Article
Pediatrics
Christie L. Glau, Elaina E. Lin, Thomas W. Conlon, Adam S. Himebauch, Garrett P. Keim, Akira Nishisaki
Summary: This study aimed to investigate the thickness and contractility values of the diaphragm in children. It found that the diaphragm thickness and contractility were similar across different age groups, but the excursion and strain varied. During mechanical ventilation, all measures of diaphragm contractility were diminished.
PEDIATRIC PULMONOLOGY
(2023)
Article
Multidisciplinary Sciences
Tomomi Ichiba, Tetsuo Miyagawa, Toru Tsuda, Takeshi Kera, Osamu Yasuda
Summary: The aim of this study was to investigate the mechanism of functional improvement in patients with chronic obstructive pulmonary disease (COPD) undergoing inspiratory muscle training (IMT). The results showed that IMT can enhance respiratory muscle function and exercise tolerance, and alleviate dyspnea and fatigue. Further analysis indicated that these effects may be attributed to improvements in peripheral factors rather than central factors.
Review
Nursing
Maila Fidalgo De Faria, Lorena Bontempo De Azevedo, Karoline Faria De Oliveira, Maria Beatriz Guimaraes Raponi, Viviane Da Silva Alves Filgueira, Marcia Marques Dos Santos Felix, Maria Sagrario Gomez Cantarino, Maria Helena Barbosa
Summary: The objective of this study was to identify the main ventilatory support medical devices related to pressure injuries in hospitalised adults and the most frequent anatomical localisations of these injuries. The results showed that nasal catheters caused the most pressure injuries, primarily affecting the ears; noninvasive mechanical ventilation oronasal masks had an incidence rate of 63.3%, mainly affecting the nasal bridge; the Set of Holders for Insight® endotracheal tubes caused the highest number of pressure injuries, primarily affecting the lip commissure; and tracheostomy cannulas accounted for 18.2% of the pressure injuries, predominantly affecting the neck. These findings are relevant for clinical practice as they provide insights for adopting preventive measures and reducing the occurrence of pressure injuries.
JOURNAL OF CLINICAL NURSING
(2023)
Article
Cardiac & Cardiovascular Systems
Joseph B. Shrager, Yoyo Wang, Myung Lee, Shannon Nesbit, Winston Trope, Harrison Konsker, Emmanuel Fatodu, Mark S. Berry, George Poulstides, Jeffrey Norton, Thomas Burdon, Leah Backhus, Roger Cooke, Huibin Tang
Summary: The clinical trial is the first-in-human mechanistic trial for preventing ventilator-induced diaphragm dysfunction (VIDD) by testing whether JAK inhibition can prevent clinical VIDD, potentially impacting ICU outcomes significantly if successful.
RESPIRATORY MEDICINE
(2021)
Article
Critical Care Medicine
Kristen H. Shanahan, Michael C. Monuteaux, Joshua Nagler, Richard G. Bachur
Summary: A large cohort study in children's hospitals from 2010 to 2018 found significant increases in both noninvasive and invasive ventilation for infants with bronchiolitis. While high hospital-level noninvasive ventilation utilization was not associated with a reduction in invasive ventilation, it was linked to higher rates of cardiac arrest. Further investigation into the unintended risk of cardiac arrest with noninvasive ventilation in bronchiolitis is needed.
CRITICAL CARE MEDICINE
(2021)
Article
Otorhinolaryngology
Linda M. Rowe, Nadine P. Connor, John A. Russell
Summary: This study assessed the effect of CRT on respiratory-swallow coordination using a rat model and found that CRT rats had significantly increased postswallow inhale events. The findings suggest that the rat CRT model is valid for studying respiratory-swallow coordination in HNC patients undergoing CRT.
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
(2021)
Article
Critical Care Medicine
Filippo Albani, Luigi Pisani, Gianni Ciabatti, Federica Fusina, Barbara Buizza, Anna Granato, Valeria Lippolis, Eros Aniballi, Francesco Murgolo, Antonio Rosano, Nicola Latronico, Massimo Antonelli, Salvatore Grasso, Giuseppe Natalini
Summary: This study aimed to assess the association between the shape of inspiratory flow quantified by Flow Index and patient's inspiratory effort during pressure support ventilation. Results showed that Flow Index was independently associated with patient effort and may provide useful information for setting inspiratory support and monitoring patient-ventilator interactions.
