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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/27850585/947-comparison-of-pes-derived-and-cvp-derived-transpulmonary-pressure-in-immobilized-hypoxemic-children
#2
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
#3
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/27842745/managing-acute-lung-injury
#4
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/27794083/the-effect-of-compartmental-asymmetry-on-the-monitoring-of-pulmonary-mechanics-and-lung-volumes
#5
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/27761886/comparison-between-effects-of-pressure-support-and-pressure-controlled-ventilation-on-lung-and-diaphragmatic-damage-in-experimental-emphysema
#6
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
#7
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
#8
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/27694355/esophageal-pressure-measurements-in-patients-with-acute-respiratory-distress-syndrome
#9
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/27659967/short-term-effects-of-low-volume-resuscitation-with-hypertonic-saline-and-hydroxyethylstarch-in-an-experimental-model-of-lung-contusion-and-haemorrhagic-shock
#10
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
#11
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
https://www.readbyqxmd.com/read/27626833/mechanical-ventilation-to-minimize-progression-of-lung-injury-in-acute-respiratory-failure
#12
Laurent Brochard, Arthur Slutsky, Antonio Pesenti
Mechanical Ventilation (MV) is used to sustain life in patients with acute respiratory failure. A major concern in mechanically ventilated patients is the risk of Ventilator-Induced Lung Injury (VILI), which is partially prevented by lung protective ventilation. Spontaneously breathing, non-intubated, patients with acute respiratory failure may have a high respiratory drive and breathe with large tidal volumes and potentially injurious transpulmonary pressure swings. In patients with existing lung injury, regional forces generated by the respiratory muscles may lead to injurious effects on a regional level...
September 14, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27620877/low-cardiac-index-and-stroke-volume-on-admission-are-associated-with-poor-outcome-in-critically-ill-burn-patients-a-retrospective-cohort-study
#13
Sabri Soussi, Benjamin Deniau, Axelle Ferry, Charlotte Levé, Mourad Benyamina, Véronique Maurel, Maïté Chaussard, Brigitte Le Cam, Alice Blet, Maurice Mimoun, Jêrome Lambert, Marc Chaouat, Alexandre Mebazaa, Matthieu Legrand
BACKGROUND: Impact of early systemic hemodynamic alterations and fluid resuscitation on outcome in the modern burn care remains controversial. We investigate the association between acute-phase systemic hemodynamics, timing of fluid resuscitation and outcome in critically ill burn patients. METHODS: Retrospective, single-center cohort study was conducted in a university hospital. Forty critically ill burn patients with total body surface area (TBSA) burn-injured >20 % with invasive blood pressure and cardiac output monitoring (transpulmonary thermodilution technique) within 8 h from trauma were included...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27620876/transpulmonary-pressure-during-high-frequency-oscillation-ventilation-is-it-the-culprit
#14
EDITORIAL
M Cressoni, Davide Chiumello
No abstract text is available yet for this article.
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27612586/airway-occlusion-assessed-by-single-breath-n2-test-and-lung-p-v-curve-in-healthy-subjects-and-copd-patients
#15
Matteo Pecchiari, Dejan Radovanovic, Pierachille Santus, Edgardo D'Angelo
PURPOSE: To determine whether the analysis of the slow expiratory transpulmonary pressure-volume (PL-V) curve provides an alternative to the single-breath nitrogen test (SBN) for the assessment of the closing volume (CV). METHODS: SBN test and slow deflation PL-V curve were simultaneously recorded in 40 healthy subjects and 43 COPD patients. Onset of phase IV identified CV in SBN test (CVSBN), whereas in the PL-V curve CV was identified by: a) deviation from the exponential fit (CVexp), and b) inflection point of the interpolating sigmoid function (CVsig)...
