance guided pressure settings) flow-controlled ventilation compared to best clinical practice pressure-controlled ventilation in thoracic surgery requiring one lung ventilation.
Non Invasive Mechanical Ventilation Versus Respiratory Rehabilitation in Hypercapnic COPD
LungHyperlucent2 moreObjective: To analyze the additional benefits of exercise training application by the non-invasive home mechanical ventilation in patients with stable COPD and hypercapnic respiratory failure. SUBJECT: moderate-severe COPD (FEV1 <60%) in chronic respiratory failure (hypoxemia and hypercapnia PaCO2> 45mmHg). GROUPS: 45 patients included prospectively and randomly into 3 groups of 15: a) training + NIPPV group, b) Group training, c) Group NIPPV. Hypothesis: A training program to the effort associated with treatment with NIPPV significantly increase the effects compared with each treatment. MAIN OBJETIVE: Effects on exercise capacity as measured by the test of endurance cycling and test 6-minute walk (distance). SECONDARY OBJECTIVES: Impact on quality of life and dyspnea, as measured by questionnaire and CRQ, systemic inflammatory response (CRP, IL-8, TNF-α), changes in peripheral muscle strength (1RM test, isometric) and effects score BODE index.
Prone Position Effects on Work of Breathing and Intrinsic PEEP in Children With Severe Acute Viral...
Severe BronchiolitisAcute viral bronchiolitis is the first cause of respiratory distress in infant. Airway inflammation increases the respiratory system resistances and dynamic hyperinflation. This leads to an increase in the work of breathing. In Chronic obstructive pulmonary disease patients as in neonates, prone position (PP) improves lung function and decreases the end expiratory lung volume. The investigators hypothesized that in infants with severe bronchiolitis, prone position reduces the intrinsic Positive End Expiratory Pressure (PEEPi) and the work of breathing (WOB). The investigator designed a prospective randomized crossover study with 16 infants younger than six months who need ventilatory support by nasal continuous positive airway pressure (nCPAP) for severe acute viral bronchiolitis. Work of breathing (product time pressure) and PEEPi will be estimated using an esophageal pressure probe in prone and supine position.
Intrinsic PEEP During Mechanical Ventilation of Patients With Obesity
General AnesthesiaLaparoscopic CholecystectomyIt is demonstrated that expiratory flow limitation and as a consequence, intrinsic positive end-expiratory pressure (PEEP) is present in grossly obese subjects especially in the supine position. The investigators tried to investigate the effect of low respiratory rate and high tidal volume on the intrinsic PEEP and gas exchange for obese subjects undergoing general anesthesia.
A New Monitor to Measure Dermal Blood Flow in Critically Ill Patients: a Preliminary Study
Positive-Pressure RespirationIntrinsic1 moreBackground: Conditions of reduced perfusion are characterized by redistribution of blood flow away from the skin to more vital organs. Study Objectives: To assess the efficacy of a non-invasive, dermal blood flow (DBF) monitor in detecting changes in perfusion in critically ill patients. Preliminary Study Study Population: critically ill patients in a general ICU
Mechanical Ventilation in Severe Brain Injury: The Effect of Positive End Expiratory Pressure on...
Intracranial HypertensionCritical Illness5 moreThe purpose of this study is to collect physiologic data from patients with severe brain injury who require mechanical ventilation in order to describe the impact of ventilation, specifically positive end expiratory pressure (PEEP), on intracranial pressure (ICP).
Effect of Initial Empirical PEEP Setting on the Esophageal Pressure-guided PEEP Titration in ARDS...
ARDSHuman3 moreEsophageal manometry was used as surrogate of pleural pressure to titrate positive end-expiratory pressure (PEEP) in ARDS patients. However, Absolute values of esophageal pressure (Pes) could be affected by the PEEP setting. In moderate to severe ARDS patients, the end-expiratory Pes changed differently with PEEP adjustment. and the esophageal phenotypes could be divided into type I and type II. with Type I (ΔPes≥30%ΔPEEP)and Type II(ΔPes<30%ΔPEEP).
A New Method for Estimating Dynamic Intrinsic PEEP
PEEPIntrinsic3 moreDinamic intrinsic PEEP is