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https://www.readbyqxmd.com/read/29445529/cardiorespiratory-interaction-with-continuous-positive-airway-pressure
#1
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
#2
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
https://www.readbyqxmd.com/read/29445057/utility-of-fluid-assessment-based-on-the-intrathoracic-impedance-monitoring-in-a-peripartum-woman-with-heart-disease
#3
Atsushi Daimon, Chizuko A Kamiya, Masami Sawada, Yusuke Ueda, Chinami Horiuchi, Takekazu Miyoshi, Mitsuhiro Tsuritani, Naoko Iwanaga, Reiko Neki, Hideo Okamura, Shingo Kusano, Jun Yoshimatsu
Recently, implantable cardioverter-defibrillators (ICD) have become capable of monitoring intrathoracic impedance to detect an increased fluid volume and heart failure. Pregnancy is a well-known cause of an increased body fluid volume; however, it is not clear whether the measurement of intrathoracic impedance by ICD is clinically useful for precisely detecting heart failure in pregnant women. We herein report the case of a 39-year-old woman with an ICD that had been implanted after an event of ventricular fibrillation due to severe aortic regurgitation with a bicuspid aortic valve...
February 14, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29424007/inspiratory-muscle-training-improves-exercise-capacity-with-thoracic-load-carriage
#4
Ren-Jay Shei, Robert F Chapman, Allison H Gruber, Timothy D Mickleborough
Thoracic load carriage (LC) exercise impairs exercise performance compared to unloaded exercise, partially due to impaired respiratory mechanics. We investigated the effects of LC on exercise and diaphragmatic fatigue in a constant-load exercise task; and whether inspiratory muscle training (IMT) improved exercise capacity and diaphragmatic fatigue with LC. Twelve recreationally active males completed three separate running trials to exhaustion (Tlim ) at a fixed speed eliciting 70% of their V˙O2max . The first two trials were completed either unloaded (UL) or while carrying a 10 kg backpack (LC)...
February 2018: Physiological Reports
https://www.readbyqxmd.com/read/29377377/the-hemodynamic-response-to-incremental-increases-in-negative-intrathoracic-pressure-in-healthy-humans
#5
William S Cheyne, Jinelle C Gelinas, Neil D Eves
Negative intrathoracic pressure (nITP) generally augments venous return and left ventricular (LV) stroke volume (LVSV), though large increases in nITP, commonly seen in respiratory disease, attenuate LVSV. Despite this consistent finding, the degree of nITP required to reduce LVSV and the contributions of series and direct ventricular interaction (DVI) in mediating this response remain unclear. We hypothesized that nITP ≤-15 cmH2 0 would augment LVSV, while nITP ≥-20 cmH2 o would reduce LVSV via DVI and increased afterload...
January 27, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29374723/low-dose-pressurized-intrathoracic-aerosol-chemotherapy-pitac-as-an-alternative-therapy-for-pleuropulmonary-involvement-in-pseudomyxoma-peritonei
#6
Manuela Robella, Marco Vaira, Alice Borsano, Claudio Mossetti, Michele DE Simone
BACKGROUND/AIM: Pseudomyxoma peritonei (PMP) is a rare disease characterized by mucinous ascites and widespread peritoneal implants. It usually originates from the rupture of an adenoma/adenocarcinoma of the appendix. Although this tumor is only superficially invasive and does not metastasize, it could be a fatal disease. Extra-abdominal spread of PMP is an unusual occurrence with few reports in medical literature. CASE REPORT: A 50-year-old man was diagnosed with PMP according to the findings of thorax and abdomen CT scan and cytologic and histological examinations...
February 2018: Anticancer Research
https://www.readbyqxmd.com/read/29368315/intraoperative-valsalva-maneuver-a-narrative-review
#7
Chandra Mohan Kumar, André A J Van Zundert
The Valsalva maneuver (VM) involves expiratory effort against a closed mouth and/or glottis in the sitting or supine position with the increased intraoral and intrathoracic pressure raised to 40 mmHg for 15-20 sec after which the pressure is suddenly released and the breathing restored to normal. Complex cardiovascular and other physiologic changes occur during the VM. The VM has been used for diagnostic and therapeutic reasons as well as intraoperatively during specific surgical procedures. Although the VM is usually safe, rare complications have been reported...
January 24, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29364998/usefulness-of-radiological-signs-of-pulmonary-congestion-in-predicting-failed-spontaneous-breathing-trials
#8
Ana Carolina Peçanha Antonio, Cassiano Teixeira, Priscylla Souza Castro, Ana Paula Zanardo, Marcelo Basso Gazzana, Marli Knorst
Inspiratory fall in intrathoracic pressure during a spontaneous breathing trial (SBT) may precipitate cardiac dysfunction and acute pulmonary edema. We aimed to determine the relationship between radiological signs of pulmonary congestion prior to an SBT and weaning outcomes. This was a post hoc analysis of a prospective cohort study involving patients in an adult medical-surgical ICU. All enrolled individuals met the eligibility criteria for liberation from mechanical ventilation. Tracheostomized subjects were excluded...
