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https://www.readbyqxmd.com/read/28734974/the-effects-of-pneumoperitoneum-and-the-steep-trendelenburg-position-on-heart-rate-variability-and-cerebral-oxygenation-during-robotic-sacrocolpopexy
#1
Emad Matanes, Amir Weissman, Aleksandr Rivlin, Roy Lauterbach, Amnon Amit, Zeev Wiener, Lior Lowenstein
STUDY OBJECTIVE: The aim of the current study was to investigate how steep Trendelenburg positioning with pneumoperitoneum modifies brain oxygenation and autonomic nervous system modulation of heart rate variability during robotic sacrocolpopexy. DESIGN: A 5-minute computerized ECG, cerebral O2 saturation (cSO2), systemic O2 saturation (sSO2), heart rate (HR), diastolic blood pressure (BP), systolic BP and end tidal CO2 tension were recorded immediately after anesthesia induction (baseline phase) and after alterations in positioning and in intra-abdominal pressure...
July 19, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28731900/micro-and-macro-circulatory-changes-during-sepsis-and-septic-shock-in-a-rat-model
#2
Tianfeng Hua, Xiaobo Wu, Wei Wang, Hao Li, Jennifer Bradley, Mary Ann Peberdy, Joseph P Ornato, Wanchun Tang
Microcirculation is the motor of sepsis. In the present study, we investigated whether microcirculatory alterations occur prior to changes of systemic hemodynamics in a rat model of cecum ligation and puncture (CLP)-induced sepsis. We further investigated renal microcirculatory changes during sepsis and compared those with buccal microcirculation. Twelve male Sprague-Dawley rats were randomized into a sham control group (n = 6) and a CLP group (n = 6). Perfused microvessel density (PVD) and microvascular flow index (MFI) were evaluated using sidestream dark field (SDF) video microscopy at baseline, 60, 120, 180, 240, 300, and 360 minutes following CLP...
July 20, 2017: Shock
https://www.readbyqxmd.com/read/28715240/the-effect-of-inspiratory-muscle-training-on-respiratory-variables-in-a-patient-with-ankylosing-spondylitis-a-case-report
#3
Marlon L Wong, Rachael G Anderson, Kelsey Garcia, Elissa M Housmann, Erin McHale, Gregory S Goldberger, Lawrence P Cahalin
Ankylosing Spondylitis (AS) presents with both musculoskeletal and cardiorespiratory pathophysiological manifestations. Inspiratory muscle training (IMT) may be a useful intervention to address deficits in respiratory and functional status. CASE DESCRIPTION: A 25-year-old male with AS initially sought treatment for low back and right hip pain, but 7 weeks of IMT was also provided due to abnormal respiratory performance. OUTCOMES: At baseline, the patient presented with a resting respiratory rate (RR) of 14...
July 17, 2017: Physiotherapy Theory and Practice
https://www.readbyqxmd.com/read/28696966/defining-a-ventilation-strategy-for-flexible-bronchoscopy-on-mechanically-ventilated-patients-in-the-medical-intensive-care-unit
#4
Yonatan Y Greenstein, Eric Shakespeare, Peter Doelken, Paul H Mayo
BACKGROUND: Flexible bronchoscopy (FB) in intubated patients on mechanical ventilation increases airway resistance. During FB, two ventilatory strategies are possible: maintaining tidal volume (VT) while maintaining baseline CO2 or allowing reduction of VT. The former strategy carries risk of hyperinflation due to expiratory flow limitation with FB. The aim of the authors was too study end expiratory lung volume (EELV) during FB of intubated subjects while limiting VT. METHODS: We studied 16 subjects who were intubated on mechanical ventilation and required FB...
July 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28695815/effectiveness-of-underbody-forced-air-warming-system-in-preventing-hypothermia-in-patients-undergoing-major-surgeries
#5
Hao Liang, Jie Yi
Objective To compare the effectiveness of the forced-air warming system and the conventional warming care practice in preventing hypothermia in patients undergoing major surgeries.Methods A total of 62 patients were enrolled in this study. Patients of both sexes,aged≥18 years,and with an ASA physical status Ⅰ-Ⅲ were included and allocated randomly into intervention group(n=30)or control group(n=32). Patients in the intervention group were provided forced-air warming,either prior to induction or during the surgery procedure depending on core temperature monitoring results...
