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Your search keyword '"Chen-En Chiang"' showing total 7 results
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7 results on '"Chen-En Chiang"'

1. Aerosolized Hypertonic Saline Hinders Biofilm Formation to Enhance Antibiotic Susceptibility of Multidrug-Resistant Acinetobacter baumannii

Author

Hui-Ling Lin, Chen-En Chiang, Mei-Chun Lin, Mei-Lan Kau, Yun-Tzu Lin, and Chi-Shuo Chen

Subjects
multidrug-resistant Acinetobacter baumannii (MDR-AB), hypertonic saline, antibiotics, biofilm, aerosol delivery, Therapeutics. Pharmacology, RM1-950
Abstract

Limited therapeutic options are available for multidrug-resistant Acinetobacter baumannii (MDR-AB), and the development of effective treatments is urgently needed. The efficacy of four aerosolized antibiotics (gentamicin, amikacin, imipenem, and meropenem) on three different MDR-AB strains was evaluated using hypertonic saline (HS, 7 g/100 mL) as the aerosol carrier. HS aerosol effectively hindered biofilm formation by specific MDR-AB strains. It could also interrupt the swarming dynamics of MDR-AB and the production of extracellular polymeric substances, which are essential for biofilm progression. Biofilms protect the microorganisms from antibiotics. The use of HS aerosol as a carrier resulted in a decreased tolerance to gentamicin and amikacin in the biofilm-rich MDR-AB. Moreover, we tested the aerosol characteristics of antibiotics mixed with HS and saline, and results showed that HS enhanced the inhaled delivery dose with a smaller particle size distribution of the four antibiotics. Our findings demonstrate the potential of using “old” antibiotics with our “new” aerosol carrier, and potentiate an alternative therapeutic strategy to eliminate MDR-AB infections from a biofilm-disruption perspective.

Published
2021
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2. Influence of Aerosol Mask Design on Fugitive Aerosol Concentrations During Nebulization.

Author

Chen-En Chiang, Hsin-Hsien Li, Daniel D. Rowley, Tien-Pei Fang, and Hui-Ling Lin

Subjects
RESPIRATORY disease prevention, MEDICAL masks, DRUG delivery systems, KRUSKAL-Wallis Test, AEROSOLS, SPECTROPHOTOMETERS, ALBUTEROL, OCCUPATIONAL exposure, CONTINUING education units, HUMAN anatomical models, SIMULATION methods in education, MANN Whitney U Test, PRODUCT design, NEBULIZERS & vaporizers, RESPIRATORY therapy, DESCRIPTIVE statistics, RESEARCH funding, INHALATION administration, DATA analysis software, TRACHEA intubation
Abstract

BACKGROUND: Secondhand exposure to fugitive aerosols may cause airway diseases in health providers. We hypothesized that redesigning aerosol masks to be closed-featured would reduce the fugitive aerosol concentrations during nebulization. This study aimed to evaluate the influence of a mask designed for a jet nebulizer on the concentration of fugitive aerosols and delivered doses. METHODS: An adult intubation manikin was attached to a lung simulator to mimic normal and distressed adult breathing patterns. The jet nebulizer delivered salbutamol as an aerosol tracer. The nebulizer was attached to 3 aerosol face masks: an aerosol mask, a modified non-- rebreathing mask (NRM, with no vent holes), and an AerosoLess mask. An aerosol particle sizer measured aerosol concentrations at parallel distances of 0.8 m and 2.2 m and a frontal distance of 1.8 m from the manikin. The drug dose delivered distal to the manikin's airway was collected, eluted, and analyzed using a spectrophotometer at a 276 nm wavelength. RESULTS: With a normal breathing pattern, the trends of aerosol concentrations were higher with an NRM followed by an aerosol mask and AerosoLess mask (P < .001) at 0.8 m; however, the concentrations were higher with an aerosol mask followed by NRM and AerosoLess mask at 1.8 m (P < .001) and 2.2 m (P < .001). With a distressed breathing pattern, the aerosol concentrations were higher with an aerosol mask followed by an NRM and AerosoLess mask at 0.8 m, 1.8 m (P < .001), and 2.2 m (P 5 .005). The delivered drug dose was significantly higher with AerosoLess mask with a normal breathing pattern and with an aerosol mask with a distressed breathing pattern. CONCLUSIONS: Mask design influences fugitive aerosol concentrations in the environment, and a filtered mask reduces the concentration of aerosols at 3 different distances and with 2 breathing patterns. [ABSTRACT FROM AUTHOR]

Published
2023
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3. Sustained inflation: The lung recruitment maneuvers for neonates

Author

Chi-Wei Tseng, Chen-En Chiang, Ke-Yun Chao, Shu-Chi Mu, and Yu-Wen Lin

Subjects
Pulmonary and Respiratory Medicine, Inflation, medicine.medical_specialty, Functional Residual Capacity, Resuscitation, media_common.quotation_subject, Positive-Pressure Respiration, 03 medical and health sciences, 0302 clinical medicine, Functional residual capacity, 030225 pediatrics, medicine, Animals, Humans, Intensive care medicine, media_common, Respiratory Distress Syndrome, Newborn, Pulmonary Gas Exchange, business.industry, Delivery room, Infant, Newborn, Respiratory support, Lung recruitment, 030228 respiratory system, Neonatal life, Sustained inflation, Pediatrics, Perinatology and Child Health, business, Infant, Premature, Neonatal resuscitation
Abstract

Establishing effective respiration is vital in the transition from fetal to neonatal life. Respiratory support mainly facilitates and creates functional residual capacity and maintains adequate gas exchange. Sustained inflation (SI) delivers prolonged inflation and rapidly creates and establishes the functional residual capacity. The use of SI in preterm infants in the delivery room is still controversial. The optimum settings of SI remain unknown. Animal studies and clinical reports have demonstrated the advantages and disadvantages of SI. In this article, the current literature was reviewed to examine the efficacy of SI in infants.

