Research Topics
| R M KacmarekSummaryAffiliation: Massachusetts General Hospital Country: USA Publications
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Detail Information
Publications
Lung recruitment in patients with ARDSRobert M Kacmarek
N Engl J Med 355:320; author reply 321-2. 2006
Ventilatory management of ARDS: high frequency oscillation and lung recruitment!Robert M Kacmarek
Harvard Medical School and Respiratory Care, Massachusetts General Hospital, Ellison 401, 55 Fruit Street, Boston MA, USA
Crit Care 10:158. 2006..The key to managing ARDS regardless of mode is to use an open lung protective ventilatory strategy. It is not the mode that makes the difference, it is the approach used to apply the mode!..- Complications of tracheal gas insufflationR M Kacmarek
Department of Respiratory Care, Ellison 401, Massachusetts General Hospital, 55 Fruit Street, Boston MA 02114 2696, USA
Respir Care 46:167-76. 2001..As a result of the potential complications of TGI, this technique cannot be recommended for routine use until commercial systems are available... - Partial liquid ventilation in adult patients with acute respiratory distress syndromeRobert M Kacmarek
Department of Anesthesia and Critical Care, Harvard Medical School, and Respiratory Care, Massachusetts General Hospital, Boston, MA 02114, USA
Am J Respir Crit Care Med 173:882-9. 2006..Partial liquid ventilation (PLV) using perfluorocarbons has been shown to improve oxygenation and decrease lung injury in various animal models... - Last word on point:counterpoint: High-frequency ventilation is/is not the optimal physiological approach to ventilate ARDS patientsRobert M Kacmarek
J Appl Physiol 104:1241. 2008 
Survey of directors of respiratory therapy departments regarding the future education and credentialing of respiratory care students and staffRobert M Kacmarek
Respiratory Care Services, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 01460, USA
Respir Care 57:710-20. 2012....- Mechanical ventilation modulates TLR4 and IRAK-3 in a non-infectious, ventilator-induced lung injury modelJesus Villar
CIBER de Enfermedades Respiratorias, Instituto de Salud Carlos III, Spain
Respir Res 11:27. 2010.... - The mechanical ventilator: past, present, and futureRobert M Kacmarek
Respiratory Care Services, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 01460, USA
Respir Care 56:1170-80. 2011..The key term that will be used to identify these future ventilators will be smart!.. - Ventilatory adjunctsRobert M Kacmarek
Department of Respiratory Care Services, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts 02114, USA
Respir Care 47:319-30; discussion 330-3. 2002..No randomized trials of tracheal gas insufflation have been performed. Of major concern with tracheal gas insufflation is the lack of a commercial product... - Respiratory controversies in the critical care setting. Should recruitment maneuvers be used in the management of ALI and ARDS?Robert M Kacmarek
Respiratory Care Services, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA
Respir Care 52:622-31; discussion 631-5. 2007..We explore both sides of the lung recruitment controversy... - Should noninvasive ventilation be used with the do-not-intubate patient?Robert M Kacmarek
Respiratory Care Services, Massachusetts General Hospital, Boston, MA 02114, USA
Respir Care 54:223-9; discussion 229-31. 2009.... - Counterpoint: High-frequency ventilation is not the optimal physiological approach to ventilate ARDS patientsRobert M Kacmarek
Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
J Appl Physiol 104:1232-3; discussion 1233-5. 2008 - Creating a vision for respiratory care in 2015 and beyondRobert M Kacmarek
Respiratory Care Services, Massachusetts General Hospital, Boston, MA 02114, USA
Respir Care 54:375-89. 2009..We present the initial findings of that task force... - Delivery systems for long-term oxygen therapyR M Kacmarek
Respiratory Care Services, Massachusetts General Hospital, Boston 02114 2696, USA
Respir Care 45:84-92; discussion 92-4. 2000..As a result of the anticipated large number of patients worldwide expected to require home oxygen therapy, ongoing improvement in this technology will be evident in the next few years... - Lung recruitment maneuvers during acute respiratory distress syndrome: is it useful?R M Kacmarek
Department of Anesthesiology, Harvard Medical School, Boston, MA, USA
Minerva Anestesiol 77:85-9. 2011..Specifically, the ability of RM to open the lung, the safety of RM, and their affect on outcome are addressed. Finally, a specific approach to performing RM with the use of a decremental PEEP trial is outlined... - Liquid ventilationRobert M Kacmarek
Harvard Medical School, Respiratory Care Services, Massachusetts General Hospital, Boston, MA 02114, USA