June 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28691980/sudden-increase-in-etco2-during-upper-endoscopy-under-general-endotracheal-anesthesia-suggests-the-presence-of-tracheoesophageal-fistula-a-case-report
#6
Rosemarie E Garcia Getting, Cynthia L Harris
Acquired tracheoesophageal fistula is a rare and devastating complication of lung cancer. The diagnosis is typically confirmed on barium esophagram. We report a case of a patient with lung cancer status after palliative chemoradiotherapy and esophageal stenting for malignant stenosis who presented with signs and symptoms suggestive of tracheoesophageal fistula; however, no evidence of fistula was found on barium esophagram. During subsequent esophagogastroduodenoscopy, the presence of a fistula was verified by capnography, given extreme elevations in end-tidal CO2 concentrations during endoscopic CO2 insufflation...
July 6, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28675094/effect-of-increased-body-mass-index-on-complication-rates-during-laryngotracheal-surgery-utilizing-jet-ventilation
#7
Rachel A Barry, Daniel S Fink, Dusty Cole Pourciau, Kasey Hayley, Rachael Lanius, Schuylor Hayley, Eddy Sims, Andrew J McWhorter
Objective Jet ventilation has been used for >30 years as an anesthetic modality for laryngotracheal surgery. Concerns exist over increased risk with elevated body mass index (BMI). We reviewed our experience using jet ventilation for laryngotracheal stenosis to assess for complication rates with substratification by BMI. Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods A total of 126 procedures with jet ventilation were identified from October 2006 to December 2014...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28665692/excess-ventilation-in-copd-heart-failure-overlap-implications-for-dyspnea-and-exercise-intolerance
#8
Alcides Rocha, Flavio F Arbex, Priscilla A Sperandio, Aline Souza, Ligia Biazzim, Frederico Mancuso, Danilo C Berton, Bruno Hochhegger, Maria Clara N Alencar, Luiz E Nery, Denis E O'Donnell, J Alberto Neder
BACKGROUND: An increased ventilatory response to exertional metabolic demand (high ventilation (⩒E)-carbon dioxide output (⩒CO2) relationship) is a common finding in patients with coexistent COPD-heart failure. We aimed to determine the mechanisms underlying high ⩒E-⩒CO2 and its impact on operating lung volumes, dyspnea and exercise tolerance in these patients. METHODS: Twenty-two ex-smokers with combined COPD and heart failure with reduced left ventricular ejection fraction (LVEF) undertook, after careful treatment optimization, a progressive cycle exercise test with capillary (c) blood gas collection...
June 30, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28662195/the-relationship-between-minute-ventilation-and-end-tidal-co2-in-intubated-and-spontaneously-breathing-patients-undergoing-procedural-sedation
#9
Jaideep H Mehta, George W Williams, Brian C Harvey, Navneet K Grewal, Edward E George
BACKGROUND: Monitoring respiratory status using end tidal CO2 (EtCO2), which reliably reflects arterial PaCO2 in intubated patients under general anesthesia, has often proven both inaccurate and inadequate when monitoring non-intubated and spontaneously breathing patients. This is particularly important in patients undergoing procedural sedation (e.g., endoscopy, colonoscopy). This can be undertaken in the operating theater, but is also often delivered outside the operating room by non-anesthesia providers...
2017: PloS One
https://www.readbyqxmd.com/read/28659193/feasibility-of-a-prototype-newborn-resuscitation-monitor-to-study-transition-at-birth-measuring-heart-rate-and-ventilator-parameters-an-animal-experimental-study
#10
Jørgen E Linde, Joar Eilevstjønn, Knut Øymar, Hege L Ersdal
BACKGROUND: Every year, an estimated 10 million babies are born, non-breathing and in need of resuscitation. Advances in management have been made over the past decades, however, approximately 700.000 yearly deaths result from this global problem. A prototype newborn resuscitation monitor (NRM) (Laerdal Global Health, Stavanger, Norway) has been developed with the purpose of studying newborn resuscitation. The monitor has the ability to continuously display HR using dry electrode ECG technology, to measure tidal volume, pressure and end tidal CO2, and to store the results for later analysis...
