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https://www.readbyqxmd.com/read/27873763/pericardiectomy-as-a-diagnostic-and-therapeutic-procedure
#1
Ewa Konik, Jeffrey Geske, William Edwards, Bernard Gersh
A 70-year-old man presented with recent onset, predominantly right-sided heart failure. Echocardiogram demonstrated features of hypertensive heart disease and was suggestive of, but non-diagnostic for, constrictive pericarditis (CP). CT demonstrated mild pericardial thickening. Right heart catheterisation showed elevation and equalisation of diastolic pressures in all cardiac chambers with early rapid filling, minimal ventricular interdependence, and no dissociation of intrathoracic and intracardiac pressures...
November 14, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27863029/endoluminal-vacuum-therapy-for-ivor-lewis-anastomotic-leaks-a-pilot-study-in-a-swine-model
#2
R B Scott, L A Ritter, A L Shada, S H Feldman, D E Kleiner
Anastomotic leaks are a serious complication associated with Ivor Lewis esophagectomies. Endoluminal negative pressure vacuum devices create a possible treatment alternative to conventional surgical intervention. Ten pigs had an intrathoracic esophageal anastomosis with a 1-cm defect. The experimental group had the device placed intraoperatively across the defect, whereas the control group did not. Once treatment was completed, a contrast fluoroscopic study and necropsy was performed. All control pigs had contrast extravasation on fluoroscopy and contamination on necropsy...
November 11, 2016: Clinical and Translational Science
https://www.readbyqxmd.com/read/27836647/corrective-effect-of-diaphragm-pacing-on-the-decrease-in-cardiac-output-induced-by-positive-pressure-mechanical-ventilation-in-anesthetized-sheep
#3
Hicham Masmoudi, Romain Persichini, Jérôme Cecchini, Julie Delemazure, Martin Dres, Julien Mayaux, Alexandre Demoule, Jalal Assouad, Thomas Similowski
Positive pressure ventilation (PPV) is a fundamental life support measure, but it decreases cardiac output (CO). Diaphragmatic contractions produce negative intrathoracic and positive abdominal pressures, promoting splanchnic venous return. We hypothesized that: 1) diaphragm pacing alone could produce adequate ventilation without decreasing CO; 2) diaphragm pacing on top of PPV could improve CO. Of 11 anesthetized and mechanically ventilated ewes (39.6±5.9kg), 3 were discarded from analysis because of hemodynamic instability during the experiment, and 8 retained for analysis...
November 9, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27789160/-perthes-syndrome-secondary-to-an-asthma-attack-a-case-report-in-a-15-year-old-child
#4
W El Amraoui, A El Koraichi, A Bentalha, S E El Kettani
Perthes syndrome, or traumatic asphyxia syndrome, is a rare clinical entity, associating cyanosis, cervicofacial petechiae and subconjunctival hemorrhage. It is usually secondary to chest trauma, but can occur in any situation of abrupt rise in intrathoracic pressure with closed glottis. In this paper, we present a case of Perthes syndrome that triggered an asthma attack for a child during surgery.
October 24, 2016: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/27783103/changes-in-pulmonary-function-and-influencing-factors-after-high-dose-intrathoracic-radio-chemo-therapy
#5
Christina Schröder, Rita Engenhart-Cabillic, Hilke Vorwerk, Michael Schmidt, Winfried Huhnt, Eyck Blank, Dietrich Sidow, André Buchali
PURPOSE: Using prospectively collected patient-related, dose-related, and pulmonary function test (PFT) data before radiotherapy (RT) and at several follow-up visits after RT, the time course of PFT changes after high-dose radio(chemo)therapy and influencing factors were analyzed. MATERIALS AND METHODS: From April 2012 to October 2015, 81 patients with non-small-cell lung carcinoma (NSCLC), small cell lung carcinoma (SCLC), or esophageal carcinoma where treated with high-dose radio(chemo)therapy...
