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Esophageal pressure

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https://www.readbyqxmd.com/read/28936952/-application-of-injection-test-in-confirming-the-ideal-position-of-esophageal-balloon-catheter
#1
Han Chen, Ming Xu, Yanlin Yang, Xuan He, Jianxin Zhou
OBJECTIVE: To evaluate the safety and feasibility of injection test which is used to locate esophageal balloon catheter. METHODS: A prospective study was conducted. The patients undergoing invasive mechanical ventilation (MV) admitted to general intensive care unit (ICU) of Beijing Tiantan Hospital Affiliated to Capital Medical University from May 2015 and March 2017 were enrolled. The commercially available esophageal balloon catheter was modified to perform injection test...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28924729/dor-vs-toupet-fundoplication-after-laparoscopic-heller-myotomy-long-term-randomized-controlled-trial-evaluated-by-high-resolution-manometry
#2
Gonzalo Torres-Villalobos, Enrique Coss-Adame, Janette Furuzawa-Carballeda, Fernanda Romero-Hernández, Blanca Blancas-Breña, Samuel Torres-Landa, Axel Palacios-Ramírez, Edgar Alejandro-Medrano, Axel Hernández-Ávila, Athenea Flores-Najera, Lourdes Margarita Ávila Escobedo, Cecilia Ramírez Angulo, Angélica Rodríguez-Garcés, Miguel Ángel Valdovinos
BACKGROUND: Laparoscopic Heller myotomy (LHM) with partial fundoplication is an effective treatment for achalasia. However, the type of fundoplication is still a subject of debate. AIM: The aim of the study is to identify which partial fundoplication leads to better control of acid exposure, manometric parameters, and symptoms scores. METHODS: A randomized controlled trial was performed to compare Dor vs Toupet fundoplication after LHM. The preoperative diagnosis was made by high-resolution manometry (HRM), upper endoscopy, and barium esophagogram...
September 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28906412/laparoscopic-nissen-total-versus-anterior-180%C3%A2-fundoplication-for-gastro-esophageal-reflux-disease-a-meta-analysis-and-systematic-review
#3
REVIEW
Xing Du, Ji-Min Wu, Zhi-Wei Hu, Feng Wang, Zhong-Gao Wang, Chao Zhang, Chao Yan, Mei-Ping Chen
BACKGROUND: Laparoscopic Nissen fundoplication (LNF) has been the gold standard for the surgical management of Gastro-esophageal reflux disease (GERD). Laparoscopic anterior 180° fundoplication (180° LAF) is reported to reduce the incidence of postoperative complications while obtaining similar control of reflux. The present meta-analysis was conducted to confirm the value of the 2 techniques. METHODS: PubMed, Medline, Embase, Cochrane Library, Springerlink, and China National Knowledge Infrastructure Platform databases were searched for randomized controlled trials (RCTs) comparing LNF and 180° LAF...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28898473/influence-of-prucalopride-on-esophageal-secondary-peristalsis-in-reflux-patients-with-ineffective-motility
#4
Wei-Yi Lei, Jui-Sheng Hung, Tso-Tsai Liu, Chih-Hsun Yi, Chien-Lin Chen
BACKGROUNDS/AIM: Ineffective esophageal motility (IEM) is associated with gastroesophageal reflux disease (GERD). Secondary peristalsis contributes to esophageal clearance. Prucalopride promotes secondary peristalsis by stimulating 5-hydroxytrypatamine 4 receptors in the esophagus. We aimed to determine whether prucalopride would augment secondary peristalsis in GERD patients with IEM. METHODS: After a baseline recording of primary peristalsis, secondary peristalsis was stimulated by slow and rapid mid-esophageal injections of air in 15 patients with IEM...
