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Clinical Management Of Pressure Control Ventilation: An Algorithmic Method Of Patient Ventilatory Management To Address “Forgotten But Important Variables”, Lonny Ashworth, Yasuhiro Norisue, Megan Koster, Jeff Anderson, Junko Takada, Hatsuyo Ebisu 2018 Boise State University

Clinical Management Of Pressure Control Ventilation: An Algorithmic Method Of Patient Ventilatory Management To Address “Forgotten But Important Variables”, Lonny Ashworth, Yasuhiro Norisue, Megan Koster, Jeff Anderson, Junko Takada, Hatsuyo Ebisu

Respiratory Therapy Faculty Publications and Presentations

Pressure controlled ventilation is a common mode of ventilation used to manage both adult and pediatric populations. However, there is very little evidence that distinguishes the efficacy of pressure controlled ventilation over that of volume controlled ventilation in the adult population. This gap in the literature may be due to the absence of a consistent and systematic algorithm for managing pressure controlled ventilation. This article provides a brief overview of the applications of both pressure controlled ventilation and volume controlled ventilation and proposes an algorithmic approach to the management of patients receiving pressure controlled ventilation. This algorithmic approach highlights the ...


Variations In Practice Of Apnea Test For Brain Death: Review From A Multihospital Health Care System, Jeffrey Stein, Marvi V. Rijhwani, Ernesto Brauer 2017 Department of Internal Medicine, Aurora Sinai Medical Center

Variations In Practice Of Apnea Test For Brain Death: Review From A Multihospital Health Care System, Jeffrey Stein, Marvi V. Rijhwani, Ernesto Brauer

Journal of Patient-Centered Research and Reviews

Background: Ventilation encompasses both active and passive processes. Air is initially drawn into the lungs due to a negative intrathoracic pressure created using the respiratory muscles, most importantly the diaphragm. In contrast, expiration is the passive relaxation of the respiratory muscles. Oxygenation occurs when oxygen diffuses across the alveolar-capillary membrane. The ability to oxygenate without ventilation has been termed apneic diffusion oxygenation or apneic oxygenation. We believe it is crucial to keep alveoli open in order for adequate oxygenation to occur. This can be achieved with the aid of positive end-expiratory pressure (PEEP). We investigated this concept in patients who ...


Impact Of Physician Education And Availability Of Parameters Regarding Esophageal Pressure And Transpulmonary Pressure On Clinical Decisions Involving Ventilator Management, Lonny Ashworth 2017 Boise State University

Impact Of Physician Education And Availability Of Parameters Regarding Esophageal Pressure And Transpulmonary Pressure On Clinical Decisions Involving Ventilator Management, Lonny Ashworth

Respiratory Therapy Faculty Publications and Presentations

Purpose: This study investigated the effects of physician education and the availability of Peso and PL data on physicians' decisions regarding ventilator management during specific simulated clinical conditions.

Materials and methods: The study was a prospective, before–after study using a case scenario–based questionnaire and a case simulator device comprising an Avea ventilator and an artificial lung and esophagus, which was connected to a Series 1101 Electronic Breathing Simulator. The 99 physicians participating in the study were provided with five simulated cases with on-time ventilator graphics without Peso and PL and completed a questionnaire on ...


The Role Of Heterogeneity In Asthma: A Structure-To-Function Perspective, Justin K. Lui, Kenneth R. Lutchen 2017 University of Massachusetts Medical School

The Role Of Heterogeneity In Asthma: A Structure-To-Function Perspective, Justin K. Lui, Kenneth R. Lutchen

Open Access Articles

A number of methods have evolved through the years in probing the dysfunction that impacts mechanics and ventilation in asthma. What has been consistently found is the notion of heterogeneity that is not only captured in the frequency dependence of lung mechanics measurements but also rendered on imaging as patchy diffuse areas of ventilation defects. The degree of heterogeneity has been linked to airway hyperresponsiveness, a hallmark feature of asthma. How these heterogeneous constriction patterns lead to functional impairment in asthma have only been recently explored using computational airway tree models. By synthesizing measurements of lung mechanics and advances in ...