Published
2020
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4. High-flow tracheal oxygen: what is the current evidence?

Author

Ke-Yun Chao, Sa-Bi Lin, Wei-Lun Liu, Chen-En Chiang, and Chi-Wei Tseng

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_treatment, chemistry.chemical_element, medicine.disease_cause, Oxygen, 03 medical and health sciences, 0302 clinical medicine, Oxygen therapy, otorhinolaryngologic diseases, medicine, Immunology and Allergy, 030212 general & internal medicine, business.industry, digestive, oral, and skin physiology, Public Health, Environmental and Occupational Health, respiratory system, equipment and supplies, Respiratory support, surgical procedures, operative, 030228 respiratory system, chemistry, Anesthesia, Current (fluid), business, High flow, Nasal cannula
Abstract

Heated humidified high-flow oxygen therapy, administered using a nasal cannula, is called high-flow nasal cannula (HFNC). HFNC has been introduced and is used as a respiratory support mode in patie...

Published
2020
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6. Late Breaking Abstract - The efficacy of heated humidifier high-flow nasal cannula compared with noninvasive positive-pressure ventilation in prevention of reintubation in patients with prolonged mechanical ventilation

Author

Wei-Lun Liu, Ke-Yun Chao, Hsiu-Li Wu, Chen-En Chiang, Wen-Ru Chou, Chi-Wei Tseng, and Chen-Chun Lin

Subjects
Mechanical ventilation, business.industry, medicine.medical_treatment, Do not resuscitate, medicine.disease_cause, Single Center, Clinical trial, Control of respiration, Anesthesia, Breathing, Medicine, In patient, business, Nasal cannula
Abstract

Introduction: The purpose of this study is to assess the efficacy of high-flow nasal cannula (HFNC) compared with non-invasive positive pressure ventilation (NPPV) in prevention of extubation failure in patients with prolonged mechanical ventilation. Methods: This is a prospective, randomized control, single center, clinical trial. Patients who were prolonged mechanically ventilated (>14 days) had been transferred to stepdown unit for weaning. A total of 40 patients were enrolled in our study. After extubation, patients were randomly assigned to HFNC or NPPV treatment group. The major clinical outcomes measured were re-intubation rate, in hospital mortality and length of non-invasive ventilation time after extubation. Patient who had neuromuscular disorders, central respiratory drive disorders, tracheostomy and signed “do not resuscitate” were excluded. Results: The reintubation rate was significantly higher in HFNC group (NPPV 0% vs. HFNC 25%, p =.008), the length of NPPV support after extubation was shorter in NPPV group compared to HFNC group (NPPV 13-hrs vs. HFNC 20-hrs, p =.001). The physiologic variables at one hour after extubation, including PaO2/FiO2, PaCO2, were significantly improved in NPPV group than HFNC group. However, there were no diference in length of hospital stay and mortality. Conclusion: Compared with NPPV, HFNC has higher reintubation rate than NPPV. Our study demonstrated that for those patients who were prolonged mechanically ventilated, NPPV should be applied rather than HFNC after extubation to reduce the extubation failure.

Published
2019
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7. Respiratory Management in Smoke Inhalation Injury

Author

Ke-Yun Chao, Chi-Wei Tseng, Yu-Wen Lin, and Chen-En Chiang

Subjects
Respiratory Therapy, Smoke Inhalation Injury, medicine.disease_cause, Bronchospasm, Aerosol therapy, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Medicine, Humans, Respiratory system, Diffuse alveolar damage, Monitoring, Physiologic, Respiratory Distress Syndrome, Inhalation, business.industry, Rehabilitation, 030208 emergency & critical care medicine, respiratory system, Respiration, Artificial, Respiratory Function Tests, Anesthesia, Emergency Medicine, Breathing, Surgery, medicine.symptom, business, Nasal cannula, Burns, Inhalation
Abstract

Smoke inhalation injury (SII) is a major morbidity and cause of mortality in patients with burns. Damage caused by inhalation of thermal or chemical irritants, including toxic fumes and chemicals, leads to respiratory cilia and epithelial cell injuries, which turn to severe bronchospasm and alveolar damage and results in acute respiratory distress syndrome. Respiratory management plays a vital role in the treatment of SII. In this review, we provide an overview of SII with emphasis on respiratory management, including aerosol therapy, bronchial hygiene therapy, advanced ventilation modes, and heated humidified high-flow nasal cannula. In summary, the information may be helpful for further improvements in outcomes.

Published
2019

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