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Static Compliance

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https://www.readbyqxmd.com/read/28103448/bedside-contribution-of-electrical-impedance-tomography-to-set-positive-end-expiratory-pressure-for-ecmo-treated-severe-ards-patients
#1
Guillaume Franchineau, Nicolas Bréchot, Guillaume Lebreton, Guillaume Hekimian, Ania Nieszkowska, Jean-Louis Trouillet, Pascal Leprince, Jean Chastre, Charles-Edouard Luyt, Alain Combes, Matthieu Schmidt
RATIONALE: Optimal positive end-expiratory pressure (PEEP) is unknown in severe acute respiratory distress syndrome (ARDS) patients on extracorporeal membrane oxygenation (ECMO) receiving mechanical ventilation with very low tidal volume. OBJECTIVES: To evaluate electrical impedance tomography's (EIT) ability to monitor a PEEP trial and to derive from EIT the best compromise PEEP in this setting. METHODS: A decremental PEEP trial (20-0 cmH2O) in 5 cmH2O steps was monitored by EIT, with lung images divided into four ventral-to-dorsal horizontal regions of interest...
January 19, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28047646/su-f-t-606-monte-carlo-evaluation-of-tissue-inhomogeneity-corrections-in-the-treatment-of-liver-cancer-patients-using-stereotactic-body-radiotherapy
#2
D Pokhrel, S Sood, R Badkul, C McClinton, H Jiang, H Saleh, C Lominska
PURPOSE: To evaluate the dosimetric performance of X-ray Voxel Monte Carlo(XVMC) algorithm in effort to clinically validate Monte Carlo-approach in heterogeneous liver phantom and liver SBRT plans. METHODS: An anthropomorphic RPC liver phantom incorporating a liver structure with two cylindrical targets and organs-at-risk (OARs) was used in phantom validation. Subsequently, five patients with metastatic liver cancer were treated using heterogeneity-corrected pencil-beam(PB-hete)algorithm were analyzed following RTOG-1112 criteria ...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28013296/thoracoabdominal-asynchrony-is-not-associated-with-oxyhemoglobin-saturation-in-recovering-premature-infants
#3
Colleen Brennan, Lara Ulm, Samuel Julian, Aaron Hamvas, Thomas Ferkol, Julie Hoffman, Laura Linneman, James Kemp
BACKGROUND: Recovering premature infants are at risk for hypoxemia and lack of synchrony between their rib cage and abdomen due to airflow obstruction and poor respiratory compliance. Thoracoabdominal asynchrony (TAA) is a useful marker of resistive and elastic lung properties. Whether TAA predicts oxygenation is unknown. OBJECTIVES: We investigated oxyhemoglobin saturation (SpO2%) and TAA (phase angle, φ) in preterm infants with/without high-humidity nasal cannula (HHNC)...
December 24, 2016: Neonatology
https://www.readbyqxmd.com/read/27989602/lung-inflation-with-hydrogen-sulfide-during-the-warm-ischemia-phase-ameliorates-injury-in-rat-donor-lungs-via-metabolic-inhibition-after-cardiac-death
#4
Chao Meng, Xiaoguang Cui, Sihua Qi, Jiahang Zhang, Jiyu Kang, Huacheng Zhou
BACKGROUND: Hydrogen sulfide attenuates lung ischemia-reperfusion injury when inhaled or administered intraperitoneally. This study investigated the effects of lung inflation with H2S during the warm ischemia phase on lung grafts from rat donors after cardiac death. METHODS: One hour after cardiac death, donor lungs were inflated in situ for 2 h with either O2 or H2S (O2 or H2S group) during the warm ischemia phase or were deflated as a control procedure (n = 8)...
