[Physiotherapy challenges in the management of breast cancer].

Breast cancer claims fewer lives in Switzerland, but it profoundly impacts the quality of life, with various treatments carrying significant side effects. Cancer treatments include physiotherapy as soon as possible. Physiotherapist, movement expert, using physical activity, enhances survival rates, reduces treatment-related side effects, and improves quality of life.

[Acute coronary heart disease and women].

Acute coronary syndrome (ACS) is the leading cause of death among women in high-income countries. However, the literature is mainly based on the male model as are the resulting scientific guidelines. female-specific risk factors are frequent and still underestimated, contributing to a difference in overall management.

The HEV Ventilator: at the interface between particle physics and biomedical engineering.

A high-quality, low-cost ventilator, dubbed HEV, has been developed by the particle physics community working together with biomedical engineers and physicians around the world. The HEV design is suitable for use both in and out of hospital intensive care units, provides a variety of modes and is capable of supporting spontaneous breathing and supplying oxygen-enriched air. An external air supply can be combined with the unit for use in situations where compressed air is not readily available.

[Centers for bariatric medicine : why and how ?].

Obesity is a chronic, complex and relapsing disease. Because of this complexity, work up and follow up of affected patients implicate different specialists, working in synergy to diagnose and treat obesity and its complications. This follow up is specialized, and should be available in integrated centers of bariatric medicine offering all modalities of treatments with proven efficacy, whether medical, surgical or psychotherapeutical.

[Long-term non-invasive ventilation in chronic obstructive pulmonary disease patients].

Non-invasive ventilation (NIV) is recognized as first line therapy in acute hypercapnic respiratory failure and chronic alveolar hypoventilation caused by several diseases (restrictive thoracic disorders, neuromuscular disease and obesity-hypoventilation syndrome). In Switzerland and other European countries, long-term NIV has also been applied in hypercapnic patients with chronic obstructive pulmonary disease (COPD). However, only recently has conclusive evidence showing benefits of long-term NIV become available.

Closed-loop ventilation mode (IntelliVent®-ASV) in intensive care unit: a randomized trial.

Background: Closed-loop modes automatically adjust ventilation settings, delivering individualized ventilation over short periods of time. The objective of this randomized controlled trial was to compare safety, efficacy and workload for the health care team between IntelliVent®-ASV and conventional modes over a 48-hour period.

Methods: ICU patients admitted with an expected duration of mechanical ventilation of more than 48 hours were randomized to IntelliVent®-ASV or conventional ventilation modes.

Neonatal and adult ICU ventilators to provide ventilation in neonates, infants, and children: a bench model study.

Background: Using a bench test model, we investigated the hypothesis that neonatal and/or adult ventilators equipped with neonatal/pediatric modes currently do not reliably administer pressure support (PS) in neonatal or pediatric patient groups in either the absence or presence of air leaks.

Methods: PS was evaluated in 4 neonatal and 6 adult ventilators using a bench model to evaluate triggering, pressurization, and cycling in both the absence and presence of leaks. Delivered tidal volumes were also assessed.

Patient-ventilator asynchrony during noninvasive pressure support ventilation and neurally adjusted ventilatory assist in infants and children.

Objectives: To document the prevalence of asynchrony events during noninvasive ventilation in pressure support in infants and in children and to compare the results with neurally adjusted ventilatory assist.

Design: Prospective randomized cross-over study in children undergoing noninvasive ventilation.

Setting: The study was performed in a PICU.

Optimizing patient-ventilator synchrony during invasive ventilator assist in children and infants remains a difficult task*.

Objectives: To document and compare the prevalence of asynchrony events during invasive-assisted mechanical ventilation in pressure support mode and in neurally adjusted ventilatory assist in children.

Design: Prospective, randomized, and crossover study.

Setting: Pediatric and Neonatal Intensive Care Unit, University Hospital of Geneva, Switzerland.

Patient-ventilator asynchrony during noninvasive ventilation: a bench and clinical study.

Background: Different kinds of ventilators are available to perform noninvasive ventilation (NIV) in ICUs. Which type allows the best patient-ventilator synchrony is unknown. The objective was to compare patient-ventilator synchrony during NIV between ICU, transport—both with and without the NIV algorithm engaged—and dedicated NIV ventilators.