October 25, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
https://www.readbyqxmd.com/read/27769919/preoperative-levels-of-catecholamines-and-metanephrines-and-intraoperative-hemodynamics-of-patients-undergoing-pheochromocytoma-and-paraganglioma-resection
#6
Toby N Weingarten, Tasha L Welch, Tamara L Moore, Gulshat F Walters, Joni L Whipple, Alexandre Cavalcante, Irina Bancos, William F Young, Lucinda M Gruber, Muhammad Z Shah, Travis J McKenzie, Darrell R Schroeder, Juraj Sprung
OBJECTIVE: To determine whether, despite pharmacologic adrenergic receptor blockade, higher preoperative levels of catecholamines and metanephrines (adrenergic activity) are associated with increased intraoperative complications. METHODS: Records of patients undergoing paraganglioma and pheochromocytoma (PGL-PCC) resection from January 1, 2000, through June 31, 2015, were reviewed for preoperative levels of adrenergic activity, intraoperative variability in blood pressure and heart rate (range), and postoperative outcomes (hypotension requiring treatment)...
October 18, 2016: Urology
https://www.readbyqxmd.com/read/27769303/short-term-and-long-term-outcomes-of-intrathoracic-vacuum-therapy-of-empyema-in-debilitated-patients
#7
Zsolt Sziklavari, Michael Ried, Florian Zeman, Christian Grosser, Tamas Szöke, Reiner Neu, Rudolf Schemm, Hans-Stefan Hofmann
BACKGROUND: This retrospective study analyzed the effectiveness of intrathoracic negative pressure therapy for debilitated patients with empyema and compared the short-term and long-term outcomes of three different intrapleural vacuum-assisted closure (VAC) techniques. METHODS: We investigated 43 consecutive (pre)septic patients with poor general condition (Karnofsky index ≤ 50 %) and multimorbidity (≥ 3 organ diseases) or immunosuppression, who had been treated for primary, postoperative, or recurrent pleural empyema with VAC in combination with open window thoracostomy (OWT-VAC) with minimally invasive technique (Mini-VAC), and instillation (Mini-VAC-Instill)...
October 21, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27765746/heart-lung-interaction-in-a-model-of-copd-importance-of-lung-volume-and-direct-ventricular-interaction
#8
William S Cheyne, Alexandra M Williams, Megan I Harper, Neil D Eves
Chronic obstructive pulmonary disease (COPD) is associated with dynamic lung hyperinflation (DH), increased pulmonary vascular resistance (PVR), and large increases in negative intrathoracic pressure (nITP). The individual and interactive effect of these stressors on left ventricular (LV) filling, emptying, and geometry and the role of direct ventricular interaction (DVI) in mediating these interactions have not been fully elucidated. Twenty healthy subjects were exposed to the following stressors alone and in combination: 1) inspiratory resistive loading of -20 cmH2O (nITP), 2) expiratory resistive loading to cause dynamic hyperinflation (DH), and 3) normobaric-hypoxia to increase PVR (hPVR)...
December 1, 2016: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/27720494/assessment-of-changes-in-hemodynamics-and-intrathoracic-fluid-using-electrical-cardiometry-during-autologous-blood-harvest
#9
Jitin Narula, Usha Kiran, Poonam Malhotra Kapoor, Minati Choudhury, Palleti Rajashekar, Ujjwal Kumar Chowdhary
OBJECTIVE: To evaluate the effect of autologous blood harvest (ABH)-induced volume shifts using electrical cardiometry (EC) in patients with pulmonary artery hypertension secondary to left heart disease. DESIGN: Prospective, randomized, controlled trial. SETTING: A tertiary care hospital. PARTICIPANTS: The study comprised 50 patients scheduled to undergo heart valve replacement. INTERVENTIONS: Patients were divided randomly into 2 experimental groups that were distinguished by whether ABH was performed...
July 26, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/27693594/obstructive-sleep-apnea-and-cardiac-arrhythmogenesis-mechanistic-insights
#10
Anna M May, David R Van Wagoner, Reena Mehra
A surge of data has reproducibly identified strong associations of obstructive sleep apnea (OSA) with cardiac arrhythmias. As an extension of epidemiologic and clinic-based findings, experimental investigations have made strides in advancing our understanding of the putative OSA and cardiac arrhythmogenesis mechanistic underpinnings. While most studies have focused on the links between OSA and atrial fibrillation (AF), relationships with ventricular arrhythmias have also been characterized. Key findings implicate OSA-related autonomic nervous system fluctuations typified by enhanced parasympathetic activation during and sympathetic surges subsequent to respiratory events which contribute to augmented arrhythmic propensity...