December 15, 2016: Surgery
https://www.readbyqxmd.com/read/27924200/effect-of-recruitment-maneuver-on-arterial-oxygenation-in-patients-undergoing-robot-assisted-laparoscopic-prostatectomy-with-intraoperative-15-cmh2o-positive-end-expiratory-pressure
#5
Sowoon Ahn, Sung Hye Byun, Haeyoon Chang, Young Bin Koo, Jong Chan Kim
BACKGROUND: This randomized, controlled study was designed to compare the effects of recruitment maneuvers (RMs) with a 15 cmH2O positive end-expiratory pressure (PEEP) on the systemic oxygenation and lung compliance of patients with healthy lungs following robot-assisted laparoscopic prostatectomy (RALP). METHODS: Sixty patients undergoing a RALP with an intraoperative 15 cmH2O PEEP were randomly allocated to an RM or a Control group. The patients in the RM group received a single RM through the application of a continuous positive airway pressure of 40 cmH2O for 40 s 15 min after being placed in the Trendelenburg position...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27911030/acellular-endocardium-as-a-novel-biomaterial-for-the-intima-of-tissue-engineered-small-caliber-vascular-grafts
#6
Feng Wang, Xin Guan, TianYi Wu, JianOu Qiao, ZhaoQing Han, JinLong Wu, XiaoWei Yu, QingJun You
We aimed to investigate whether acellular endocardium can be used as a useful biomaterial for the intima of engineered small-caliber vascular grafts. Fresh endocardium was harvested from the swine left atrium and was decellularized by digestion with the decellularization solution of Triton X-100 and SDS containing DNase I and RNase A. Surface morphological characteristics and Young's modulus were evaluated. To analyze the effect of mechanical characteristics on cell adhesion, the decellularized endocardium was stiffened with 2...
December 2016: Artificial Organs
https://www.readbyqxmd.com/read/27910484/design-analysis-and-testing-of-kinematic-mount-for-astronomical-observation-instrument-used-in-space-camera
#7
Mingxin An, Lihao Zhang, Shuyan Xu, Jihong Dong
A statically determinate kinematic mount structure is designed for an astronomical observation instrument. The basic principle of the proposed kinematic mount is introduced in detail, including the design principle, its structure, and its degrees of freedom. The compliance equations for the single-axis right circle flexure hinge are deduced, and mathematical models of the compliances of the bipod in the X-axis and Z-axis directions are established. Based on the index requirements, the range of one design parameter (the hinge groove depth, R) for the kinematic mount is determined...
November 2016: Review of Scientific Instruments
https://www.readbyqxmd.com/read/27875410/should-we-use-driving-pressure-to-set-tidal-volume
#8
Domenico L Grieco, Lu Chen, Martin Dres, Laurent Brochard
PURPOSE OF REVIEW: Ventilator-induced lung injury (VILI) can occur despite use of tidal volume (VT) limited to 6 ml/kg of predicted body weight, especially in patients with a smaller aerated compartment (i.e. the baby lung) in which, indeed, tidal ventilation takes place. Because respiratory system static compliance (CRS) is mostly affected by the volume of the baby lung, the ratio VT/CRS (i.e. the driving pressure, ΔP) may potentially help tailoring interventions on VT setting. RECENT FINDINGS: Driving pressure is the ventilatory variable most strongly associated with changes in survival and has been shown to be the key mediator of the effects of mechanical ventilation on outcome in the acute respiratory distress syndrome...
February 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/27864287/double-hit-mouse-model-of-cigarette-smoke-priming-for-acute-lung-injury
#9
Pavlo Sakhatskyy, Zhengke Wang, Diana Borgas, Joanne Lomas-Neira, Yaping Chen, Alfred Ayala, Sharon Rounds, Qing Lu
Epidemiological studies indicate that cigarette smoking (CS) increases the risk and severity of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). The mechanism is not understood, at least in part because of lack of animal models that reproduce the key features of the CS priming process. In this study, using two strains of mice, we characterized a double-hit mouse model of ALI induced by CS priming of injury caused by lipopolysaccharide (LPS). C57BL/6 and AKR mice were preexposed to CS briefly (3 h) or subacutely (3 wk) before intratracheal instillation of LPS and ALI was assessed 18 h after LPS administration by measuring lung static compliance, lung edema, vascular permeability, inflammation, and alveolar apoptosis...
