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https://www.readbyqxmd.com/read/27903671/sports-related-lung-injury-during-breath-hold-diving
#1
Tanja Mijacika, Zeljko Dujic
The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27866929/long-term-outcomes-of-pulmonary-arterial-hypertension-under-specific-drug-therapy-in-eisenmenger-syndrome
#2
Sébastien Hascoët, Alban-Elouen Baruteau, Marc Humbert, Gérald Simonneau, Xavier Jais, Jérôme Petit, Daniela Laux, Olivier Sitbon, Virginie Lambert, André Capderou
BACKGROUND: The long-term effectiveness of pulmonary arterial hypertension-specific drug therapy (PAH-SDT) in Eisenmenger syndrome is controversial. We investigated short-term and long-term hemodynamic changes under PAH-SDT and their associations with outcomes in a bicentric cohort. METHODS: Over 20 years, we included 69 patients with congenital heart disease, an indexed pulmonary vascular resistance (PVRi) >8 WU·m(2), and 292 standardized catheterizations at baseline and after PAH-SDT initiation or intensification...
October 15, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27850585/947-comparison-of-pes-derived-and-cvp-derived-transpulmonary-pressure-in-immobilized-hypoxemic-children
#3
Miyako Kyogoku, Muneyuki Takeuchi, Yoshiyuki Shimizu, Takeshi Hatachi, Kazue Moon, Kazuya Tachibana
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27850036/396-the-impact-of-education-and-availability-of-transpulmonary-pressure-on-physicians-decisions
#4
Yasuhiro Norisue, Jun Kataoka, Takaki Naito, Shigeki Fujitani, Junko Takada, Sunao Usami, Lonny Ashworth, Muneyuki Takeuchi
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27849437/optimum-temperature-of-oxygen-for-transpulmonary-hypothermia-with-cooled-oxygen-inhalation-a-preliminary-study-in-a-rat-model
#5
Banu Karakus Yilmaz, Hatice Topcu, Yahya A Acar, Duygu Sultan Oran, Sule Ozsoy, Erdem Çevik, Aylin Hakligor, Orhan Çinar
Cooled oxygen inhalation was hypothesized as a novel hypothermia technique in a previous study. In the current study, we aimed to determine the optimal temperature of oxygen for this method. This is a prospective, randomized, controlled, examiner-blinded experimental study conducted with 45 healthy, adult, Wistar Hannover male rats. Rats were randomly divided into five groups; group 1: +4°C intubated group (n = 7), group 2: +4°C nonintubated group (n = 9), group 3: +8°C intubated group (n = 9), group 4: +8°C nonintubated group (n = 9), and group 5: control group (n = 9)...
November 16, 2016: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/27842745/managing-acute-lung-injury
#6
REVIEW
Gregory A Schmidt
The foundation of mechanical ventilation for acute respiratory distress syndrome involves limiting lung overdistention by using small tidal volumes or transpulmonary pressures. Potential for additional lung recruitment with higher positive end-expiratory pressure (PEEP) should be assessed. When stress index indicates tidal recruitment-derecruitment, PEEP is increased to higher values. Alternatively, a high PEEP table is used in all patients. When these conventional approaches are insufficient to sustain acceptable gas exchange, rescue is attempted using extracorporeal therapies, airway pressure-release ventilation, inhaled vasodilators, or high-frequency oscillatory ventilation...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27826705/feasibility-and-accuracy-of-cardiac-right-to-left-shunt-detection-in-children-by-new-transpulmonary-ultrasound-dilution-method
#7
Martin Boehne, Mathias Baustert, Verena Paetzel, Dietmar Boethig, Harald Köditz, Nils Dennhardt, Philipp Beerbaum, Harald Bertram
Transpulmonary ultrasound dilution (TPUD) method, a novel indicator dilution (ID) technique for cardiac output measurement, detects and quantifies shunts, both in children and adults. However, its accuracy and reproducibility in cardiac right-to-left-shunt (RLS) detection have not been investigated. In a prospective observational study, we assessed the validity of TPUD algorithm for RLS detection in children with congenital heart disease (CHD) and proven RLS in comparison with controls without shunts between February 2010 and October 2011...
November 8, 2016: Pediatric Cardiology
https://www.readbyqxmd.com/read/27817009/applicability-of-stroke-volume-variation-in-patients-of-a-general-intensive-care-unit-a-longitudinal-observational-study
#8
Sebastian Mair, Julia Tschirdewahn, Simon Götz, Johanna Frank, Veit Phillip, Benedikt Henschel, Caroline Schultheiss, Ulrich Mayr, Sebastian Noe, Matthias Treiber, Roland M Schmid, Bernd Saugel, Wolfgang Huber
Sinus rhythm (SR) and controlled mechanical ventilation (CV) are mandatory for the applicability of respiratory changes of the arterial curve such as stroke volume variation (SVV) to predict fluid-responsiveness. Furthermore, several secondary limitations including tidal volumes <8 mL/kg and SVV-values within the "gray zone" of 9-13% impair prediction of fluid-responsiveness by SVV. Therefore, we investigated the prevalence of these four conditions in general ICU-patients. This longitudinal observational study analyzed a prospectively maintained haemodynamic database including 4801 transpulmonary thermodilution and pulse contour analysis measurements of 278 patients (APACHE-II 21...
