Understanding of pulmonary mechanics is essential to understanding mechanical ventilation. Typically, clinicians are mindful of peak and plateau pressures displayed on the ventilator and lung compliance, which is decreased in lung disease such as idiopathic pulmonary fibrosis (IPF). Decreased lung compliance leads to elevated peak and plateau pressures. We present a patient with IPF undergoing mechanical ventilation after cardiac arrest. Despite low lung compliance, he had normal peak and plateau pressures due to the presence of flail chest and increased chest wall compliance. This case highlights the role chest wall compliance plays in total respiratory system compliance and pulmonary mechanics.
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http://dx.doi.org/10.1016/j.rmcr.2022.101802 | DOI Listing |
Ultrasound J
January 2025
Health Sciences North Research Institute, Sudbury, ON, Canada.
The duration of mechanical systole-also termed the flow time (FT) or left ventricular ejection time (LVET)-is measured by Doppler ultrasound and increasingly used as a stroke volume (SV) surrogate to guide patient care. Nevertheless, confusion exists as to the determinants of FT and a critical evaluation of this measure is needed. Using Doppler ultrasound of the left ventricular outflow tract velocity time integral (LVOT VTI) as well as strain and strain rate echocardiography as grounding principles, this brief commentary offers a model for the independent influences of FT.
View Article and Find Full Text PDFAm J Respir Crit Care Med
January 2025
Radbound Univeristy Medical Center, Nijmegen, Netherlands;
Rationale: In critically ill patients receiving invasive mechanical ventilation, switching from controlled to assisted ventilation is a crucial milestone towards ventilator liberation. The optimal timing for switching to assisted ventilation has not been studied.
Objectives: Our objective was to determine whether a strategy of early as compared to delayed switching affects the duration of invasive mechanical ventilation, ICU length of stay, and mortality.
Multimed Man Cardiothorac Surg
January 2025
Division of Thoracic Surgery University of Padua via Giustiniani 2 35128 Padua Italy.
In patients with suspected interstitial lung disease, diagnostic confirmation can be achieved through an awake video-assisted surgical lung biopsy. This procedure enables the collection of a substantial amount of parenchymal tissue for diagnostic purposes while minimizing perioperative complications associated with mechanical ventilation with the patient under general anaesthesia, given the impaired lung function due to the underlying condition.
View Article and Find Full Text PDFCirc Res
January 2025
Division of Cardiology, Department of Medicine, Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, PA. (R.A.C., C.C.C., R.W., A.C., C.B., C.R., W.J.M., M.J. Bashline, A.P., A.M.P., P.B., M.J. Brown, C.S.H.).
Background: Calcific aortic valve disease is the pathological remodeling of valve leaflets. The initial steps in valve leaflet osteogenic reprogramming are not fully understood. As TERT (telomerase reverse transcriptase) overexpression primes mesenchymal stem cells to differentiate into osteoblasts, we investigated whether TERT contributes to the osteogenic reprogramming of valve interstitial cells.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Intensive Care Unit, Zhongshan City People's Hospital, Zhongshan City, China.
Background: Electrical impedance tomography (EIT) evaluates lung function by providing continuous, real-time monitoring of regional lung ventilation distribution to guide the restoration of lung ventilation. Patients with obesity who are dependent on mechanical ventilation often struggle with weaning. This case report highlights the potential of EIT to guide the weaning of ventilator-dependent patients in an obese patient with severe pneumonia.
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