January 1, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/27861182/cryopreserved-xeno-free-human-umbilical-cord-mesenchymal-stromal-cells-reduce-lung-injury-severity-and-bacterial-burden-in-rodent-escherichia-coli-induced-acute-respiratory-distress-syndrome
#10
Gerard F Curley, Mirjana Jerkic, Steve Dixon, Grace Hogan, Claire Masterson, Daniel O'Toole, James Devaney, John G Laffey
OBJECTIVE: Although mesenchymal stem/stromal cells represent a promising therapeutic strategy for acute respiratory distress syndrome, clinical translation faces challenges, including scarcity of bone marrow donors, and reliance on bovine serum during mesenchymal stem/stromal cell proliferation. We wished to compare mesenchymal stem/stromal cells from human umbilical cord, grown in xeno-free conditions, with mesenchymal stem/stromal cells from human bone marrow, in a rat model of Escherichia coli pneumonia...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/27851954/airway-bistability-is-modulated-by-smooth-muscle-dynamics-and-length-tension-characteristics
#11
Graham M Donovan
Airway closure has important implications for lung disease, especially asthma; in particular, the prospect of bistability between open and closed (or effectively closed) airway states has been thought to play a prominent role in airway closure associated with the formation of clustered ventilation defects in asthma. However, many existing analyses of closure consider only static airway equilibria; here we construct, to our knowledge, a new model wherein airway narrowing and closure dynamics are modulated by coupling the airway to cross-bridge models of airway smooth muscle dynamics and force generation...
November 15, 2016: Biophysical Journal
https://www.readbyqxmd.com/read/27776936/compliance-guided-versus-fio2-driven-positive-end-expiratory-pressure-in-patients-with-moderate-or-severe-acute-respiratory-distress-syndrome-according-to-the-berlin-definition
#12
M-C Pintado, R de Pablo, M Trascasa, J-M Milicua, M Sánchez-García
OBJECTIVE: To study the effect of setting positive end-expiratory pressure (PEEP) in an individualized manner (based on highest static compliance) compared to setting PEEP according to FiO2 upon mortality at 28 and 90 days, in patients with different severity acute respiratory distress syndrome (ARDS). SETTING: A Spanish medical-surgical ICU. DESIGN: A post hoc analysis of a randomized controlled pilot study. PATIENTS: Patients with ARDS...
October 21, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27746995/suppressive-oligonucleotides-inhibit-inflammation-in-a-murine-model-of-mechanical-ventilator-induced-lung-injury
#13
Julia Scheiermann, Dennis M Klinman
BACKGROUND: Mechanical ventilation (MV) is commonly used to improve blood oxygenation in critically ill patients and for general anesthesia. Yet the cyclic mechanical stress induced at even moderate ventilation volume settings [tidal volume (Vt) <10 mL/kg] can injure the lungs and induce an inflammatory response. This work explores the effect of treatment with suppressive oligonucleotides (Sup ODN) in a mouse model of ventilator-induced lung injury (VILI). METHODS: Balb/cJ mice were mechanically ventilated for 4 h using clinically relevant Vt and a positive end-expiratory pressure of 3 cmH2O under 2-3% isoflurane anesthesia...
September 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/27743249/the-association-between-the-pulse-pressure-gradient-at-the-cranio-cervical-junction-derived-from-phase-contrast-magnetic-resonance-imaging-and-invasively-measured-pulsatile-intracranial-pressure-in-symptomatic-patients-with-chiari-malformation-type-1
#14
Radek Frič, Erika Kristina Lindstrøm, Geir Andre Ringstad, Kent-André Mardal, Per Kristian Eide
BACKGROUND: In symptomatic Chiari malformation type 1 (CMI), impaired intracranial compliance (ICC) is associated with an increased cranio-spinal pulsatile pressure gradient. Phase-contrast magnetic resonance imaging (MRI) represents a non-invasive modality for the assessment of the pulse pressure gradient at the cranio-cervical junction (CCJ). We wished to explore how the MRI-derived pulse pressure gradient (MRI-dP) compares with invasively measured pulsatile intracranial pressure (ICP) in CMI, and with healthy controls...
October 14, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27740725/assessment-of-extravascular-lung-water-by-ultrasound-after-congenital-cardiac-surgery
#15
Anu K Kaskinen, Laura Martelius, Turkka Kirjavainen, Paula Rautiainen, Sture Andersson, Olli M Pitkänen
BACKGROUND: Lung ultrasounds show vertical artifacts known as B-lines in the presence of increased extravascular lung water (EVLW). We aimed to investigate whether lung ultrasound could estimate EVLW after congenital cardiac surgery. METHODS: This prospective observational study comprised 61 children (age range 3 days to 7.4 years) undergoing congenital cardiac surgery. We compared postoperative B-line scores from lung ultrasounds, early postoperative ultrasound as our primary interest, with corresponding postoperative chest radiography (CXR) lung edema scores, with static lung compliance, and with short-term clinical outcome interpreted as time on mechanical ventilation and length of pediatric intensive care unit (PICU) stay...
