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Critical Care

Intrinsic positive end-expiratory pressure (PEEPi) is a “threshold” load that must be overcome to trigger conventional pneumatically-controlled pressure support (PSP) in chronic obstructive pulmonary disease (COPD). Application of extrinsic PEEP (PEEPe) reduces trigger delays and mechanical inspiratory efforts. Using the diaphragm electrical activity (EAdi), neurally controlled pressure support (PSN) could hypothetically eliminate asynchrony and reduce mechanical inspiratory effort, hence substituting the need for PEEPe. The primary objective of this study was to show that PSN can reduce the need for PEEPe to improve patient-ventilator interaction and to reduce both the “pre-trigger” and “total inspiratory” neural and mechanical efforts in COPD patients with PEEPi. A secondary objective was to evaluate the impact of applying PSN on breathing pattern.  
ccforum.com
over 6 years ago
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Strategies used for the withdrawal of humidified high flow nasal cannulae (HHFNC) in preterm infants | Cochrane

Background: Humidified high flow nasal cannula (HHFNC) is a form of respiratory support used in the treatment of preterm infants. Potential risks of HHFNC include damage to the nose and leaking of air from the lungs. Infants on HHFNC require more nursing care and the use of extra equipment (when compared to not being on any support). However, potential complications of removing HHFNC from babies too early include increased episodes of forgetting to breathe, increased oxygen needs, increased effort of breathing, the need to restart HHFNC, and the need for a breathing tube with mechanical ventilation. Any of these complications can be seen as a "failure" and are potentially distressing to staff and family. The best way to withdraw HHFNC once it has been started is unknown. Options include simply stopping, weaning the flow, increasing the time off HHFNC each day, or combinations of both.  
cochrane.org
over 6 years ago
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Continuous distending pressure for respiratory distress in preterm infants | Cochrane

Review question: In spontaneously breathing preterm infants with respiratory failure, does continuous distending pressure (CDP) of the lung reduce the need for assisted ventilation and other associated complications of prematurity?  
cochrane.org
over 6 years ago
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15

Effects of opioid, hypnotic and sedating medications on obstructive sleep apnoea (OSA) in adults with known OSA | Cochrane

Obstructive sleep apnoea (OSA) is a common sleep disorder characterised by intermittent apnoeas (pauses in breathing) leading to dips in oxygen levels in the blood during sleep. Many people with known or unknown (undiagnosed) OSA receive hypnotics, sedatives and opiate/opioid drugs to treat other conditions including pain, anxiety and difficulty sleeping. Opiates/opioids are commonly prescribed to treat pain after major surgery. These drugs might make sleep apnoea worse - increasing the frequency and duration of apnoeas.  
cochrane.org
over 6 years ago
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Fresh frozen plasma for patients undergoing surgery on the heart or blood vessels | Cochrane

Fresh frozen plasma is obtained from whole blood from blood donors. It contains a number of factors that help blood to clot. The risk of bleeding in open heart surgery or surgery on the main blood vessels in the body is high. Fresh frozen plasma is sometimes administered to these patients to reduce bleeding. It can be administered prophylactically (to prevent bleeding) or therapeutically (to treat bleeding). However, there are risks of side effects from fresh frozen plasma, such as severe allergic reactions or breathing problems.  
cochrane.org
over 6 years ago
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Can taking inhaled corticosteroids when needed for symptoms help people with mild asthma from becoming more unwell? | Cochrane

Daily inhaled corticosteroids (ICS) are the mainstay of medications prescribed for people with asthma who have ongoing difficulty with their breathing. However, for those with a milder form of the condition, it is hard to predict when their asthma will get worse and so many people do not use their inhaler regularly. In this review, we compared the use of ICS used intermittently at the start of an asthma episode with placebo treatment in children and adults with mild asthma (two trials representing 385 participants) and in preschool children deemed to be at risk of developing asthma symptoms in the future (four trials representing 490 participants).  
cochrane.org
over 6 years ago
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Does hyperbaric oxygen therapy improve outcome after heart attack? | Cochrane

Acute heart attacks and severe angina (heart pain) are usually due to blockages in the arteries supplying the heart (coronary arteries). These problems are collectively referred to as 'acute coronary syndrome' (ACS). ACS is very common and may lead to severe complications including death. Hyperbaric oxygen therapy (HBOT) involves people breathing pure oxygen at high pressures in a specially designed chamber. It is sometimes used as a treatment to increase the supply of oxygen to the damaged heart in an attempt to reduce the area of the heart that is at risk of dying.  
cochrane.org
over 6 years ago
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"Dry drowning" the summer medical oxymoron

Undoubtedly you will see a child with a “near drowning” if you work in the ED during the summer. Most children are fine, even those that received some back blows, mouth to mouth or some semblance of bystander rescue maneuvers. Asymptomatic children (no respiratory symptoms) can be safely discharged home. Those that are having difficulty breathing or other symptoms should receive appropriate respiratory support and be followed closely clinically and with chest x-rays when the situation changes. All symptomatic children should be admitted to the hospital.  
pemcincinnati.com
over 6 years ago
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Surgical versus nonsurgical interventions for flail chest (ribs with more than one fracture) | Cochrane

Flail chest is a medical term describing multiple rib fractures, when ribs are broken or dislocated in more than one place and are no longer completely connected to the other rib bones. When a person injured in this way breathes, the broken segment may move in a different way compared to the rest of the chest wall. Flail chest can cause a person to have difficulty breathing, in which case they may be given mechanical ventilation (machine-assisted breathing). Surgery is sometimes performed in order to reconnect the broken ribs.  
cochrane.org
over 6 years ago
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First Response Monitor Tracks Heart, Respiratory Rates in Multiple Trauma Victims |

The Cambridge Design Partnership, an industrial design consulting firm out of Cambridge, UK, has created a vital signs monitor designed to help first respo  
medgadget.com
over 6 years ago
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Sleep wake disorders breathing related sleep disorders

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT...  
youtube.com
over 6 years ago