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Transdiaphragmatic pressure

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https://www.readbyqxmd.com/read/29792554/effect-of-acetazolamide-and-methazolamide-on-diaphragm-and-dorsiflexor-fatigue-a-randomized-controlled-trial
#1
Paolo B Dominelli, Chris J McNeil, Tyler Dennis Vermeulen, Troy J R Stuckless, Courtney V Brown, Giulio S Dominelli, Erik Richard Swenson, Lucas J Teppema, Glen Edward Foster
Acetazolamide, a carbonic anhydrase (CA) inhibitor used clinically and to prevent acute mountain sickness, worsens skeletal muscle fatigue in animals and humans. In animals, methazolamide, a methylated analogue of acetazolamide and an equally potent CA inhibitor, reportedly exacerbates fatigue less than acetazolamide. Accordingly, we sought to determine, in humans, if methazolamide would attenuate diaphragm and dorsiflexor fatigue compared to acetazolamide. Healthy men (dorsiflexor: n=12; diaphragm: n=7) performed fatiguing exercise on three occasions, after ingesting acetazolamide (250 mg three times a day) and then in random order, methazolamide (100 mg twice a day) or placebo for 48 h...
May 24, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29779593/assessing-diaphragm-function-in-chest-wall-and-neuromuscular-diseases
#2
REVIEW
Taro Minami, Kamran Manzoor, F Dennis McCool
Diaphragm dysfunction is defined as the partial or complete loss of diaphragm muscle contractility. However, because the diaphragm is one of only a few skeletal muscles that is not amenable to direct examination, the tools available for the clinician to assess diaphragm function have been limited. Traditionally, measures of lung volume, inspiratory muscle strength, and radiographic techniques such as fluoroscopy have provided the major method to assess diaphragm function. Measurement of transdiaphragmatic pressure provides the most direct means of evaluating the diaphragm, but this technique is not readily available to clinicians...
June 2018: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/29771711/respiratory-muscle-effort-during-expiration-in-successful-and-failed-weaning-from-mechanical-ventilation
#3
Jonne Doorduin, Lisanne H Roesthuis, Diana Jansen, Johannes G van der Hoeven, Hieronymus W H van Hees, Leo M A Heunks
BACKGROUND: Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. Previous studies have mainly focused on inspiratory muscle activity during weaning; expiratory muscle activity is less well understood. The current study describes expiratory muscle activity during weaning, including tonic diaphragm activity. The authors hypothesized that expiratory muscle effort is greater in patients who fail to wean compared to those who wean successfully...
May 16, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29756638/sex-differences-in-diaphragmatic-fatigue-the-cardiovascular-response-to-inspiratory-resistance
#4
Joseph F Welch, Bruno Archiza, Jordan A Guenette, Christopher R West, A William Sheel
KEY POINTS: Diaphragmatic fatigue (DF) elicits a sympathetically mediated metaboreflex resulting in increased heart rate, blood pressure and limb vascular resistance. Women may be more resistant to DF compared to men and therefore, it was hypothesised that women would experience an attenuated inspiratory muscle metaboreflex during inspiratory pressure-threshold loading (PTL) performed to task failure. At the time of PTL task failure, the severity of DF was not different between sexes; however, inspiratory muscle endurance time was significantly longer in women than men...
May 14, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29703214/ultrasound-assessed-diaphragmatic-impairment-is-a-predictor-of-outcomes-in-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-undergoing-noninvasive-ventilation
#5
Alessandro Marchioni, Ivana Castaniere, Roberto Tonelli, Riccardo Fantini, Matteo Fontana, Luca Tabbì, Andrea Viani, Francesco Giaroni, Valentina Ruggieri, Stefania Cerri, Enrico Clini
BACKGROUND: Ultrasound (US) evaluation of diaphragmatic dysfunction (DD) has proved to be a reliable technique in critical care. In this single-center prospective study, we investigated the impact of US-assessed DD on noninvasive ventilation (NIV) failure in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its correlation with the transdiaphragmatic pressure assessed using the invasive sniff maneuver (Pdi sniff). METHODS: A population of 75 consecutive patients with AECOPD with hypercapnic acidosis admitted to our respiratory intensive care unit (RICU) were enrolled...
