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Intrathoracic pressure

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https://www.readbyqxmd.com/read/29892226/blood-shift-during-cough-negligible-or-significant
#1
Antonella LoMauro, Andrea Aliverti
Rationale: It was reported how forceful rhythmic coughing can provide effective blood flow during ventricular fibrillation without direct chest compression. This mechanism of cough-assisted cardiopulmonary resuscitation constitutes a form of "cardiac massage" secondary to the intrathoracic and intra-abdominal pressure changes during cough. We have previously shown that significant blood shifts (BSs) occurs from the thorax to the extremities during expulsive maneuvers and that abdominal pressure controls the outflow of blood from the splanchnic vasculature...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29885374/effects-of-intrathoracic-pressure-inhalation-time-and-breath-hold-time-on-lung-diffusing-capacity
#2
Caitlin C Jorgenson, Kirsten E Coffman, Bruce D Johnson
The single breath hold maneuver for measuring lung diffusing capacity for carbon monoxide (DLCO) and nitric oxide (DLNO) incorporates multiple sources of variability. This study examined how changes in intrathoracic pressure, inhalation time, and breath hold time affect DLCO, DLNO, alveolar-capillary membrane conductance (DmCO) and pulmonary capillary blood volume (Vc) at rest and during submaximal exercise. Thirteen healthy subjects (mean ± SD; age = 26 ± 3y) performed duplicate tests at rest and during submaximal exercise...
June 6, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29884971/boerhaave-syndrome-due-to-hypopharyngeal-stenosis-associated-with-chemoradiotherapy-for-hypopharyngeal-cancer-a-case-report
#3
Hideharu Tanaka, Norihisa Uemura, Daisuke Nishikawa, Keisuke Oguri, Tetsuya Abe, Eiji Higaki, Takahiro Hosoi, Byonggu An, Yasuhisa Hasegawa, Yasuhiro Shimizu
BACKGROUND: Spontaneous esophageal rupture, also known as Boerhaave syndrome, is a very serious life-threatening benign disease of the gastrointestinal tract. It is typically caused by vomiting after heavy eating and drinking. However, in our patient, because of a combination of hypopharyngeal cancer with stenosis and chemoradiotherapy (CRT), which caused chemotherapy-induced vomiting, radiotherapy-induced edema, relaxation failure, and delayed reflexes; resistance to the release of increased pressure due to vomiting was exacerbated, thus leading to Boerhaave syndrome...
June 8, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29743121/high-frequency-oscillatory-ventilation-guided-by-transpulmonary-pressure-in-acute-respiratory-syndrome-an-experimental-study-in-pigs
#4
Philipp Klapsing, Onnen Moerer, Christoph Wende, Peter Herrmann, Michael Quintel, Annalen Bleckmann, Jan Florian Heuer
BACKGROUND: Recent clinical studies have not shown an overall benefit of high-frequency oscillatory ventilation (HFOV), possibly due to injurious or non-individualized HFOV settings. We compared conventional HFOV (HFOVcon ) settings with HFOV settings based on mean transpulmonary pressures (PLmean ) in an animal model of experimental acute respiratory distress syndrome (ARDS). METHODS: ARDS was induced in eight pigs by intrabronchial installation of hydrochloric acid (0...
May 9, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29724392/the-role-of-high-resolution-oesophageal-manometry-in-occult-respiratory-symptoms
#5
Jennifer M Burke, Warren Jackson, Alyn H Morice
PURPOSE: Cough Hypersensitivity Syndrome is the urge to cough following minimal stimulation, but its mechanism and method of provocation remain unexplained. 121 patients (44 males, 77 females; age range 18-81 years) were evaluated. PROCEDURES: High resolution manometry was performed on consecutive patients presenting with unexplained respiratory symptoms (Respiratory Group 61). Data were compared with matched controls, i.e. dyspepsia without respiratory symptoms (Dyspepsia Group 60)...