September 12, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28866876/understanding-the-chicago-classification-from-tracings-to-patients
#5
REVIEW
Francisco Schlottmann, Fernando A Herbella, Marco G Patti
Current parameters of the Chicago classification include assessment of the esophageal body (contraction vigour and peristalsis), lower esophageal sphincter relaxation pressure, and intra-bolus pressure pattern. Esophageal disorders include achalasia, esophagogastric junction outflow obstruction, major disorders of peristalsis, and minor disorders of peristalsis. Sub-classification of achalasia in types I, II, and III seems to be useful to predict outcomes and choose the optimal treatment approach. The real clinical significance of other new parameters and disorders is still under investigation...
September 1, 2017: Journal of Neurogastroenterology and Motility
https://www.readbyqxmd.com/read/28866536/decision-graph-embedding-for-high-resolution-manometry-diagnosis
#6
Julian Kreiser, Alexander Hann, Eugen Zizer, Timo Ropinski
High-resolution manometry is an imaging modality which enables the categorization of esophageal motility disorders. Spatio-temporal pressure data along the esophagus is acquired using a tubular device and multiple test swallows are performed by the patient. Current approaches visualize these swallows as individual instances, despite the fact that aggregated metrics are relevant in the diagnostic process. Based on the current Chicago Classification, which serves as the gold standard in this area, we introduce a visualization supporting an efficient and correct diagnosis...
August 29, 2017: IEEE Transactions on Visualization and Computer Graphics
https://www.readbyqxmd.com/read/28859391/esophagogastric-junction-outflow-obstruction-is-often-associated-with-coexistent-abnormal-esophageal-body-motility-and-abnormal-bolus-transit
#7
E Zheng, R M Gideon, J Sloan, P O Katz
Currently, the diagnosis of esophageal motility disorders is in part based upon a hierarchical algorithm in which abnormalities of the esophagogastric junction (EGJ) is prioritized. An important metric in evaluating the EGJ is the integrated relaxation pressure (IRP). Patients who do not have achalasia but are found to have an elevated IRP are diagnosed with EGJ outflow obstruction. It has been our observation that a subset of these patients also has a second named motility disorder and may also have abnormal bolus transit...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28857852/effects-of-high-flow-nasal-cannula-on-the-work-of-breathing-in-patients-recovering-from-acute-respiratory-failure
#8
Mathieu Delorme, Pierre-Alexandre Bouchard, Mathieu Simon, Serge Simard, François Lellouche
OBJECTIVES: High-flow nasal cannula is increasingly used in the management of respiratory failure. However, little is known about its impact on respiratory effort, which could explain part of the benefits in terms of comfort and efficiency. This study was designed to assess the effects of high-flow nasal cannula on indexes of respiratory effort (i.e., esophageal pressure variations, esophageal pressure-time product/min, and work of breathing/min) in adults. DESIGN: A randomized controlled crossover study was conducted in 12 patients with moderate respiratory distress (i...
August 28, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28857171/characterization-of-swallow-modulation-in-response-to-bolus-volume-in-healthy-subjects-accounting-for-catheter-diameter
#9
Lara Ferris, Mistyka Schar, Lisa McCall, Sebastian Doeltgen, Ingrid Scholten, Nathalie Rommel, Charles Cock, Taher Omari
OBJECTIVES/HYPOTHESIS: Characterization of the pharyngeal swallow response to volume challenges is important for swallowing function assessment. The diameter of the pressure-impedance recording catheter may influence these results. In this study, we captured key physiological swallow measures in response to bolus volume utilizing recordings acquired by two catheters of different diameter. STUDY DESIGN: Ten healthy adults underwent repeat investigations with 8- and 10-Fr catheters...
August 31, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28856802/esophagogastric-junction-cancer-successfully-treated-by-laparoscopic-proximal-gastrectomy-and-lower-esophagectomy-with-intrathoracic-double-flap-technique-a-case-report
#10
Kei Hosoda, Keishi Yamashita, Hiromitsu Moriya, Marie Washio, Hiroaki Mieno, Akira Ema, Masahiko Watanabe
A 66-year-old man was referred to our hospital for treatment of esophagogastric junction cancer. He was diagnosed as cT2N0M0, and the esophageal invasion was found to be 1 cm from the esophagogastric junction. He underwent laparoscopy-assisted proximal gastrectomy and lower esophagectomy with esophagogastrostomy using the intrathoracic double-flap technique through the transhiatal approach. The operative time was 662 min (suturing time was 198 min), and blood loss was 200 mL. The operative time was much longer for this procedure than for esophagogastrostomy with the conventional (intra-abdominal) double-flap technique...
