Article
Medicine, General & Internal
Guan Wang, Lei Zhang, Bin Li, Bingyin Niu, Jian Jiang, Duo Li, Zhu Yue, Yibing Weng
Summary: This study found that the pre-SBT global impedance and SBT region of interest 2 values were significantly associated with predicting successful ventilator weaning, suggesting that EIT could be a valuable tool in improving weaning success rates. Further cohort studies are needed to confirm the efficacy of EIT in the evaluation system.
INTERNATIONAL JOURNAL OF GENERAL MEDICINE
(2021)
Article
Critical Care Medicine
Deepti Kilaru, Nova Panebianco, Cameron Baston
Summary: A 65-year-old man with septic shock due to pneumonia was admitted to the ICU and required mechanical ventilation. After extubation, he developed increased work of breathing and was eventually reintubated. Diaphragmatic weakness was identified as the likely cause of respiratory failure after thorough evaluation.
Article
Computer Science, Artificial Intelligence
Yan Jia, Chaitanya Kaul, Tom Lawton, Roderick Murray-Smith, Ibrahim Habli
Summary: Weaning from mechanical ventilation is crucial in ICU care, as both prolonged dependence on mechanical ventilation and premature extubation increase the risk of complications and healthcare costs. This study developed a decision support model using CNN to predict extubation readiness with 86% accuracy, based on historical ICU data extracted from MIMIC-III.
ARTIFICIAL INTELLIGENCE IN MEDICINE
(2021)
Article
Biotechnology & Applied Microbiology
Pengcheng Wang, Xianlong Zhou, Gang Li, Haoli Ma, Ruining Liu, Yan Zhao
Summary: This study identified 38 significantly differentially expressed miRNAs in a ventilator-induced diaphragm dysfunction model, with 22 miRNAs upregulated and 16 downregulated. Functional analysis revealed that these miRNAs may impact diaphragm function through signaling pathways such as MAPK, FoxO, and autophagy-animal. Luciferase reporter assays confirmed direct targeting relationships between miRNAs and genes like STAT3, miR-92a-1-5p, miR-874-3p, and Trim63 with miR-3571.
Article
Respiratory System
Alessandro Ghiani, Joanna Paderewska, Swenja Walcher, Claus Neurohr
Summary: The study demonstrates that dynamic lung-thorax compliance normalized MP accurately differentiates between low and high-risk patients for weaning failure following prolonged mechanical ventilation. The discriminatory performance of MP indices increases over the course of weaning, reaching maximum accuracy immediately before completion.
BMC PULMONARY MEDICINE
(2021)
Review
Medicine, General & Internal
Federico Longhini, Andrea Bruni, Eugenio Garofalo, Simona Tutino, Luigi Vetrugno, Paolo Navalesi, Edoardo De Robertis, Gianmaria Cammarota
Summary: Patient-ventilator asynchrony during non-invasive ventilation is a significant problem that can cause discomfort and treatment failure. Prompt identification and management of asynchronies are crucial in both pediatric and adult populations. This review provides a definition of asynchronies, their classification, and quantification methods. It also describes techniques for detecting patient-ventilator asynchronies during non-invasive ventilation in pediatric and adult patients with acute respiratory failure. Additionally, it discusses strategies to reduce asynchronies and the impact of asynchronies on clinical outcomes in infants, children, and adults based on existing literature.
FRONTIERS IN MEDICINE
(2023)
Article
Critical Care Medicine
Martin Dres, Marcelo Gama de Abreu, Hamid Merdji, Holger Muller-Redetzky, Dominic Dellweg, Winfried J. Randerath, Satar Mortaza, Boris Jung, Christian Bruells, Onnen Moerer, Martin Scharffenberg, Samir Jaber, Sebastien Besset, Thomas Bitter, Arnim Geise, Alexander Heine, Maximilian Malfertheiner, Andreas Kortgen, Jonathan Benzaquen, Teresa Nelson, Alexander Uhrig, Olaf Moenig, Ferhat Meziani, Alexandre Demoule, Thomas Similowski
Summary: This study aimed to evaluate the effects of temporary transvenous diaphragm neurostimulation on weaning success and maximal inspiratory pressure. The results showed that the neurostimulation did not increase the proportion of successful weaning, but it significantly increased maximal inspiratory pressure, suggesting improvement in diaphragm function.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2022)
Article
Critical Care Medicine
Robert G. T. Blokpoel, Johannes G. M. Burgerhof, Dick G. Markhorst, Martin C. J. Kneyber
Summary: The study found that the level of patient-ventilator asynchrony in mechanically ventilated children increased over time, but was not related to patient discomfort and was inversely related to the duration of mechanical ventilation. The prevalence of asynchronous breaths was highest on the day of extubation.
