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https://www.readbyqxmd.com/read/29771608/paced-breathing-and-phrenic-nerve-responses-evoked-by-epidural-stimulation-following-complete-high-cervical-spinal-cord-injury-in-rats
#1
Tatiana Bezdudnaya, Michael A Lane, Vitaliy Marchenko
Spinal cord injury (SCI) at the level of cervical segments often results in life-threatening respiratory complications and requires long-term mechanical ventilator assistance. Thus, restoring diaphragm activity and regaining voluntary control of breathing are the primary clinical goals for patients with respiratory dysfunction following cervical SCI. Epidural stimulation (EDS) is a promising strategy that has been explored extensively for non-respiratory functions, and to a limited extent within the respiratory system...
May 17, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29763713/practice-of-mechanical-ventilation-in-cardiac-arrest-patients-and-effects-of-targeted-temperature-management-a-substudy-of-the-targeted-temperature-management-trial
#2
Matthew B A Harmon, David M P van Meenen, Annelou L I P van der Veen, Jan M Binnenkade, Josef Dankiewicz, Florian Ebner, Niklas Nielsen, Paolo Pelosi, Marcus J Schultz, Janneke Horn, Hans Friberg, Nicole P Juffermans
AIMS: Mechanical ventilation practices in patients with cardiac arrest are not well described. Also, the effect of temperature on mechanical ventilation settings is not known. The aims of this study were 1) to describe practice of mechanical ventilation and its relation with outcome 2) to determine effects of different target temperatures strategies (33 °C versus 36 °C) on mechanical ventilation settings. METHODS: This is a substudy of the TTM-trial in which unconscious survivors of a cardiac arrest due to a cardiac cause were randomized to two TTM strategies, 33 °C (TTM33) and 36 °C (TTM36)...
May 12, 2018: Resuscitation
https://www.readbyqxmd.com/read/29739857/how-ventilation-is-delivered-during-cardiopulmonary-resuscitation-an-international-survey
#3
Ricardo Luiz Cordioli, Laurent Brochard, Laurent Suppan, Aissam Lyazidi, François Templier, Abdo Khoury, Stephane Delisle, Dominique Savary, Jean-Christophe Richard
BACKGROUND: Recommendations regarding ventilation during cardiopulmonary resuscitation (CPR) are based on a low level of scientific evidence. We hypothesized that practices about ventilation during CPR might be heterogeneous and may differ worldwide. To address this question, we surveyed physicians from several countries on their practices during CPR. METHODS: We used a Web-based opinion survey. Links to the survey were sent by e-mail newsletters and displayed on the Web sites of medical societies involved in CPR practice from December 2013 to March 2014...
May 8, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29736280/the-effect-of-perioperative-fluid-management-on-intraocular-pressure-during-gynecologic-laparoscopic-pelvic-surgery
#4
Izakson Alexander, Sindawi Ahmad, Ben Shachar Inbar, Pikkel Joseph
Purpose: Visual loss is a devastating perioperative complication that can result from elevated intraocular pressure (IOP). The Trendelenburg position during surgery increases IOP. The purpose of this study was to quantify IOP changes in patients undergoing laparoscopic hysterectomy, at different time points and body positions throughout the procedure, and to compare fluctuations of IOP during the perioperative period according to two fluid management protocols. Methods: Thirty women scheduled to undergo elective gynecologic laparoscopic pelvic surgery were randomly allocated to receive a liberal or restrictive fluid management protocol...
2018: Journal of Ophthalmology
https://www.readbyqxmd.com/read/29734208/improved-lung-recruitment-and-oxygenation-during-mandatory-ventilation-with-a-new-expiratory-ventilation-assistance-device-a-controlled-interventional-trial-in-healthy-pigs
#5
Johannes Schmidt, Christin Wenzel, Marlene Mahn, Sashko Spassov, Heidi Cristina Schmitz, Silke Borgmann, Ziwei Lin, Jörg Haberstroh, Stephan Meckel, Sebastian Eiden, Steffen Wirth, Hartmut Buerkle, Stefan Schumann
BACKGROUND: In contrast to conventional mandatory ventilation, a new ventilation mode, expiratory ventilation assistance (EVA), linearises the expiratory tracheal pressure decline. OBJECTIVE: We hypothesised that due to a recruiting effect, linearised expiration oxygenates better than volume controlled ventilation (VCV). We compared the EVA with VCV mode with regard to gas exchange, ventilation volumes and pressures and lung aeration in a model of peri-operative mandatory ventilation in healthy pigs...