May 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29721546/surgical-approach-to-the-intrathoracic-goiter
#6
Michael Vaiman, Inessa Bekerman, Jabarin Basel, Michael Peer
Objective: In a retrospective study, the authors analyzed the surgical approach to the intrathoracic goiter to avoid sternotomy or thoracotomy. Methods: We selected 70 intrathoracic cases of multinodular goiter out of 988 cases of thyroidectomy and compared them with cervical goiter cases. Surgical technique, results, and postsurgical complications were assessed. Results: The analyzed cases presented the retrosternal goiter (n = 53; 75...
April 2018: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29703561/tension-hydrothorax-emergency-decompression-of-a-pleural-cause-of-cardiac-tamponade
#7
E E Vinck, J C Garzón, T Peterson, R Villarreal, L Cabrera, L Van den Eijnden
INTRODUCTION: A tension hydrothorax is defined as a massive pleural effusion presenting with hemodynamic abnormalities secondary to mediastinal compression. In these patients pleural volume increases intrathoracic pressure to the point of compromising diastolic filling and cardiac output simulating a cardiac tamponade physiology. This is an uncommon yet potentially fatal medical emergency that if left untreated may progress to cardiac arrest. Early detection and rapid intervention of these patients prevents cardiorespiratory collapse...
April 21, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29642696/periprocedural-and-perioperatory-management-of-patients-with-tricuspid-valve-disease
#8
Fabrizio Monaco, Ambra L DI Prima, Monica DE Luca, Gaia Barucco, Alberto Zangrillo
Tricuspid regurgitation (TR) is a common valvular lesion which may affect morbidity and mortality. It can be related to an intrinsic abnormality of the tricuspid valve leaflets (organic) or secondary to annular dilatation (functional). Often organic and functional TR coexist in the same patient. A long standing TR is associated with ascites, congestive hepatopathy, peripheral edema, renal failure, and abdominal fullness which significantly affect the outcome. In particular, the perioperative course may be complicated due to both the presence of comorbidities and the development of a severe postoperative right ventricle (RV) dysfunction...
April 11, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29617746/thoracoabdominal-pressure-gradient-and-gastroesophageal-reflux-insights-from-lung-transplant-candidates
#9
T Masuda, S K Mittal, B Kovacs, M Smith, R Walia, J Huang, R M Bremner
Advanced lung disease is associated with gastroesophageal reflux disease (GERD). The thoracoabdominal pressure gradient (TAPG) facilitates gastroesophageal reflux, but the effects of TAPG on gastroesophageal reflux in patients with pulmonary disease have not been well defined. Patients diagnosed with end-stage lung disease are expected to have the most extreme derangement in respiratory mechanics. The aim of this study is to explore the relationship between TAPG and reflux in lung transplant (LTx) candidates...
March 31, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29605197/airway-obstruction-and-lung-hyperinflation-in-copd-are-linked-to-an-impaired-left-ventricular-diastolic-filling
#10
Peter Alter, Henrik Watz, Kathrin Kahnert, Michael Pfeifer, Winfried J Randerath, Stefan Andreas, Benjamin Waschki, Björn E Kleibrink, Tobias Welte, Robert Bals, Holger Schulz, Frank Biertz, David Young, Claus F Vogelmeier, Rudolf A Jörres
AIMS: Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases are thought to be linked through various factors. We aimed to assess the relationship between airway obstruction, lung hyperinflation and diastolic filling in COPD. METHODS: The study population was a subset of the COPD cohort COSYCONET. Echocardiographic parameters included the left atrial diameter (LA), early (E) and late (A) transmitral flow, mitral annulus velocity (e'), E wave deceleration time (E[dt]), and isovolumic relaxation time (IVRT)...