Article
Critical Care Medicine
Filippo Albani, Federica Fusina, Gianni Ciabatti, Luigi Pisani, Valeria Lippolis, Maria Elena Franceschetti, Alessia Giovannini, Rossella di Mussi, Francesco Murgolo, Antonio Rosano, Salvatore Grasso, Giuseppe Natalini
Summary: The study aimed to evaluate the accuracy of Flow Index in detecting high and low inspiratory effort during pressure support ventilation and establish cutoff values. Results showed that Flow Index accurately detects high and low spontaneous inspiratory effort.
Article
Critical Care Medicine
Fabio Varon-Vega, Luis F. Giraldo-Cadavid, Ana Maria Uribe, Adriana Rincon, Jonathan Palacios, Stephanie Crevoisier, Eduardo Tuta-Quintero, Lina Ordonez, Natalia Boada, Paola Rincon, Marcela Poveda, Pablo Monedero
Summary: The study found that objective measurements of cough and diaphragmatic contraction velocity can predict the success of the spontaneous breathing trial. The equation for predicting successful extubation, which includes values for the trial, cough, and diaphragmatic contraction velocity, showed excellent discriminative capacity.
Review
Medicine, General & Internal
Gaetano Scaramuzzo, Irene Ottaviani, Carlo A. Volta, Savino Spadaro
Summary: This article explores the importance and specificity of mechanical ventilation in chronic obstructive pulmonary disease (COPD) in relation to morphological changes in the lungs and chest wall. Lung emphysema and reduced elastic recoil increase expiratory time, worsening lung overinflation, while chronic airway inflammation increases resistance and can lead to distal air-trapping. Muscle wasting and dominance of fast fibers may result in weakness and earlier onset of muscle fatigue, prolonging the weaning process.
Article
Radiology, Nuclear Medicine & Medical Imaging
Nerea Molina-Hernandez, Jose Lopez Chicharro, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, David Rodriguez-Sanz, Davinia Vicente-Campos, Daniel Marugan-Rubio, Samuel Eloy Gutierrez-Torre, Cesar Calvo-Lobo
Summary: The study aimed to evaluate the reliability and repeatability of using a thoracic orthosis for simultaneous thickness measurements of both hemi-diaphragms during normal breathing. The results showed good reliability and repeatability of the measurements using the thoracic orthosis, indicating its potential for hemi-diaphragm breathing re-education.
QUANTITATIVE IMAGING IN MEDICINE AND SURGERY
(2023)
Article
Critical Care Medicine
Lu Chen, Domenico L. Grieco, Francois Beloncle, Guang-Qiang Chen, Norberto Tiribelli, Fabiana Madotto, Sebastian Fredes, Cong Lu, Massimo Antonelli, Alain Mercat, Arthur S. Slutsky, Jian-Xin Zhou, Laurent Brochard
Summary: This study aimed to investigate the association between physiological parameters and 60-day outcome in patients with ARDS. The results showed that transpulmonary pressures and airway driving pressures were associated with 60-day mortality, while elastance-derived plateau P-L was not. A positive end-expiratory P-L was associated with better outcome in obese patients.
INTENSIVE CARE MEDICINE
(2022)
Article
Medicine, Research & Experimental
Jianwei Zhou, Chuanguang Wang, Ran Lv, Na Liu, Yan Huang, Wu Wang, Lina Yu, Junran Xie
Summary: The study demonstrated that a protective ventilation strategy could improve oxygenation and reduce the clinical pulmonary infection score in patients undergoing robot-assisted radical prostatectomy.
Review
Neurosciences
Elisa J. Gonzalez-Rothi, Kun-Ze Lee
Summary: Acute intermittent hypoxia has shown promise as a treatment for respiratory insufficiency in individuals with spinal cord injury, through inducing neuroplasticity and functional recovery. Research in animal models has laid the foundation for the translation of this therapeutic strategy to clinical populations.
EXPERIMENTAL NEUROLOGY
(2021)
Review
Anesthesiology
Dejan Radovanovic, Pierachille Santus, Silvia Coppola, Marina Saad, Stefano Pini, Fabio Giuliani, Michele Mondoni, Davide A. Chiumello
Summary: A total of 52 studies involving 287,359 adult COVID-19 patients from 17 different countries were included in this review. The use of respiratory support and related outcomes showed significant heterogeneity. Regional standard operating procedures and local guidance had a major impact on patient management and outcomes, particularly in severe and critical cases.
