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https://www.readbyqxmd.com/read/28333037/cerebral-hemodynamic-with-intra-aortic-balloon-pump-business-as-usual
#1
Juliana Caldas, Ronney B Panerai, Edson Bor-Seng-Shu, Juliano Almeida, Graziela Ferreira, Ligia Cunha, Ricardo Nogueira, Marcelo Oliveira, Fabio Jatene, Thompson Robinson, Ludhmila Hajjar
Intra-aortic balloon pump (IABP) is commonly used as mechanical support after cardiac surgery or cardiac shock. Although its benefits for cardiac function have been well documented, its effects on cerebral circulation are still controversial. We hypothesized that transfer function analysis (TFA) and continuous estimates of dynamic cerebral autoregulation (CA) provide consistent results in the assessment of cerebral autoregulation in patients with IABP. Continuous recordings of blood pressure (BP, intra-arterial line), end-tidal CO2, heart rate and cerebral blood flow velocity (CBFV, transcranial Doppler) were obtained i) 5 minutes with IABP ratio 1:3, ii) 5 minutes, starting 1 minute with the IABP-ON, and continuing for another 4 minutes without pump assistance (IABP-OFF)...
March 23, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28323763/prospective-randomized-clinical-trial-investigating-the-effect-of-the-reamer-irrigator-aspirator-on-the-volume-of-embolic-load-and-respiratory-function-during-intramedullary-nailing-of-femoral-shaft-fractures
#2
Jeremy A Hall, Michael D McKee, Milena R Vicente, Zachary A Morison, Niloofar Dehghan, Christine E Schemitsch, Hans J Kreder, Brad Petrisor, Emil H Schemitsch
OBJECTIVES: We sought to determine whether the use of the Reamer-Irrigator-Aspirator (RIA) device resulted in a decreased amount of fat emboli compared with standard reaming (SR) when performing intramedullary (IM) nailing of femoral shaft fractures. DESIGN: Prospective randomized clinical trial. SETTING: Multi-centered trial, level I trauma centers. PATIENTS/PARTICIPANTS: All eligible patients who presented to participating institutions with an isolated femoral shaft fracture amenable to fixation with antegrade IM nailing...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323759/hypercapnia-caused-by-a-therapeutic-dosage-of-pregabalin-in-a-tetraplegic-patient-with-cervical-spinal-cord-injury
#3
Kyung Hee Do, Eun Jung Choi, Min Cheol Chang, Hea-Eun Yang
Pregabalin is often used for the treatment of neuropathic pain in patients with spinal cord injury (SCI). We reported a patient with C5 [S(C5/C6)] ASIA Impairment Scale C SCI due to cervical myelopathy who presented CO2 retention when taking a therapeutic dosage of pregabalin. An 88-year-old patient with cervical SCI was transferred to the department of physical medicine and rehabilitation. When he had transferred, his neuropathic pain had been treated with 150-mg pregabalin per day (75 mg twice a day); however, he still exhibited severe neuropathic pain with a Numeric Pain Rating Scale score of 7 to 8...
March 20, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28314626/cerebral-hemodynamic-effects-of-cheyne-stokes-respiration-in-a-patient-with-stroke
#4
R C Nogueira, R B Panerai, M J Teixeira, T G Robinson, E Bor-Seng-Shu
INTRODUCTION: Cheyne-Stokes respiration (CSR) and central sleep apnea (CSA) are common in patients with heart failure and/or stroke. We aim to describe the cerebrovascular effects of CSR during the acute phase of stroke in a heart failure patient. CASE REPORT: A 74-year-old male with previous dilated cardiomyopathy had sudden onset of right hemiparesis and aphasia. A transcranial Doppler was performed with continuous measurement of blood pressure (BP) (Finometer) and end-tidal CO2 (nasal capnography)...
