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Cardiopulmonary interactions

Kyle R Barnes, Andrew E Kilding
Running economy (RE) is considered an important physiological measure for endurance athletes, especially distance runners. This review considers 1) how RE is defined and measured and 2) physiological and biomechanical factors that determine or influence RE. It is difficult to accurately ascertain what is good, average, and poor RE between athletes and studies due to variation in protocols, gas-analysis systems, and data averaging techniques. However, representative RE values for different caliber of male and female runners can be identified from existing literature with mostly clear delineations in oxygen uptake across a range of speeds in moderately and highly trained and elite runners...
December 2015: Sports Medicine—Open
Reza Avazmohammadi, Michael R Hill, Marc A Simon, Will Zhang, Michael S Sacks
The function of right ventricle (RV) is recognized to play a key role in the development of many cardiopulmonary disorders, such as pulmonary arterial hypertension (PAH). Given the strong link between tissue structure and mechanical behavior, there remains a need for a myocardial constitutive model that accurately accounts for right ventricular myocardium architecture. Moreover, most available myocardial constitutive models approach myocardium at the length scale of mean fiber orientation and do not explicitly account for different fibrous constituents and possible interactions among them...
October 1, 2016: Biomechanics and Modeling in Mechanobiology
Young Sun Ro, Sang Do Shin, Yu Jin Lee, Seung Chul Lee, Kyoung Jun Song, Hyun Wook Ryoo, Marcus Eng Hock Ong, Bryan McNally, Bentley Bobrow, Hideharu Tanaka, Helge Myklebust, Tonje Søraas Birkenes
STUDY OBJECTIVE: We study the effect of a nationwide dispatcher-assisted cardiopulmonary resuscitation (CPR) program on out-of-hospital cardiac arrest outcomes by arrest location (public and private settings). METHODS: All emergency medical services (EMS)-treated adults in Korea with out-of-hospital cardiac arrests of cardiac cause were enrolled between 2012 and 2013, excluding cases witnessed by EMS providers and those with unknown outcomes. Exposure was bystander CPR categorized into 3 groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no bystander CPR...
September 18, 2016: Annals of Emergency Medicine
Stinne Eika Rasmussen, Mette Amalie Nebsbjerg, Lise Qvirin Krogh, Katrine Bjørnshave, Kristian Krogh, Jonas Agerlund Povlsen, Ingunn Skogstad Riddervold, Thorbjørn Grøfte, Hans Kirkegaard, Bo Løfgren
BACKGROUND: Emergency dispatchers use protocols to instruct bystanders in cardiopulmonary resuscitation (CPR). Studies changing one element in the dispatcher's protocol report improved CPR quality. Whether several changes interact is unknown and the effect of combining multiple changes previously reported to improve CPR quality into one protocol remains to be investigated. We hypothesize that a novel dispatch protocol, combining multiple beneficial elements improves CPR quality compared with a standard protocol...
September 19, 2016: Resuscitation
Marc R Mendler, Claudia Weber, Mohammad A Hassan, Li Huang, Benjamin Mayer, Helmut D Hummler
BACKGROUND: There are few data available on the interaction of inflations, chest compressions (CC), and delivery of tidal volumes in newborn infants undergoing resuscitation in the presence of endotracheal tube (ET) leaks. OBJECTIVES: To determine the effects of different respiratory support strategies along with CC on changes in tidal volume and ET leaks in hypoxic newborn piglets with cardiac arrest. METHODS: Asphyxiated newborn piglets, intubated with weight-adapted uncuffed ET, were randomized into three groups and resuscitated according to ILCOR 2010 guidelines: (1) T-piece resuscitator (TPR) group = peak inspiratory pressure (PIP)/positive end-expiratory pressure (PEEP) 25/5 cm H2O, rate 30/min, inflations interposed between CC (3:1 ratio); (2) self- inflating bag (SIB) group = PIP 25 cm H2O without PEEP, rate 30/min, inflations interposed between CC (3:1 ratio), and (3) ventilator group = PIP/PEEP of 25/5 cm H2O, rate 30/min...
September 20, 2016: Neonatology
Brittney Williams, John McNeil, Andrew Crabbe, Kenichi A Tanaka
Achieving hemostasis after complex cardiovascular and transplant surgical procedures is one of the greatest challenges anesthesiologists face. Preoperative coagulation disturbances due to underlying disease or antithrombotic therapy are common, and they are worsened by intraoperative blood loss and fluid replacement. The coagulation reactions in vivo are incredibly complex interactions among blood cells, proteins, and vasculature, standing in sharp contrast to rather simple treatment options including transfusion of platelets, plasma, and cryoprecipitate...
