Abstract:
BACKGROUND:Previous studies have demonstrated the safety of flexible bronchoscopy (FB) in mechanically ventilated subjects. However, the safety of FB in adult subjects receiving extracorporeal membrane oxygenation (ECMO) has not been described previously. METHODS:A retrospective review was conducted of all adult subjects who underwent FB while receiving ECMO support at the University of Alabama at Birmingham Hospital from January 1, 2013, to December 31, 2014. Physiologic variables, pre- and post-FB ECMO, and ventilator settings were recorded. RESULTS:79 adult subjects underwent FB receiving ECMO with a total of 223 bronchoscopies. The most common indications for bronchoscopy included diagnostic evaluation of infection in subjects with pneumonia (29%) and clearance of excessive secretions (22%). In 70% of subjects, moderate or greater amounts of secretions were noted. FB yielded positive culture data in 37 subjects (47%), which resulted in a change to the antibiotic regimen in 14 subjects (38%) with positive culture data. No significant differences in mean PaO2 /FIO2 , mean ECMO flow, mean sweep gas, ventilator settings, or hemodynamic parameters (heart rate, oxygen saturation, and mean blood pressure) were noted before and after FB. Complications were mild and transient: blood-tinged secretions after FB in 21% cases, which resolved spontaneously, intraprocedural hypoxemia in 2.2% of cases, and dysrhythmia in <1% of cases. There were no episodes of ECMO cannula dislodgement or inadvertent extubation. CONCLUSIONS:FB can be used safely in adult subjects supported with ECMO and is not associated with significant hemodynamics changes, bleeding, or mechanical complications during ECMO support.
journal_name
Respir Carejournal_title
Respiratory careauthors
Sharma NS,Peters T,Kulkarni T,Hoopes CW,Bellot SC,Wille KM,Diaz-Guzman Edoi
10.4187/respcare.04456subject
Has Abstractpub_date
2016-05-01 00:00:00pages
646-51issue
5eissn
0020-1324issn
1943-3654pii
respcare.04456journal_volume
61pub_type
杂志文章相关文献
Respiratory Care文献大全abstract:INTRODUCTION:There is a need to develop simple, noninvasive, and sensitive outcome measures for respiratory therapy. Adventitious respiratory sounds (ie, crackles and wheezes) can be objectively characterized with computerized respiratory sound analysis (CORSA) and have been shown to contribute for diagnosis purposes; ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.02765
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVE:To investigate the predictive value of the maximal inspiratory pressure obtained by a digital vacuometer using a unidirectional valve (P(ImaxUV)) as to weaning outcome, and to compare its performance with the respiratory drive using airway occlusion pressure at 0.1 second (P(0.1)), and P(0.1)/P(ImaxUV). METH...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01489
更新日期:2012-08-01 00:00:00
abstract:BACKGROUND:Endotracheal tubes with standard polyvinyl chloride cuffs create folds on inflation into the trachea, which lead to potential leakage of subglottic secretions into the lower airways and cause lung colonization and pneumonia. The use of a double-layer prototype leak-proof cuff has shown effective prevention o...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06573
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:The impulse oscillometry system (IOS) is increasingly used to evaluate lung function, but individual results must be compared with appropriate reference values. We aimed to obtain such reference values in Mexican children and adolescents. METHODS:Healthy subjects were recruited from kindergartens and school...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03374
更新日期:2015-01-01 00:00:00
abstract::Functional residual capacity (FRC) is essentially the alveolar volume and a determinant of both oxygenation and respiratory system compliance (CRS). ARDS decreases FRC, and sufficient PEEP restores FRC; thus, assessments of PEEP by its impact on oxygenation and CRS are intimately linked. PEEP also can ameliorate or ag...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.04657
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To determine whether outcomes (mortality and need for intensive care unit [ICU] readmission) of patients undergoing tracheostomy in the ICU can be predicted by common clinical or historical criteria. METHODS:We conducted a retrospective review of data from the medical record and Project Impact database in a ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:High-flow nasal cannula (HFNC) use has greatly increased in recent years. In non-neonatal pediatric patients, there are limited data available to guide HFNC use, and clinical practice may vary significantly. The goal of this study was to evaluate current HFNC practice by surveying practicing pediatric respir...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.05961
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:We previously reported the effects of high-flow nasal cannula (HFNC) oxygen therapy on thoraco-abdominal synchrony. This study was designed to clarify the effect of HFNC on thoraco-abdominal synchrony in pediatric subjects after cardiac surgery and to investigate HFNC optimal flow in this population. METHOD...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:10.4187/respcare.06193
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Causing pneumothorax is one of the main concerns of lung recruitment maneuvers in pediatric patients, especially newborns. Therefore, these maneuvers are not performed routinely during anesthesia. Our objective was to determine the pressures that cause pneumothorax in healthy newborns by a prospective experi...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04250
更新日期:2016-02-01 00:00:00
abstract::Pulmonary rehabilitation (PR) is the standard of care for patients suffering chronic obstructive pulmonary disease (COPD). This report describes and defines PR and reviews the evidence regarding the efficacy of PR. COPD management guidelines that include PR have been published by the European Respiratory Society, the ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2004-01-01 00:00:00
abstract::Polysomnography studies are an essential tool for the sleep physician and aid in the diagnosis and treatment of sleep disorders. Polysomnography refers to the recording, analysis, and interpretation of multiple physiologic signals collected simultaneously. Rapid advancements in technology have transformed the field fr...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:The frequency of combined obstruction and restriction identified in pulmonary function tests has not been well described. Moreover, although the causes of combined-obstruction-and-restriction patterns are known, the frequency of the various etiologies has received little attention. METHODS:We retrospectivel...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:The nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its effectiveness. METHODS:Prospective observational study from January 2007 ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02556