May 4, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29700664/halving-the-volume-of-anaconda-initial-clinical-experience-with-a-new-small-volume-anaesthetic-reflector-in-critically-ill-patients-a-quality-improvement-project
#6
Hagen Bomberg, Franziska Meiser, Sarah Zimmer, Martin Bellgardt, Thomas Volk, Daniel I Sessler, Heinrich V Groesdonk, Andreas Meiser
AnaConDa-100 ml (ACD-100, Sedana Medical, Uppsala, Sweden) is well established for inhalation sedation in the intensive care unit. But because of its large dead space, the system can retain carbon dioxide (CO2 ) and increase ventilatory demands. We therefore evaluated whether AnaConDa-50 ml (ACD-50), a device with half the internal volume, reduces CO2 retention and ventilatory demands during sedation of invasively ventilated, critically ill patients. Ten patients participated in this cross-over protocol. After sedation with isoflurane via ACD-100 for 24 h, the 5-h observation period started...
April 26, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29668325/is-cushing-mechanism-a-dynamic-blood-pressure-stabilizing-system-insights-from-granger-causality-analysis-of-spontaneous-blood-pressure-and-cerebral-blood-flow
#7
Saqib Saleem, Paul D Teal, Connor A Howe, Michael M Tymko, Philip N Ainslie, Yu-Chieh Tzeng
Blood pressure regulation is widely recognised as being integral to the control of end-organ perfusion but it remains unclear whether end-organ perfusion also plays a role in driving changes in blood pressure (BP). A randomized and placebo controlled study design was followed to examine the feedback relationships between very-low-frequency fluctuations in BP and cerebral blood flow (CBF) in humans under placebo treatment and α1-adrenergic blockade. To determine the causal relations among haemodynamic variables, BP, middle cerebral artery blood velocity (MCAv), and end-tidal CO2 time-series were decimated, low-pass filtered (<0...
April 18, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29665427/end-tidal-co-2-guided-automated-robot-cpr-system-in-the-pig-preliminary-communication
#8
Gil Joon Suh, Jaeheung Park, Jung Chan Lee, Sang Hoon Na, Woon Yong Kwon, Kyung Su Kim, Taegyun Kim, Yoon Sun Jung, Jung-In Ko, So Mi Shin, Kyoung Min You
BACKGROUND: Our aim was to compare the efficacy of the end-tidal CO2 -guided automated robot CPR (robot CPR) system with manual CPR and mechanical device CPR. METHODS: We developed the algorithm of the robot CPR system which automatically finds the optimal compression position under the guidance of end-tidal CO2 feedback in swine models of cardiac arrest. Then, 18 pigs after 11 minutes of cardiac arrest were randomly assigned to one of three groups, robot CPR, LUCAS CPR, and manual CPR groups (n = 6 each group)...
April 14, 2018: Resuscitation
https://www.readbyqxmd.com/read/29644221/physiologic-factors-influencing-the-arterial-to-end-tidal-co-2-difference-and-the-alveolar-dead-space-fraction-in-spontaneously-breathing-anesthetised-horses
#9
Martina Mosing, Stephan H Böhm, Anthea Rasis, Giselle Hoosgood, Ulrike Auer, Gerardo Tusman, Regula Bettschart-Wolfensberger, Johannes P Schramel
The arterial to end-tidal CO2 difference (P(a-ET) CO2 ) and alveolar dead space fraction (VDalvfrac  = P(a-ET) CO2 /PaCO2 ), are used to estimate Enghoff's "pulmonary dead space" (V/QEng ), a factor which is also influenced by venous admixture and other pulmonary perfusion abnormalities and thus is not just a measure of dead space as the name suggests. The aim of this experimental study was to evaluate which factors influence these CO2 indices in anesthetized spontaneously breathing horses. Six healthy adult horses were anesthetized in dorsal recumbency breathing spontaneously for 3 h...