July 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29344963/refractory-pulmonary-edema-and-upper-body-hypoxemia-during-veno-arterial-extracorporeal-membrane-oxygenation-a-case-for-atrial-septostomy
#9
Amit Prasad, Ali Ghodsizad, Christoph Brehm, Mark Kozak, Michael Körner, Aly El Banayosy, Kai Singbartl
Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) provides mechanical circulatory support for patients with advanced cardiogenic shock, facilitating myocardial recovery and limiting multi-organ failure. In patients with severely limited left ventricular ejection, peripheral VA-ECMO can further increase left ventricular and left atrial pressures (LAP). Failure to decompress the left heart under these circumstances can result in pulmonary edema and upper body hypoxemia, that is, myocardial and cerebral ischemia...
January 18, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29317351/a-new-physiological-model-for-studying-the-effect-of-chest-compression-and-ventilation-during-cardiopulmonary-resuscitation-the-thiel-cadaver
#10
Emmanuel Charbonney, Stéphane Delisle, Dominique Savary, Gilles Bronchti, Marceau Rigollot, Adrien Drouet, Bilal Badat, Paul Ouellet, Patrice Gosselin, Alain Mercat, Laurent Brochard, Jean-Christophe M Richard
BACKGROUND: Studying ventilation and intrathoracic pressure (ITP) induced by chest compressions (CC) during Cardio Pulmonary Resuscitation is challenging and important aspects such as airway closure have been mostly ignored. We hypothesized that Thiel Embalmed Cadavers could constitute an appropriate model. METHODS: We assessed respiratory mechanics and ITP during CC in 11 cadavers, and we compared it to measurements obtained in 9 out-of-hospital cardiac arrest patients and to predicted values from a bench model...
January 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29317326/study-of-the-upper-airway-of-obstructive-sleep-apnea-patient-using-fluid-structure-interaction
#11
Yang Liu, Jennifer Mitchell, Yitung Chen, Woosoon Yim, Wenxiao Chu, Robert C Wang
Up to 14% of the U.S. population is estimated to have obstructive sleep apnea (OSA), while the outcomes of the treatments have variable results. In the current study, a three-dimensional fluid-structure interaction modeling was applied to simulate the upper airway to identify the precise location, severity, and characteristic of airway collapse. This was accomplished using Simpleware® and ANSYS® software applied to a 3-D rendering of the airway in a real patient with severe OSA. During this simulation, areas which are prone to collapse and precipitate apneic episodes were identified at the tip of the soft palate and the base of the tongue, with intrathoracic pressure as low as -1370 Pa...
January 6, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29237457/the-role-of-src-erk1-2-kinases-in-inspiratory-resistive-breathing-induced-acute-lung-injury-and-inflammation
#12
Dimitrios Toumpanakis, Vyronia Vassilakopoulou, Ioanna Sigala, Panagiotis Zacharatos, Ioanna Vraila, Vassiliki Karavana, Stamatios Theocharis, Theodoros Vassilakopoulos
BACKGROUND: Inspiratory resistive breathing (IRB), a hallmark of obstructive airway diseases, is associated with large negative intrathoracic pressures, due to strenuous contractions of the inspiratory muscles. IRB is shown to induce lung injury in previously healthy animals. Src is a multifunctional kinase that is activated in the lung by mechanical stress. ERK1/2 kinase is a downstream target of Src. We hypothesized that Src is activated in the lung during IRB, mediates ERK1/2 activation and IRB-induced lung injury...
December 13, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29202543/-experts-consensus-on-the-management-of-the-right-heart-function-in-critically-ill-patients
#13
X T Wang, D W Liu, H M Zhang, Y Long, X D Guan, H B Qiu, K J Yu, J Yan, H Zhao, Y Q Tang, X Ding, X C Ma, W Du, Y Kang, B Tang, Y H Ai, H W He, D C Chen, H Chen, W Z Chai, X Zhou, N Cui, H Wang, X Rui, Z J Hu, J G Li, Y Xu, Y Yang, B Ouyan, H Y Lin, Y M Li, X Y Wan, R L Yang, Y Z Qin, Y G Chao, Z Y Xie, R H Sun, Z Y He, D F Wang, Q Q Huang, D P Jiang, X Y Cao, R G Yu, X Wang, X K Chen, J F Wu, L N Zhang, M G Yin, L X Liu, S W Li, Z J Chen, Z Luo
To establish the experts consensus on the right heart function management in critically ill patients. The panel of consensus was composed of 30 experts in critical care medicine who are all members of Critical Hemodynamic Therapy Collaboration Group (CHTC Group). Each statement was assessed based on the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) principle. Then the Delphi method was adopted by 52 experts to reassess all the statements. (1) Right heart function is prone to be affected in critically illness, which will result in a auto-exaggerated vicious cycle...