August 27, 2016: Transfusion Medicine Reviews
Fatima I Lunze, Babar S Hasan, Kimberlee Gauvreau, David W Brown, Steven D Colan, Doff B McElhinney
BACKGROUND: Relief of postoperative right ventricular outflow tract (RVOT) obstruction with transcatheter pulmonary valve replacement (TPVR) results in functional improvement in the short term which we investigated at baseline (BL), early follow-up (FU), and midterm FU after TPVR. METHODS: Echocardiography and cardiopulmonary exercise testing were performed at BL and at early (median 6 months) and midterm FU (median 2.5years) after TPVR. RESULTS: Patients with RVOT obstruction (n=22, median age 17years) were studied...
September 2016: American Heart Journal
Young Sun Ro, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Ki Ok Ahn, Do Kyun Kim, Young Ho Kwak
OBJECTIVE: We studied the effect of a dispatcher-assisted cardiopulmonary resuscitation (CPR) program on paediatric out-of-hospital cardiac arrest (OHCA) outcomes by age groups. METHODS: All emergency medical services (EMS)-treated paediatric OHCAs in Korea were enrolled between 2012 and 2014, excluding cases witnessed by EMS providers and those with unknown outcomes. The cases were divided into three groups: bystander CPR with dispatcher assistance, bystander CPR without dispatcher assistance, and no-bystander CPR...
August 31, 2016: Resuscitation
Deise M Pacheco, Viviane D Silveira, Alex Thomaz, Ramiro B Nunes, Viviane R Elsner, Pedro Dal Lago
OBJECTIVE: To analyze respiratory mechanics and hemodynamic alterations in an experimental model of chronic heart failure (CHF) following myocardial infarction. METHOD: Twenty-seven male adult Wistar rats were randomized to CHF group (n=12) or Sham group (n=15). Ten weeks after coronary ligation or sham surgery, the animals were anesthetized and submitted to respiratory mechanics and hemodynamic measurements. Pulmonary edema as well as cardiac remodeling were measured...
July 2016: Brazilian Journal of Physical Therapy
Paulo Roberto L Prates, Judson B Williams, Rajendra H Mehta, Susanna R Stevens, Laine Thomas, Peter K Smith, L Kristin Newby, Renato A K Kalil, John H Alexander, Renato D Lopes
INTRODUCTION: Antiplatelet therapy after coronary artery bypass graft (CABG) has been used. Little is known about the predictors and efficacy of clopidogrel in this scenario. OBJECTIVE: Identify predictors of clopidogrel following CABG. METHODS: We evaluated 5404 patients who underwent CABG between 2000 and 2009 at Duke University Medical Center. We excluded patients undergoing concomitant valve surgery, those who had postoperative bleeding or death before discharge...
April 2016: Brazilian Journal of Cardiovascular Surgery
Yuko Kato, Shinya Suzuki, Tokuhisa Uejima, Hiroaki Semba, Hiroto Kano, Shunsuke Matsuno, Hideaki Takai, Takayuki Otsuka, Yuji Oikawa, Kazuyuki Nagashima, Hajime Kirigaya, Koichi Sagara, Takashi Kunihara, Junji Yajima, Hitoshi Sawada, Tadanori Aizawa, Takeshi Yamashita
This study aimed to examine the discrete impacts of peak oxygen consumption (VO2) and brain natriuretic peptide (BNP) levels on future heart failure (HF) events in sinus rhythm (SR) and atrial fibrillation (AF). A total of 1447 patients who underwent symptom-limited cardiopulmonary exercise testing and whose BNP values were determined simultaneously were analysed (SR, N = 1151 and AF, N = 296). HF events were defined as HF hospitalization or HF death. Over a mean follow-up period of 1472 days, 140 HF events were observed...
August 22, 2016: Heart and Vessels
Myriam Ermonval, Florence Baychelier, Noël Tordo
Hantaviruses, like other members of the Bunyaviridae family, are emerging viruses that are able to cause hemorrhagic fevers. Occasional transmission to humans is due to inhalation of contaminated aerosolized excreta from infected rodents. Hantaviruses are asymptomatic in their rodent or insectivore natural hosts with which they have co-evolved for millions of years. In contrast, hantaviruses cause different pathologies in humans with varying mortality rates, depending on the hantavirus species and its geographic origin...
2016: Viruses
Tara L Mahramus, Daleen A Penoyer, Eugene M E Waterval, Mary L Sole, Eileen M Bowe
PURPOSE/AIM: Teamwork during cardiopulmonary arrest events is important for resuscitation. Teamwork improvement programs are usually lengthy. This study assessed the effectiveness of a 2-hour teamwork training program. DESIGN: A prospective, pretest/posttest, quasi-experimental design assessed the teamwork training program targeted to resident physicians, nurses, and respiratory therapists. METHODS: Participants took part in a simulated cardiac arrest...