September 29, 2016: Chest
https://www.readbyqxmd.com/read/27667769/patterns-of-perioperative-thoracic-fluid-indices-changes-in-liver-transplantation-with-or-without-postoperative-acute-lung-injury
#11
Kuang-Cheng Chan, Chun-Yu Wu, Ming-Hui Hung, Po-Huang Lee, Ya-Jung Cheng
BACKGROUND/PURPOSE: Postoperative acute lung injury (ALI) after liver transplantation is clinically relevant and common. The perioperative thoracic fluid indices changes as well as the association with ALI in liver transplantation have not been thoroughly investigated. METHODS: A total of 52 consecutive adult recipients for elective living donor liver transplantation were enrolled. Each recipient received the same perioperative care plan. Thoracic fluid indices, including the cardiac index, intrathoracic blood volume index (ITBVI), extravascular lung water index (EVLWI), and pulmonary vascular permeability index (PVPI), were obtained at seven time points (pretransplantation, anhepatic phase, 30 minutes after reperfusion, 2 hours after reperfusion, and postoperative days 1-3) using the pulse contour cardiac output system...
September 22, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27575552/relation-of-concavity-in-the-expiratory-flow-volume-loop-to-dynamic-hyperinflation-during-exercise-in-copd
#12
Janos Varga, Richard Casaburi, Shuyi Ma, Ariel Hecht, David Hsia, Attila Somfay, Janos Porszasz
Active expiration during exercise can increase intrathoracic pressure yielding concavity in the expiratory flow-volume loop in COPD. We investigated the relationship between this concavity and dynamic hyperinflation (DH). 17 COPD patients (FEV1: 38±10%pred, GOLD stage 3-4) and 12 healthy subjects performed cycle ergometer incremental exercise. Expiratory limb of the spontaneous flow-volume loop was analyzed breath-by-breath using a geometric approach (rectangular area ratio (RAR), Respir. Med., 104(3):389-96, 2010)...
August 26, 2016: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/27555171/elective-use-of-the-ventrain-for-upper-airway-obstruction-during-high-frequency-jet-ventilation
#13
Robert A Fearnley, Sheela Badiger, Richard J Oakley, Imran Ahmad
The safety of high pressure source ventilation (jet ventilation) is dependent upon upper airway patency to facilitate adequate passive expiration and prevent increasing intrathoracic pressure and its associated deleterious sequelae. Distortions in airway anatomy may make passive expiration inadequate or impossible in some patients. We report the elective use of the Ventrain device to provide ventilation in a clinical setting of upper airway obstruction in a patient with post radiation fibrosis that had previously prevented passive expiration during attempted high pressure source ventilation...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27469608/central-venous-catheter-tip-migration-due-to-tracheal-extubation-a-prospective-randomized-study
#14
Manuel F Struck, Theresa Jünemann, Konrad Reinhart, Wolfram Schummer
Considerable numbers of patients undergo central venous catheterization (CVC) under mechanical ventilation. We hypothesized that the return of spontaneous breathing and tracheal extubation could be associated with distal CVC tip migration towards intracardiac positions due to decreasing intrathoracic pressures and subsequent readjustment of mediastinal organs. Patients scheduled for cardiac surgery were randomized for right or left internal jugular vein (IJV) CVC placement under general anesthesia and mechanical ventilation...
July 28, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27423821/three-simultaneous-cases-of-spontaneous-pneumomediastinum-with-epidural-pneumatosis-during-vocal-training
#15
Yuki Yoshimatsu, Kazushi Yamairi, Kazutaka Nakasone, Michiru Sasaki, Saori Terai, Naoki Nakamura, Naomi Maruyama, Yae Yoshida, Munetake Takata, Natsuko Iwae, Kenichiro Otani, Takao Kamimori, Hiroshi Fujiwara
OBJECTIVE: The aim of this study was to describe a case series of three simultaneous cases of spontaneous pneumomediastinum (SPM) with epidural pneumatosis during vocal training. METHODS: A report of three cases with chart review was performed. Literature review was carried out using PubMed. RESULTS: This was an extremely rare case series where at least three of the 20 participants of a vocal training in a self-development seminar developed SPM, epidural pneumatosis, pneumothorax, and subcutaneous emphysema...
