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Patient-Ventilator Interaction.

Patient-ventilator interaction has been the focus of increasing attention from both manufacturers and researchers during the last 25 years. There is now compelling evidence that passive (controlled) mechanical ventilation leads to respiratory muscle dysfunction and atrophy, prolonging the need for ventilatory support and predisposing to a number of adverse patient outcomes.

Although there is consensus that the respiratory muscles should retain some activity during acute respiratory failure, patient-ventilator asynchrony is now recognized as a cause of ineffective ventilation, impaired gas exchange, lung overdistention, increased work of breathing, and patient discomfort. Far more common than previously recognized, it also predisposes to respiratory muscle dysfunction...

Patient-Ventilator Interaction During Noninvasive Ventilation.

There is arguably more evidence to support the use of noninvasive ventilation (NIV) than any other practice related to the care of patients with acute respiratory failure. Despite this strong evidence base, NIV seems to be under-utilized and the failure rate (need for intubation) may be as high as 40%. Some of these failures potentially relate to asynchrony, although the relationship between asynchrony and NIV failure has not been well studied. Good NIV tolerance has been associated with success of NIV, and improved comfort has been associated with better synchrony.

In one study a high rate of asynchrony occurred in 43% of patients during NIV. Asynchrony is commonly associated with leaks. Thus, reducing the leak related to the interface and using a ventilator with good...

Postoperative complications and respiratory function following segmentectomy of the lung - comparison of the methods of making an inter-segmental plane [Institutional report - Thoracic oncologic]

Segmentectomy could be one of the standard modes of surgery for the treatment of early lung cancer. However, segmentectomy could be more difficult than lobectomy as to the management of inter-segmental plane. The relationship between methods of dividing an inter-segmental plane and postoperative complication/pulmonary function was investigated in this study.

A retrospective study was conducted on 49 patients who underwent segmentectomy of the lung between February 2008 and April 2009 at our institute. Eighteen (36.7%) were male and 31 (63.3%) were female. The inter-segmental plane was divided with only a mechanical stapler in 18 patients, and electrocautery was used in the other 31 patients. There were no significant relationships between clinicopathological features and both procedures, ...

Subpleural Honeycombing on High Resolution Computed Tomography is Risk Factor for Fatal Pneumonitis [ORIGINAL ARTICLES: GENERAL THORACIC]

Subpleural honeycombing on high-resolution computed tomography is a significant predictor of postoperative interstitial pneumonia in asymptomatic patients who undergo resection for lung cancer.

Acute bronchitis: Many patients expect to be treated with antibiotics and cough meds but this differs from guidelines

Mind map of differential diagnosis of cough. See more Allergy and Immunology mind maps here.Cough is the most common symptom bringing patients to the primary care physician's office. The most common diagnosis in these patients is acute bronchitis, according to a recent review in the official journal of AFP, American Family Physician.

Acute bronchitis should be differentiated from other common causes of cough such as pneumonia and asthma - because the therapies are clearly different.Symptoms of acute bronchitis typically last 3 weeks. As we already know, the presence of colored (e.g., yellow or green) sputum does not reliably differentiate between bacterial and viral lower respiratory tract infections. Viruses cause more than 90% of acute bronchitis, and therefore, antibiotics are generally ...

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