The 11 reference contexts in paper A. Hermely , M. Jakubova , J Salantay , P. Candik , I. Sopko , M. Majek , J. Cocherova , P. Torok , A. Hermely , M. Jakubova , J Salantay , P. Candik , I. Sopko , M. Majek , J. Cocherova , P. Torok (2010) “Non-Invasive Airway Cleansing with Application of Expulsion Effect of HFJV (High Frequency Jet Ventilation) // Non-Invasive Airway Cleansing with Application of Expulsion Effect of HFJV (High Frequency Jet Ventilation)” / spz:neicon:reanimatology:369

  1. Start
    6413
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    : torokp@t-zones.sk The other purification mechanisms can be secretions solution, exhalation of volatile substances, alveolar and bronchial fluid transport, interstitial lymph drainage, phagocytosis with alveolar macrophages or hystiocytes, penetration of antigens into lymph nodes, cellular immune responses, immunoglobulin secretion, destruction of particles by enzyme systems [
    Exact
    Trojan 1992
    Suffix
    ]. Pathophysiological mechanisms for the application of ALV. During the ALV there is a disruption of those defenses and by several factors. 1. Endotracheal or tracheostomic cannula discard activity of the upper airways, because the inhalation of air into the trachea without prior filtering and especially warming and humidification.
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  2. Start
    9353
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    Other possible causes are patient's relaxation, a condition associated with muscle paralysis (myasthenia, poliomyelitis, polyradiculoneuritis), loss of cough reflex (central nervous system involvement, intoxication, drugs, for example opiates), energy insufficiency of expiratory muscle, atrophy, inadequate analgesia [
    Exact
    Zilber, 1984;
    Suffix
    Jayr, 1993]. 5. Intubation or tracheostomy cannulation represent a foreign body in trachea, which narrows and also mechanically interrupts the path for mucociliar transportation. Mucus is in the trachea under withheld sealing balloon of endotracheal cannula.
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    10358
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    The most common and serious complications in these patients are respiratory infections, which prolong the duration of hospitalization and often lead to the death. Hence the importance of strict observance of certain principles and applications of several procedures to prevent and to manage these complications [
    Exact
    Warner, 1999
    Suffix
    ]. Some of the basic attributes on maintaining a good airway patency. Heating and humidifying of respiratory gases. As it was mentioned above, the alveolar gas should have a 100% relative humidity (RH) at the body temperature, (37 st.
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  4. Start
    11282
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    Energy — nutrition cover is essential for the maintenance of defense features, for respiratory muscles to work, for effective cough and in the transition to spontaneous ventilation and disconnecting the ventilator. Malnutrition leads to atrophy of respiratory muscles [
    Exact
    Zilber, 1984;
    Suffix
    Warner and Weiskopf, 2000]. Mucolysis. Liquefying mucus and reduction of its viscosity is often a prerequisite to its removal from airways by suction or other technique. The most effective method of application is the direct application of medication into the cannula, a suitable combination is a total parenteral administration generally [Warner and Weiskopf, 2000].
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  5. Start
    13564
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    Bronchoscopic desobstruction It is targeted extraction and removal of mucus plugs using bronchoscopy working channel under direct visual control. It can be combined with targeted application of mukolytics to affected parts, making extraction easier [
    Exact
    Henke et al., 1994
    Suffix
    ]. The disadvantage of the method: the need to interrupt ventilation, can be eliminated by simultaneous administration of high-frequency ventilation, which does not require sealing of airways. In an already established atelectasis the desobstruction is almost always not enough, because the obstruction of lung tissue behind obstruction is collapsed and in hyperexpansis within c
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  6. Start
    14659
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    After the secretions suction the bronchoscope was jammed into the bronchi, the pressure was increased to 3 kPa and 60 seconds. Slow flow rate was maintained. This procedure allows the local application of high pressures to the collapsed tissue, which increases efficiency and prevents barotrauma [
    Exact
    Heerden et al., 1999
    Suffix
    ]. Mechanic exsufflation. These artificial supported expiration in which exhaled air in a split of second reaches top flow about 7 l/s, while there is an entrainment of sputum and its movement towards the outside of the lungs.
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  7. Start
    15173
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    This method is comparable to the consequences of cough and requires special machinery — mechanical exsufflator. In clinical practice it was introduced in 1950th and despite its effectiveness and canniness to tracheal mucosa did not find wider application [
    Exact
    Bach, 1993
    Suffix
    ]. Percussive fans Operating on the principle of superposition of the oscillation frequency on the fan breath curve, and oscillatory vibration with frequency of 100—300 c/min vibrating sputum and facilitate its removal [Jelic, 2005].
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  8. Start
    15415
    Prefix
    Percussive fans Operating on the principle of superposition of the oscillation frequency on the fan breath curve, and oscillatory vibration with frequency of 100—300 c/min vibrating sputum and facilitate its removal [
    Exact
    Jelic, 2005
    Suffix
    ]. High frequency compression of rib cage They work on a mechanical frequency of pneumatic vest fitted on the patient's chest, which oscillates. In a spontaneously breathing patient it may improve removal of mucus from the respiratory tract [Jones, 1995].
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    16073
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    Pneumatic oscillators Operating on the principle that during the expiration in spontaneously breathing patient to resistance they vibrate gas stream. The vibrations are transmitted to the airway and help remove the mucus [
    Exact
    Jelic, 2005
    Suffix
    ]. Expulsion by frequency ventilation. One of the positive effects of the high frequency jet ventilation (HFJV) is that it can move with bodies (foreign body, mucus, aspiration, aerosol, drug) within the tracheobronchial tree and this movement can be programmed.
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    34433
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    For wetting and heating the gases we use solely heated — molecular humidifiers, even if in the literature views appear on the appropriateness of the use of recuperation humidifiers (so-called artificial noses) and for longALV [
    Exact
    Misset et al., 1991
    Suffix
    ]. We strictly stick to a gas temperature of 35—38 st.C and it is considered necessary to include a bacterial filter to inspiration branch of the respiratory circuit. Cold aerosol generators are used only for the time necessary to nebulisate the drugs — 15—20 minutes to greatly reduce the risk of airwy's contamination.
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  11. Start
    35272
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    Since the efficiency of mucolytic products is very close, their use in the workplace depends on experienced staff and availability. In our department, we particularly use mucolyticum Mistabron for its good tolerance, reliability and availability. However, N-acetylcysteine in combination with bronchodilatanciom [
    Exact
    Henke et al., 1994
    Suffix
    ] is popular abroad, at least according to available sources. Physiotherapy is considered an appropriate complement to expulsion. Positional drainage, hammering the chest and breathing against resistancewere were proved as the best.
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