April 27, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29683923/effects-of-age-and-sex-on-inspiratory-muscle-activation-patterns-during-exercise
#6
Yannick Molgat-Seon, Paolo B Dominelli, Andrew H Ramsook, Michele R Schaeffer, Lee M Romer, Jeremy D Road, Jordan A Guenette, A William Sheel
PURPOSE: Characterize the effects of age, sex, and their interaction on inspiratory muscle activation patterns during exercise. METHODS: Twenty younger (20-30y, n=10 women) and twenty older (60-80y, n=10 women) subjects performed an incremental cycle exercise test. Electromyography of the scalene (EMGsca) and sternocleidomastoid (EMGscm) muscles were measured using skin surface electrodes, while diaphragm electromyography (EMGdi) and esophageal and transdiaphragmatic pressures were measured using an esophageal catheter...
April 21, 2018: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/29566571/respiratory-measures-in-amyotrophic-lateral-sclerosis
#7
Noah Lechtzin, Merit E Cudkowicz, Mamede de Carvalho, Angela Genge, Orla Hardiman, Hiroshi Mitsumoto, Jesus S Mora, Jeremy Shefner, Leonard H Van den Berg, Jinsy A Andrews
OBJECTIVE: Amyotrophic lateral sclerosis (ALS) is a progressive neuromuscular disease that causes skeletal muscle weakness, including muscles involved with respiration. Death often results from respiratory failure within 3-5 years. Monitoring respiratory status is therefore critical to ALS management, as respiratory/pulmonary function tests (PFTs) are used to make decisions including when to initiate noninvasive ventilation. Understanding the different respiratory and PFTs as they relate to disease progression and survival may help determine which tests are most suitable...
March 23, 2018: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/29357497/temporal-characteristics-of-exercise-induced-diaphragmatic-fatigue
#8
Bruno Archiza, Joseph F Welch, Caitlin M Geary, Grayson P Allen, Audrey Borghi-Silva, A William Sheel
There is evidence suggesting diaphragmatic fatigue (DF) occurs relatively early during high-intensity exercise; however, studies investigating the temporal characteristics of exercise-induced DF are limited by incongruent methodology. Eight healthy adult males (25 ± 5 yr) performed a maximal incremental exercise test on a cycle ergometer on day 1. A constant-load time-to-exhaustion (TTE) exercise test was conducted on day 2 at 60% delta between the calculated gas exchange threshold and peak work rate. Two additional constant-load exercise tests were performed at the same intensity on days 3 and 4 in a random order to either 50 or 75% TTE...
April 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29191982/exercise-induced-diaphragm-fatigue-in-a-paralympic-champion-rower-with-spinal-cord-injury
#9
Nicholas B Tiller, Thomas R Aggar, Christopher R West, Lee M Romer
The aim of this case report was to determine whether maximal upper body exercise was sufficient to induce diaphragm fatigue in a Paralympic champion adaptive rower with low-lesion spinal cord injury (SCI). An elite arms-only oarsman (age: 28 yr; stature: 1.89 m; and mass: 90.4 kg) with motor-complete SCI (T12 ) performed a 1,000-m time trial on an adapted rowing ergometer. Exercise measurements comprised pulmonary ventilation and gas exchange, diaphragm EMG-derived indexes of neural respiratory drive, and intrathoracic pressure-derived indexes of respiratory mechanics...
March 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29165681/diaphragmatic-function-in-infants-and-children-with-congenital-diaphragmatic-hernia-a-cross-sectional-study
#10
Sonia Khirani, Alessandro Amaddeo, Naziha Khen-Dunlop, Jorge Olmo Arroyo, Alexandre Lapillonne, Odile Becquet, Elsa Kermorvant-Duchemin, Sylvie Beaudoin, Véronique Rousseau, Christophe Delacourt, Brigitte Fauroux
OBJECTIVES: Few studies have evaluated long-term diaphragmatic function in congenital diaphragmatic hernia (CDH). The aim of our cross-sectional study was to assess diaphragmatic function in infants and young children with CDH after surgical repair. METHODS: All the patients with CDH repair followed in our centre between February 2014 and January 2016 were enrolled. Patients with a postnatal diagnosis after 1 month of life were excluded. Breathing pattern and diaphragmatic function were assessed using esophageal and gastric (Pgas) pressure recording after surgery, or at 1 or 5 years of age...
