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Pulmonary compliance

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https://www.readbyqxmd.com/read/28632529/respiratory-system-mechanics-during-low-versus-high-positive-end-expiratory-pressure-in-open-abdominal-surgery-a-substudy-of-provhilo-randomized-controlled-trial
#1
Davide D'Antini, Robert Huhle, Jacob Herrmann, Demet S Sulemanji, Jun Oto, Pasquale Raimondo, Lucia Mirabella, Sabrine N T Hemmes, Marcus J Schultz, Paolo Pelosi, David W Kaczka, Marcos Francisco Vidal Melo, Marcelo Gama de Abreu, Gilda Cinnella
BACKGROUND: In the 2014 PROtective Ventilation using HIgh versus LOw positive end-expiratory pressure (PROVHILO) trial, intraoperative low tidal volume ventilation with high positive end-expiratory pressure (PEEP = 12 cm H2O) and lung recruitment maneuvers did not decrease postoperative pulmonary complications when compared to low PEEP (0-2 cm H2O) approach without recruitment breaths. However, effects of intraoperative PEEP on lung compliance remain poorly understood. We hypothesized that higher PEEP leads to a dominance of intratidal overdistension, whereas lower PEEP results in intratidal recruitment/derecruitment (R/D)...
June 19, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28629872/sevoflurane-relieves-lung-function-deterioration-after-cardiopulmonary-bypass
#2
Adam L Balogh, Ferenc Peták, Gergely H Fodor, Roberta Sudy, Barna Babik
OBJECTIVE: To investigate sevoflurane's potential to alleviate the detrimental pulmonary changes after cardiopulmonary bypass (CPB). DESIGN: Prospective, randomized clinical investigation. SETTING: University hospital. PARTICIPANTS: One hundred ninety patients undergoing elective cardiac surgery. INTERVENTIONS: Ninety-nine patients under intravenous anesthesia were administered 1 minimal alveolar concentration of sevoflurane for 5 minutes after being weaned from CPB (group SEV); intravenous anesthesia was maintained in the other 91 patients (group CTRL)...
February 24, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28629359/forced-expiration-measurements-in-mouse-models-of-obstructive-and-restrictive-lung-diseases
#3
Fien C Devos, André Maaske, Annette Robichaud, Lore Pollaris, Sven Seys, Carolina Aznar Lopez, Erik Verbeken, Matthias Tenbusch, Rik Lories, Benoit Nemery, Peter Hm Hoet, Jeroen Aj Vanoirbeek
BACKGROUND: Pulmonary function measurements are important when studying respiratory disease models. Both resistance and compliance have been used to assess lung function in mice. Yet, it is not always clear how these parameters relate to forced expiration (FE)-related parameters, most commonly used in humans. We aimed to characterize FE measurements in four well-established mouse models of lung diseases. METHOD: Detailed respiratory mechanics and FE measurements were assessed concurrently in Balb/c mice, using the forced oscillation and negative pressure-driven forced expiration techniques, respectively...
June 19, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28621582/assessment-of-pulmonary-arterial-compliance-evaluated-using-harmonic-oscillator-kinematics
#4
Yasunobu Hayabuchi, Akemi Ono, Yukako Homma, Shoji Kagami
We hypothesized that KPA, a harmonic oscillator kinematics-derived spring constant parameter of the pulmonary artery pressure (PAP) profile, reflects PA compliance in pediatric patients. In this prospective study of 33 children (age range = 0.5-20 years) with various cardiac diseases, we assessed the novel parameter designated as KPA calculated using the pressure phase plane and the equation KPA = (dP/dt_max)(2)/([Pmax - Pmin])/2)(2), where dP/dt_max is the peak derivative of PAP, and Pmax - Pmin is the difference between the minimum and maximum PAP...
June 16, 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28619123/chd-and-respiratory-syncytial-virus-global-expert-exchange-recommendations
#5
Robert M R Tulloh, Constancio Medrano-Lopez, Paul A Checchia, Claudia Stapper, Naokata Sumitomo, Matthias Gorenflo, Eun Jung Bae, Antonio Juanico, Juan M Gil-Jaurena, Mei-Hwan Wu, Talal Farha, Ali Dodge-Khatami, Rocky Tsang, Gerard Notario, Colleen Wegzyn
BACKGROUND: Palivizumab is the standard immunoprophylaxis against serious disease due to respiratory syncytial virus infection. Current evidence-based prophylaxis guidelines may not address certain children with CHD within specific high-risk groups or clinical/management settings. METHODS: An international steering committee of clinicians with expertise in paediatric heart disease identified key questions concerning palivizumab administration; in collaboration with an additional international expert faculty, evidence-based recommendations were formulated using a quasi-Delphi consensus methodology...