更新日期:2014-04-01 00:00:00
abstract::Surface active material is important in the function of both the infant and adult lung. In the premature infant, surfactant depletion results in the requirement for very high distending pressures to open alveoli. As a consequence, shunt, hypoxemia, and right ventricular dysfunction occur. Surfactant replacement, espec...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:Health-care providers often diagnose and empirically treat COPD without a confirmative pulmonary function test (PFT) or even despite a PFT that is not diagnostic of obstructive lung disease. We hypothesized that a portion of patients continue to carry a persistent empiric COPD diagnosis and receive treatment...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04647
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Asthma is defined by airway inflammation associated with various respiratory symptoms, and pharmacologic treatment is based on inhaled corticosteroids and bronchodilators. Physical activity, educational training, nutritional support, and psychological counseling are considered part of non-pharmacologic treat...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06761
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:Directed cough maneuvers are often included in physiotherapy management aimed at preventing postoperative pulmonary complications after open heart surgery, but there is little scientific evidence of the effectiveness of directed cough maneuvers. METHODS:We conducted a randomized intra-subject crossover tria...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:Emphysema and fibrosis, typically the idiopathic pulmonary fibrosis (IPF) form of usual interstitial pneumonia (UIP), can co-exist as combined pulmonary fibrosis emphysema (CPFE). It is unknown whether there is a pathobiologic basis for CPFE beyond the coexistence of fibrosis and emphysema. The aim of this s...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03389
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:The value of impulse oscillometry (IOS) for bronchial provocation testing is poorly defined. We investigated the positive threshold derived from the parameters and diagnostic power of IOS for asthma with the leukotriene D(4) bronchial provocation test. METHODS:We enrolled 62 subjects with asthma and 21 heal...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02417
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Electrical impedance tomography measures changes in lung impedance, which are mainly related to changes in lung volume. We used electrical impedance tomography to investigate the effects of high-flow nasal cannula (HFNC) and body position on global and regional end-expiratory lung impedance variation (ΔEELI)...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02086
更新日期:2013-04-01 00:00:00
abstract::A 20-year-old man was admitted in the neurology ICU after the drainage of a large frontal hematoma related to the spontaneous bleeding of a recently diagnosed cavernoma. On admission the Glasgow coma score was 4/15, with evidence of sub-falcorial herniation and elevated intracranial pressure. On the 4th postoperative...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01322
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Switching patients affected by early severe ARDS and undergoing extracorporeal membrane oxygenation (ECMO) from controlled ventilation to spontaneous breathing can be either beneficial or harmful, depending on how effectively the breathing pattern is controlled with ECMO. Identifying the factors associated w...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07391
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To determine the effects of intrapulmonary percussive ventilation (IPV) on mucus clearance in tracheostomized Duchenne muscular dystrophy patients. METHODS:We studied 8 patients, 5 of whom had mucus hypersecretion (> 30 mL/d). In a randomized, cross-over study we compared assisted mucus clearance techniques ...
journal_title:Respiratory care
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2003-10-01 00:00:00
abstract::In patients with ventilator-associated pneumonia, systemic use of antibiotics is the cornerstone of medical management. Supplemental use of aerosolized antibiotics with intravenous antibiotics in both experimental and clinical studies has been shown to have the following pharmacologic benefits: (1) aerosolized antibio...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.04748
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Current literature has been inconsistent in demonstrating that minimizing the duration of mechanical ventilation in very-low-birth-weight (VLBW) newborns reduces lung damage. OBJECTIVE:To determine if introduction of bubble nasal CPAP (bnCPAP), early surfactant treatment, and rapid extubation (combined bnCP...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01998
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND:Field walking tests are commonly used in patients with chronic pulmonary diseases for assessment of functional capacity. However, the physiological demands and magnitude of desaturation on 6-min walk test (6MWT), incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT) have not been inves...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07171
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:The prevalence of sleep-disordered breathing (SDB) in patients with prolonged mechanical ventilation (PMV) is unknown. The aim of this study was to assess the frequency of SDB in patients admitted to a long-term acute care (LTAC) hospital who weaned from PMV. METHODS:Retrospective chart review was conducte...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01260
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The use of neurally-adjusted ventilatory assist (NAVA) during noninvasive ventilation (NIV) results in better patient-ventilator interaction. Whether this improves clinical outcomes lacks dedicated study. METHODS:In this randomized controlled trial, we compared NAVA with PSV for delivering NIV in consecutiv...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07952
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Though smokers are known to have elevated blood carboxyhemoglobin (COHb), due to inhalation of carbon monoxide (CO) in cigarette smoke, limited data exist regarding COHb levels in nonsmokers exposed to secondhand smoke. METHODS:COHb was measured using a new noninvasive pulse CO-oximeter (Rad-57, Masimo, Irv...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2006-07-01 00:00:00
abstract::Two electronic systems for monitoring respiratory rates in critical care patients were evaluated--one a system using impedance sensors and the other a system using thermistor sensors. The thermistor sensor, attached to a nasal cannula or air-entrainment mask, was connected to a sensitivity calibrating control and a di...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1981-03-01 00:00:00