PEDIATRIC CRITICAL CARE MEDICINE
(2021)
Article
Pharmacology & Pharmacy
Alessandro Ghiani, Konstantinos Tsitouras, Joanna Paderewska, Katrin Milger, Swenja Walcher, Mareike Weiffenbach, Claus Neurohr, Nikolaus Kneidinger
Summary: This study evaluated the incidence, causes, and predictors of unsuccessful decannulation following prolonged weaning. The results showed that failure to decannulate mainly resulted from persistent ICU-acquired dysphagia and long-term ventilator dependence following weaning failure, each associated with its own set of predictors.
THERAPEUTIC ADVANCES IN CHRONIC DISEASE
(2022)
Article
Engineering, Multidisciplinary
LiMing Hao, Xiao Li, Yan Shi, MaoLin Cai, Shuai Ren, Fei Xie, YaNa Li, Na Wang, YiXuan Wang, ZuJin Luo, Meng Xu
Summary: Mechanical ventilation is effective in treating critically ill patients, COVID-19, and other pulmonary diseases, but pulmonary rehabilitation is essential for improving spontaneous breathing ability. Inappropriate ventilation strategies may lead to weaning difficulties and complications.
SCIENCE CHINA-TECHNOLOGICAL SCIENCES
(2021)
Review
Medicine, General & Internal
Pauliane Vieira Santana, Leticia Zumpano Cardenas, Andre Luis Pereira de Albuquerque
Summary: Mechanical ventilation (MV) is a life-saving respiratory support therapy, but it can cause diaphragm muscle injury and dysfunction. Diaphragmatic dysfunction is associated with adverse outcomes and the main mechanisms of myotrauma are inadequate MV support and patient-ventilator asynchrony. Protecting the diaphragm during MV requires monitoring diaphragmatic effort and detecting asynchrony, which can be done with diaphragm ultrasound.
Review
Critical Care Medicine
Padmastuti Akella, Louis P. Voigt, Sanjay Chawla
Summary: This review provides a comprehensive view of weaning classification, causes of weaning failure, and evidence behind weaning predictors and weaning modes.
JOURNAL OF INTENSIVE CARE MEDICINE
(2022)
Article
Respiratory System
Shigang Li, Zhe Chen, Weifeng Yan
Summary: This study found that diaphragm thickening fraction (DTF) has higher sensitivity and specificity for predicting successful weaning in elderly patients compared to other parameters. Using a combination of rapid shallow breathing index (RSBI), lung ultrasound score (LUS), diaphragmatic excursion (DE), and DTF performed well in predicting weaning outcome, with high sensitivity and specificity. The clinical utility of these parameters in predicting extubation success may have important implications and should be further evaluated.
BMC PULMONARY MEDICINE
(2021)
Article
Physiology
Elena Keough-Delgado, Lucia Lopez-Rodriguez, Beatriz de Olaiz, Agustin Bertomeu-Garcia, Oscar Penuelas, Marta Jimenez-Fernandez, Pedro Gato-Diaz, Helene Perez-Dominguez, Francisco Perez-Vizcaino, Marcus J. Schultz, Jose A. Lorente
Summary: Temporary diaphragm pacing was used in two critically ill patients with ventilator-induced diaphragm dysfunction (VIDD), showing improvements in diaphragm function and successful weaning from the ventilator in one patient. The results suggest potential benefits of diaphragm pacing in treating VIDD, but larger studies are needed to confirm safety and efficacy.