June 16, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28611374/efficacy-and-safety-of-mycobacterium-indicus-pranii-as-an-adjunct-therapy-in-category-ii-pulmonary-tuberculosis-in-a-randomized-trial
#6
Surendra K Sharma, Kiran Katoch, Rohit Sarin, Raman Balambal, Nirmal Kumar Jain, Naresh Patel, Kolluri J R Murthy, Neeta Singla, P K Saha, Ashwani Khanna, Urvashi Singh, Sanjiv Kumar, A Sengupta, J N Banavaliker, D S Chauhan, Shailendra Sachan, Mohammad Wasim, Sanjay Tripathi, Nilesh Dutt, Nitin Jain, Nalin Joshi, Sita Ram Raju Penmesta, Sumanlatha Gaddam, Sanjay Gupta, Bakulesh Khamar, Bindu Dey, Dipendra K Mitra, Sunil K Arora, Sangeeta Bhaskar, Rajni Rani
Prolonged treatment of tuberculosis (TB) often leads to poor compliance, default and relapse, converting primary TB patients into category II TB (Cat IITB) cases, many of whom may convert to multi-drug resistant TB (MDR-TB). We have evaluated the immunotherapeutic potential of Mycobacterium indicus pranii (MIP) as an adjunct to Anti-Tubercular Treatment (ATT) in Cat II pulmonary TB (PTB) patients in a prospective, randomized, double blind, placebo controlled, multicentric clinical trial. 890 sputum smear positive Cat II PTB patients were randomized to receive either six intra-dermal injections (2 + 4) of heat-killed MIP at a dose of 5 × 10(8) bacilli or placebo once in 2 weeks for 2 months...
June 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28608650/comparison-of-different-dosing-strategies-of-intratracheally-instilled-budesonide-on-meconium-injured-piglet-lungs
#7
Chih-Hsueh Lin, Mei-Jy Jeng, Yi-Chiang Yang, Yu-Hsuan Hsiao, Yu Ru Kou
BACKGROUND: Severe inflammation plays a vital role in the pathogenesis of meconium aspiration syndrome (MAS). Intratracheal (IT) instillation of corticosteroids may be beneficial for MAS in optimizing local effect and reducing systemic adverse effects, but the optimum dosing course remains open to question. METHODS: Thirty meconium-injured newborn piglets were enrolled into six study groups. The first four groups consisted of the IT instillation of 0.25/0.5 mg/kg using either one (IT-B251/IT-B501) or two (IT-B252/IT-B502) doses of budesonide, while the other two groups were the intravenous (IV) dexamethasone (0...
July 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28603829/adherence-to-treatment-with-continuous-positive-airway-pressure-in-the-obstructive-sleep-apnea-syndrome
#8
Ahmed Abdelghani, Wafa Benzarti, Hlima Ben Salem, Imen Gargouri, Abdelhamid Garrouche, Abdelaziz Hayouni, Mohamed Benzarti
INTRODUCTION: Continuous positive airway pressure (CPAP) is the most effective treatment for obstructive sleep apnea (OSA). Adequate compliance with the use of CPAP is cardinal to achieve cardiovascular, metabolic and neuropsychological benefits of treatment. AIM: Assess the factors affecting compliance to the CPAP treatment and analyze the long term acceptance. METHODS: Retrospective study on 130 patients treated by CPAP for OSA in the department of pulmonology between 2005 and 2014...
August 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28597762/the-safety-and-pharmacokinetics-of-rapid-iloprost-aerosol-delivery-via-the-breelib-nebulizer-in-pulmonary-arterial-hypertension
#9
Tobias Gessler, Hossein-Ardeschir Ghofrani, Matthias Held, Hans Klose, Hanno Leuchte, Horst Olschewski, Stephan Rosenkranz, Lueder Fels, Na Li, Dawn Ren, Andreas Kaiser, Marcus-Hillert Schultze-Mosgau, Bernhard Müllinger, Beate Rohde, Werner Seeger
The BREELIB nebulizer was developed for iloprost to reduce inhalation times for patients with pulmonary arterial hypertension (PAH). This multicenter, randomized, unblinded, four-part study compared inhalation time, pharmacokinetics, and acute tolerability of iloprost 5 µg at mouthpiece delivered via BREELIB versus the standard I-Neb nebulizer in 27 patients with PAH. The primary safety outcome was the proportion of patients with a maximum increase in heart rate (HR) ≥ 25% and/or a maximum decrease in systolic blood pressure ≥ 20% within 30 min after inhalation...