March 14, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28298784/ventilation-of-nonparalyzed-patients-under-anesthesia-with-laryngeal-mask-airway-comparison-of-three-modes-of-ventilation-volume-controlled-ventilation-pressure-controlled-ventilation-and-pressure-controlled-ventilation-volume-guarantee
#5
Maroun Badwi Ghabach, Elie M El Hajj, Rouba D El Dib, Jeanette M Rkaiby, May S Matta, May R Helou
BACKGROUND: Pressure controlled ventilation (PCV) is the preferable mode of ventilation of nonparalyzed patients undergoing anesthesia with laryngeal mask airway (LMA) as compared to volume controlled ventilation (VCV) and spontaneously breathing patient. In this study, we compared the PC-volume guarantee (PC-VG) mode of ventilation with VCV and PCV modes. MATERIALS AND METHODS: A total of 30 patients, American Society of Anesthesiologists (ASA) physical status Classes I and II, scheduled for elective surgery under general anesthesia with a classic LMA were ventilated, subsequently, with the three modes of ventilation: VCV, PCV, and PC-VG for 10 min each mode...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28268431/exploratory-analysis-of-nonlinear-coupling-between-eeg-global-field-power-and-end-tidal-carbon-dioxide-in-free-breathing-and-breath-hold-tasks
#6
Maria Sole Morelli, Gaetano Valenza, Alberto Greco, Alberto Giannoni, Claudio Passino, Michele Emdin, Enzo Pasquale Scilingo, Nicola Vanello
Brain activations underlying control of breathing are not completely known. Furthermore, the coupling between neural and respiratory dynamics is usually estimated through linear correlation measures, thus totally disregarding possible underlying nonlinear interactions. To overcome these limitations, in this preliminary study we propose a nonlinear coupling analysis of simultaneous recordings of electroencephalographic (EEG) and respiratory signals at rest and after variation of carbon dioxide (CO2) level. Specifically, a CO2 increase was induced by a voluntary breath hold task...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28261153/non-invasive-respiratory-impedance-enhances-cerebral-perfusion-in-healthy-adults
#7
Christopher G Favilla, Ashwin B Parthasarathy, John A Detre, Arjun G Yodh, Michael T Mullen, Scott E Kasner, Kimberly Gannon, Steven R Messé
Optimization of cerebral blood flow (CBF) is the cornerstone of clinical management in a number of neurologic diseases, most notably ischemic stroke. Intrathoracic pressure influences cardiac output and has the potential to impact CBF. Here, we aim to quantify cerebral hemodynamic changes in response to increased respiratory impedance (RI) using a non-invasive respiratory device. We measured cerebral perfusion under varying levels of RI (6 cm H2O, 9 cm H2O, and 12 cm H2O) in 20 healthy volunteers. Simultaneous measurements of microvascular CBF and middle cerebral artery mean flow velocity (MFV), respectively, were performed with optical diffuse correlation spectroscopy and transcranial Doppler ultrasound...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28255086/mechanisms-of-the-deep-slow-wave-sleep-related-increase-of-upper-airway-muscle-tone-in-healthy-humans
#8
Amelia Hicks, Jennifer M Cori, Amy S Jordan, Christian L Nicholas, Leszek Kubin, John G Semmler, Atul Malhotra, David Gerard Peter McSharry, John A Trinder
Upper airway muscle activity is reportedly elevated during slow-wave sleep (SWS) when compared to lighter sleep stages. To uncover the possible mechanisms underlying this elevation, we explored the correlation between different indices of central and reflex inspiratory drive, such as the changes in airway pressure and end-expiratory CO2, and the changes in the genioglossus (GG) and tensor palatini (TP) muscle activity accompanying transitions from the lighter N2 to the deeper N3 stage of non-rapid eye movement (NREM) sleep in healthy young adult men...
March 2, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28250493/mind-the-gap-reversal-of-arterial-to-end-tidal-co2-gradient-in-thoracoscopic-bronchogenic-cyst-excision
#9
Priyanka Pradeep Karnik, Ketan S Kulkarni, Nandini Malay Dave, Madhu Garasia
No abstract text is available yet for this article.
February 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28244881/oral-or-nasal-breathing-real-time-effects-of-switching-sampling-route-onto-exhaled-voc-concentrations
#10
Pritam Sukul, Peter Oertel, Svend Kamysek, Phillip Trefz
There is a need for standardisation in sampling and analysis of breath volatile organic compounds (VOCs) in order to minimise ubiquitous confounding effects. Physiological factors may mask concentration changes induced by pathophysiological effects. In humans, unconscious switching of oral and nasal breathing can occur during breath sampling, which may affect VOC patterns. Here, we investigated exhaled VOC concentrations in real-time while switching breathing routes. Breath from 15 healthy volunteers was analysed continuously by proton transfer reaction time-of-flight mass spectrometry during paced breathing (12 breaths min(-1))...
March 21, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28244596/cardiopulmonary-exercise-testing-improves-diagnostic-specificity-in-patients-with-echocardiography-suspected-pulmonary-hypertension
#11
Qin-Hua Zhao, Lan Wang, Bigyan Pudasaini, Rong Jiang, Ping Yuan, Su-Gang Gong, Jian Guo, Qiang Xiao, Hui Liu, Cheng Wu, Zhi-Cheng Jing, Jin-Ming Liu
BACKGROUND: Doppler echocardiography is usually the first diagnostic investigation for patients suspected with pulmonary hypertension (PH), but it is often inaccurate when used alone, especially in mild PH. HYPOTHESIS: Cardiopulmonary exercise testing (CPET) may serve as a complementary tool to improve diagnostic accuracy in echocardiography-suspected "PH possible" patients. METHODS: Eighty-eight consecutive patients with suspected PH (referred to as "PH possible" hereafter) based on echocardiography were included in the study...