Measuring The Energy Of Ventilation And Circulation During Human Walking Using Induced Hypoxia, Masahiro Horiuchi, Yoshiyuki Fukuoka, Yoko Handa, Daijiro Abe, Herman Pontzer 2017 Mt. Fuji Research Institute

Measuring The Energy Of Ventilation And Circulation During Human Walking Using Induced Hypoxia, Masahiro Horiuchi, Yoshiyuki Fukuoka, Yoko Handa, Daijiro Abe, Herman Pontzer

Publications and Research

Energy expenditure (EE) during walking includes energy costs to move and support the body and for respiration and circulation. We measured EE during walking under three different oxygen concentrations. Eleven healthy, young, male lowlanders walked on a treadmill at seven gait speeds (0.67–1.83 m s−1) on a level gradient under normobaric normoxia (room air, 21% O2), moderate hypoxia (15% O2), and severe hypoxia (11% O2). By comparing the hypoxia-induced elevation in heart rate (HR [bpm]), ventilation (VE [L min−1]) with the change in energy expenditure (EE [W]) at each speed, we were able to determine ...


Determining The Gaps Between Cochrane Reviews And Trials Of Effectiveness Of Interventions For Acute Respiratory Infections: An Audit, Jasmin Alloo, Sanya Vallath, Chris Del Mar, Matt Carter, Sarah Thorning, Justin Clark 2017 Bond University

Determining The Gaps Between Cochrane Reviews And Trials Of Effectiveness Of Interventions For Acute Respiratory Infections: An Audit, Jasmin Alloo, Sanya Vallath, Chris Del Mar, Matt Carter, Sarah Thorning, Justin Clark

Christopher Del Mar

BACKGROUND:

Cochrane primarily aims to systematically review trials of effectiveness that are important to inform clinical decisions. Editorial groups support authors to achieve high-quality reviews and prioritise review proposals in their clinical domain that are submitted or elicited. Prioritising proposals requires two approaches, identifying (1) clinical practises for which the evidence of effectiveness is uncertain and (2) interventions in which there are trials of effectiveness (especially randomised controlled trials (RCTs)) not systematically reviewed. This study addresses this second approach for the Cochrane Acute Respiratory Infections Group (CARIG) in order to identify RCTs of acute respiratory infections that have not been ...


May 2017, SWOSU Bulldog Wellness Committee 2017 Southwestern Oklahoma State University

May 2017, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

No abstract provided.


Determining The Gaps Between Cochrane Reviews And Trials Of Effectiveness Of Interventions For Acute Respiratory Infections: An Audit, Jasmin Alloo, Sanya Vallath, Chris Del Mar, Matt Carter, Sarah Thorning, Justin Clark 2017 Bond University

Determining The Gaps Between Cochrane Reviews And Trials Of Effectiveness Of Interventions For Acute Respiratory Infections: An Audit, Jasmin Alloo, Sanya Vallath, Chris Del Mar, Matt Carter, Sarah Thorning, Justin Clark

Faculty of Health Sciences & Medicine Publications

BACKGROUND:

Cochrane primarily aims to systematically review trials of effectiveness that are important to inform clinical decisions. Editorial groups support authors to achieve high-quality reviews and prioritise review proposals in their clinical domain that are submitted or elicited. Prioritising proposals requires two approaches, identifying (1) clinical practises for which the evidence of effectiveness is uncertain and (2) interventions in which there are trials of effectiveness (especially randomised controlled trials (RCTs)) not systematically reviewed. This study addresses this second approach for the Cochrane Acute Respiratory Infections Group (CARIG) in order to identify RCTs of acute respiratory infections that have not been ...


Cigarette Smoke Impairs A2a Adenosine Receptor Mediated Wound Repair Through Up-Regulation Of Duox-1 Expression., Zhi Tian, Hui Zhang, Jendayi Dixon, Nicole Traphagen, Todd A. Wyatt, Kusum K. Kharbanda, Samantha Simet, Narasaiah Kolliputi, Diane S Allen-Gipson 2017 University of South Florida

Cigarette Smoke Impairs A2a Adenosine Receptor Mediated Wound Repair Through Up-Regulation Of Duox-1 Expression., Zhi Tian, Hui Zhang, Jendayi Dixon, Nicole Traphagen, Todd A. Wyatt, Kusum K. Kharbanda, Samantha Simet, Narasaiah Kolliputi, Diane S Allen-Gipson