June 28, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28654638/increased-inspiratory-resistance-affects-the-dynamic-relationship-between-blood-pressure-changes-and-subarachnoid-space-width-oscillations
#11
Magdalena Wszedybyl-Winklewska, Jacek Wolf, Ewa Swierblewska, Katarzyna Kunicka, Kamila Mazur, Marcin Gruszecki, Pawel J Winklewski, Andrzej F Frydrychowski, Leszek Bieniaszewski, Krzysztof Narkiewicz
BACKGROUND AND OBJECTIVE: Respiration is known to affect cerebrospinal fluid (CSF) movement. We hypothesised that increased inspiratory resistance would affect the dynamic relationship between blood pressure (BP) changes and subarachnoid space width (SAS) oscillations. METHODS: Experiments were performed in a group of 20 healthy volunteers undergoing controlled intermittent Mueller Manoeuvres (the key characteristic of the procedure is that a studied person is subjected to a controlled, increased inspiratory resistance which results in marked potentiation of the intrathoracic negative pressure)...
2017: PloS One
https://www.readbyqxmd.com/read/28642340/cardiovascular-and-cerebral-hemodynamics-during-exercise-and-recovery-in-obese-individuals-as-a-function-of-their-fitness-status
#12
Mathieu Gayda, Gabriel Lapierre, Olivier Dupuy, Sarah Fraser, Louis Bherer, Martin Juneau, Vincent Gremeaux, Anil Nigam
The aim of this study was to compare cardiovascular hemodynamics and cerebral oxygenation/perfusion (COP) during and after maximal incremental exercise in obese individuals according to their aerobic fitness versus age-matched healthy controls (AMHC). Fifty-four middle-aged obese (OB) and 16 AMHC were recruited. Maximal cardiopulmonary function (gas exchange analysis), cardiac hemodynamics (impedance cardiography), and left frontal COP (near-infrared spectroscopy: NIRS) were measured continuously during a maximal incremental ergocycle test...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28642293/random-squat-stand-maneuvers-a-novel-approach-for-assessment-of-dynamic-cerebral-autoregulation
#13
Sam C Barnes, Naomi Ball, Victoria Joanna Haunton, Ronney B Panerai, Thompson G Robinson
BACKGROUND: Squat-stand maneuvers (SSM) have been used to assess dynamic cerebral autoregulation (dCA), but always at a fixed-frequency (FF). This study aimed to assess the use of random-frequency (RF) SSMs as a stimulus for measuring dCA, and to determine the reproducibility of FF and RFSSMs. METHOD: 29 healthy volunteers (19 male, mean age 23.0 [4.9] years) completed the study; 11 returned for a repeat visit (median 45 days). Heart rate, beat-to-beat blood pressure, middle cerebral artery (MCA) blood flow velocity, end-tidal CO2 and angle of the squat movement were measured...
June 22, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28630395/cerebral-infarction-by-paradoxical-gas-embolism-during-laparoscopic-liver-resection-with-injury-of-the-hepatic-vessels-in-a-patient-without-a-right-to-left-systemic-shunt
#14
Toshiyasu Kawahara, Masahiro Hagiwara, Hiroyuki Takahashi, Mariko Tanaka, Koji Imai, Jun Sawada, Takayuki Kunisawa, Hiroyuki Furukawa
BACKGROUND Carbon dioxide (CO2) is believed to be the safest gas for laparoscopic surgery, which is a standard procedure. We experienced severe cerebral infarction caused by paradoxical CO2 embolism during laparoscopic liver resection with injury of the hepatic vessels despite the absence of a right-to-left systemic shunt. CASE REPORT A 60-year-old man was diagnosed with hepatocellular carcinoma in the right hepatic lobe secondary to alcoholic liver disease. We planned the laparoscopy-assisted liver resection...
June 20, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28620058/intermittent-hypercapnic-hypoxia-during-sleep-does-not-induce-ventilatory-long-term-facilitation-in-healthy-males
#15
Naomi Louise Deacon, Doug R McEvoy, Daniel L Stadler, Peter G Catcheside
Intermittent hypoxia induced ventilatory neuroplasticity is likely important in obstructive sleep apnea pathophysiology. Although concomitant CO2 levels and arousal state critically influence neuroplastic effects of intermittent hypoxia, no studies have investigated intermittent hypercapnic hypoxia effects during sleep in humans. Thus, the purpose of this study was to investigate if intermittent hypercapnic hypoxia during sleep induces neuroplasticity (ventilatory long-term facilitation and increased chemoreflex responsiveness) in humans...
