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Intrathoracic pressure

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https://www.readbyqxmd.com/read/28641752/congenital-diaphragmatic-hernia-associated-pulmonary-hypertension
#1
Matthew T Harting
Congenital diaphragmatic hernia (CDH) is a complex entity wherein a diaphragmatic defect allows intrathoracic herniation of intra-abdominal contents and both pulmonary parenchymal and vascular development are stifled. Pulmonary pathology and pathophysiology, including pulmonary hypoplasia and pulmonary hypertension, are hallmarks of CDH and are associated with disease severity. Pulmonary hypertension (PH) is sustained, supranormal pulmonary arterial pressure, and among patients with CDH (CDH-PH), is driven by hypoplastic pulmonary vasculature, including alterations at the molecular, cellular, and tissue levels, along with pathophysiologic pulmonary vasoreactivity...
June 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28625243/-experimental-study-on-effect-of-airway-pressure-on-cardiopulmonary-resuscitation
#2
Dingyu Tan, Feng Sun, Yangyang Fu, Shihuan Shao, Yazhi Zhang, Yingying Hu, Jun Xu, Huadong Zhu, Xuezhong Yu
OBJECTIVE: To observe the effect of different airway pressure on ventilation, organ perfusion and return of spontaneous circulation (ROSC) of cardiac arrest (CA) pigs during cardiopulmonary resuscitation (CPR), and to explore the possible beneficial mechanism of positive airway pressure during CPR. METHODS: Twenty healthy landrace pigs of clean grade were divided into low airway pressure group (LP group, n = 10) and high airway pressure group (HP group, n = 10) with random number table...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28621617/intrathoracic-meningocele-associated-with-neurofibromatosis-type-1-and-a-novel-technique-for-surgical-repair-case-report
#3
Paramita Das, Tarini Goyal, Matthew A Hunt
Neurofibromatosis Type 1 (NF1) is a neurocutaneous disorder that can have associated spinal abnormalities related to both bone and dural dysplasia. Thoracic meningoceles are one spine anomaly associated with NF1, although they are a fairly uncommon pathology. Surgical techniques to treat these meningoceles, usually undertaken only when the patient is symptomatic, are targeted at decreasing the size of the protrusion and improving lung capacity. Surgical interventions discussed in the literature include shunting the pseudomeningocele, primary repair with laminectomy, thoracoscopic plication, and reinforcement of the closure with cement, muscle, or fascia...
June 16, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28577164/internal-jugular-vein-blood-flow-in-the-upright-position-during-external-compression-and-increased-central-venous-pressure-an-ultrasound-study-in-healthy-volunteers
#4
Tze Yeng Yeoh, Lashmi Venkatraghavan, Joseph A Fisher, Massimiliano Meineri
BACKGROUND: External compression of the jugular veins is an effective method to increase intracranial blood volume and brain stiffness in rats and healthy volunteers. It has been reported that, on assuming an upright posture, cerebral venous drainage is distributed away from the internal jugular veins (IJVs) to the cervical venous plexus, causing complete collapse of the IJV. If so, it is not clear why external IJV compression would increase intracranial blood volume, but the latter is frequently observed in neurosurgery in the sitting position...
June 2, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28575398/carbon-dioxide-insuf%C3%AF-ation-and-thoracoscopic-ultrasonography-image-of-pure-ground-glass-nodule
#5
Hirofumi Uehara, Atsushi Yasuda, Hiroshi Kondo, Masafumi Kawamura
Thoracic surgeons frequently encounter early lung cancer showing a pure ground-glass nodule. Although thoracoscopic wedge resection is used extensively, it cannot be easily located for surgical procedures. Thoracoscopic ultrasonography is a real-time and less invasive technique for small lung lesion localization during thoracoscopic surgery. However, this technique has not been widely adopted because residual air in the lung results in poor ultrasound images. A 64-year-old woman was found to have pure ground-glass nodule...
May 29, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28572979/complex-effects-of-high-flow-nasal-cannula-therapy-on-hemodynamics-in-the-pediatric-patient-after-cardiac-surgery
#6
EDITORIAL
Yu Inata, Muneyuki Takeuchi
BACKGROUND: The high-flow nasal cannula (HFNC) system has been widely used for children in various clinical settings. However, the physiological and clinical impact of HFNC therapy on the pediatric patient with respiratory distress after cardiac surgery has not been thoroughly investigated. MAIN BODY OF THE ABSTRACT: It seems logical to use HFNC as a primary therapy for post-extubation respiratory failure after congenital heart surgery, in which low cardiac output syndrome and upper airway obstruction are commonly encountered; the HFNC therapy alleviates the work of breathing and large negative swings of intrathoracic pressure, which in turn helps to decrease the systemic ventricular afterload...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28544108/elevated-intrathoracic-co2-pressure-during-thoracoscopic-surgery-decreases-regional-cerebral-oxygen-saturation-in-neonates-and-infants-a-pilot-study
#7
Felix Neunhoeffer, Steven W Warmann, Michael Hofbeck, Alisa Müller, Frank Fideler, Guido Seitz, Martin U Schuhmann, Hans-Joachim Kirschner, Matthias Kumpf, Jörg Fuchs
BACKGROUND: Intraoperative hypercapnia and acidosis are risk factors during thoracoscopy in neonates and infants. METHODS: In a prospective pilot study, we evaluated the effects of thoracoscopy in neonates and infants on cerebral microcirculation, oxygen saturation, and oxygen consumption. Regional cerebral oxygen saturation and blood flow were measured noninvasively using a new device combining laser Doppler flowmetry and white light spectrometry. Additionally, cerebral fractional tissue oxygen extraction and approximated oxygen consumption were calculated...
July 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28543857/vena-cava-responsiveness-to-controlled-isovolumetric-respiratory-efforts
#8
Anna Folino, Marco Benzo, Paolo Pasquero, Andrea Laguzzi, Luca Mesin, Alessandro Messere, Massimo Porta, Silvestro Roatta
OBJECTIVES: Respirophasic variation of inferior vena cava (IVC) size is affected by large variability with spontaneous breathing. This study aims at characterizing the dependence of IVC size on controlled changes in intrathoracic pressure. METHODS: Ten healthy subjects, in supine position, performed controlled isovolumetric respiratory efforts at functional residual capacity, attaining positive (5, 10, and 15 mmHg) and negative (-5, -10, and -15 mmHg) alveolar pressure levels...
May 22, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28530203/eit-based-pulsatile-impedance-monitoring-during-spontaneous-breathing-in-cystic-fibrosis
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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