Journal Articles: Pulmonary & Critical Care Med

Cigarette smoke (CS) exposure and intrinsic factors such as the NADPH oxidases produce high levels of reactive oxygen species (ROS), ensuing inflammatory tissue injury. We previously demonstrated that CS-generated ROS, particularly hydrogen peroxide (H2O2), impaired adenosine stimulated wound repair. We hypothesized that CS exposure modulates expression of Dual oxidase 1 (Duox-1), a NADPH oxidases known to generate H2O2. To test this hypothesis, we used human bronchial epithelial cell line Nuli-1 and C57BL/6 mice. Cells were treated with 5% CS extract (CSE) for various periods of time, and mice were exposed to whole body CS for six weeks. Both CSE ...


Effect Of Low-Level Co2 On Innate Inflammatory Protein Response To Organic Dust From Swine Confinement Barns., David Schneberger, Jane M. DeVasure, Kristina L. Bailey, Debra J. Romberger, Todd A. Wyatt 2017 University of Nebraska Medical Center

Effect Of Low-Level Co2 On Innate Inflammatory Protein Response To Organic Dust From Swine Confinement Barns., David Schneberger, Jane M. Devasure, Kristina L. Bailey, Debra J. Romberger, Todd A. Wyatt

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Organic hog barn dust (HDE) exposure induces lung inflammation and long-term decreases in lung function in agricultural workers. While concentrations of common gasses in confined animal facilities are well characterized, few studies have been done addressing if exposure to elevated barn gasses impacts the lung immune response to organic dusts. Given the well documented effects of hypercapnia at much higher levels we hypothesized that CO2 at 8 h exposure limit levels (5000 ppm) could alter innate immune responses to HDE.

METHODS: Using a mouse model, C57BL/6 mice were nasally instilled with defined barn dust extracts and then housed ...


Effect Of Low-Level Co2 On Innate Inflammatory Protein Response To Organic Dust From Swine Confinement Barns., David Schneberger, Jane M. DeVasure, Kristina L. Bailey, Debra J. Romberger, Todd A. Wyatt 2017 University of Nebraska Medical Center

Effect Of Low-Level Co2 On Innate Inflammatory Protein Response To Organic Dust From Swine Confinement Barns., David Schneberger, Jane M. Devasure, Kristina L. Bailey, Debra J. Romberger, Todd A. Wyatt

Journal Articles: Pulmonary & Critical Care Med

BACKGROUND: Organic hog barn dust (HDE) exposure induces lung inflammation and long-term decreases in lung function in agricultural workers. While concentrations of common gasses in confined animal facilities are well characterized, few studies have been done addressing if exposure to elevated barn gasses impacts the lung immune response to organic dusts. Given the well documented effects of hypercapnia at much higher levels we hypothesized that CO2 at 8 h exposure limit levels (5000 ppm) could alter innate immune responses to HDE.

METHODS: Using a mouse model, C57BL/6 mice were nasally instilled with defined barn dust extracts and then housed ...


The Effects Of Intrauterine Growth Restriction (Iugr) On The Pulmonary Surfactant And Lung Injury, Reza Khazaee 2017 University of Western Ontario

The Effects Of Intrauterine Growth Restriction (Iugr) On The Pulmonary Surfactant And Lung Injury, Reza Khazaee

Western Research Forum

The Effects of Intrauterine Growth Restriction (IUGR) on the Pulmonary Surfactant and Lung Injury

Khazaee R1, McCaig LA2, Hardy D1, Yamashita CM2, Veldhuizen, RAW2

Department of Physiology and Pharmacology1, Western University, London, ON, Canada. Lawson Health Research Institute2, London, ON, Canada

Background: Acute respiratory distress syndrome (ARDS) is defined as severe lung dysfunction that occurs after an insult to the lung such as an infection. The lung dysfunction in ARDS is due to alterations to surfactant, a lipid-protein mixture coats the inside of the lung and maintains the lungs’ ability to expand easily ...