Respir Care Clin N Am 8:187-209. 2002..Based on the failure of the two trials in adult ARDS patients, however, a long time may pass before another human PLV trial is undertaken... - Optimal mean airway pressure during high-frequency oscillation: predicted by the pressure-volume curveS Goddon
Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
Anesthesiology 94:862-9. 2001..77, P < 0.05). CONCLUSION: In this model of acute respiratory distress syndrome, optimal Paw during HFO is equal to P(CL) + 6, which correlates with the PMC... - The relationship between gas delivery patterns and the lower inflection point of the pressure-volume curve during partial liquid ventilationG Ferreyra
Department of Anaesthesia Respiratory Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
Chest 117:191-8. 2000..gif" BORDER="0">), and volume vs time waveforms during partial liquid ventilation (PLV)... - Strategies to optimize alveolar recruitmentR M Kacmarek
Department of Anesthesia, Harvard Medical School, Respiratory Care, Massachusetts General Hospital, Boston, Massachusetts, USA
Curr Opin Crit Care 7:15-20. 2001.... - The response of flow-triggered infant ventilatorsM Nishimura
Respiratory Care Department Laboratory, Massachusetts General Hospital, Boston 02114, USA
Am J Respir Crit Care Med 152:1901-9. 1995..04 +/- 0.02 cm H2O; trigger work 114.48 +/- 0.88 g.ml). PTV may not be appropriate under conditions of increased ventilatory drive and small endotracheal tube size in infants... - Heliox delivery with noninvasive positive pressure ventilation: a laboratory studyS Chatmongkolchart
Department of Respiratory Care, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
Respir Care 46:248-54. 2001..With heliox there was a potential for ventilator malfunction in some conditions. The clinical implications of these findings remain to be determined... - Open-lung protective ventilation with pressure control ventilation, high-frequency oscillation, and intratracheal pulmonary ventilation results in similar gas exchange, hemodynamics, and lung mechanicsKhaled A Sedeek
Department of Anesthesia/Respiratory Care, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
Anesthesiology 99:1102-11. 2003.... - The effect of heliox on nebulizer function using a beta-agonist bronchodilatorD R Hess
Department of Respiratory Care, Massachusetts General Hospital, Harvard Medical School, Boston 02114, USA
Chest 115:184-9. 1999..To evaluate nebulizer performance when heliox was used to power the nebulizer... - Repetitive high-pressure recruitment maneuvers required to maximally recruit lung in a sheep model of acute respiratory distress syndromeY Fujino
Respiratory Care Department Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
Crit Care Med 29:1579-86. 2001..Multiple recruitment maneuvers in some animals were required for maximum effect... - Set positive end-expiratory pressure during protective ventilation affects lung injuryMuneyuki Takeuchi
Department of Anesthesia/Respiratory Care, Massachusetts General Hospital, The Center for Blood Research, Boston 02114, USA
Anesthesiology 97:682-92. 2002..PEEP at 2 cm H(2)O above the lower inflection point was most effective... - In vitro evaluation of aerosol bronchodilator delivery during mechanical ventilation: pressure-control vs. volume control ventilationDean R Hess
Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
Intensive Care Med 29:1145-50. 2003..To determine the effect of inspiratory time and inspiratory flow pattern on albuterol delivery by aerosol during mechanical ventilation... - Adaptive support ventilation: an appropriate mechanical ventilation strategy for acute respiratory distress syndrome?Demet Sulemanji
Department of Anesthesiology and Critical Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Anesthesiology 111:863-70. 2009..Adaptive support ventilation (ASV) allows the clinician to set a maximum plateau pressure (PP) and automatically adjusts tidal volume to keep PP below the set maximum... - Low concentrations of nitric oxide increase oxygen affinity of sickle erythrocytes in vitro and in vivoC A Head
Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston, Massachusetts 02115, USA
J Clin Invest 100:1193-8. 1997..These results suggest that low concentrations of NO gas may offer an attractive new therapeutic model for the treatment of SCD... - The impact of endotracheal suctioning on gas exchange and hemodynamics during lung-protective ventilation in acute respiratory distress syndromeMaria Paula Caramez
Department of Anesthesia and Critical Care, Massachusetts General Hospital, and with Harvard Medical School, Boston Massachusetts 02114, USA
Respir Care 51:497-502. 2006..CONCLUSION: PaO2/FIO2) was better maintained during CS with both VC and PC modes during lung-protective ventilation for ARDS, as compared with OS, and shunt fraction post-suctioning changed least with PC... - Adult ICU ventilators to provide neonatal ventilation: a lung simulator studyAndrew D Marchese