April 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29559613/clavicle-kirschner-wire-migration-into-left-lung-a-case-report
#11
Érica Lofrano Reghine, Caio César Inaco Cirino, André Amate Neto, Fabiana Rossi Varallo, Paulo Roberto Barbosa Évora, Tales Rubens de Nadai
BACKGROUND Kirschner wires are often used to perform osteosynthesis. Migration through tissue of these wires is a rare but well-known occurrence. CASE REPORT A 65-year-old female presented with light intensity pain complaints in the upper left chest area; personal history included left clavicle fracture 20 years ago that was treated surgically with fixation using a K-wire. Chest radiography showed the presence of metallic foreign body in the left pulmonary apex. An exploratory axillary thoracotomy was performed, and the foreign body was extracted by a pneumotomy...
March 21, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29541763/associations-of-obstructive-sleep-apnea-with-atrial-fibrillation-and-continuous-positive-airway-pressure-treatment-a-review
#12
Dominik Linz, R Doug McEvoy, Martin R Cowie, Virend K Somers, Stanley Nattel, Patrick Lévy, Jonathan M Kalman, Prashanthan Sanders
Importance: Obstructive sleep apnea (OSA) is the most common clinically significant breathing abnormality during sleep. It is highly prevalent among patients with atrial fibrillation (AF), and it promotes arrhythmogenesis and impairs treatment efficacy. Observations: The prevalence of OSA ranges from 3% to 49% in population-based studies and from 21% to 74% in patients with AF. Diagnosis and treatment of OSA in patients with AF requires a close interdisciplinary collaboration between electrophysiologists, cardiologists, and sleep specialists...
March 14, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29536209/right-trisectionectomy-and-caval-reconstruction-with-peritoneal-patch-under-short-total-vascular-exclusion-for-hepatocellular-carcinoma-with-tumoral-thrombus-in-suprahepatic-vena-cava
#13
Safi Dokmak, Béatrice Aussilhou, Tiziana Marchese, Nizar Kardoun, François Cauchy, Anne Sophie Schneck, Olivier Soubrane
BACKGROUND: Hepatocellular carcinoma (HCC) can be complicated by major vascular invasion, and resection can be beneficial in some patients.1 Some of these patients are traditionally operated under total vascular exclusion (TVE), refrigeration, extracorporeal circulatory bypass, and cardiac surgery, with high morbidity and mortality.2 However, HCC thrombi are not adherent to the venous wall, and with advances in surgical techniques, resection can be simplified and performed during short-duration TVE alone...
May 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29519280/-variability-of-peripheral-arterial-peak-velocity-predicts-fluid-responsiveness-in-patients-with-septic-shock
#14
Nianfang Lu, Li Jiang, Bo Zhu, Wenyong Han, Yingqi Zhao, Yuntao Shi, Fashuang Guo, Xiuming Xi
OBJECTIVE: To explore the accuracy of fluid responsiveness assessment by variability of peripheral arterial peak velocity and variability of inferior vena cava diameter (ΔIVC) in patients with septic shock. METHODS: A prospective study was conducted. The patients with septic shock undergoing mechanical ventilation (MV) admitted to intensive care unit (ICU) of Beijing Electric Power Hospital from January 2016 to December 2017 were enrolled. According to sepsis bundles of septic shock, volume expansion (VE) was conducted...
