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Intrathoracic pressure

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https://www.readbyqxmd.com/read/28530203/eit-based-pulsatile-impedance-monitoring-during-spontaneous-breathing-in-cystic-fibrosis
#1
Sabine Krueger-Ziolek, Benjamin Schullcke, Bo Gong, Ullrich Müller-Lisse, Knut Moeller
OBJECTIVE: Evaluating the lung function in patients with obstructive lung disease by electrical impedance tomography (EIT) usually requires breathing maneuvers containing deep inspirations and forced expirations. Since these maneuvers strongly depend on the patient's co-operation and health status, normal tidal breathing was investigated in an attempt to develop continuous maneuver-free measurements. APPROACH: Ventilation related and pulsatile impedance changes were systematically analyzed during normal tidal breathing in 12 cystic fibrosis (CF) patients and 12 lung-healthy controls (HL)...
June 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28497774/evaluation-of-respiratory-and-postural-induced-changes-on-the-ballistocardiogram-signal-by-time-warping-averaging
#2
Alba Martin-Yebra, Federica Landreani, Claudia Casellato, Esteban Enrique Pavan, Pierre-François Migeotte, Carlo Frigo, Juan Martinez Cortes, Enrico Caiani
OBJECTIVE: The aim of this work was to evaluate the potential changes in the ballistocardiogram (BCG) signal induced by different respiratory patterns and posture, by using the dynamic time warping (DTW) technique. APPROACH: BCG signals were recorded in a group of 20 healthy volunteers, simultaneously to the ECG. Two recordings, one in supine (SUP) and one in standing (ST) position, including spontaneous breathing, two 1-minute apneas (at full and empty-lungs, respectively) and 30s of Valsalva, were analyzed...
May 12, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28458532/relationship-between-lung-function-and-grip-strength-in-older-hospitalized-patients-a-pilot-study
#3
Sarah J Holmes, Stephen C Allen, Helen C Roberts
OBJECTIVE: Older people with reduced respiratory muscle strength may be misclassified as having COPD on the basis of spirometric results. We aimed to evaluate the relationship between lung function and grip strength in older hospitalized patients without known airways disease. METHODS: Patients in acute medical wards were recruited who were aged ≥70 years; no history, symptoms, or signs of respiratory disease; Mini Mental State Examination ≥24; willing and able to consent to participate; and able to perform hand grip and forced spirometry...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28433043/-complete-minimally-invasive-ivor-lewis-esophageal-resection
#4
P Zonča, M Peteja, V Richter, P Vávra, P Ostruszka, D Worek, J Stigler
INTRODUCTION: Minimally invasive esophagectomy is becoming a standard procedure in the treatment of esophageal cancer. We would like to present our experience with Ivor Lewis esophagectomy completed by minimally invasive technique. METHODS: The primary aim of the study was to analyse potential technical difficulties and intraoperative complications of thoracolaparoscopic Ivor Lewis esophagectomy with intrathoracic anastomosis. A secondary aim of the study was to evaluate postoperative complications according to the Clavien-Dindo classification...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28363617/exploring-the-best-predictors-of-fluid-responsiveness-in-patients-with-septic-shock
#5
Nianfang Lu, Xiuming Xi, Li Jiang, Degang Yang, Kai Yin
OBJECTIVE: To evaluate respiratory variations in carotid and brachial peak velocity and other hemodynamic parameters to predict responsiveness to fluid challenge. METHODS: A prospective observational study was performed on mechanically ventilated patients with septic shock. Outcomes included the measurements of central venous pressure, intrathoracic blood volume index, stroke volume variation (SVV), pleth variability index(PVI), and ultrasound assessments of respiratory variations in inferior vena cava diameter (ΔIVC), carotid Doppler peak velocity (ΔCDPV), and brachial artery peak velocity (ΔVpeak brach)...
