Use of recruitment maneuvers during mechanical ventilation in pediatric and neonatal intensive care units in the Netherlands

Halbertsma, F.J.; Vaneker, Michiel; Hoeven, Johannes G. van der

doi:10.1007/s00134-007-0581-7

Cited by 14 publications

(10 citation statements)

References 15 publications

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“…At the same time, ventilation with high tidal volume is recognized as an important cause of ventilation-induced lung inflammation and injury [133,156]. In extreme cases, mechanical ventilation can result in the release of lung-borne inflammatory mediators into the systemic circulation, thereby causing multiple system organ failure [55,134]. In patients with acute lung injury, plasma levels of inflammatory cytokines such as IL-6 and IL-8 are associated with morbidity and mortality [127].…”

Section: Cyclic Stretchmentioning

confidence: 99%

Airway Smooth Muscle Cell as Therapeutic Target of Inflammation

Hai

2007

CMC

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Airway inflammation is an outcome of complex interactions of multiple cell types in an inflammatory network. In recent years, it has become clear that a single target approach is unlikely to be effective for the treatment of inflammatory airway diseases such as asthma. This recognition suggests an alternative approach of targeting multiple cell types and/or mediators. Airway smooth muscle (ASM) cells are unique in serving the dual function of bronchoconstriction and inflammation in the airway system. ASM cells respond to a large array of external stimuli such as acetylcholine, bradykinin, inflammatory cytokines, and cyclic stretch with the expression of inflammatory mediators such as cytokines and cyclooxygenase products. Ca(2+) influx through voltage-gated and transient receptor potential channels are important mechanisms of Ca(2+)-dependent transcription in ASM cells. Calcineurin and Ca(2+), calmodulin-dependent kinase (CaMK) are Ca(2+)-sensitive enzymes that regulate the activation of the two transcription factors, nuclear factor of activated T-cells (NFAT) and cyclic AMP response element binding protein (CREB). Erk1/2 and p38 mitogen-activated protein kinases are signaling enzymes that couple receptor activation to gene transcription by phosphorylating CREB and stabilizing mRNA against de-adenylation. CREB is a unique transcription factor that is phosphorylated by both CaMK II and Erk1/2 MAPK. Nuclear factor kappaB (NFkappaB) appears to be a universal transcription factor that regulates the transcription of almost all inflammatory genes. Detailed understanding of the cellular components and interactions in the inflammatory network of the airway system may lead to rational targeting of multiple cells and mediators in the treatment of airway inflammation.

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Section: Cyclic Stretchmentioning

confidence: 99%

Airway Smooth Muscle Cell as Therapeutic Target of Inflammation

Hai

2007

CMC

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“…Halbertsma et al . found a radiographic improvement over time after the administration of the exogenous surfactant, which was associated with low values of oxygen index and an elevated Cs.…”

Section: Discussionmentioning

confidence: 87%

“…In ARDS treatment, it is essential, besides treating the disease from the base, to use protective ventilation. The beneficial effect of ARM on improving PaO 2 /FIO 2 have been demonstrated by several authors , a benefit that will be achieved if an appropriate PEEP is identified post the recruitment manoeuvres.…”

Section: Discussionmentioning

confidence: 89%

Exogenous surfactant and alveolar recruitment in the treatment of the acute respiratory distress syndrome

Rodríguez-Moya

Gallo-Borrero

Santos-Áreas

et al. 2016

Clinical Respiratory J

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“…27 Surveys of pediatric and neonatal ICUs describe the use of PEEP, PIP, or a combination of both, and complications are rare with the exception of transient hypotension and desaturation episodes. 28 Another lung-recruitment option is HFOV with incremental increases in mean airway pressure to achieve the desired oxygen saturation or lung inflation on chest radiograph. 29 Goldman et al used HFOV to facilitate lung recruitment after repair of long-segment congenital tracheal stenosis, 18 and HFOV appeared to be beneficial during ECMO.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty

et al. 2011

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Long-segment congenital tracheal stenosis is characterized by complete tracheal rings. Surgery is required during infancy to optimize outcomes, and the post-surgery complications include mucus plugging, airway trauma, dehiscence at the surgery site, and death. We report a 5-week-old patient who developed a tracheal-wall dehiscence after a slide tracheoplasty. To safeguard against further dehiscence and to protect her one functional lung, we used extracorporeal membrane oxygenation (ECMO). After she was stabilized on veno-arterial ECMO we extubated and continued ECMO for 5 days. On postoperative day 14 we removed the ECMO and transitioned her to high-frequency oscillatory ventilation, and performed slow lung-recruitment maneuvers every 2 hours. This strategy of ECMO with extubation, then high-frequency oscillatory ventilation is a useful rescue therapy in patients with postoperative tracheal dehiscence.

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Use of recruitment maneuvers during mechanical ventilation in pediatric and neonatal intensive care units in the Netherlands

Cited by 14 publications

References 15 publications

Airway Smooth Muscle Cell as Therapeutic Target of Inflammation

Airway Smooth Muscle Cell as Therapeutic Target of Inflammation

Exogenous surfactant and alveolar recruitment in the treatment of the acute respiratory distress syndrome

Extracorporeal Membrane Oxygenation, Extubation, and Lung-Recruitment Maneuvers as Rescue Therapy in a Patient With Tracheal Dehiscence Following Slide Tracheoplasty

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