July 13, 2016: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/27412025/evaluation-of-esophageal-intramural-pseudo-diverticulosis-using-high-resolution-manometry
#16
Masahito Aimi, Hironobu Mikami, Daisuke Izumi, Eiko Okimoto, Yasumasa Tada, Tsuyoshi Mishiro, Norihisa Ishimura, Shunji Ishihara, Yoshikazu Kinoshita
Esophageal intramural pseudo-diverticulosis (EIPD) is a rare disease characterized by multiple small flask-shaped pouches in the esophageal wall, with the predominant symptom of chronic progressive or intermittent dysphagia. However, its etiology and pathogenesis remain unknown. We present a case of EIPD evaluated with high-resolution manometry in a 75-year-old man with food impaction after eating beef, who came to our emergency department. The patient experienced similar episodes three times previously, though the cause was unknown...
October 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27398682/video-assisted-thoracoscopic-resection-of-a-noninvasive-thymoma-in-a-cat-with-myasthenia-gravis-using-low-pressure-carbon-dioxide-insufflation
#17
Maureen A Griffin, Jessie S Sutton, Geraldine B Hunt, Bruno H Pypendop, Philipp D Mayhew
OBJECTIVE: To report the use of low-pressure carbon dioxide insufflation during video-assisted thoracoscopic surgery for resection of a noninvasive thymoma in a cat with secondary myasthenia gravis. STUDY DESIGN: Clinical case report. ANIMAL: Client-owned cat. METHODS: An 11-year-old castrated male domestic shorthair cat was examined for generalized weakness, voice change, hypersalivation, hyporexia, vomiting, coughing, and gagging...
November 2016: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/27397657/apical-lung-herniation-associated-with-continuous-positive-airway-pressure-in-a-4-year-old-girl
#18
Christopher J Lehmann, Ameet S Daftary, Evans M Machogu
We report a case of apical lung herniation through the superior thoracic aperture of an obese child using nocturnal CPAP. Lung herniation has been described in association with congenital thoracic abnormalities and elevated intra-thoracic pressure, such as trauma. This patient was hospitalized with community acquired pneumonia and required nocturnal CPAP for treatment of concurrent obstructive sleep apnea. Her lung hernia was discovered incidentally on routine follow-up chest radiography and resolved with cessation of CPAP treatment...
November 15, 2016: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/27382824/patient-ventilation-asynchrony-causing-negative-pressure-pulmonary-edema-in-an-intubated-obese-patient
#19
Sahar M Siddik-Sayyid, Waseem AlFahel, Mohamad F El-Khatib
Negative pressure pulmonary edema is a potentially life-threatening condition that may occur when a large negative intrathoracic pressure is generated against a 'physically' obstructed upper airway during emergence from anesthesia. We report a 35 year old male patient who is morbidly obese and undergoing laparoscopic gastric bypass who developed negative pressure pulmonary edema without any evidence of a 'physical' upper airway obstruction. In our patient, the negative pressure pulmonary edema occurred after complete reversal of neuromuscular blockade and during manual positive pressure ventilation with the endotracheal tube still in place and in the presence of an oral airway...
February 2016: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/27377010/worsening-hypoxemia-in-the-face-of-increasing-peep-a-case-of-large-pulmonary-embolism-in-the-setting-of-intracardiac-shunt
#20
Glen T Granati, Getu Teressa
BACKGROUND Patent foramen ovale (PFO) are common, normally resulting in a left-to-right shunt or no net shunting. Pulmonary embolism (PE) can cause sustained increased pulmonary vascular resistance (PVR) and right atrial pressure. Increasing positive end-expiratory pressure (PEEP) improves oxygenation at the expense of increasing intrathoracic pressures (ITP). Airway pressure release ventilation (APRV) decreases shunt fraction, improves ventilation/perfusion (V/Q) matching, increases cardiac output, and decreases right atrial pressure by facilitating low airway pressure...
2016: American Journal of Case Reports
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