Computational Fluid Dynamics In A Terminal Alveolated Bronchiole Duct With Expanding Walls: Proof-Of-Concept In Openfoam, Jeremy Myers 2017 Virginia Commonwealth University

Computational Fluid Dynamics In A Terminal Alveolated Bronchiole Duct With Expanding Walls: Proof-Of-Concept In Openfoam, Jeremy Myers

Theses and Dissertations

Mathematical Biology has found recent success applying Computational Fluid Dynamics (CFD) to model airflow in the human lung. Detailed modeling of flow patterns in the alveoli, where the oxygen-carbon dioxide gas exchange occurs, has provided data that is useful in treating illnesses and designing drug-delivery systems. Unfortunately, many CFD software packages have high licensing fees that are out of reach for independent researchers. This thesis uses three open-source software packages, Gmsh, OpenFOAM, and ParaView, to design a mesh, create a simulation, and visualize the results of an idealized terminal alveolar sac model. This model successfully demonstrates that OpenFOAM can be ...


Human Metapneumovirus Induces Reorganization Of The Actin Cytoskeleton For Direct Cell-To-Cell Spread, Farah El Najjar, Nicolás Cifuentes-Muñoz, Jing Chen, Haining Zhu, Ursula J. Buchholz, Carole L. Moncman, Rebecca Ellis Dutch 2016 University of Kentucky

Human Metapneumovirus Induces Reorganization Of The Actin Cytoskeleton For Direct Cell-To-Cell Spread, Farah El Najjar, Nicolás Cifuentes-Muñoz, Jing Chen, Haining Zhu, Ursula J. Buchholz, Carole L. Moncman, Rebecca Ellis Dutch

Molecular and Cellular Biochemistry Faculty Publication

Paramyxovirus spread generally involves assembly of individual viral particles which then infect target cells. We show that infection of human bronchial airway cells with human metapneumovirus (HMPV), a recently identified paramyxovirus which causes significant respiratory disease, results in formation of intercellular extensions and extensive networks of branched cell-associated filaments. Formation of these structures is dependent on actin, but not microtubule, polymerization. Interestingly, using a co-culture assay we show that conditions which block regular infection by HMPV particles, including addition of neutralizing antibodies or removal of cell surface heparan sulfate, did not prevent viral spread from infected to new target cells ...


Hdac6 Inhibition Prevents Tnf-Α-Induced Caspase 3 Activation In Lung Endothelial Cell And Maintains Cell-Cell Junctions, Jinyan Yu, Mengshi Ma, Zhongsen Ma, Jian Fu 2016 University of Kentucky

Hdac6 Inhibition Prevents Tnf-Α-Induced Caspase 3 Activation In Lung Endothelial Cell And Maintains Cell-Cell Junctions, Jinyan Yu, Mengshi Ma, Zhongsen Ma, Jian Fu

Center for Research on Environmental Disease Faculty Publications

Pro-inflammatory mediators such as TNF-α induce caspase activation in endothelial cells, which leads to degradation of cellular proteins, induction of apoptotic signaling, and endothelial cell dysfunction. New therapeutic agents that can inhibit caspase activation may provide protection against inflammatory injury to endothelial cells. In the present study, we examined the effects of selective histone deacetylase 6 (HDAC6) inhibition on TNF-α induced caspase 3 activation and cell-cell junction dysfunction in lung endothelial cells. We also assessed the protective effects of HDAC6 inhibition against lung inflammatory injury in a mouse model of endotoxemia. We demonstrated that selective HDAC6 inhibition or knockdown of ...


Angioedema: Adverse Reaction From Ace-Inhibitors, Jennifer L. Hawkins 2016 Otterbein University

Angioedema: Adverse Reaction From Ace-Inhibitors, Jennifer L. Hawkins

Master of Science in Nursing (MSN) Student Scholarship

Angiotensin-converting enzyme inhibitor (ACEI) medications are one of the leading causes of angioedema in the United States, also known as ACEI-RA (Chan & Soliman, 2015). ACEI medications are frequently prescribed to help manage diseases, such as hypertension and congestive heart failure, and include, but are not limited to lisinopril and enalapril, with lisinopril being the most commonly prescribed at this time (Chan & Soliman, 2015). In addition, ACEIs are used to help prevent myocardial infarction, diabetic neuropathy, and a cerebrovascular accident (Chua, Ignaszewski, & Schwenger, 2011). There are several risk factors for developing ACEI-RA, with African-American females being the greatest at risk group ...