August 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28855978/a-case-of-shunting-postoperative-patent-foramen-ovale-under-mechanical-ventilation-controlled-by-different-ventilator-settings
#11
Claudio Pragliola, Sara Di Michele, Domenico Galzerano
A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE) performed while the patient was being ventilated at a positive end expiratory pressure (PEEP) of 8 cm H2O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO). Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H2O led to the complete resolution of the shunt with no change in arterial blood gases...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28842719/ten-tips-to-facilitate-understanding-and-clinical-use-of-esophageal-pressure-manometry
#12
Takeshi Yoshida, Laurent Brochard
No abstract text is available yet for this article.
August 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28836246/-clinical-experience-of-combined-laparoscopic-endoscopic-heller-myotomy-and-modified-dor-fundoplication-for-cardiochalasia
#13
Xiaofang Qiao, Jinlong Li, Hua Xu, Xin Wan, Jiaming Zhu
OBJECTIVE: To investigate the efficacy of combined laparoscopic-endoscopic lower esophageal sphincterotomy and modified Dor fundoplication for cardiochalasia patients. METHODS: Clinical data of 11 cardiochalasia patients who underwent combined laparoscopic-endoscopic lower esophageal sphincterotomy and modified Dor fundoplication by the same medical team from January 2015 to December 2016 at The Second Hospital of Jilin University were retrospectively analyzed. The procedure was as follows: an incision was made in the anterior wall of esophagus and dissection of esophageal muscular layer was performed, then the bulged esophageal mucosa was covered by the fundus after 180 degrees fold to the right (fundoplication), finally the gastric fundus was joined to the right diaphragmatic foot by 3 to 5 knotted suture...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28833926/effects-of-remifentanil-on-esophageal-and-esophagogastric-junction-egj-bolus-transit-in-healthy-volunteers-using-novel-pressure-flow-analysis
#14
C Cock, S H Doeltgen, T Omari, J Savilampi
BACKGROUND: Remifentanil is associated with subjective dysphagia and an objective increase in aspiration risk. Studies of opioid effects have shown decreased lower esophageal sphincter relaxation. We assessed bolus transit through the esophagus and esophagogastric junction (EGJ) during remifentanil administration using objective pressure-flow analysis. METHODS: Data from 11 healthy young participants (23±3 years, 7 M) were assessed for bolus flow through the esophagus and EGJ using high-resolution impedance manometry (Manoscan™, Sierra Scientific Instruments, Inc...
August 18, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28828590/direct-reopening-of-the-occluded-hepatic-veins-of-budd-chiari-syndrome-verification-of-our-operative-method-by-the-perioperative-course-of-esophageal-varices
#15
Yukio Kuniyoshi, Hitoshi Inafuku, Satoshi Yamashiro, Yuya Kise, Takaaki Nagano, Ryoko Arakaki, Tatsuya Maeda, Mizuki Ando, Shotaro Higa
OBJECTIVE: A total of 69 patients with Budd-Chiari syndrome (BCS) were operated by direct approach under cardiopulmonary bypass (CPB). To assess the operative procedure, the perioperative course of esophageal varices (EVs) was evaluated. PATIENTS AND METHODS: Of the 69 patients, 59 (22 females) were enrolled in this study because they had complete follow-up data for endoscopic evaluation of EVs. Their mean age was 46.3 ± 13.0 years (range 21-73.3 years). EVs were found in 52 patients...