April 1, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29134500/systematic-review-of-the-feasibility-and-future-of-laparoscopic-liver-resection-for-difficult-lesions
#11
REVIEW
Kenichiro Araki, Norio Kubo, Akira Watanabe, Hiroyuki Kuwano, Ken Shirabe
Laparoscopic liver resection (LLR) is now performed widely, but is difficult to accomplish in some anatomical locations, such as the posterosuperior segments (S7 and S8) and caudate lobe (S1). An international survey revealed that lesions in these locations are less frequently indicated for LLR than those in other segments. Recent reports from experienced centers document several case series and present technical tips for treating such lesions. The lateral approach using intercostal (transdiaphragmatic) trocars was reported to be useful for lesions in the posterosuperior segments with a semi- to full-decubitus position...
November 13, 2017: Surgery Today
https://www.readbyqxmd.com/read/29097629/increased-respiratory-neural-drive-and-work-of-breathing-in-exercise-induced-laryngeal-obstruction
#12
Emil S Walsted, Azmy Faisal, Caroline J Jolley, Laura L Swanton, Matthew J Pavitt, Yuan-Ming Luo, Vibeke Backer, Michael I Polkey, James H Hull
Exercise-induced laryngeal obstruction (EILO), a phenomenon in which the larynx closes inappropriately during physical activity, is a prevalent cause of exertional dyspnea in young individuals. The physiological ventilatory impact of EILO and its relationship to dyspnea are poorly understood. The objective of this study was to evaluate exercise-related changes in laryngeal aperture on ventilation, pulmonary mechanics, and respiratory neural drive. We prospectively evaluated 12 subjects (6 with EILO and 6 healthy age- and gender-matched controls)...
February 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29094360/effects-of-manipulations-to-detect-sliding-hiatal-hernia-in-dogs-with-brachycephalic-airway-obstructive-syndrome
#13
Olivier Broux, Cécile Clercx, Anne-Laure Etienne, Valeria Busoni, Stéphanie Claeys, Annick Hamaide, Frédéric Billen
OBJECTIVE: To determine the influence of manipulations aimed at increasing the transdiaphragmatic pressure gradient on the gastro-esophageal junction (GEJ) of dogs with brachycephalic airway obstructive syndrome (BAOS), and to identify the manipulation that most improves the detection of GEJ abnormalities and sliding hiatal hernia (SHH) in dogs with BAOS. STUDY DESIGN: In vivo experimental pilot study and prospective clinical study. ANIMALS: Five purpose-bred Beagles and 20 dogs diagnosed with BAOS...
February 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29059880/evaluation-of-indirect-measures-of-neural-inspiratory-time-from-invasive-and-noninvasive-recordings-of-respiratory-activity
#14
Daniel Garcia-Castellote, Abel Torres, Luis Estrada, Leonardo Sarlabous, Raimon Jane
Measuring diaphragmatic electromyography (EMGdi) provides an indirect quantification of neural respiratory drive and allows the delimitation of diaphragm neural activation and deactivation during inspiration. EMGdi recordings have been incorporated in novel modes of assisted mechanical ventilation, such as neurally adjusted ventilatory assist (NAVA), to trigger and cycle-off the ventilator. The EMGdi signal improves the assistance delivered by more conventional ventilatory modes, in which the ventilator is synchronized with the patient employing a pneumatic triggering...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28993264/sensory-mechanical-effects-of-a-dual-bronchodilator-and-its-anticholinergic-component-in-copd
#15
Denis E O'Donnell, Amany F Elbehairy, Azmy Faisal, J Alberto Neder, Katherine A Webb
This randomized, double-blind, crossover study examined the physiological rationale for using a dual long-acting bronchodilator (umeclidinium/vilanterol (UME/VIL)) versus its muscarinic-antagonist component (UME) as treatment for dyspnea and exercise intolerance in moderate COPD. After each 4-week treatment period, subjects performed pulmonary function and symptom-limited constant-work rate cycling tests with diaphragm electromyogram (EMGdi), esophageal (Pes), gastric (Pga) and transdiaphragmatic (Pdi) pressure measurements...