June 15, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28619736/effects-of-hypercapnia-on-myocardial-blood-flow-in-healthy-human-subjects
#16
Matthieu Pelletier-Galarneau, Robert A deKemp, Chad Rrn Hunter, Ran Klein, Michael Klein, Joel Ironstone, Joseph A Fisher, Terrence Ruddy
Background: Elevation of end-tidal partial pressure of CO2 (PETCO2) increases cerebral and myocardial blood flow (MBF), suggesting that it may be a suitable alternative to pharmacological stress or exercise for myocardial perfusion imaging. The purpose of this study was to document the pharmacodynamics of CO2 on MBF using prospective end-tidal targeting to precisely control arterial PCO2 and use positron emission tomography (PET) to measure the outcome variable, MBF Methods: 10 healthy males underwent serial (82)Rb PET/CT imaging...
June 15, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28612267/auto-trilevel-versus-bilevel-positive-airway-pressure-ventilation-for-hypercapnic-overlap-syndrome-patients
#17
Mei Su, De Huai, Juan Cao, Ding Ning, Rong Xue, Meijie Xu, Mao Huang, Xilong Zhang
PURPOSE: Although bilevel positive airway pressure (Bilevel PAP) therapy is usually used for overlap syndrome (OS), there is still a portion of OS patients in whom Bilevel PAP therapy could not simultaneously eliminate residual apnea events and hypercapnia. The current study was expected to explore whether auto-trilevel positive airway pressure (auto-trilevel PAP) therapy with auto-adjusting end expiratory positive airway pressure (EEPAP) can serve as a better alternative for these patients...
June 13, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/28611153/effects-of-short-term-mild-hypercapnia-during-head-down-tilt-on-intracranial-pressure-and-ocular-structures-in-healthy-human-subjects
#18
Steven S Laurie, Gianmarco Vizzeri, Giovanni Taibbi, Connor R Ferguson, Xiao Hu, Stuart M C Lee, Robert Ploutz-Snyder, Scott M Smith, Sara R Zwart, Michael B Stenger
Many astronauts experience ocular structural and functional changes during long-duration spaceflight, including choroidal folds, optic disc edema, globe flattening, optic nerve sheath diameter (ONSD) distension, retinal nerve fiber layer thickening, and decreased visual acuity. The leading hypothesis suggests that weightlessness-induced cephalad fluid shifts increase intracranial pressure (ICP), which contributes to the ocular structural changes, but elevated ambient CO2 levels on the International Space Station may also be a factor...
June 2017: Physiological Reports
https://www.readbyqxmd.com/read/28591467/the-effect-of-impella-cp-on-cardiopulmonary-physiology-during-venoarterial-extracorporeal-membrane-oxygenation-support
#19
Hoong Sern Lim
Left ventricle (LV) distension is a complication of venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. The effects of Impella on the pulmonary circulatory physiology were studied in a single-center study of six consecutive patients on VA-ECMO support who had LV unloading with Impella. Right ventricular stroke volume, pulmonary hemodynamics, and partial pressure of end-tidal CO2 (PETCO2 ) were measured on echocardiogram, pulmonary artery catheter, and capnography, respectively. The addition of Impella CP increased total blood flow and reduced pulmonary artery wedge pressure...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28590065/safety-and-efficacy-of-laryngeal-mask-airway-ventilation-in-obese-patients-with-airway-stenosis
#20
D Cole Pourciau, D Peter Hotard, Schuylor Hayley, Kasey Hayley, Collin Sutton, Andrew J McWhorter, Daniel S Fink
OBJECTIVE: To assess the efficacy of laryngeal mask airway (LMA) ventilation in obese patients with airway stenosis. STUDY DESIGN: A retrospective chart review was conducted in an academic practice in a tertiary care center. METHODS: We retrospectively reviewed our experience using LMA ventilation in obese patients with airway stenosis. Lowest intraoperative O2 saturation and maximum-end tidal carbon dioxide (CO2 ) levels were recorded. Complications including intubation, unplanned admission, re-admission, postoperative pain, dysphonia, oral trauma, pneumothorax, pneumomediastinum, and tracheostomy were recorded...
June 7, 2017: Laryngoscope
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