2018: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/29629989/an-open-loop-physiologic-model-based-decision-support-system-can-provide-appropriate-ventilator-settings
#10
Dan Stieper Karbing, Savino Spadaro, Nilanjan Dey, Riccardo Ragazzi, Elisabetta Marangoni, Francesca Dalla Corte, Federico Moro, David Lodahl, Niklas Schurmann Hansen, Robert Winding, Stephen Edward Rees, Carlo Alberto Volta
OBJECTIVES: To evaluate the physiologic effects of applying advice on mechanical ventilation by an open-loop, physiologic model-based clinical decision support system. DESIGN: Prospective, observational study. SETTING: University and Regional Hospitals' ICUs. PATIENTS: Varied adult ICU population. INTERVENTIONS: Advice were applied if accepted by physicians for a period of up to 4-8 hours. MEASUREMENTS AND MAIN RESULTS: Seventy-two patients were included for data analysis...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29628575/hemodynamic-airway-pressure-and-capnometric-changes-and-perioperative-outcome-in-pediatric-laparoscopic-inguinal-herniorrhaphy-a-comparison-with-open-inguinal-herniorrhaphy
#11
Jyoti Garg, Suniti Kale, Nikki Sabharwal, Deepak Bagga, Anoop Raj Gogia
Background: Laparoscopic procedures which are now established in pediatric population as well exposes the child to supplemental cardiorespiratory changes due to increase in intraabdominal pressure (IAP) and hypercarbia. Aims: This study aims to analyze the effects of pneumoperitoneum and postural modifications on cardiorespiratory system (primary outcome) during pediatric laparoscopic herniorrhaphy (LH) and its comparison with open herniorrhaphy (OH) and assessment of overall perioperative outcome (secondary outcome)...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628557/intraocular-pressure-changes-during-laparoscopic-surgery-in-trendelenburg-position-in-patients-anesthetized-with-propofol-based-total-intravenous-anesthesia-compared-to-sevoflurane-anesthesia-a-comparative-study
#12
Gagandeep Kaur, Mamta Sharma, Poonam Kalra, Shobha Purohit, Kanchan Chauhan
Background: Intraocular pressure (IOP) is increased during laparoscopic surgery with Trendelenburg position and may contribute to deleterious effects on optic nerve in susceptible patients. Aims: The primary objective of this study is to compare the effects of propofol-based total intravenous anesthesia (TIVA) with those of sevoflurane anesthesia on IOP in patients undergoing lower abdominal laparoscopic surgery in Trendelenburg position. Secondary objectives are to compare hemodynamic changes, mean arterial pressure (MAP), end-tidal CO2 , and peak inspiratory pressure changes...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29605703/variability-in-the-time-to-initiation-of-cpr-in-continuously-monitored-pediatric-icus
#13
M Olson, E Helfenbein, L Su, M Berg, L Knight, L Troy, L Sacks, D Sakai, F Su
AIM: To study the influence of patient characteristics and unit ergonomics and human factors on the time to initiation of CPR. METHODS: A single center study of children, 0 to 21 years old, admitted to an ICU who experienced cardiopulmonary arrest (CPA) requiring >1 minute of chest compressions. Time of CPA was determined by analysis of continuous ECG, plethysmography, arterial blood pressure, and end-tidal CO2 (EtCO2 ) waveforms. Initiation of CPR was identified by the onset of cyclic artifact in the ECG waveform...
March 29, 2018: Resuscitation
https://www.readbyqxmd.com/read/29600896/wavelet-decomposition-analysis-is-a-clinically-relevant-strategy-to-evaluate-cerebrovascular-buffering-of-blood-pressure-after-spinal-cord-injury
#14
Saqib Saleem, Diana Vucina, Zoe Sarafis, Amanda H X Lee, Jordan W Squair, Otto F Barak, Geoff B Coombs, Tanja Mijacika, Andrei V Krassioukov, Philip N Ainslie, Zeljko Dujic, Yu-Chieh Tzeng, Aaron A Phillips
The capacity of cerebrovasculature to buffer changes in blood pressure (BP) is crucial to prevent stroke, the incidence of which is 3-4 fold elevated after spinal cord injury (SCI). Disruption of descending sympathetic pathways within the spinal cord due to cervical SCI may result in impaired cerebrovascular buffering. Only linear analyses of cerebrovascular buffering of BP, such as transfer function, have been utilized in SCI research. This approach does not account for inherent non-linearity and non-stationarity components of cerebrovascular regulation, often depends on perturbations of BP to increase the statistical power, and does not account for influence of arterial CO2 tension...
March 30, 2018: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29595918/dynamic-cerebral-autoregulation-is-preserved-during-isometric-handgrip-and-head-down-tilt-in-healthy-volunteers
#15
Maria Skytioti, Signe Søvik, Maja Elstad
In healthy humans, cerebral blood flow (CBF) is autoregulated against changes in arterial blood pressure. Spontaneous fluctuations in mean arterial pressure (MAP) and CBF can be used to assess cerebral autoregulation. We hypothesized that dynamic cerebral autoregulation is affected by changes in autonomic activity, MAP, and cardiac output (CO) induced by handgrip (HG), head-down tilt (HDT), and their combination. In thirteen healthy volunteers, we recorded blood velocity by ultrasound in the internal carotid artery (ICA), HR, MAP and CO-estimates from continuous finger blood pressure, and end-tidal CO2 ...