JOURNAL OF APPLIED PHYSIOLOGY
(2021)
Review
Critical Care Medicine
Henry M. Parada-Gereda, Adriana L. Tibaduiza, Alejandro Rico-Mendoza, Daniel Molano-Franco, Victor H. Nieto, Wanderley A. Arias-Ortiz, Purificacion Perez-Teran, Joan R. Masclans
Summary: A systematic review and meta-analysis showed that measurement of diaphragmatic excursion and diaphragmatic thickening fraction can predict the probability of successful weaning from mechanical ventilation with satisfactory diagnostic accuracy. However, significant heterogeneity was evident in the different included studies. High-quality studies in specific subgroups of patients in intensive care units are needed to evaluate the role of diaphragmatic ultrasound as a predictor of weaning from mechanical ventilation.
Letter
Respiratory System
A. Grassetto, T. Pettenuzzo, F. Badii, R. Carlon, N. Sella, P. Navalesi
Article
Anesthesiology
Eugenio Garofalo, Serena Rovida, Gianmaria Cammarota, Eugenio Biamonte, Letizia Troisi, Leonardo Cosenza, Corrado Pelaia, Paolo Navalesi, Federico Longhini, Andrea Bruni
Summary: Short cycles of high-frequency percussive ventilation (HFPV) can improve gas exchange and lung aeration, especially in tracheostomized patients with high secretion load.
JOURNAL OF CLINICAL MONITORING AND COMPUTING
(2023)
Article
Respiratory System
M. Vitacca, A. Malovini, A. Spanevello, P. Ceriana, M. Paneroni, M. Maniscalco, B. Balbi, L. Rizzello, R. Murgia, R. Bellazzi, N. Ambrosino
Summary: Due to the low availability of pulmonary rehabilitation (PR) for individuals recovering from a COPD exacerbation (ECOPD), this study aimed to identify subpopulations with different responses to PR based on clustering analysis of baseline characteristics. The results can be used to define priority criteria for PR.
Article
Radiology, Nuclear Medicine & Medical Imaging
Gianmaria Cammarota, Andrea Bruni, Giulio Morettini, Leonardo Vitali, Francesco Brunelli, Filippo Tinarelli, Rachele Simonte, Elisa Rossi, Matteo Bellucci, Giacomo De Girolamo, Antonio Galzerano, Luigi Vetrugno, Salvatore M. Maggiore, Elena Bignami, Danila Azzolina, Olivia Dow, Paolo Navalesi, Edoardo De Robertis
Summary: This study used bedside ultrasound to assess the effects of recruitment maneuver and prone positioning on lung aeration in intubated patients with ARDS related to COVID-19. The results showed that both recruitment maneuver and prone positioning improved lung ventilation compared to the supine position.
ULTRASOUND JOURNAL
(2023)
Letter
Anesthesiology
Francesco Zarantonello, Nicolo Sella, Tommaso Pettenuzzo, Annalisa Boscolo, Paolo Navalesi
Review
Anesthesiology
Federico Geraldini, Paolo Diana, Davide Fregolent, Alessandro De Cassai, Annalisa Boscolo, Tommaso Pettenuzzo, Nicolo Sella, Irene Lupelli, Paolo Navalesi, Marina Munari
Summary: This study aimed to evaluate the effects of general anesthesia and conscious sedation on functional outcomes in endovascular treatment for stroke patients. The results showed that the choice of anesthetic strategy did not significantly impact functional outcome, but patients treated under general anesthesia may have more frequent successful reperfusion.
CANADIAN JOURNAL OF ANESTHESIA-JOURNAL CANADIEN D ANESTHESIE
(2023)
Article
Critical Care Medicine
Jonathon Fanning, Natasha B. Weaver, Robert J. Fanning, Matthew Griffee, Sung-Min Cho, Mauro G. Panigada, Nchafatso M. Obonyo, Akram Zaaqoq, Hannah Rando, Yew Woon Chia, Bingwen Eugene Fan, Declan Sela, Davide Chiumello, Silvia Coppola, Ahmed Labib, Glenn J. R. C. Whitman, Rakesh S. Arora, Bo Kim, Anna Motos, Antoni Torres, Ferran Barbe, Giacomo Grasselli, Alberto Zanella, Eric Etchill, Asad Ali Usman, Maximilian M. Feth, Nicole Y. White, Jacky Suen, Gianluigi J. Li Bassi, Giles F. Peek, John Fraser, Heidi Dalton
Summary: A high prevalence of HECTOR complications (hemorrhage, disseminated intravascular coagulopathy, and thrombosis) was observed in ICU patients with severe COVID-19. Hemorrhagic complications were associated with increased ICU mortality, while thrombosis complications were associated with reduced mortality.