March 22, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28348943/correlation-of-ivc-diameter-and-collapsibility-index-with-central-venous-pressure-in-the-assessment-of-intravascular-volume-in-critically-ill-patients
#6
Abid Ilyas, Wasib Ishtiaq, Salman Assad, Haider Ghazanfar, Salman Mansoor, Muhammad Haris, Aayesha Qadeer, Aftab Akhtar
OBJECTIVE: The objective of our study is to assess the correlation between inferior vena cava (IVC) diameters, central venous pressure (CVP) and the IVC collapsibility index for estimating the volume status in critically ill patients. METHODS: This cross-sectional study used the convenient sampling of 100 adult medical intensive care unit (ICU) patients for a period of three months. Patients ≥ 18 years of age with an intrathoracic central venous catheter terminating in the distal superior vena cava connected to the transducer to produce a CVP waveform were included in the study...
February 12, 2017: Curēus
https://www.readbyqxmd.com/read/28346232/the-future-is-now-neuroprotection-during-cardiopulmonary-resuscitation
#7
Johanna C Moore, Jason A Bartos, Timothy R Matsuura, Demetris Yannopoulos
PURPOSE OF REVIEW: Survival with favorable neurological function after cardiac arrest remains low. The purpose of this review is to identify recent advances that focus on neuroprotection during cardiopulmonary resuscitation (CPR). RECENT FINDINGS: Multiple strategies have been shown to enhance neuroprotection during CPR. Brain perfusion during CPR is increased with therapies such as active compression decompression CPR and intrathoracic pressure regulation that improve cardiac preload and decrease intracranial pressure...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28338504/ventilation-with-high-or-low-tidal-volume-with-peep-does-not-influence-lung-function-after-spinal-surgery-in-prone-position-a-randomized-controlled-trial
#8
Sarah Soh, Jae-Kwang Shim, Yoon Ha, Young-Sam Kim, Hyelin Lee, Young-Lan Kwak
BACKGROUND: Spinal surgery in the prone position is accompanied by increased intrathoracic pressure and decreased respiratory compliance. This study investigated whether intraoperative lung protective mechanical ventilation improved lung function evaluated with pulmonary function tests in patients at risk of postoperative pulmonary complications (PPCs) after major spinal surgery in the prone position. METHODS: Seventy-eight patients at potential risk of PPCs were randomly assigned to the protective group (tidal volume; 6 mL/kg predicted body weight, 6 cm H2O positive end-expiratory pressure with recruitment maneuvers) or the conventional group (10 mL/kg predicted body weight, no positive end-expiratory pressure)...
March 23, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28329460/model-based-comparison-of-the-normal-and-fontan-circulatory-systems-part-iii
#9
COMPARATIVE STUDY
Raymond L Watrous, Alvin J Chin
BACKGROUND: For patients with the Fontan circulatory arrangement, angiotensin-converting enzyme inhibition, guanylate cyclase activation, phosphodiesterase 5 inhibition, and endothelin receptor antagonism have so far resulted in little or no improvement in [Formula: see text] or peak cardiac index (CI), suggesting that our understanding of the factors that most impact the exercise hemodynamics is incomplete. METHODS: To facilitate comparisons with clinical reports of the exercise performance of preadolescent Fontan patients, we rescaled our previously reported computational models of a two-year-old normal child and similarly aged Fontan patient, extended our Fontan model to capture the nonlinear relationship between flow and resistance quantified from previous computational fluid dynamic analyses of the total cavopulmonary connection (TCPC), and added respiration as well as skeletal muscle contraction...
March 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28294285/evaluation-of-a-flexible-bronchoscope-prototype-designed-for-bronchoscopy-during-mechanical-ventilation-a-proof-of-concept-study
#10
M-A Nay, A Auvet, J Mankikian, V Herve, P-F Dequin, A Guillon
Bronchoscopy during mechanical ventilation of patients' lungs significantly affects ventilation because of partial obstruction of the tracheal tube, and may thus be omitted in the most severely ill patients. It has not previously been possible to reduce the external diameter of the bronchoscope without reducing the diameter of the suction channel, thus reducing the suctioning capacity of the device. We believed that a better-designed bronchoscope could improve the safety of bronchoscopy in patients whose lungs were ventilated...