Patterns Of Growth And Decline In Lung Function In Persistent Childhood Asthma, Michael J. McGeachie, Gaurav Jain, Amartya Sanyal, Ye Zhan, Bryan R. Lajoie, Job Dekker, Scott T. Weiss, CAMP Research Group 2016 Brigham and Women’s Hospital

Patterns Of Growth And Decline In Lung Function In Persistent Childhood Asthma, Michael J. Mcgeachie, Gaurav Jain, Amartya Sanyal, Ye Zhan, Bryan R. Lajoie, Job Dekker, Scott T. Weiss, Camp Research Group

Program in Systems Biology Publications and Presentations

BACKGROUND: Tracking longitudinal measurements of growth and decline in lung function in patients with persistent childhood asthma may reveal links between asthma and subsequent chronic airflow obstruction.

METHODS: We classified children with asthma according to four characteristic patterns of lung-function growth and decline on the basis of graphs showing forced expiratory volume in 1 second (FEV1), representing spirometric measurements performed from childhood into adulthood. Risk factors associated with abnormal patterns were also examined. To define normal values, we used FEV1 values from participants in the National Health and Nutrition Examination Survey who did not have asthma.

RESULTS: Of the 684 ...


The Utilization Of Exogenous Surfactant In The Neonate, Katherine Thorkildsen 2016 Liberty University

The Utilization Of Exogenous Surfactant In The Neonate, Katherine Thorkildsen

Senior Honors Theses

Respiratory distress syndrome (RDS) is a common consequence of pulmonary immaturity in the lungs of neonates. RDS is the result of the deficient secretion of endogenous surfactant, causing increased surface tension in the alveolar sacs leading to respiratory compromise. RDS is more common in the preterm neonate but can be experienced by neonates at any gestational age. Treatment for RDS formerly consisted of mechanical ventilation and oxygen therapy to treat and relieve symptoms but not the cause. A new treatment method, developed largely in the 1980s and 90s is the use of exogenous surfactant to treat the deficiency exhibited in ...


Correlation Of Maximal Inspiratory Pressure To Transdiaphragmatic Twitch Pressure In Intensive Care Unit Patients, Gerald S. Supinski, Philip M. Westgate, Leigh Ann Callahan 2016 University of Kentucky

Correlation Of Maximal Inspiratory Pressure To Transdiaphragmatic Twitch Pressure In Intensive Care Unit Patients, Gerald S. Supinski, Philip M. Westgate, Leigh Ann Callahan

Internal Medicine Faculty Publications

Background: Respiratory muscle weakness contributes to respiratory failure in ICU patients. Unfortunately, assessment of weakness is difficult since the most objective test, transdiaphragmatic pressure in response to phrenic nerve stimulation (PdiTw), is difficult to perform. While most clinicians utilize maximum inspiratory pressure (Pimax) to assess strength, the relationship of this index to PdiTw has not been evaluated in a large ICU population. The purpose of the present study was to assess both PdiTw and Pimax in ICU patients to determine how these indices correlate with each other, what factors influence these indices, and how well these indices predict outcomes.

Methods ...


Evolution Of An Interprofessional Patient Skills Course With The Incorporation Of Simulation Scenarios, Lutana Haan, Rosemary Macy, Leslie E. Kendrick 2016 Boise State University

Evolution Of An Interprofessional Patient Skills Course With The Incorporation Of Simulation Scenarios, Lutana Haan, Rosemary Macy, Leslie E. Kendrick

Respiratory Therapy Faculty Publications and Presentations

A university level interprofessional patient care skills course including Nursing, Radiologic Sciences, and Respiratory Care students has evolved over 20 years. The course includes a lecture and laboratory portion with specific content and skills focused on principles common to the three disciplines. Students are placed in interprofessional groups during lab to practice and learn together including a simulation scenario on each week’s content. This educational strategy has enhanced the students’ teamwork and communication skills and prepared them to apply these skills to clinical practice. Further research is needed to look at IPE undergraduate healthcare course outcomes related to teamwork.


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