November 5, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27794083/the-effect-of-compartmental-asymmetry-on-the-monitoring-of-pulmonary-mechanics-and-lung-volumes
#9
Joseph C Keenan, Gustavo A Cortes-Puentes, Alexander B Adams, David J Dries, John J Marini
BACKGROUND: Esophageal pressure measurement for computation of transpulmonary pressure (Ptp) has begun to be incorporated into clinical use for evaluating forces across the lungs. Gaps exist in our understanding of how esophageal pressure (and therefore Ptp), a value measured at a single site, responds when respiratory system compartments are asymmetrically affected by whole-lung atelectasis or unilateral injury as well as changes in chest wall compliance. We reasoned that Ptp would track with aerated volume changes as estimated by functional residual capacity (FRC) and tidal volume...
November 2016: Respiratory Care
https://www.readbyqxmd.com/read/27766022/flooded-lung-generates-a-suitable-acoustic-pathway-for-transthoracic-application-of-high-intensity-focused-ultrasound-in-liver
#10
Thomas Günther Lesser, Carsten Boltze, Harald Schubert, Frank Wolfram
Background: In recent years, high intensity focused ultrasound (HIFU) has gained increasing clinical interest as a non-invasive method for local therapy of liver malignancies. HIFU treatment of tumours and metastases in the liver dome is limited due to the adjacent ultrasound blocking lung. One-lung flooding (OLF) enables complete sonography of lung and adjoining organs including liver. HIFU liver ablation passing through the flooded lung could enable a direct intercostal beam path and thus improve dose deposition in liver...
2016: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/27764870/-invasive-and-minimally-invasive-hemodynamic-monitoring
#11
Matthias Hansen
Advanced hemodynamic monitoring is necessary for adequate management of high-risk patients or patients with derangement of circulation. Studies demonstrate a benefit of early goal directed therapy in unstable cardiopulmonary situations. In these days we have different possibilities of minimally invasive or invasive hemodynamic monitoring. Minimally invasive measurements like pulse conture analysis or pulse wave analysis being less accurate under some circumstances, however only an artery catheter is needed for cardiac output monitoring...
October 2016: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/27761886/comparison-between-effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-and-diaphragmatic-damage-in-experimental-emphysema
#12
Gisele de A Padilha, Lucas F B Horta, Lillian Moraes, Cassia L Braga, Milena V Oliveira, Cíntia L Santos, Isalira P Ramos, Marcelo M Morales, Vera Luiza Capelozzi, Regina C S Goldenberg, Marcelo Gama de Abreu, Paolo Pelosi, Pedro L Silva, Patricia R M Rocco
BACKGROUND: In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. METHODS: Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks...
December 2016: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/27748627/partial-neuromuscular-blockade-during-partial-ventilatory-support-in-sedated-patients-with-high-tidal-volumes
#13
Jonne Doorduin, Joeke L Nollet, Lisanne H Roesthuis, Hieronymus W H van Hees, Laurent J Brochard, Christer A Sinderby, Johannes G van der Hoeven, Leo M A Heunks
RATIONALE: Controlled mechanical ventilation is used to deliver lung-protective ventilation in patients with acute respiratory distress syndrome. Despite recognized benefits, such as preserved diaphragm activity, partial support ventilation modes may be incompatible with lung-protective ventilation due to high tidal volume and high transpulmonary pressure. As an alternative to high dose sedatives and controlled mechanical ventilation, pharmacologically induced neuromechanical uncoupling of the diaphragm should facilitate lung-protective ventilation under partial support modes...
October 17, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27716702/global-end-diastolic-volume-an-emerging-preload-marker-vis-a-vis-other-markers-have-we-reached-our-goal
#14
P M Kapoor, Vandana Bhardwaj, Amita Sharma, Usha Kiran
A reliable estimation of cardiac preload is helpful in the management of severe circulatory dysfunction. The estimation of cardiac preload has evolved from nuclear angiography, pulmonary artery catheterization to echocardiography, and transpulmonary thermodilution (TPTD). Global end-diastolic volume (GEDV) is the combined end-diastolic volumes of all the four cardiac chambers. GEDV has been demonstrated to be a reliable preload marker in comparison with traditionally used pulmonary artery catheter-derived pressure preload parameters...