March 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29507790/hyperthermic-intrathoracic-chemotherapy-after-extended-pleurectomy-and-decortication-for-malignant-pleura-mesothelioma-an-observational-study-on-outcome-and-microcirculatory-changes
#15
Luca Luzzi, Federico Franchi, Annarita Dapoto, Marco Ghisalberti, Roberto Corzani, Daniele Marrelli, Luca Marchetti, Piero Paladini, Sabino Scolletta
Background: In the treatment of malignant pleural mesothelioma the Hyperthermic Intra THOracic Chemotherapy (HITHOC) can improve the efficacy of pleurectomy and decortication with a local cytotoxic effect. However its biological impact in patient's hemodynamic and microcirculatory changes were rarely investigated. Aim of this study is to describe our experience with HITHOC after pleurectomy and decortication evaluating the role of sublingual video-microscopy in assessing the microcirculatory changes in the perioperative period...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29501267/paradoxical-cerebral-embolism-after-gastrointestinal-endoscopy-in-a-patient-with-crohn-s-disease
#16
Hajime Ikenouchi, Naoto Sugeno, Takaaki Nakamura, Junpei Kobayashi, Ryuji Oshima, Hiroshi Kuroda, Masashi Aoki
Development of paradoxical cerebral embolism requires both unstable venous thrombosis and right-to-left shunt (RLS). Gastrointestinal endoscopy (GE) has the potential to affect intrathoracic and abdominal venous thrombi and to enhance RLS because the procedure alters intrathoracic and abdominal pressure. We describe a patient with Crohn's disease who developed paradoxical cerebral embolism after GE. Both an unstable venous thrombus in the superior vena cava and RLS through patent foramen ovale were thought to be responsible for the stroke...
February 28, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29500508/-single-port-vats-assisted-internal-fixation-of-serial-rib-fractures
#17
REVIEW
M T Berninger, F Kellermann, A Woltmann, V Bühren, M Lang
This article describes the operative stabilization of a flail chest due to traumatic serial rib fractures with extensive chest wall deformation and respiratory insufficiency. Initial conservative treatment including systemic and regional pain management and non-invasive positive pressure ventilation did not improve the pain or ventilation. Therefore, a single-port video-assisted thoracoscopic surgery (VATS) assisted internal fixation of the ribs was performed. The thoracoscopy enabled easy repositioning of the ribs and additionally an estimation of intrathoracic injuries...
April 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29494288/respiratory-pump-maintains-cardiac-stroke-volume-during-hypovolemia-in-young-healthy-volunteers
#18
Maria Skytioti, Signe Søvik, Maja Elstad
Spontaneous breathing has beneficial effects on the circulation, since negative intrathoracic pressure enhances venous return and increases cardiac stroke volume. We quantified the contribution of the respiratory pump to preserve stroke volume during hypovolemia in awake, young, healthy subjects. Non-invasive stroke volume, cardiac output, heart rate and mean arterial pressure (Finometer) were recorded in 31 volunteers (19 females), 19-30 years old, during normovolemia and hypovolemia (approximating 450-500 ml reduction in central blood volume) induced by lower body negative pressure...
March 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29445529/cardiorespiratory-interaction-with-continuous-positive-airway-pressure
#19
REVIEW
Martino F Pengo, Sara Bonafini, Cristiano Fava, Joerg Steier
The treatment of choice for obstructive sleep apnoea (OSA) is continuous positive airway pressure therapy (CPAP). Since its introduction in clinical practice, CPAP has been used in various clinical conditions with variable and heterogeneous outcomes. In addition to the well-known effects on the upper airway CPAP impacts on intrathoracic pressures, haemodynamics and blood pressure (BP) control. However, short- and long-term effects of CPAP therapy depend on multiple variables which include symptoms, underlying condition, pressure used, treatment acceptance, compliance and usage...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29445526/intermittent-hypoxia-cardiovascular-disease-and-obstructive-sleep-apnoea
#20
REVIEW
Chris D Turnbull
Obstructive sleep apnoea (OSA) is a common disorder and is associated with cardiovascular disease. Continuous positive airway pressure (CPAP), whilst reducing blood pressure, has not been shown to reduce cardiovascular events when used as a treatment solely for this purpose in patients with previous cardiovascular disease. Developing a better understanding of the mechanisms underlying cardiovascular disease in OSA is important to develop new treatments. Potential causative mechanisms for cardiovascular disease in OSA include arousal induced sympathetic activation, large intrathoracic pressure swings leading to shear stress on the heart and great vessels, and intermittent hypoxia (IH)...
January 2018: Journal of Thoracic Disease
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