August 21, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28828360/transpulmonary-pressure-importance-and-limits
#16
REVIEW
Domenico Luca Grieco, Lu Chen, Laurent Brochard
Transpulmonary pressure (PL) is computed as the difference between airway pressure and pleural pressure and separates the pressure delivered to the lung from the one acting on chest wall and abdomen. Pleural pressure is measured as esophageal pressure (PES) through dedicated catheters provided with esophageal balloons. We discuss the role of PL in assessing the effects of mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). In the supine position, directly measured PL represents the pressure acting on the alveoli and airways...
July 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28827669/cerebral-blood-volume-and-oxygen-supply-uniformly-increase-following-various-intrathoracic-pressure-strains
#17
Zhongxing Zhang, Nina Bolz, Marco Laures, Margit Oremek, Christoph Schmidt, Ming Qi, Ramin Khatami
Intrathoracic pressure (ITP) swings challenge many physiological systems. The responses of cerebral hemodynamics to different ITP swings are still less well-known due to the complexity of cerebral circulation and methodological limitation. Using frequency-domain near-infrared spectroscopy and echocardiography, we measured changes in cerebral, muscular and cardiac hemodynamics in five graded respiratory maneuvers (RM), breath holding, moderate and strong Valsalva maneuvers (mVM/sVM) with 20 and 40 cmH2O increments in ITP, moderate and strong Mueller maneuvers (mMM/sMM) with 20 and 40 cmH2O decrements in ITP controlled by esophageal manometry...
August 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28820885/diagnostic-efficacy-of-noninvasive-liver-fibrosis-indexes-in-predicting-portal-hypertension-in-patients-with-cirrhosis
#18
Le Wang, Yuemin Feng, Xiaowen Ma, Guangchuan Wang, Hao Wu, Xiaoyu Xie, Chunqing Zhang, Qiang Zhu
BACKGROUND: Recent data suggest that noninvasive liver fibrosis indexes could be useful for predicting esophageal varices (EV) in cirrhotic patients. However, thus far, the diagnostic efficacy of these indexes in predicting portal hypertension (PH) in cirrhotic patients has been poorly evaluated. AIMS: To evaluate the diagnostic efficacy of noninvasive liver fibrosis indexes in the diagnosis of PH. METHODS: A total of 238 cirrhotic patients underwent hepatic venous pressure gradient (HVPG) evaluation and relevant serum tests to analyze the variables associated with PH grade...
2017: PloS One
https://www.readbyqxmd.com/read/28804936/subtle-lower-esophageal-sphincter-relaxation-abnormalities-in-patients-with-unexplained-esophageal-dysphagia
#19
T V K Herregods, F B van Hoeij, A J Bredenoord, A J P M Smout
BACKGROUND: Esophageal dysphagia is a relatively common symptom. We aimed to evaluate whether subtle, presently not acknowledged forms of dysfunction of the lower esophageal sphincter (LES) could explain dysphagia in a subset of patients with normal findings at high-resolution manometry (HRM) according to the Chicago classification v3.0. METHODS: We used HRM to compare LES relaxation characteristics in 97 patients with unexplained dysphagia with those in 44 healthy subjects...
August 14, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28791885/shunt-preserving-disconnection-of-the-portal-to-systemic-circulation-in-patients-with-hepatic-encephalopathy
#20
Osamu Ikeda, Seijiro Inoue, Yoshitaka Tamura, Yo-Ichi Yamashita, Hideo Baba, Yukihiro Inomata, Yasuyuki Yamashita
Background Portosystemic shunt obliteration by surgical or interventional radiological techniques can be effective for patients with hepatic encephalopathy (HE) although this approach is often associated with accumulation of ascites and/or formation of esophageal varices. Purpose To evaluate the clinical efficacy and safety of shunt-preserving disconnection of the portosystemic circulation (SPDPS) in patients with HE. Material and Methods Nine patients with HE and a splenorenal shunt were treated by SPDPS: eight underwent selective coil embolization of the splenic vein and one underwent stent-graft closure of the shunt...
January 1, 2017: Acta Radiologica
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