April 2017: Pulmonary Circulation
https://www.readbyqxmd.com/read/28596258/overuse-of-chest-ct-in-patients-with-stage-i-and-ii-breast-cancer-an-opportunity-to-increase-guidelines-compliance-at-an-nccn-member-institution
#10
Barbara Dull, Andrew Linkugel, Julie A Margenthaler, Amy E Cyr
Background: The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) recommend that patients with clinical stage I/II breast cancer undergo advanced imaging for staging only when symptomatic. Regardless, many asymptomatic patients undergo chest CT. The goal of this study was to assess the use and results of chest CT in these patients at an NCCN Member Institution. Methods: Patients with breast cancer diagnosed between 1998 and 2012 were identified in a prospectively maintained database. All patients with clinical stage I/II disease who did not receive neoadjuvant chemotherapy were included...
June 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28594706/diagnosis-of-tuberous-sclerosis-complex-in-a-patient-referred-for-uncontrolled-hypertension-and-renal-dysfunction-a-case-highlighting-the-importance-of-proper-diagnostic-work-up-of-hypertensive-patients
#11
Pantelis A Sarafidis, Athanasios Bikos, Charalampos Loutradis, Stergios Tzikas, Efstratios Vakirlis, Eugenia Avdelidou, Dimitrios Zafeiriou, Aikaterini Papagianni, Vasileios Vassilikos
: We report a case of a 39-year-old woman with resistant hypertension and renal dysfunction. The patient was hospitalized 3 months earlier for dyspnea at the Department of Cardiology, where she was diagnosed with heart failure (left ventricle injection fraction: 25-30%), pulmonary hypertension, chronic kidney disease (serum creatinine: 1.58 mg/dl), and resistant hypertension and discharged with optimal heart failure treatment. At presentation to our clinic, apart from uncontrolled hypertension for more than 10 years and history of pre-eclampsia and fetal loss, the patient had obesity (BMI: 38 kg/m) and facial fibromas...
June 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28588116/high-oxygen-concentrations-adversely-affect-the-performance-of-pulmonary-surfactant
#12
Craig D Smallwood, Parnian Boloori-Zadeh, Maricris R Silva, Andrew Gouldstone
BACKGROUND: Although effective in the neonatal population, exogenous pulmonary surfactant has not demonstrated a benefit in pediatric and adult subjects with hypoxic lung injury despite a sound physiologic rationale. Importantly, neonatal surfactant replacement therapy is administered in conjunction with low fractional FIO2 while pediatric/adult therapy is administered with high FIO2 . We suspected a connection between FIO2 and surfactant performance. Therefore, we sought to assess a possible mechanism by which the activity of pulmonary surfactant is adversely affected by direct oxygen exposure in in vitro experiments...
June 6, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28587802/cytokine-filtration-modulates-pulmonary-metabolism-and-edema-formation-during-ex-vivo-lung-perfusion
#13
Ilker Iskender, Tugba Cosgun, Stephan Arni, Michael Trinkwitz, Stefan Fehlings, Yoshito Yamada, Nikola Cesarovic, Keke Yu, Thomas Frauenfelder, Wolfgang Jungraithmayr, Walter Weder, Ilhan Inci
BACKGROUND: Ex vivo lung perfusion (EVLP) has improved the process of donor lung management. Cytokine accumulation during EVLP has been shown to correlate with worse outcome after lung transplantation. Our objective in this study was to test the safety and efficacy of cytokine filtration during EVLP in a large animal model. METHODS: Pig donor lungs were preserved for 24 hours at 4°C, followed by 12 hours of EVLP, according to the Toronto protocol. The perfusate was continuously run through an absorbent device (CytoSorb) via a veno-venous shunt from the reservoir in the filter group...
May 20, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28584212/variations-of-postresuscitation-lung-function-after-thrombolysis-therapy-in-a-cardiac-arrest-porcine-model-caused-by-pulmonary-thromboembolism
#14
Jun Yang, Lian-Xing Zhao, Chun-Sheng Li, Nan Tong, Hong-Li Xiao, Le An
BACKGROUND: Study of lung function in survivor from cardiac arrest (CA) caused by pulmonary thromboembolism (PTE) was rare. The aim of this study was to investigate the variations of postresuscitation lung function after thrombolysis treatment in a CA porcine model caused by PTE. METHODS: After 2 min of untreated CA, pigs of 10-12 weeks with a weight of 30 ± 2 kg (n = 24) were treated with recombinant human tissue plasminogen activator (50 mg). Cardiopulmonary resuscitation (CPR) and ventilation were initiated after drug administration...