March 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28288537/exit-procedure-for-fetal-mediastinal-teratoma-with-large-pericardial-effusion-a-case-report-with-review-of-literature
#11
Arpit Agarwal, Eliot Rosenkranz, Salih Yasin, Sethuraman Swaminathan
BACKGROUND: Large mediastinal teratomas in the fetus are rare and can present with direct compression of intrathoracic structures as well as pericardial and pleural effusions. Mediastinal fetal teratoma may be detected as a mass in the chest during a routine prenatal ultrasound. Because of the pressure on mediastinal structures it may result in non-immune fetal hydrops (NIFH) and polyhydramnios. The development of hydrops may lead to fetal demise. Timely obstetric and/or surgical intervention is important to improve survival in this patient population...
April 2, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28261153/non-invasive-respiratory-impedance-enhances-cerebral-perfusion-in-healthy-adults
#12
Christopher G Favilla, Ashwin B Parthasarathy, John A Detre, Arjun G Yodh, Michael T Mullen, Scott E Kasner, Kimberly Gannon, Steven R Messé
Optimization of cerebral blood flow (CBF) is the cornerstone of clinical management in a number of neurologic diseases, most notably ischemic stroke. Intrathoracic pressure influences cardiac output and has the potential to impact CBF. Here, we aim to quantify cerebral hemodynamic changes in response to increased respiratory impedance (RI) using a non-invasive respiratory device. We measured cerebral perfusion under varying levels of RI (6 cm H2O, 9 cm H2O, and 12 cm H2O) in 20 healthy volunteers. Simultaneous measurements of microvascular CBF and middle cerebral artery mean flow velocity (MFV), respectively, were performed with optical diffuse correlation spectroscopy and transcranial Doppler ultrasound...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28250153/microinjection-of-kynurenic-acid-in-the-rostral-nucleus-of-the-tractus-solitarius-disrupts-spatiotemporal-aspects-of-mechanically-induced-tracheobronchial-cough
#13
Ivan Poliacek, Teresa Pitts, Melanie J Rose, Paul W Davenport, Michal Simera, Marcel Veternik, Zuzana Kotmanova, Donald C Bolser
The importance of neurons in the solitary tract nucleus (NTS) in the production of coughing was tested by microinjections of the non-specific glutamate receptor antagonist kynurenic acid (kyn; 100 mM in artificial cerebrospinal fluid) in 15 adult spontaneously breathing anesthetized cats. Repetitive coughing was elicited by mechanical stimulation of the intrathoracic airway. Electromyograms (EMG) were recorded from inspiratory parasternal and expiratory transversus abdominis muscles (ABD). Bilateral microinjections of kyn into the NTS rostral to obex (55±4 nl total in two locations; n=6 or 110±4 nl total in four locations; n=5), primarily the ventrolateral subnucleus, reduced cough number and expiratory cough efforts (amplitudes of ABD EMG and maxima of esophageal pressure) compared to control...
March 1, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28213202/determinants-of-cough-effectiveness-in-patients-with-respiratory-muscle-weakness
#14
Franco Laghi, Veeranna Maddipati, Timothy Schnell, W Edwin Langbein, Martin J Tobin
Experiments were undertaken to mechanistically define expiratory-muscle contribution to effectiveness of cough while controlling glottic movement. We hypothesized that electrical abdominal-muscle stimulation in patients with respiratory-muscle weakness produces effective coughs only when glottic closure accompanies coughs. In ten spinal-cord-injury patients, esophago-gastric pressure and airflow were recorded during solicited-coughs, coughs augmented by abdominal-muscle stimulation, and passive open-glottis exhalations...
June 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28198458/a-simple-method-for-noninvasive-quantification-of-pressure-gradient-across-the-pulmonary-valve
#15
Xueying Zhou, Changyang Xing, Yang Feng, Yunyou Duan, Qiangsun Zheng, Zuojun Wang, Jie Liu, Tiesheng Cao, Lijun Yuan
Pressure gradient across the pulmonary valve (PVPG) is an important hemodynamic variable used in the management of patients with cardiovascular and pulmonary disease. However, a reliable noninvasive method is unavailable. We hypothesized that a progressive Muller maneuver would elicit the pulmonary valve premature opening (PVPO) in diastole and that this event would be detectable by Doppler echocardiography. The intrathoracic pressure (ITP) decrease during this maneuver equals PVPG, which may be assessed with a custom airway pressure measurement device...