MINERVA ANESTESIOLOGICA
(2021)
Review
Critical Care Medicine
Alexandre Tran, Shannon M. Fernando, Bram Rochwerg, Ryan P. Barbaro, Carol L. Hodgson, Laveena Munshi, Graeme Maclaren, Kollengode Ramanathan, Catherine L. Hough, Laurent J. Brochard, Kathryn M. Rowan, Niall Ferguson, Alain Combes, Arthur S. Slutsky, Eddy Fan, Daniel Brodie
Summary: This study summarized the association between pre-cannulation prognostic factors and risk of mortality in adult patients requiring venovenous ECMO for the treatment of COVID-19. The results showed that factors such as older age, male sex, chronic lung disease, longer duration of symptoms, longer duration of invasive mechanical ventilation, higher partial pressure of arterial carbon dioxide, and less previous experience with ECMO were associated with increased mortality risk.
LANCET RESPIRATORY MEDICINE
(2023)
Review
Critical Care Medicine
Jose Dianti, Idunn S. Morris, Martin Urner, Marcello Schmidt, George Tomlinson, Marcelo B. P. Amato, Lluis Blanch, Gordon Rubenfeld, Ewan C. Goligher
Summary: ICU clinicians heavily rely on bedside physiological measurements for clinical decisions, but testing hypotheses through mathematical models of the relationship between physiology and outcomes presents methodological challenges. These models can be influenced by researchers' assumptions and beliefs, requiring careful consideration of measurement errors, confounding factors, coupling, and causality direction. This paper outlines the challenges in analyzing and interpreting these models, providing potential solutions.
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Manuel Tisminetzky, Bruno L. Ferreyro, Michael C. Sklar, Lu Chen, Shaf Keshavjee, Marcelo Cypel, Eddy Fan, Niall D. Ferguson, Laurent Brochard, Ghislaine Doufle, Lorenzo Del Sorbo
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
(2023)
Article
Critical Care Medicine
Shannon M. Fernando, Rebecca Mathew, Behnam Sadeghirad, Bram Rochwerg, Benjamin Hibbert, Laveena Munshi, Eddy Fan, Daniel Brodie, Pietro Di Santo, Alexandre Tran, Shelley L. Mcleod, Christian Vaillancourt, Sheldon Cheskes, Niall D. Ferguson, Damon C. Scales, Steve Lin, Claudio Sandroni, Jasmeet Soar, Paul Dorian, Gavin D. Perkins, Jerry P. Nolan
Summary: The study included 18 trials and found that high-dose epinephrine, standard-dose epinephrine, and epinephrine plus vasopressin can increase return of spontaneous circulation and survival to hospital admission, but may not improve survival to discharge or survival with good functional outcome. Standard-dose epinephrine was found to improve survival to discharge for patients with nonshockable rhythm.
Article
Respiratory System
Alexandra Lenoir, Andreas Christe, Lukas Ebner, Catherine Beigelman-Aubry, Pierre-Olivier Bridevaux, Martin Brutsche, Christian Clarenbach, Berra Erkosar, Christian Garzoni, Thomas Geiser, Sabina A. Guler, Dik Heg, Frederic Lador, Marco Mancinetti, Sebastian R. Ott, Lise Piquilloud, Maura Prella, Yok-Ai Que, Christophe von Garnier, Manuela Funke-Chambour
Summary: This study aimed to investigate lung function and radiological abnormalities over 12 months in patients after severe and non-severe COVID-19. The study found that patients with severe COVID-19 had lower lung function after one year compared to non-severe patients, although the severe disease group had a greater extent of recovery.
Article
Critical Care Medicine
Tai Pham, Leo Heunks, Giacomo Bellani, Fabiana Madotto, Irene Aragao, Gaetan Beduneau, Ewan C. Goligher, Giacomo Grasselli, Jon Henrik Laake, Jordi Mancebo, Oscar Penuelas, Lise Piquilloud, Antonio Pesenti, Hannah Wunsch, Frank van Haren, Laurent Brochard, John G. Laffey
Summary: This study investigated the management and outcomes of weaning from invasive mechanical ventilation in patients requiring at least 2 days of ventilation. The results showed that only 65% of patients were successfully weaned at 90 days. Factors such as delayed initiation of weaning and excessive sedation levels were associated with weaning failure. Understanding these factors could improve the success rate of weaning.