September 6, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27610948/interventricular-conduction-disorders-after-orthotopic-heart-transplantation-risk-factors-and-clinical-relevance
#16
Sonia Ferretto, Elvin Tafciu, Immacolata Giuliani, Giuseppe Feltrin, Tomaso Bottio, Antonio Gambino, Angela Fraiese, Sabino Iliceto, Gino Gerosa, Loira Leoni
BACKGROUND: Causes and significance of interventricular conduction disorders (IVCDs) after orthotopic heart transplantation (OHT) are still unknown. METHODS: We retrospectively researched the presence of IVCDs in 240 patients who underwent bicaval OHT in three time periods: at day 1, after 1 year, and after 3 years from OHT. To evaluate the impact of the surgical technique, a control population treated with biatrial anastomosis was used. RESULTS: The most common IVCD was right bundle branch block (RBBB)...
September 9, 2016: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/27606837/transpulmonary-pressure-the-importance-of-precise-definitions-and-limiting-assumptions
#17
Stephen H Loring, George P Topulos, Rolf D Hubmayr
Recent studies applying the principles of respiratory mechanics to respiratory disease have used inconsistent and mutually exclusive definitions of the term "transpulmonary pressure." By the traditional definition, transpulmonary pressure is the pressure across the whole lung including the intrapulmonary airways, i.e., the pressure difference between the opening to the pulmonary airway and the pleural surface. However more recently, transpulmonary pressure has also been defined as the pressure across only the lung tissue, i...
September 8, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27590259/evaluation-of-the-pharmacodynamic-effects-of-riociguat-in-subjects-with-pulmonary-hypertension-and-heart-failure-with-preserved-ejection-fraction-study-protocol-for-a%C3%A2-randomized-controlled-trial
#18
Julia Mascherbauer, Ekkehard Grünig, Michael Halank, Wolfgang Hohenforst-Schmidt, Andreas A Kammerlander, Ingrid Pretsch, Regina Steringer-Mascherbauer, Silvia Ulrich, Irene M Lang, Manfred Wargenau, Reiner Frey, Diana Bonderman
BACKGROUND: The presence of pulmonary hypertension (PH) severely aggravates the clinical course of heart failure with preserved ejection fraction (HFPEF) resulting in substantial morbidity and mortality. So far, neither established heart failure therapies nor pulmonary vasodilators have proven to be effective for this condition. Riociguat (Adempas®, BAY 63-2521), a stimulator of soluble guanylate cyclase, is a novel pulmonary and systemic vasodilator that has been approved for the treatment of precapillary forms of PH...
September 2, 2016: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/27587711/a-critical-appraisal-of-transpulmonary-and-diastolic-pressure-gradients
#19
M Louis Handoko, Frances S De Man, Frank P T Oosterveer, Harm-Jan Bogaard, Anton Vonk-Noordegraaf, Nico Westerhof
Pulmonary hypertension (PH) resulting from left heart failure is an increasingly recognized clinical entity. To distinguish isolated postcapillary PH from combined post- and precapillary PH, the use of a diastolic pressure gradient (DPG = diastolic Pulmonary Artery Pressure - Pulmonary Arterial Wedge Pressure, dPAP - PAWP) has been advocated over the transpulmonary pressure gradient (TPG = mean Pulmonary Artery Pressure - PAWP, mPAP - PAWP) since DPG was suggested to be independent of cardiac output (CO) and only slightly related to PAWP, while TPG depends on both...
September 2016: Physiological Reports
https://www.readbyqxmd.com/read/27577052/effect-of-high-frequency-oscillatory-ventilation-on-esophageal-and-transpulmonary-pressures-in-moderate-to-severe-acute-respiratory-distress-syndrome
#20
Christophe Guervilly, Jean-Marie Forel, Sami Hraiech, Antoine Roch, Daniel Talmor, Laurent Papazian
BACKGROUND: High-frequency oscillatory ventilation (HFOV) has not been shown to be beneficial in the management of moderate-to-severe acute respiratory distress syndrome (ARDS). There is uncertainty about the actual pressure applied into the lung during HFOV. We therefore performed a study to compare the transpulmonary pressure (P L) during conventional mechanical ventilation (CMV) and different levels of mean airway pressure (mPaw) during HFOV. METHODS: This is a prospective randomized crossover study in a university teaching hospital...
December 2016: Annals of Intensive Care
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