Publications by authors named "Miyako Kyogoku"
Background: We have previously reported a simple correction method for estimating pleural pressure (Ppl) using central venous pressure (CVP). However, it remains unclear whether this method is applicable to patients with varying levels of intravascular volumes and/or chest wall compliance. This study aimed to investigate the accuracy of our method under different conditions of intravascular volume and chest wall compliance.
View Article and Find Full Text PDFArticle Synopsis
- Monitoring respiratory effort in ventilated pediatric patients is crucial for protecting lung function and diaphragm effectiveness, but current methods like esophageal manometry are invasive and require special training.
- This study analyzed data from children with acute respiratory distress syndrome to correlate changes in esophageal pressure during breathing with airway pressures from three specific occlusion maneuvers.
- Results indicated that expiratory occlusion pressure has the strongest correlation with esophageal pressure changes, suggesting its potential as a reliable, less invasive method to assess respiratory effort in children.
Article Synopsis
- * The review discusses methods for calibrating balloon catheters and interpreting esophageal pressure measurements, both directly and via elastance-based methods, to enhance clinical practices.
- * Clinical applications of esophageal manometry include assessing lung compliance, optimizing ventilator support, and aiding in weaning patients off ventilation, providing tailored care for those with respiratory issues.
Objectives: To compare the pathogen identification rate and use of antibiotics before and after the implementation of multiplex polymerase chain reaction testing in children with respiratory infections in a PICU.
Design: Single-center, pre-post study.
Setting: PICU of Osaka Women's and Children's Hospital, Osaka, Japan.
Background: It is important to evaluate the size of respiratory effort to prevent patient self-inflicted lung injury and ventilator-induced diaphragmatic dysfunction. Esophageal pressure (Pes) measurement is the gold standard for estimating respiratory effort, but it is complicated by technical issues. We previously reported that a change in pleural pressure (ΔPpl) could be estimated without measuring Pes using change in CVP (ΔCVP) that has been adjusted with a simple correction among mechanically ventilated, paralyzed pediatric patients.
View Article and Find Full Text PDFReverse triggering (RT) occurs when respiratory effort begins after a mandatory breath is initiated by the ventilator. RT may exacerbate ventilator-induced lung injury and lead to breath stacking. We sought to describe the frequency and risk factors for RT among patients with acute respiratory distress syndrome (ARDS) and identify risk factors for breath stacking.
View Article and Find Full Text PDFObjectives: Inspiratory holds with measures of airway pressure to estimate driving pressure (elastic work) are often limited to patients without respiratory effort. We sought to evaluate if measures of airway pressure during inspiratory holds could be used for patients with spontaneous respiratory effort during mechanical ventilation to estimate the degree of spontaneous effort and elastic work.
Design: We compared the direction and degree of change in airway pressure during inspiratory holds versus esophageal pressure through secondary analysis of physiologic data.
Objectives: We aimed to identify the occurrence and risk factors for unplanned catheter removal due to catheter-associated complications and the effects on catheter survival probability in a PICU.
Design: Retrospective, single-center, observational study of cases involving conventional central venous catheters or peripherally inserted central venous catheters.
Setting: The PICU of a tertiary children's hospital.
The objective of the study is to develop a correction method for estimating the change in pleural pressure (ΔPpl) and plateau transpulmonary pressure (P) by using the change in central venous pressure (ΔCVP). Seven children (aged < 15 years) with acute respiratory failure (PaO/FO < 300 mmHg), who were paralyzed and mechanically ventilated with a PEEP of < 10 cmHO and had central venous catheters and esophageal balloon catheters placed for clinical purposes, were enrolled prospectively. We compared change in esophageal pressure (ΔPes), ΔCVP, and ΔPpl calculated using a corrected ΔCVP (cΔCVP-derived ΔPpl).
View Article and Find Full Text PDFIn 2014, our hospital introduced inhaled nitric oxide (iNO) therapy combined with high-flow nasal cannula (HFNC) oxygen therapy after extubation following the Fontan procedure in patients with unstable hemodynamics. We report the benefits of HFNC-iNO therapy in these patients. This was a single-center, retrospective review of 38 patients who underwent the Fontan procedure between January 2010 and June 2016, and required iNO therapy before extubation.
View Article and Find Full Text PDFObjectives: Healthcare-associated infections after pediatric cardiac surgery are significant causes of morbidity and mortality. We aimed to identify the risk factors for the occurrence of healthcare-associated infections after pediatric cardiac surgery.
Design: Retrospective, single-center observational study.