February 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28190583/fibrinogen-is-an-independent-predictor-of-mortality-in-major-trauma-patients-a-five-year-statewide-cohort-study
#16
Zoe K McQuilten, Erica M Wood, Michael Bailey, Peter A Cameron, David J Cooper
INTRODUCTION: Fibrinogen may be reduced following traumatic injury due to loss from haemorrhage, increased consumption and reduced synthesis. In the absence of clinical trials, guidelines for fibrinogen replacement are based on expert opinion and vary internationally. We aimed to determine prevalence and predictors of low fibrinogen on admission in major trauma patients and investigate association of fibrinogen levels with patient outcomes. PATIENTS AND METHODS: Data on all major trauma patients (January 2007-July 2011) identified through a prospective statewide trauma registry in Victoria, Australia were linked with laboratory and transfusion data...
November 21, 2016: Injury
https://www.readbyqxmd.com/read/28184275/postoperative-negative-pressure-pulmonary-edema-following-repetitive-laryngospasm-even-after-reversal-of-neuromuscular-blockade-by-sugammadex-a-case-report
#17
Ji Hyeon Lee, Jae Ho Lee, Min Hyun Lee, Hyun Oh Cho, Soon Eun Park
Laryngospasm, an occlusion of the glottis, can occur at any time during anesthesia, and is associated with serious perioperative complications such as hypoxia, hypercabia, aspiration, bronchospasm, arrhythmia, prolonged recovery, cardiac collapse, and eventually catastrophic death. Importantly, postoperative negative pressure pulmonary edema (NPPE) is a rare, but well described life-threatening complication related to acute and chronic upper airway obstruction. Sugammadex well known for affirmatively reducing the postoperative pulmonary complications associated with residual neuromuscular blockade may have an indirect role in triggering the negative intrathoracic pressure by raising a rapid and efficacious respiratory muscle strength in acute upper airway obstruction...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28178996/hemodynamic-effects-of-lung-recruitment-maneuvers-in-acute-respiratory-distress-syndrome
#18
Anup Das, Mainul Haque, Marc Chikhani, Oana Cole, Wenfei Wang, Jonathan G Hardman, Declan G Bates
BACKGROUND: Clinical trials have, so far, failed to establish clear beneficial outcomes of recruitment maneuvers (RMs) on patient mortality in acute respiratory distress syndrome (ARDS), and the effects of RMs on the cardiovascular system remain poorly understood. METHODS: A computational model with highly integrated pulmonary and cardiovascular systems was configured to replicate static and dynamic cardio-pulmonary data from clinical trials. Recruitment maneuvers (RMs) were executed in 23 individual in-silico patients with varying levels of ARDS severity and initial cardiac output...
February 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28161892/osa-and-cardiometabolic-risk-what-s-the-bottom-line
#19
REVIEW
Camilla M Hoyos, Luciano F Drager, Sanjay R Patel
Obstructive sleep apnoea (OSA) is a common condition characterized by repetitive upper airway obstruction during sleep. OSA promotes wide intrathoracic pressure swings, intermittent hypoxia and sleep fragmentation. Growing evidence derived from animal models mimicking the oxygen profile observed in patients with OSA as well as clinical studies support that this important sleep-disordered breathing is associated with increased cardiovascular risk. Although the precise mechanisms are not fully established, it is conceivable that the metabolic deregulation promoted by the components of OSA may have an important causal role in the poor cardiovascular prognosis...
April 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28144067/stenting-of-critical-tracheal-stenosis-with-adjuvant-cardio-pulmonary-bypass
#20
Himanshu Bhardwaj, Ahmed Awab, Houssein A Youness, Brent Brown
Severe and critical central airway obstruction causing impaired ventilation and/or oxygenation can impose tremendous challenges on the interventional pulmonologist. Near total airway obstruction can rapidly evolve into potentially fatal complete airway occlusion during bronchoscopic airway manipulation under moderate sedation; as well as during the induction of the general anesthesia. Although there are currently interventional pulmonary procedures available to tackle the critical airway obstruction in extreme situations, cardio-pulmonary bypass should be considered prior to the intervention to maintain the adequate gas exchange during the procedure...
January 2017: Lung India: Official Organ of Indian Chest Society
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