Respiratory Care Massachusetts General Hospital, Boston, MA 02114, USA
Intensive Care Med 35:631-8. 2009..Traditionally, specific ventilators have been manufactured to only provide neonatal mechanical ventilation. However, many of the current generation of ICU ventilators also include a neonatal mode... - Combination therapyR M Kacmarek
Department of Anesthesia, Harvard Medical School, Boston, Massachusetts, USA
Respir Care Clin N Am 7:663-81. 2001..Clearly, more laboratory and clinical studies examining the combined use of these therapies are needed, as is identification of the specific patient populations where these combined therapies may be most effective... - Continuous positive airway pressure in new-generation mechanical ventilators: a lung model studyMuneyuki Takeuchi
Department of Anesthesia and Respiatory Care, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
Anesthesiology 96:162-72. 2002..Pressure triggering during continuous positive airway pressure does require a slightly greater pressure than flow triggering... - Gas exchange impairment induced by open suctioning in acute respiratory distress syndrome: impact of permissive hypercapniaMaria Paula Caramez
Department of Anesthesia and Critical Care, and Respiratory Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Crit Care Med 36:560-4. 2008..To determine whether hypercarbia occurs following the use of open suctioning in lung lavage injured sheep and whether the baseline PaCO2 and duration of suctioning affect gas exchange... - The impact of closed endotracheal suctioning systems on mechanical ventilator performanceAshraf El Masry
Department of Anesthesia and Critical Care, Massachusetts General Hospital, Boston 02114, USA
Respir Care 50:345-53. 2005..However, closed suctioning can decrease end-expiratory pressure during suctioning... - Position of exhalation port and mask design affect CO2 rebreathing during noninvasive positive pressure ventilationGuilherme P P Schettino
Department of Anesthesia and Critical Care and Respiratory Care, Massachusetts General Hospital, Harvard Medical School, Boston, 02214, USA
Crit Care Med 31:2178-82. 2003..Additional studies are necessary to confirm if mask design can clinically affect patient's inspiratory effort during noninvasive positive pressure ventilation... - Evaluation of inspiratory rise time and inspiration termination criteria in new-generation mechanical ventilators: a lung model studyS Chatmongkolchart
Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
Respir Care 46:666-77. 2001..Inspiration termination criteria adjustment markedly affects transition to exhalation in the Puritan Bennett 840... - Comparison of the effects of nitric oxide, nitroprusside, and nifedipine on hemodynamics and right ventricular contractility in patients with chronic pulmonary hypertensionB A Cockrill
Pulmonary and Critical Care Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
Chest 119:128-36. 2001..The effects of inhaled nitric oxide (NO) on hemodynamics and right ventricular (RV) contractility were compared with those of nitroprusside and nifedipine in 14 patients with severe chronic pulmonary hypertension... - Peak pressure during volume history and pressure-volume curve measurement affects analysisM Takeuchi
Department of Anesthesia/Respiratory Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA
Am J Respir Crit Care Med 164:1225-30. 2001..Pflex, Cstart, Cend, and Ctop were not affected by the PIP. However, UIP, PMC, Cinf, and Cdef increased as the PIP increased. Volume history and the PIP during P-V curve measurements affect both the inflation and deflation P-V curves... - Factors affecting oxygen delivery with bi-level positive airway pressureAndrew R Schwartz
Respiratory Care, Ellison 401, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA
Respir Care 49:270-5. 2004..Because of this, it is important to continuously measure arterial oxygen saturation via pulse oximetry with patients in acute respiratory failure who are receiving noninvasive ventilation from a bi-level ventilator... - Noninvasive positive-pressure ventilation in acute respiratory failure outside clinical trials: experience at the Massachusetts General HospitalGuilherme Schettino
Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA
Crit Care Med 36:441-7. 2008..However, few data are available on the use of NPPV as routine standard medical care for patients with respiratory failure outside of controlled trials... - The principle of upper airway unidirectional flow facilitates breathing in humansYandong Jiang
Dept of Respiratory Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
J Appl Physiol 105:854-8. 2008..We suggest this may be the reason that such a breathing pattern is preferred during respiratory distress... - Noninvasive positive pressure ventilation reverses acute respiratory failure in select "do-not-intubate" patientsGuilherme Schettino
Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Crit Care Med 33:1976-82. 2005..An easy-to-calculate score combining SAPS II and serum albumin level is a good prediction of outcome in DNI patients receiving NPPV... - Peak volume history and peak pressure-volume curve pressures independently affect the shape of the pressure-volume curve of the respiratory systemTomoyo Nishida
Department of Anesthesia/Respiratory Care, Massachusetts General Hospital, Boston, MA 02114, USA
Crit Care Med 32:1358-64. 2004..The peak pressure achieved during the pressure-volume curve is important during interpretation of deflation compliance and the point of maximum compliance change on the deflation limb... - High-frequency oscillatory ventilation: what large-animal studies have taught us!Robert M Kacmarek
Department of Anesthesiology, Harvard Medical School, Boston, MA, USA
Crit Care Med 33:S148-54. 2005..CONCLUSION: The study of HFO in large animal models has been essential to our understanding of the optimal approach to applying HFO in human studies... - Cellular phone interference with the operation of mechanical ventilatorsCheryl I Shaw
Department of Biomedical Engineering, Massachusetts General Hospital, Boston, MA, USA
Crit Care Med 32:928-31. 2004..Manufacturers should ensure that their products are not affected by wireless technology even when placed immediately next to the device... - Wheeze detection in the pediatric intensive care unit: comparison among physician, nurses, respiratory therapists, and a computerized respiratory sound monitorParthak Prodhan
Division of Pediatric Critical Care Medicine, MassGeneral Hospital for Children, Harvard Medical School, Boston, Massachusetts 02114, USA
Respir Care 53:1304-9. 2008..To correlate wheeze detection in the pediatric intensive care unit among staff members (a physician, nurses, and respiratory therapists [RTs]) and digital recordings from a computerized respiratory sound monitor (PulmoTrack)... - Performance comparison of 15 transport ventilatorsDaniel W Chipman
Department of Respiratory Care, Massachusetts General Hospital, Boston MA 02114, USA
Respir Care 52:740-51. 2007..Numerous mechanical ventilators are designed and marketed for use in patient transport. The complexity of these ventilators differs considerably, but very few data exist to compare their operational capabilities... - Trigger performance of mid-level ICU mechanical ventilators during assisted ventilation: a bench studyJuliana C Ferreira
Departments of Respiratory Care and Anesthesia and Critical Care, Massachusetts General Hospital, Boston, MA 02114, USA
Intensive Care Med 34:1669-75. 2008..To compare the triggering performance of mid-level ICU mechanical ventilators with a standard ICU mechanical ventilator... - A comparison of methods to identify open-lung PEEPMaria Paula Caramez
Department of Anesthesia and Critical Care, and Respiratory Care, Massachusetts General Hospital, Boston, MA, USA
Intensive Care Med 35:740-7. 2009..Many methods exist in the literature for identifying PEEP to set in ARDS patients following a lung recruitment maneuver (RM). We compared ten published parameters for setting PEEP following a RM... - Competencies needed by graduate respiratory therapists in 2015 and beyondThomas A Barnes
Department of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, MA 02115 5000, USA
Respir Care 55:601-16. 2010..Future specialty practice areas for experienced RTs are identified without defining specific competencies. We present the findings of the task force on the competencies needed by graduate RTs upon entry into practice in 2015... - Nasal ventilation is more effective than combined oral-nasal ventilation during induction of general anesthesia in adult subjectsYafen Liang
Department of Anesthesia and Critical Care, MassachusettsGeneral Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA
Anesthesiology 108:998-1003. 2008..They tested this hypothesis by comparing the volume of carbon dioxide removed per breath with nasal versus combined oral-nasal mask ventilation in nonparalyzed, apneic, adult subjects during induction of general anesthesia... - Pro/con clinical debate: is high-frequency oscillatory ventilation useful in the management of adult patients with respiratory failure?Jeffrey M Singh
Department of Medicine, Mount Sinai Hospital, Toronto, Canada
Crit Care 6:183-5. 2002.... - Screening of ARDS patients using standardized ventilator settings: influence on enrollment in a clinical trialNiall D Ferguson
Division of Respirology, Department of Medicine, and the Interdepartmental Division of Critical Care Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Canada
Intensive Care Med 30:1111-6. 2004.... - In vitro evaluation of aerosol bronchodilator delivery during noninvasive positive pressure ventilation: effect of ventilator settings and nebulizer positionSunisa Chatmongkolchart