September 2016: Clinical Nurse Specialist CNS
Ronald A Bronicki, Daniel J Penny, Nick G Anas, Bradley Fuhrman
OBJECTIVES: The objectives of this review are to discuss the mechanisms by which respiration impacts cardiovascular function and vice versa, with an emphasis on the impact of these interactions in pediatric cardiac critical care. DATA SOURCE: A search of MEDLINE was conducted using PubMed. CONCLUSIONS: In the presence of underlying cardiac and respiratory disease, the interplay between these two systems is significant and plays a pivotal role in the pathophysiology of acute and chronic phases of a wide spectrum of diseases...
August 2016: Pediatric Critical Care Medicine
Ronald A Bronicki, Mary Taylor, Harris Baden
OBJECTIVES: The objectives of this review are to discuss the clinical assessment, pathophysiology, and management of shock, with an emphasis on circulatory physiology, cardiopulmonary interactions, and pharmacologic strategies to optimize systemic oxygen delivery. These principles will then be applied to the clinical syndromes of heart failure and cardiogenic shock that are seen in children. DATA SOURCE: MEDLINE, PubMed. CONCLUSION: An understanding of essential circulatory physiology and the pathophysiology of shock are necessary for managing patients at risk for or in a state of shock...
August 2016: Pediatric Critical Care Medicine
Esa Soppi, Ansa Iivanainen, Leila Sikanen, Elina Jouppila-Kupiainen
The relationship between the efficacy of resuscitation and the mattresses and backboards used in acute care units, has been studied previously. However, few reports focus on the relative efficacy of resuscitation when using mattresses with different modes of function. This study examines the performance of different support surfaces during experimental cardiopulmonary resuscitation (CPR). The surfaces included a hard surface, a higher specification foam mattress, a dynamic, alternating pressure mattress, and a dynamic, reactive minimum pressure air mattress system...
February 2016: Heliyon
Milo Engoren, Russell R Brown, Anna Dubovoy
PURPOSE: Acute anemia is associated with both cerebral dysfunction and acute kidney injury and is often treated with red blood cell transfusion. We sought to determine if blood transfusion changed the cerebral oximetry entropy, a measure of the complexity or irregularity of the oximetry values, and if this change was associated with subsequent acute kidney injury. METHODS: This was a retrospective, case-control study of patients undergoing cardiac surgery with cardiopulmonary bypass at a tertiary care hospital, comparing those who received a red blood cell transfusion to those who did not...
July 20, 2016: Perfusion
A A Gimbel, E Flores, A Koo, G García-Cardeña, J T Borenstein
Blood oxygenators provide crucial life support for patients suffering from respiratory failure, but their use is severely limited by the complex nature of the blood circuit and by complications including bleeding and clotting. We have fabricated and tested a multilayer microfluidic blood oxygenation prototype designed to have a lower blood prime volume and improved blood circulation relative to current hollow fiber cartridge oxygenators. Here we address processes for scaling the device toward clinically relevant oxygen transfer rates while maintaining a low prime volume of blood in the device, which is required for clinical applications in cardiopulmonary support and ultimately for chronic use...
August 16, 2016: Lab on a Chip
Marc O Fischer, Pierre G Guinot, Matthieu Biais, Yazine Mahjoub, Jihad Mallat, Emmanuel Lorne
Dynamic indices (based on cardiopulmonary interactions in mechanically ventilated patients in sinus rhythm) have been developed as simple tools for predicting fluid responsiveness in the absence of cardiac output monitoring. Although the earliest dynamic indices relied on the invasive measurement of pulse pressure variations or stroke volume variations, the most recently developed indices are based on non-invasive photoplethysmography. However, a number of confounding factors have been found to decrease the clinical value of these indices...
July 12, 2016: Minerva Anestesiologica
Matilde Winther-Jensen, Jesper Kjaergaard, Niklas Nielsen, Michael Kuiper, Hans Friberg, Helle Søholm, Jakob Hartvig Thomsen, Martin Frydland, Christian Hassager
OBJECTIVES: We investigated whether comorbidity burden of comatose survivors of out-of-hospital cardiac arrest (OHCA) affects outcome and if comorbidity modifies the effect of target temperature management (TTM) on final outcome. DESIGN: The TTM trial randomized 939 patients to 24 hours of TTM at either 33°C or 36°C with no difference regarding mortality and neurological outcome. This post-hoc study of the TTM-trial formed a modified Comorbidity Index (mCI), based on available comorbidities from the Charlson Comorbidity index...
July 7, 2016: Scandinavian Cardiovascular Journal: SCJ
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