January 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28885469/bigger-is-better-comparison-of-alternative-devices-for-tension-hemopneumothorax-and-pulseless-electrical-activity-in-a-yorkshire-swine-model
#16
COMPARATIVE STUDY
Matthew L Leatherman, Laura M Fluke, Christian S McEvoy, Douglas M Pokorny, Robert L Ricca, Matthew J Martin, Christopher S Gamble, Travis M Polk
BACKGROUND: Tension pneumothorax is a cause of potentially preventable death in prehospital and battlefield settings and 14-gauge angiocatheter (14G AC) decompression remains the current treatment standard, despite its high incidence of failure. Traumatic pneumothorax is often associated with hemothorax, but 14G AC has no proven efficacy for associated hemothorax. We sought to compare the 14G AC to three alternative devices for treatment of tension hemopneumothorax (t-H/PTX) in a positive-pressure ventilation swine model...
December 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28790008/compensatory-effects-following-unilateral-diaphragm-paralysis
#17
Obaid U Khurram, Gary C Sieck, Carlos B Mantilla
Injury to nerves innervating respiratory muscles such as the diaphragm muscle results in significant respiratory compromise. Electromyography (EMG) and transdiaphragmatic pressure (Pdi) measurements reflect diaphragm activation and force generation. Immediately after unilateral diaphragm denervation (DNV), ventilatory behaviors can be accomplished without impairment, but Pdi generated during higher force non-ventilatory behaviors is significantly decreased. We hypothesized that 1) the initial reduction in Pdi during higher force behaviors after DNV is ameliorated after 14 days, and 2) changes in Pdi over time after DNV are associated with concordant changes in contralateral diaphragm EMG activity and ventilatory parameters...
December 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28767523/respiratory-mechanical-and-cardiorespiratory-consequences-of-cycling-with-aerobars
#18
Jesse M Charlton, Andrew H Ramsook, Reid A Mitchell, Michael A Hunt, Joseph H Puyat, Jordan A Guenette
PURPOSE: Aerobars place a cyclist in a position where the trunk is flexed forward and the elbows are close to the midline of the body. This position is known to improve cycling aerodynamics and time trial race performance compared with upright cycling positions. However, the aggressive nature of this position may have important cardiorespiratory and metabolic consequences. The purpose of this investigation was to examine the respiratory mechanical, ventilatory, metabolic, and sensory consequences of cycling while using aerobars during laboratory-based cycling...
December 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28646592/influence-of-inspiratory-resistive-loading-on-expiratory-muscle-fatigue-in-healthy-humans
#19
Carli M Peters, Joseph F Welch, Paolo B Dominelli, Yannick Molgat-Seon, Lee M Romer, Donald C McKenzie, A William Sheel
What is the central question of this study? This study is the first to measure objectively both inspiratory and expiratory muscle fatigue after inspiratory resistive loading to determine whether the expiratory muscles are activated to the point of fatigue when specifically loading the inspiratory muscles. What is the main finding and its importance? The absence of abdominal muscle fatigue suggests that future studies attempting to understand the neural and circulatory consequences of diaphragm fatigue can use inspiratory resistive loading without considering the confounding effects of abdominal muscle fatigue...
September 1, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28620310/abdominal-binding-improves-neuromuscular-efficiency-of-the-human-diaphragm-during-exercise
#20
Sara J Abdallah, David S Chan, Robin Glicksman, Cassandra T Mendonca, Yuanming Luo, Jean Bourbeau, Benjamin M Smith, Dennis Jensen
We tested the hypothesis that elastic binding of the abdomen (AB) would enhance neuromuscular efficiency of the human diaphragm during exercise. Twelve healthy non-obese men aged 24.8 ± 1.7 years (mean ± SE) completed a symptom-limited constant-load cycle endurance exercise test at 85% of their peak incremental power output with diaphragmatic electromyography (EMGdi) and respiratory pressure measurements under two randomly assigned conditions: unbound control (CTRL) and AB sufficient to increase end-expiratory gastric pressure (Pga,ee) by 5-8 cmH2O at rest...
2017: Frontiers in Physiology
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