LANCET RESPIRATORY MEDICINE
(2023)
Article
Health Care Sciences & Services
Dmitry Rozenberg, Noor Al Kaabi, Encarna Camacho Perez, Sahar Nourouzpour, Laura Lopez-Hernandez, Laura McGillis, Ewan Goligher, W. Darlene Reid, Chung-Wai Chow, Clodagh M. Ryan, Dinesh Kumbhare, Ella Huszti, Kateri Champagne, Satish Raj, Susanna Mak, Daniel Santa Mina, Hance Clarke, Nimish Mittal
Summary: This study aims to evaluate the factors associated with dyspnea and assess the feasibility and effectiveness of inspiratory muscle training (IMT) combined with standard-of-care rehabilitation. The study will include patients with hypermobile Ehlers-Danlos Syndrome (hEDS) or generalized hypermobility spectrum disorder (G-HSD) and healthy controls. The results are expected to be completed by the end of 2023.
JMIR RESEARCH PROTOCOLS
(2023)
Article
Ethics
John Tambakis, Lauris Kaldijian, Ewan C. Goligher
Summary: Contemporary bioethics calls for public moral deliberation to be free from religious influence in health policy and law. However, an examination of non-theistic arguments used to justify euthanasia reveals a reliance on metaethical and metaphysical beliefs that may not be universally accepted in a pluralistic society. The foundational similarity between religious and secular beliefs suggests that those who oppose the secular arguments for euthanasia should not be compelled to participate in or support such practices in pluralistic societies that value moral freedom.
THEORETICAL MEDICINE AND BIOETHICS
(2023)
Article
Critical Care Medicine
Martin Urner, Peter Juni, L. Paloma Rojas-Saunero, Bettina Hansen, Laurent J. Brochard, Niall D. Ferguson, Eddy Fan
Summary: This study investigated whether limiting the daily static or dynamic increment P can reduce mortality in mechanically ventilated patients, and found that limiting the dynamic increment P to less than or equal to 15 cm H2O can reduce mortality.
CRITICAL CARE MEDICINE
(2023)
Editorial Material
Critical Care Medicine
Irene M. J. Wong, Niall D. Ferguson, Martin Urner
INTENSIVE CARE MEDICINE
(2023)
Article
Critical Care Medicine
Giacomo Grasselli, Carolyn S. Calfee, Luigi Camporota, Daniele Poole, Marcelo B. P. Amato, Massimo Antonelli, Yaseen M. Arabi, Francesca Baroncelli, Jeremy R. Beitler, Giacomo Bellani, Geoff Bellingan, Bronagh Blackwood, Lieuwe D. J. Bos, Laurent Brochard, Daniel Brodie, Karen E. A. Burns, Alain Combes, Sonia D'Arrigo, Daniel De Backer, Alexandre Demoule, Sharon Einav, Eddy Fan, Niall D. Ferguson, Jean-Pierre Frat, Luciano Gattinoni, Claude Guerin, Margaret S. Herridge, Carol Hodgson, Catherine L. Hough, Samir Jaber, Nicole P. Juffermans, Christian Karagiannidis, Jozef Kesecioglu, Arthur Kwizera, John G. Laffey, Jordi Mancebo, Michael A. Matthay, Daniel F. McAuley, Alain Mercat, Nuala J. Meyer, Marc Moss, Laveena Munshi, Sheila N. Myatra, Michelle Ng Gong, Laurent Papazian, Bhakti K. Patel, Mariangela Pellegrini, Anders Perner, Antonio Pesenti, Lise Piquilloud, Haibo Qiu, Marco Ranieri, Elisabeth Riviello, Arthur S. Slutsky, Renee D. Stapleton, Charlotte Summers, Taylor B. Thompson, Carmen Valente Barbas, Jesus Villar, Lorraine B. Ware, Bjoern Weiss, Fernando G. Zampieri, Elie Azoulay, Maurizio Cecconi
Summary: The aim of these guidelines is to update the 2017 clinical practice guideline (CPG) of the European Society of Intensive Care Medicine (ESICM). The scope of this CPG is limited to adult patients and to non-pharmacological respiratory support strategies across different aspects of acute respiratory distress syndrome (ARDS), including ARDS due to coronavirus disease 2019 (COVID-19). These guidelines were formulated by an international panel of clinical experts, one methodologist and patients' representatives on behalf of the ESICM.