February 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28241026/acute-hypoxia-diminishes-the-relationship-between-blood-pressure-and-subarachnoid-space-width-oscillations-at-the-human-cardiac-frequency
#12
Magdalena Wszedybyl-Winklewska, Jacek Wolf, Ewa Swierblewska, Katarzyna Kunicka, Agnieszka Gruszecka, Marcin Gruszecki, Wieslawa Kucharska, Pawel J Winklewski, Joanna Zabulewicz, Wojciech Guminski, Michal Pietrewicz, Andrzej F Frydrychowski, Leszek Bieniaszewski, Krzysztof Narkiewicz
BACKGROUND: Acute hypoxia exerts strong effects on the cardiovascular system. Heart-generated pulsatile cerebrospinal fluid motion is recognised as a key factor ensuring brain homeostasis. We aimed to assess changes in heart-generated coupling between blood pressure (BP) and subarachnoid space width (SAS) oscillations during hypoxic exposure. METHODS: Twenty participants were subjected to a controlled decrease in oxygen saturation (SaO2 = 80%) for five minutes. BP and heart rate (HR) were measured using continuous finger-pulse photoplethysmography, oxyhaemoglobin saturation with an ear-clip sensor, end-tidal CO2 with a gas analyser, and cerebral blood flow velocity (CBFV), pulsatility and resistive indices with Doppler ultrasound...
2017: PloS One
https://www.readbyqxmd.com/read/28226601/exploratory-analysis-of-nonlinear-coupling-between-eeg-global-field-power-and-end-tidal-carbon-dioxide-in-free-breathing-and-breath-hold-tasks
#13
Maria Sole Morelli, Gaetano Valenza, Alberto Greco, Alberto Giannoni, Claudio Passino, Michele Emdin, Enzo Pasquale Scilingo, Nicola Vanello, Maria Sole Morelli, Gaetano Valenza, Alberto Greco, Alberto Giannoni, Claudio Passino, Michele Emdin, Enzo Pasquale Scilingo, Nicola Vanello, Maria Sole Morelli, Claudio Passino, Alberto Greco, Nicola Vanello, Gaetano Valenza, Alberto Giannoni, Michele Emdin, Enzo Pasquale Scilingo
Brain activations underlying control of breathing are not completely known. Furthermore, the coupling between neural and respiratory dynamics is usually estimated through linear correlation measures, thus totally disregarding possible underlying nonlinear interactions. To overcome these limitations, in this preliminary study we propose a nonlinear coupling analysis of simultaneous recordings of electroencephalographic (EEG) and respiratory signals at rest and after variation of carbon dioxide (CO2) level. Specifically, a CO2 increase was induced by a voluntary breath hold task...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28194546/a-multisite-benchmarking-trial-of-capnometry-guided-respiratory-intervention-for-panic-disorder-in-naturalistic-treatment-settings
#14
David F Tolin, Patrick B McGrath, Lisa R Hale, Daniel N Weiner, Ralitza Gueorguieva
Panic disorder (PD) is associated with hyperventilation. The efficacy of a brief respiratory feedback program for PD has been established. The aim of the present study was to expand these results by testing a similar program with more clinically representative patients and settings. Sixty-nine adults with PD received 4 weeks of Capnometry Guided Respiratory Intervention (CGRI) using Freespira, which provides feedback of end-tidal CO2 (PETCO2) and respiration rate (RR), in four non-academic clinical settings...
March 2017: Applied Psychophysiology and Biofeedback
https://www.readbyqxmd.com/read/28192113/a-randomised-clinical-trial-comparing-the-effects-of-antitussives-on-respiratory-centre-output-in-patients-with-chronic-cough
#15
Claudia Mannini, Federico Lavorini, Alessandro Zanasi, Federico Saibene, Luigi Lanata, Giovanni Fontana
BACKGROUND: Cough is produced by the same neuronal pool implicated in respiratory rhythm generation and antitussive drugs acting at the central level, such as the opioids, may depress ventilation. Levodropropizine is classified as a non-opioid, peripherally-acting antitussive drug acting at the level of airway sensory nerves. However, the lack of a central action by Levodropropizine remains to be fully established. We set out to compare the effects of Levodropropizine and the opioid antitussive agent Dihydrocodeine on the respiratory responses to a conventional CO2 re-breathing test in patients with chronic cough of any origin...