October 14, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27727070/correlation-between-pao2-fio2-and-airway-and-vascular-parameters-in-the-assessment-of-cellular-ex-vivo-lung-perfusion-system
#16
Toshihiro Okamoto, David Wheeler, Qiang Liu, Cristiano Quintini, J Steven Hata, Kenneth R McCurry
BACKGROUND: Ex vivo lung perfusion (EVLP) may be an essential process for the pre-transplant evaluation of the donor lungs. Currently, the partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2, or PF) ratio is the standard in the assessment of lung function in cellular EVLP, whereas other parameters, including airway and vascular parameters, have only been partially utilized. The primary purpose of this study is to assess the potential utility of other parameters as a surrogate of lung function in EVLP...
May 20, 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27704718/hydamtiq-a-selective-parp-1-inhibitor-improves-bleomycin-induced-lung-fibrosis-by-dampening-the-tgf-%C3%AE-smad-signalling-pathway
#17
Laura Lucarini, Mariaconcetta Durante, Cecilia Lanzi, Alessandro Pini, Giulia Boccalini, Laura Calosi, Flavio Moroni, Emanuela Masini, Guido Mannaioni
Idiopathic pulmonary fibrosis is a severe disease characterized by excessive myofibroblast proliferation, extracellular matrix and fibrils deposition, remodelling of lung parenchyma and pulmonary insufficiency. Drugs able to reduce disease progression are available, but therapeutic results are unsatisfactory; new and safe treatments are urgently needed. Poly(ADP-ribose) polymerases-1 (PARP-1) is an abundant nuclear enzyme involved in key biological processes: DNA repair, gene expression control, and cell survival or death...
October 4, 2016: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/27676901/dynamic-activity-of-unloader-knee-braces-in-genu-varum-subjects-new-insights-to-improve-compliance-in-medial-knee-osteoarthritis-patients
#18
Patrice Rougier, Etienne Cusin
OBJECTIVE: Using unloader knee braces with 3-point pressure in knee osteoarthritis patients is debated. The main reason is discomfort resulting in poor compliance. Studying the external knee adduction moment (EKAM) curve, gold standard in the medial knee load estimation, should be helpful to reduce this discomfort. Reducing constraint solely during the stance phase of gait (combined with an inactivation during large knee flexion) should indeed considerably improve comfort. Thus, the objective of this study was to validate both a method for measuring dynamic activity of new unloader knee braces and to highlight the biomechanical effectiveness of these orthoses...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27676888/fitting-with-an-electronic-knee-for-a-schizophrenic-patient-with-bilateral-amputation-of-lower-limbs-what-s-the-point
#19
Thibaut Mirlicourtois, Tche Hong Loquineau, Pierre Yves Chagnon, Thomas Rondepierre, Serge Mirlicourtois, Jean Christophe Bonnardel
OBJECTIVE: The replacement of a mechanical knee with prosthetic class I foot fitting by an electronic knee with prosthetic class II foot was proposed to a 54-years-old schizophrenic patient, active, with right femoral and left tibial traumatic amputation. This fitting evolution was assessed both quantitatively and qualitatively. OBSERVATIONS/METHOD: Compared evaluation of electronic knee with prosthetic class II foot versus mechanical polycentric knee with prosthetic class I foot (fitting unchanged moreover) in: - functional abilities and quality of life using standardized scores (Functional Ambulation Classification, Houghton, Functional Independence Measurement, B...
September 2016: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27651443/changes-in-therapeutic-intensity-level-following-airway-pressure-release-ventilation-in-severe-traumatic-brain-injury
#20
Jeffrey J Fletcher, Thomas J Wilson, Venkatakrishna Rajajee, Scott B Davidson, Jon C Walsh
PURPOSE: Airway pressure release ventilation (APRV) utilizes high levels of airway pressure coupled with brief expiratory release to facilitate open lung ventilation. The aim of our study was to evaluate the effects of APRV-induced elevated airway pressure mean in patients with severe traumatic brain injury. MATERIALS AND METHODS: This was a retrospective cohort study at a 424-bed Level I trauma center. Linear mixed effects models were developed to assess the difference in therapeutic intensity level (TIL), intracranial pressure (ICP), and cerebral perfusion pressure (CPP) over time following the application of APRV...
September 20, 2016: Journal of Intensive Care Medicine
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