CRITICAL CARE MEDICINE
(2023)
Article
Respiratory System
Robert L. Owens, Eric Derom, Nicolino Ambrosino
Summary: The respiratory system in individuals with advanced COPD may be compromised, leading to respiratory failure, with reduced arterial oxygen tension and/or increased arterial carbon dioxide tension. Long-term oxygen therapy (LTOT) can improve survival in severe cases, while noninvasive ventilation (NIV) may reduce mortality and improve quality of life in individuals with chronic hypercapnia. However, there are still many questions about the optimal mode, settings and goal of NIV therapy.
EUROPEAN RESPIRATORY REVIEW
(2023)
Review
Respiratory System
Annalisa Boscolo, Tommaso Pettenuzzo, Nicola Sella, Matteo Zatta, Michele Salvagno, Martina Tassone, Chiara Pretto, Arianna Peralta, Luisa Muraro, Francesco Zarantonello, Andrea Bruni, Federico Geraldini, Alessandro De Cassai, Paolo Navalesi
Summary: This study assessed the effects of noninvasive respiratory support (NRS) on post-extubation respiratory failure and found that NRS reduced re-intubations and ventilator-associated pneumonia (VAP) but increased discomfort. Prophylactic NRS did not prevent extubation failure in low-risk or hypoxaemic patients.
EUROPEAN RESPIRATORY REVIEW
(2023)
Article
Microbiology
Maria Mazzitelli, Dario Gregori, Lolita Sasset, Marco Trevenzoli, Vincenzo Scaglione, Sara Lo Menzo, Serena Marinello, Daniele Mengato, Francesca Venturini, Ivo Tiberio, Paolo Navalesi, Annamaria Cattelan
Summary: During the COVID-19 pandemic, there was a significant increase in multi-drug-resistant Acinetobacter baumannii infections, particularly carbapenem-resistant strains. Cefiderocol appeared to be a promising treatment option, but guidelines and evidence are conflicting.
Review
Medicine, General & Internal
Marco Gambato, Nicola Scotti, Giacomo Borsari, Jacopo Zambon Bertoja, Joseph-Domenico Gabrieli, Alessandro De Cassai, Giacomo Cester, Paolo Navalesi, Emilio Quaia, Francesco Causin
Summary: This short review aims to help radiologists identify medical devices and their most common complications when interpreting a chest X-ray. Nowadays, a variety of medical devices are frequently used, especially in critical patients. It is crucial for radiologists to be knowledgeable about what to look for and to consider the technical factors associated with each device's positioning.
Editorial Material
Respiratory System
C. Crimi, N. Ambrosino
Review
Medicine, General & Internal
Luca Giordano, Andrea Francavilla, Tomaso Bottio, Andrea Dell'Amore, Dario Gregori, Paolo Navalesi, Giulia Lorenzoni, Ileana Baldi
Summary: Extracorporeal membrane oxygenation (ECMO) is increasingly used for hemodynamic and respiratory support in critically ill patients. Prognostic scores are essential for selecting patients who should initiate ECMO. However, most prognostic models have not been externally validated, leading to uncertainties in ECMO initiation.
SYSTEMATIC REVIEWS
(2023)
Article
Anesthesiology
Alessandro De Cassai, Vito Torrano, Elisa Pistollato, Francesco Monteleone, Giulia Tinti, Francesco Volpe, Daniele Piazzai, Fabio Cavaliere, Fabrizio Piras, Paolo De Simone, Francesco Baccoli, Sara Frasson, Irene Lupelli, Federico Geraldini, Francesco Zarantonello, Annalisa Boscolo, Tommaso Pettenuzzo, Giulia Lorenzoni, Dario Gregori, Paolo Navalesi
BRITISH JOURNAL OF ANAESTHESIA
(2023)
Article
Medicine, General & Internal
Federico Longhini, Rachele Simonte, Rosanna Vaschetto, Paolo Navalesi, Gianmaria Cammarota
Summary: RTB occurs during both pressure support ventilation and neurally adjusted ventilatory assist, and the level of propofol sedation and the mode of ventilation may influence the incidence of RTBs.
JOURNAL OF CLINICAL MEDICINE
(2023)