Delivery of helium–oxygen mixture during spontaneous breathing: evaluation of three high-concentration face masks.

Purpose: To evaluate the efficacy of delivering a mixture of helium and oxygen gas (He–O2) in spontaneous ventilation. Three high oxygen flow reservoir masks were tested: the Heliox21, specifically designed for helium; the Hi-Ox80 mask, with an inspiratory and an expiratory valve; and a standard high-concentration face mask.

Methods: This prospective randomized crossover study was performed in six healthy volunteers in a laboratory setting.

Monitoring of noninvasive ventilation by built-in software of home bilevel ventilators: a bench study.

Background: Current bilevel positive-pressure ventilators for home noninvasive ventilation (NIV) provide physicians with software that records items important for patient monitoring, such as compliance, tidal volume (Vt), and leaks. However, to our knowledge, the validity of this information has not yet been independently assessed.

Methods: Testing was done for seven home ventilators on a bench model adapted to simulate NIV and generate unintentional leaks (ie, other than of the mask exhalation valve).

[Non invasive ventilation outside of the intensive care: principles and modalities].

Non invasive ventilation encompasses all techniques of ventilatory support which do not require an endotracheal approach. Interfaces are available for coping with most situations, with an acceptable control of leaks, of patient comfort, even in severely ventilator dependant subjects. A wide variety of home ventilators, also used in hospital wards outside of intensive care units, are available, either volume-cycled, pressure-cycled, or "multi-mode", allowing flexibility in prescription and adjustment of treatment.

Online estimation of respiratory mechanics in non-invasive pressure support ventilation: a bench model study.

An online algorithm for determining respiratory mechanics in patients using non-invasive ventilation (NIV) in pressure support mode was developed and embedded in a ventilator system. Based on multiple linear regression (MLR) of respiratory data, the algorithm was tested on a patient bench model under conditions with and without leak and simulating a variety of mechanics. Bland-Altman analysis indicates reliable measures of compliance across the clinical range of interest (± 11-18% limits of agreement).

Neurally adjusted ventilatory assist improves patient-ventilator interaction.

Purpose: To determine if, compared with pressure support (PS), neurally adjusted ventilatory assist (NAVA) reduces trigger delay, inspiratory time in excess, and the number of patient-ventilator asynchronies in intubated patients.

Methods: Prospective interventional study in spontaneously breathing patients intubated for acute respiratory failure. Three consecutive periods of ventilation were applied: (1) PS1, (2) NAVA, (3) PS2.

Performance of noninvasive ventilation algorithms on ICU ventilators during pressure support: a clinical study.

Objective: To evaluate the impact of noninvasive ventilation (NIV) algorithms available on intensive care unit ventilators on the incidence of patient-ventilator asynchrony in patients receiving NIV for acute respiratory failure.

Design: Prospective multicenter randomized cross-over study.

Setting: Intensive care units in three university hospitals.

Automated detection of asynchrony in patient-ventilator interaction.

An automated classification algorithm for the detection of expiratory ineffective efforts in patient-ventilator interaction is developed and validated. Using this algorithm, 5624 breaths from 23 patients in a pulmonary ward were examined. The participants (N = 23) underwent both conventional and non-invasive ventilation.

Evaluation of the user-friendliness of seven new generation intensive care ventilators.

Objective: To explore the user-friendliness and ergonomics of seven new generation intensive care ventilators.

Design: Prospective task-performing study.

Setting: Intensive care research laboratory, university hospital.

Patient-ventilator asynchrony during non-invasive ventilation for acute respiratory failure: a multicenter study.

Objective: To determine the prevalence of patient-ventilator asynchrony in patients receiving non-invasive ventilation (NIV) for acute respiratory failure.

Design: Prospective multicenter observation study.

Setting: Intensive care units in three university hospitals.

Performance of noninvasive ventilation modes on ICU ventilators during pressure support: a bench model study.

Objective: Noninvasive ventilation (NIV) is often applied with ICU ventilators. However, leaks at the patient-ventilator interface interfere with several key ventilator functions. Many ICU ventilators feature an NIV-specific mode dedicated to preventing these problems.