INTENSIVE CARE MEDICINE
(2023)
Article
Medicine, General & Internal
Patrick R. Lawler, Lennie P. G. Derde, Frank L. van de Veerdonk, Bryan J. McVerry, David T. Huang, Lindsay R. Berry, Elizabeth Lorenzi, Roland van Kimmenade, Frank Gommans, Muthiah Vaduganathan, David E. Leaf, Rebecca M. Baron, Edy Y. Kim, Claudia Frankfurter, Slava Epelman, Yvonne Kwan, Richard Grieve, Stephen O'Neill, Zia Sadique, Michael Puskarich, John C. Marshall, Alisa M. Higgins, Paul R. Mouncey, Kathryn M. Rowan, Farah Al-Beidh, Djillali Annane, Yaseen M. Arabi, Carly Au, Abi Beane, Wilma van Bentum-Puijk, Marc J. M. Bonten, Charlotte A. Bradbury, Frank M. Brunkhorst, Aidan Burrell, Adrian Buzgau, Meredith Buxton, Maurizio Cecconi, Allen C. Cheng, Matthew Cove, Michelle A. Detry, Lise J. Estcourt, Justin Ezekowitz, Mark Fitzgerald, David Gattas, Lucas C. Godoy, Herman Goossens, Rashan Haniffa, David A. Harrison, Thomas Hills, Christopher M. Horvat, Nao Ichihara, Francois Lamontagne, Kelsey M. Linstrum, Daniel F. McAuley, Anna McGlothlin, Shay P. McGuinness, Zoe McQuilten, Srinivas Murthy, Alistair D. Nichol, David R. J. Owen, Rachael L. Parke, Jane C. Parker, Katrina M. Pollock, Luis Felipe Reyes, Hiroki Saito, Marlene S. Santos, Christina T. Saunders, Christopher W. Seymour, Manu Shankar-Hari, Vanessa Singh, Alexis F. Turgeon, Anne M. Turner, Ryan Zarychanski, Cameron Green, Roger J. Lewis, Derek C. Angus, Scott Berry, Anthony C. Gordon, Colin J. McArthur, Steve A. Webb
Summary: In patients with COVID-19, overactivation of the renin-angiotensin system (RAS) may have negative clinical outcomes. This study aimed to determine if initiating angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) could improve outcomes in hospitalized COVID-19 patients. The results showed that in critically ill patients, the use of ACE inhibitors or ARBs did not improve, and likely worsened, clinical outcomes.
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2023)
Article
Health Care Sciences & Services
Tyler Pitre, Samantha Cheng, Ellen Cusano, Nadia Khan, David Mikhail, Gareth Leung, Robin W. M. Vernooij, Christopher J. Yarnell, Ewan Goligher, Srinivas Murthy, Anna Heath, Jasmine Mah, Bram Rochwerg, Dena Zeraatkar
Summary: The objective of this review is to summarize published platform trials, examine specific methodological design features among these studies, and hopefully aid readers in the evaluation and interpretation of platform trial results. A systematic review was performed, and 98 unique randomized platform trials were identified. The results showed that Bayesian methods were used in 28.6% of platform trials, while frequentist methods were used in 66.3% of trials. Out of the 25 trials with published results, 7 trials used Bayesian methods. In conclusion, this review provides the most updated and rigorous summary of platform trials.
JOURNAL OF CLINICAL EPIDEMIOLOGY
(2023)
Review
Respiratory System
Annemijn H. Jonkman, Irene Telias, Elena Spinelli, Evangelia Akoumianaki, Lise Piquilloud
Summary: Personalising ventilator settings through measurement of oesophageal pressure (Poes) allows assessment of respiratory mechanics and quantification of lung stress, guiding individualised ventilator settings and improving assisted ventilation and weaning. This review provides an understanding of relevant physiological concepts assessed using Poes measurements and presents a practical approach for implementing oesophageal manometry at the bedside. Further clinical data is needed to confirm the benefits and determine optimal targets, but potential practical approaches are discussed.
EUROPEAN RESPIRATORY REVIEW
(2023)
Article
Physiology
Melissa Miles, Paul Davenport, Sunita Mathur, Ewan C. Goligher, Dmitry Rozenberg, W. Darlene Reid
Summary: This study compared deoxygenation of different neck muscles during submaximal intermittent neck flexion (INF) and submaximal inspiratory threshold loading (ITL) in healthy adults. The results showed that intermittent INF significantly activated the sternocleidomastoid with lower perceived effort, suggesting it may be an alternative approach for inspiratory muscle training in mechanically ventilated patients.
EUROPEAN JOURNAL OF APPLIED PHYSIOLOGY
(2023)