December 1, 2017: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29191982/case-studies-in-physiology-exercise-induced-diaphragm-fatigue-in-a-paralympic-champion-rower-with-spinal-cord-injury
#14
Nicholas B Tiller, Thomas R Aggar, Christopher R West, Lee M Romer
INTRODUCTION: 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). CASE PRESENTATION: An elite arms-only oarsman (age 28 y, stature 1.89 m, mass 90.4 kg) with motor-complete SCI (T12) performed a 1000 m time-trial on an adapted rowing ergometer. Exercise measurements comprised pulmonary ventilation and gas exchange, diaphragm EMG-derived indices of neural respiratory drive and intrathoracic pressure-derived indices of respiratory mechanics...
November 30, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29186485/indications-and-practical-approach-to-non-invasive-ventilation-in-acute-heart-failure
#15
Josep Masip, W Frank Peacock, Susanna Price, Louise Cullen, F Javier Martin-Sanchez, Petar Seferovic, Alan S Maisel, Oscar Miro, Gerasimos Filippatos, Christiaan Vrints, Michael Christ, Martin Cowie, Elke Platz, John McMurray, Salvatore DiSomma, Uwe Zeymer, Hector Bueno, Chris P Gale, Maddalena Lettino, Mucio Tavares, Frank Ruschitzka, Alexandre Mebazaa, Veli-Pekka Harjola, Christian Mueller
In acute heart failure (AHF) syndromes significant respiratory failure (RF) is essentially seen in patients with acute cardiogenic pulmonary oedema (ACPE) or cardiogenic shock (CS). Non-invasive ventilation (NIV), the application of positive intrathoracic pressure through an interface, has shown to be useful in the treatment of moderate to severe RF in several scenarios. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and pressure support ventilation (NIPSV) with positive end expiratory pressure...
November 26, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29175978/constrictive-pericarditis-diagnosis-management-and-clinical-outcomes
#16
REVIEW
Terrence D Welch
Constrictive pericarditis (CP) is a form of diastolic heart failure that arises because an inelastic pericardium inhibits cardiac filling. This disorder must be considered in the differential diagnosis for unexplained heart failure, particularly when the left ventricular ejection fraction is preserved. Risk factors for the development of CP include prior cardiac surgery and radiation therapy, but most cases are still deemed to be idiopathic. Making the diagnosis may be challenging and requires meticulous echocardiographic assessment, often supplemented by cross-sectional cardiac imaging and haemodynamic catheterisation...
November 25, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29140888/intrathoracic-pressure-regulation-improves-cerebral-perfusion-and-cerebral-blood-flow-in-a-porcine-model-of-brain-injury-erratum
#17
(no author information available yet)
No abstract text is available yet for this article.
December 2017: Shock
https://www.readbyqxmd.com/read/29119733/administration-of-fentanyl-via-a-slow-intravenous-fluid-line-compared-with-rapid-bolus-alleviates-fentanyl-induced-cough-during-general-anesthesia-induction
#18
Min-Qiang Liu, Feng-Xian Li, Ya-Kun Han, Jun-Yong He, Hao-Wen Shi, Li Liu, Ren-Liang He
OBJECTIVE: Fentanyl-induced cough (FIC) is a common complication with a reported incidence from 18.0% to 74.4% during general anesthesia induction. FIC increases the intrathoracic pressure and risks of postoperative nausea and vomiting, yet available treatments are limited. This study was designed to investigate whether administering fentanyl via a slow intravenous fluid line can effectively alleviate FIC during induction of total intravenous general anesthesia. METHODS: A total number of 1200 patients, aged 18-64 years, were enrolled, all of whom were American Society of Anesthesiologists (ASA) grade I or II undergoing scheduled surgeries...
2017: Journal of Zhejiang University. Science. B
https://www.readbyqxmd.com/read/29060627/effects-of-septum-and-pericardium-on-heart-lung-interactions-in-a-cardiopulmonary-simulation-model
#19
Nikolaos Karamolegkos, Antonio Albanese, Nicolas W Chbat
Mechanical heart-lung interactions are often overlooked in clinical settings. However, their impact on cardiac function can be quite significant. Mechanistic physiology-based models can provide invaluable insights into such cardiorespiratory interactions, which occur not only under external mechanical ventilatory support but in normal physiology as well. In this work, we focus on the cardiac component of a previously developed mathematical model of the human cardiopulmonary system, aiming to improve the model's response to the intrathoracic pressure variations that are associated with the respiratory cycle...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/29051629/-boerhaave-s-syndrome-secondary-to-gastric-volvulus
#20
I Eguaras Córdoba, A Goikoetxea Urdiain, A Hernando Sanz, I Esquiroz Lizaur, B Camarero Triana, A Artajona Rosino
Boerhaave's syndrome is a spontaneous rupture of the oesophagus, caused by an increase of intraluminal pressure that is produced in the context of negative intrathoracic pressure. It has a high index of morbimortality (14-40%), which is why it requires early diagnosis and treatment. When a patient presents vomiting, the differential diagnosis should include epigastric pain. Para-esophageal hiatal hernias can be complicated by gastric volvulus. In its turn, this can produce both oesophageal and gastric necrosis requiring early surgical treatment...
October 19, 2017: Anales del Sistema Sanitario de Navarra
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