Two patients with the adult respiratory distress syndrome (ARDS) were placed on pressure-controlled inverse-ratio ventilation (IRV) when their condition deteriorated despite optimal treatment with intermittent mandatory ventilation and positive end-expiratory pressure. In the first case, high peak airway pressure was reduced by 50 percent with the institution of IRV. In the second, refractory hypoxemia was eliminated by using an inspiratory-to-expiratory ratio of 4:1. These cases show that IRV may offer certain advantages in the treatment of severe ARDS.
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http://dx.doi.org/10.1378/chest.89.2.211 | DOI Listing |
Pulmonology
December 2025
Department of Emergency and Intensive Care, Fondazione IRCCS San Gerardo dei tintori, Monza, Italy.
Background: Non-invasive helmet respiratory support is suitable for several clinical conditions. Continuous-flow helmet CPAP systems equipped with HEPA filters have become popular during the recent Coronavirus pandemic. However, HEPA filters generate an overpressure above the set PEEP.
View Article and Find Full Text PDFAm J Vet Res
January 2025
National Taiwan University Veterinary Hospital, National Taiwan University, Taipei, Taiwan.
Objective: Enhancing ventilatory effort during pulmonary function testing can help reveal flow limitations not evident in normal tidal breathing. This study aimed to assess the efficacy and tolerability of using a CO2/O2 gas mixture to enhance tidal breathing with a barometric whole-body plethysmography system in both healthy cats and those with feline lower airway disease (FLAD).
Methods: This prospective study included healthy cats and those with FLAD, which underwent pulmonary function testing and were exposed to a 10% CO2/90% O2 gas mixture in a barometric whole-body plethysmography chamber, with CO2 concentrations maintained within the target range of 5% to 10%.
JAMA Otolaryngol Head Neck Surg
January 2025
Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Importance: Airway stenosis is a rare but debilitating disorder that significantly degrades the quality of life in affected patients. Treatments are primarily surgical, and disease management lacks established medical therapies. The North American Airway Collaborative held its third symposium at The Johns Hopkins Hospital in Baltimore, Maryland, on April 15, 2024, focused on strategies to advance the care of these patients.
View Article and Find Full Text PDFAust Crit Care
January 2025
KU Leuven, Department of Rehabilitation Sciences, Research Group for Rehabilitation in Internal Disorders, B-3000, Leuven, Belgium; University Hospitals Leuven, Department of Intensive Care Medicine, Leuven, Belgium.
Background: Recent studies suggest that fast and deep inspirations against either low or high external loads may provide patients with weaning difficulties with a training stimulus during inspiratory muscle training (IMT). However, the relationship between external IMT load, reflected by changes in airway pressure swings (ΔPaw), and total inspiratory effort, measured by oesophageal pressure swings (ΔPes), remains unexplored. Additionally, the association between ΔPes, ΔPaw, and inspiratory muscle activations remains unclear.
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