October 2016: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/27703980/advanced-hemodynamic-management-in-patients-with-septic-shock
#15
Bernd Saugel, Wolfgang Huber, Axel Nierhaus, Stefan Kluge, Daniel A Reuter, Julia Y Wagner
In patients with sepsis and septic shock, the hemodynamic management in both early and later phases of these "organ dysfunction syndromes" is a key therapeutic component. It needs, however, to be differentiated between "early goal-directed therapy" (EGDT) as proposed for the first 6 hours of emergency department treatment by Rivers et al. in 2001 and "hemodynamic management" using advanced hemodynamic monitoring in the intensive care unit (ICU). Recent large trials demonstrated that nowadays protocolized EGDT does not seem to be superior to "usual care" in terms of a reduction in mortality in emergency department patients with early identified septic shock who promptly receive antibiotic therapy and fluid resuscitation...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27698722/analysis-of-the-first-therapeutic-target-achieving-time-of-warfarin-therapy-and-associated-factors-in-patients-with-pulmonary-embolism
#16
Xiaowei Gong, Haiyan Wang, Yadong Yuan
The present study aimed to investigate the factors affecting the first therapeutic-target-achieving (TTA) time of warfarin therapy in patients with acute pulmonary embolism (PTE). Between January 2008 and June 2013, patients with PTE confirmed by transpulmonary arterial enhanced computed tomographic pulmonary angiography or pulmonary ventilation perfusion scanning were included in the present study. Data collected included demographic information, history of tobacco and alcohol intake, basic diseases (stable and unstable hypertension, diabetes, heart failure, cancer/cerebral infarction, old myocardial infarction and atrial fibrillation), liver and kidney function, the haemoglobin and platelet count of the blood, international normalized ratio monitoring, warfarin dosage adjustment and medication combinations...
October 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27694355/esophageal-pressure-measurements-in-patients-with-acute-respiratory-distress-syndrome
#17
Grace Hofmann, Lutana Haan, Jeff Anderson
Esophageal balloons are used in the respiratory monitoring of critical care patients. After the esophageal pressure is measured, the corresponding pleural pressure in the thorax can be projected, enabling lung-thorax compliance to be partitioned into chest-wall compliance and lung compliance. The esophageal balloon allows determination of transpulmonary pressures and a correspondingly individually tailored approach to respiratory care, such as patient-specific titration of positive end-expiratory pressure for patients with extrapulmonary acute respiratory distress syndrome...
October 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27681859/surgical-repair-of-a-complete-atrioventricular-septal-defect-with-tetralogy-of-fallot-using-a-classical-one-patch-technique-and-pulmonary-valve-preservation
#18
Carine Pavy, Olivier Ghez
The association of complete atrial ventricular septal defect (cAVSD) with tetralogy of Fallot remains a complex malformation that involves both inlet and outlet components of the ventricles. The surgical treatment used to be, in the 1980s, a staged repair strategy due to the high mortality rate of first primary repairs (PRs). However, nowadays, PRs have better outcomes. Although double-patch procedures are widely performed, this article describes the single-patch approach for cAVSD repair with transatrial-transpulmonary repair of the Fallot component with preservation of the pulmonary valve...
2016: Multimedia Manual of Cardiothoracic Surgery: MMCTS
https://www.readbyqxmd.com/read/27659967/short-term-effects-of-low-volume-resuscitation-with-hypertonic-saline-and-hydroxyethylstarch-in-an-experimental-model-of-lung-contusion-and-haemorrhagic-shock
#19
Bertrand Prunet, Pierre-Yves Cordier, Nicolas Prat, Sophie De Bourmont, David Couret, Dominique Lambert, Pierre Michelet
OBJECTIVES: This study aimed to assess the short-term respiratory tolerance and haemodynamic efficiency of low-volume resuscitation with hypertonic saline and hydroxyethylstarch (HS/HES) in a pig model of lung contusion and controlled haemorrhagic shock. We hypothesised that a low-volume of HS/HES after haemorrhagic shock did not impact contused lungs in terms of extravascular lung water 3hours after trauma. METHODS: A lung contusion resulting from blunt chest trauma was induced in 28 anaesthetised female pigs with five bolt-shots to the right thoracic cage, followed by haemorrhagic shock and fluid resuscitation...
September 20, 2016: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/27645151/transpulmonary-and-pleural-pressure-in-a-respiratory-system-model-with-an-elastic-recoiling-lung-and-an-expanding-chest-wall
#20
Per Persson, Stefan Lundin, Ola Stenqvist
BACKGROUND: We have shown in acute lung injury patients that lung elastance can be determined by a positive end-expiratory pressure (PEEP) step procedure and proposed that this is explained by the spring-out force of the rib cage off-loading the chest wall from the lung at end-expiration. The aim of this study was to investigate the effect of the expanding chest wall on pleural pressure during PEEP inflation by building a model with an elastic recoiling lung and an expanding chest wall complex...
December 2016: Intensive Care Medicine Experimental
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