June 20, 2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28578633/early-pulmonary-compliance-increase-during-cardiac-surgery-predicted-post-operative-lung-dysfunction
#15
Yann Sacuto, Thierry Sacuto
INTRODUCTION: Lung dysfunction following cardiac surgery is currently viewed as the consequence of atelectasis and lung injury. While the mechanism of atelectasis has been largely detailed, the pathogenesis of lung injury after cardiopulmonary bypass is still unclear. Based upon clinical and experimental studies, we hypothesized that lungs could be injured through a mechanical phenomenon. METHODS: We recorded pulmonary compliance at six key moments of a heart operation in 62 adult patients undergoing elective cardiac surgery...
June 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28572119/right-ventricular-dyssynchrony-and-exercise-capacity-in-idiopathic-pulmonary-arterial-hypertension
#16
Roberto Badagliacca, Silvia Papa, Gabriele Valli, Beatrice Pezzuto, Roberto Poscia, Manuela Reali, Giovanna Manzi, Elisa Giannetta, Daniele Berardi, Susanna Sciomer, Paolo Palange, Francesco Fedele, Robert Naeije, Carmine Dario Vizza
Survival in patients with pulmonary arterial hypertension (PAH) is determined by right ventricular (RV) function adaptation to afterload. How altered RV function impacts on exercise capacity in PAH is not exactly known.104 idiopathic PAH (IPAH) patients aged 52±14 years underwent a diagnostic right heart catheterisation, a comprehensive echocardiography including two-dimensional speckle tracking for RV dyssynchrony evaluation and a cardiopulmonary exercise test. Multivariate analyses were performed to identify independent predictors of peak oxygen uptake (peak V'O2 )...
June 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28562388/procedural-sedation-in-the-icu-and-emergency-department
#17
Nikhil Chawla, Adjoa Boateng, Ranjit Deshpande
PURPOSE OF REVIEW: Procedures are increasingly being performed in the acute care setting, outside of the operating rooms (OR). This article aims to review the current literature on out-of-OR procedural sedation with a focus on the ICU and emergency department, highlighting the following topics: multidisciplinary team approach, choice of pharmacologic agent, sedation scales, current safety guidelines, anticipating complications, appropriate monitoring and necessary resources. RECENT FINDINGS: Subjective assessment of sedation using sedation scales is controversial...
May 27, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28558697/does-an-electronic-cognitive-aid-have-an-effect-on-the-management-of-severe-gynaecological-turp-syndrome-a-prospective-randomised-simulation-study
#18
Michael St Pierre, Georg Breuer, Dieter Strembski, Christopher Schmitt, Bjoern Luetcke
BACKGROUND: Lack of familiarity with the content of current guidelines is a major factor associated with non-compliance by clinicians. It is conceivable that cognitive aids with regularly updated medical content can guide clinicians' task performance by evidence-based practices, even if they are unfamiliar with the actual guideline. Acute hyponatraemia as a consequence of TURP syndrome is a rare intraoperative event, and current practice guidelines have changed from slow correction to rapid correction of serum sodium levels...
May 30, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28550946/reply-to-the-commentary-by-hillman-et-al-on-vascular-distensibilities-have-minor-effects-on-intracardiac-shunt-patterns-in-reptiles-by-filogonio-et-al-2017
#19
Renato Filogonio, Cléo Alcantara Costa Leite, Tobias Wang
Our meta-analysis (Filogonio et al., 2017) on central vascular blood flows in a snake (Crotalus durissus) and a turtle (Trachemys scripta) was motivated by Hillman et al.'s (2014) analysis on amphibians to investigate whether cardiac shunt patterns depend on cardiac output and vascular distensibilities. In contrast to Hillman et al. (2014), we did not uncover a general trend that supports the notion that cardiac shunts in reptiles are dictated by vascular distensibilities. In addition to our response to the criticism raised by Hillman et al...
May 17, 2017: Zoology: Analysis of Complex Systems, ZACS
https://www.readbyqxmd.com/read/28546747/the-direct-and-indirect-costs-of-managing-chronic-obstructive-pulmonary-disease-in-greece
#20
Kyriakos Souliotis, Hara Kousoulakou, Georgios Hillas, Nikos Tzanakis, Michalis Toumbis, Theodoros Vassilakopoulos
OBJECTIVE: COPD is associated with significant economic burden. The objective of this study was to explore the direct and indirect costs associated with COPD and identify the key cost drivers of disease management in Greece. METHODS: A Delphi panel of Greek pulmonologists was conducted, which aimed at eliciting local COPD treatment patterns and resource use. Resource use was translated into costs using official health insurance tariffs and Diagnosis-Related Groups (DRGs)...
2017: International Journal of Chronic Obstructive Pulmonary Disease
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