Department of Anesthesiology, Faculty of Medicine, Prince of Songkla University, Thailand
Crit Care Med 30:2515-9. 2002.... - Successful recruitmentG A Richards
Crit Care Med 30:2169; author reply 2169-70. 2002 - Is high frequency oscillation the best lung protective ventilatory approach for ARDS?Robert M Kacmarek
Intensive Care Med 29:1629-31. 2003 - Reversibility of lung collapse and hypoxemia in early acute respiratory distress syndromeJoao B Borges
Respiratory Intensive Care Unit, Pulmonary Department, and General Intensive Care Unit, Emergency Clinics Division, Hospital das Clinicas, University of Sao Paulo, Sao Paulo, Brazil
Am J Respir Crit Care Med 174:268-78. 2006..The hypothesis that lung collapse is detrimental during the acute respiratory distress syndrome is still debatable. One of the difficulties is the lack of an efficient maneuver to minimize it... - Lung protection: the cost in some is increased work of breathing. Is it too high?Robert M Kacmarek
Respir Care 50:1614-6. 2005 - A decremental PEEP trial identifies the PEEP level that maintains oxygenation after lung recruitmentKarim Girgis
Surgical Intensive Care Unit, New Kasr El-Aini Teaching Hospital and Cairo University, Cairo, Egypt
Respir Care 51:1132-9. 2006..PEEP was 11.9 + 3.0 cm H2O at baseline and 9.1 + 4.7 cm H2O (p = 0.011) at 4 h. CONCLUSION: A decremental PEEP trial identifies a PEEP setting that sustains for 4 h the oxygenation benefit of a 40-cm H2O, 40-s lung-recruitment maneuver... - Determinants of tidal volume during high-frequency oscillationKhaled A Sedeek
Department of Anesthesia/Respiratory Care, Massachusetts General Hospital and Harvard Medical School, Boston 02114, USA
Crit Care Med 31:227-31. 2003..1 +/- 34.8 mL (4.4 +/- 1.2 mL/kg) was delivered. CONCLUSIONS: At low rates and high-pressure amplitudes in this model, tidal volumes approaching conventional mechanical ventilation can be delivered during high-frequency oscillation... - Paradoxical responses to positive end-expiratory pressure in patients with airway obstruction during controlled ventilationMaria Paula Caramez
Respiratory and Emergency Intensive Care Unit, Emergency Department, , , Brazil
Crit Care Med 33:1519-28. 2005..An empirical PEEP trial investigating plateau pressure response in these patients appears to be a reasonable strategy with minimal side effects... - NPPV in acute respiratory failure: is it time to reconsider where it may be applied?Robert M Kacmarek
Respir Care 51:1226-7. 2006 - Respiratory controversies in the critical care setting. Should tidal volume be 6 mL/kg predicted body weight in virtually all patients with acute respiratory failure?Kenneth P Steinberg
Division of Pulmonary and Critical Care Medicine, Harborview Medical Center, 325 Ninth Avenue, Box 359762, Seattle, WA 98104, USA
Respir Care 52:556-64; discussion 565-7. 2007..Consensus at this time is not possible, and this paper presents the arguments on both sides of the controversy... - A protocol for high-frequency oscillatory ventilation in adults: results from a roundtable discussionHenry E Fessler
Division of Pulmonary and Critical Care Medicine, Johns Hopkins Medical Institutions, Baltimore, USA
Crit Care Med 35:1649-54. 2007..We provide guidelines for HFO in adults with acute respiratory distress syndrome that should optimize the lung-protective characteristics of this ventilation mode... - An early PEEP/FIO2 trial identifies different degrees of lung injury in patients with acute respiratory distress syndromeJesus Villar
Multidisciplinary Organ Dysfunction Evaluation Research Network, Hospital Universitario Dr Negrin, Las Palmas de Gran Canaria, Canary Islands, Spain
Am J Respir Crit Care Med 176:795-804. 2007.... - Combining high-frequency oscillatory ventilation and recruitment maneuvers in adults with early acute respiratory distress syndrome: the Treatment with Oscillation and an Open Lung Strategy (TOOLS) Trial pilot studyNiall D Ferguson
Department of Medicine, Division of Respirology, and the Interdepartmental Division of Critical Care Medicine, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, Canada
Crit Care Med 33:479-86. 2005..This explicit high-frequency oscillatory ventilation protocol appears well tolerated, feasible, and physiologically sound... - Why are physicians so skeptical about positive randomized controlled clinical trials in critical care medicine?Jesus Villar
Research Institute, Hospital Universitario N S de Candelaria, Carretera del Rosario s n, Canary Islands, 38010, Santa Cruz de Tenerife, Spain
Intensive Care Med 31:196-204. 2005 - A high positive end-expiratory pressure, low tidal volume ventilatory strategy improves outcome in persistent acute respiratory distress syndrome: a randomized, controlled trialJesus Villar
Canarian Institute for Biomedical Research, Tomas Morales 6 1, 35003 Las Palmas de Gran Canaria, Canary Islands, Spain
Crit Care Med 34:1311-8. 2006....