February 10, 2017: Chest
https://www.readbyqxmd.com/read/28177206/propofol-sedation-reduces-diaphragm-activity-in-spontaneously-breathing-patients-ultrasound-assessment
#16
Monica Rocco, Luigi Maggi, Giorgio Ranieri, Giovanni Ferrari, Cesare Gregoretti, Giorgio Conti, Roberto A DE Blasi
BACKGROUND: The diaphragm is the most important respiratory muscle in humans, and the close relationship between inspired volume and diaphragmatic movement in normal subjects has led to investigations into diaphragmatic activity using ultrasound, during spontaneous breathing and sedative drug infusion. METHODS: A total of 36 consecutive patients undergoing diagnostic procedures under deep propofol sedation were studied. Ultrasound measurements included the following: diaphragmatic thickening end-inspiration (TEI) and end-expiration (TEE)...
March 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28167915/the-role-of-acute-intermittent-hypoxia-in-neutrophil-generated-superoxide-sympathovagal-balance-and-vascular-function-in-healthy-subjects
#17
Germana P L Almeida, Ivani C Trombetta, Felipe X Cepeda, Elaine Hatanaka, Rui Curi, Cristiano Mostarda, Maria C Irigoyen, José A S Barreto-Filho, Eduardo M Krieger, Fernanda M Consolim-Colombo
Introduction: Recurrent hypoxia (HPX), a hallmark of the obstructive sleep apnea (OSA), impairs autonomic balance, and increases arterial blood pressure (BP). Oxidative stress is one of the mechanisms involved in these alterations. The cumulative effect of acute intermittent HPX and the chronicity may determine whether the response crosses the threshold from having protective value to pathology. However, the impact of acute intermittent HPX-reoxygenation on markers of oxidative stress in healthy individuals remains to be fully understood...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28144134/evaluation-of-carbon-dioxide-rebreathing-during-exercise-assisted-by-noninvasive-ventilation-with-plateau-exhalation-valve
#18
Yong-Er Ou, Zhi-Min Lin, Dong-Ming Hua, Ying Jiang, Ya-Ting Huo, Qun Luo, Rong-Chang Chen
Noninvasive ventilation with a plateau exhalation valve (PEV) is often used as an adjunct to exercise to achieve a physiologic training effect in severe chronic obstructive pulmonary disease (COPD) patients. However, during exercise, with the increase of exhalation flow and respiratory rate and limited capability of PEV to exhale gases out of the circuit, it is still unknown whether CO2 rebreathing occurs in COPD patients ventilated during exercise assisted by single-limb circuit with a PEV. A maximal symptom-limited cycle exercise test was performed while ventilated on pressure support (inspiratory:expiratory pressure 14:4 cmH2O) in 18 male patients with stable severe COPD (mean ± standard deviation, forced expiratory volume in 1 s: 29...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28116675/anesthetic-considerations-for-patients-with-esophageal-achalasia-undergoing-peroral-endoscopic-myotomy-a-retrospective-case-series-review
#19
Benjamin Löser, Yuki B Werner, Mark A Punke, Bernd Saugel, Sebastian Haas, Daniel A Reuter, Oliver Mann, Anna Duprée, Guido Schachschal, Thomas Rösch, Martin Petzoldt
PURPOSE: Peroral endoscopic myotomy (POEM) is a novel technique for treating esophageal achalasia. During POEM, carbon dioxide (CO2) is insufflated to aid surgical dissection, but it may inadvertently track into surrounding tissues, causing systemic CO2 uptake and tension capnoperitoneum. This in turn may affect cardiorespiratory function. This study quantified these cardiorespiratory effects and treatment by hyperventilation and percutaneous abdominal needle decompression (PND). METHODS: One hundred and seventy-three consecutive patients who underwent POEM were included in this four-year retrospective study...
January 23, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28114163/doppler-ultrasonography-of-the-central-retinal-vessels-in-children-with-brain-death
#20
Becky J Riggs, Joanna S Cohen, Bhavana Shivakumar, Carmelina Trimboli-Heidler, Jason T Patregnani, Marijean M Miller, Michael C Spaeder, Nathan P Dean
OBJECTIVE: The purpose of this observational study is to explore if bedside Doppler ultrasonography of the central retinal vessels has the potential to become an ancillary study to support the timely diagnosis of brain death in children. DESIGN: Seventeen-month prospective observational cohort. SETTING: Forty-four bed pediatric medical and surgical ICU in an academic teaching hospital. PATIENTS: All children 0-18 years old who were clinically evaluated for brain death at Children's National Health Systems were enrolled and followed until discharge or death...
March 2017: Pediatric Critical Care Medicine
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