March 2018: Physiological Reports
https://www.readbyqxmd.com/read/29590559/decreased-prefrontal-oxygenation-elicited-by-stimulation-of-limb-mechanosensitive-afferents-during-cycling-exercise
#16
Ryota Asahara, Kanji Matsukawa
Our laboratory reported using near-infrared spectroscopy that feedback from limb mechanoafferents may decrease prefrontal oxygenated-hemoglobin concentration (Oxy-Hb) during the late period of voluntary and passive cycling. To test the hypothesis that the decreased Oxy-Hb of the prefrontal cortex would be augmented depending on the extent of limb mechanoafferent input, the prefrontal Oxy-Hb response was measured during motor-driven one- and two-legged passive cycling for 1 min at various revolutions of pedal movement in 19 subjects...
March 28, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29579597/physiological-insights-of-exercise-hyperventilation-in-arterial-and-chronic-thromboembolic-pulmonary-hypertension
#17
Stefania Farina, Noemi Bruno, Cecilia Agalbato, Mauro Contini, Roberto Cassandro, Davide Elia, Sergio Harari, Piergiuseppe Agostoni
BACKGROUND: Pulmonary hypertension (PH) patients show, during exercise, an excessive increase in ventilation (VE ) compared to carbon dioxide output (VCO2 ), determining a high VE /VCO2 slope. There are several possible causes, including an elevated dead space ventilation (VD ), VE /perfusion (Q) mismatch and/or an enhanced peripheral or central chemoreceptor activity. We evaluated the causes of exercise hyperventilation in PH patients. METHODS: Eighteen group I and IV PH patients underwent cardiopulmonary exercise test with blood gas analysis at every minute...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29569112/phenylephrine-increases-cardiac-output-by-raising-cardiac-preload-in-patients-with-anesthesia-induced-hypotension
#18
A F Kalmar, S Allaert, P Pletinckx, J-W Maes, J Heerman, J J Vos, M M R F Struys, T W L Scheeren
Induction of general anesthesia frequently induces arterial hypotension, which is often treated with a vasopressor, such as phenylephrine. As a pure α-agonist, phenylephrine is conventionally considered to solely induce arterial vasoconstriction and thus increase cardiac afterload but not cardiac preload. In specific circumstances, however, phenylephrine may also contribute to an increase in venous return and thus cardiac output (CO). The aim of this study is to describe the initial time course of the effects of phenylephrine on various hemodynamic variables and to evaluate the ability of advanced hemodynamic monitoring to quantify these changes through different hemodynamic variables...
March 22, 2018: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29546563/a-high-flow-nasal-cannula-system-with-relatively-low-flow-effectively-washes-out-co-2-from-the-anatomical-dead-space-in-a-sophisticated-respiratory-model-made-by-a-3d-printer
#19
Yu Onodera, Ryo Akimoto, Hiroto Suzuki, Masayuki Okada, Masaki Nakane, Kaneyuki Kawamae
BACKGROUND: Although clinical studies of the high-flow nasal cannula (HFNC) and its effect on positive end-expiratory pressure (PEEP) have been done, the washout effect has not been well evaluated. Therefore, we made an experimental respiratory model to evaluate the respiratory physiological effect of HFNC. METHODS: An airway model was made by a 3D printer using the craniocervical 3D-CT data of a healthy 32-year-old male. CO2 was infused into four respiratory lung models (normal-lung, open- and closed-mouth models; restrictive- and obstructive-lung, open-mouth models) to maintain the partial pressure of end-tidal CO2 (PET CO2 ) at 40 mmHg...
March 15, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29540714/analysis-of-generic-coupling-between-eeg-activity-and-p-et-co-2-in-free-breathing-and-breath-hold-tasks-using-maximal-information-coefficient-mic
#20
Maria Sole Morelli, Alberto Greco, Gaetano Valenza, Alberto Giannoni, Michele Emdin, Enzo Pasquale Scilingo, Nicola Vanello
Brain activations related to the control of breathing are not completely known. The respiratory system is a non-linear system. However, the relationship between neural and respiratory dynamics is usually estimated through linear correlation measures, completely neglecting possible underlying nonlinear interactions. This study evaluate the linear and nonlinear coupling between electroencephalographic (EEG) signal and variations in carbon dioxide (CO2 ) signal related to different breathing task. During a free breathing and a voluntary breath hold tasks, the coupling between EEG power in nine different brain regions in delta (1-3 Hz) and alpha (8-13 Hz) bands and end-tidal CO2 (PET CO2 ) was evaluated...
March 14, 2018: Scientific Reports
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