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Intrathoracic pressure

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https://www.readbyqxmd.com/read/29237457/the-role-of-src-erk1-2-kinases-in-inspiratory-resistive-breathing-induced-acute-lung-injury-and-inflammation
#1
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
#2
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
#3
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
#4
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
#5
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
#6
(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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/29025545/constrictive-pericarditis
#10
REVIEW
Terrence D Welch, Jae K Oh
Constrictive pericarditis is a potentially treatable cause of diastolic heart failure that arises because a diseased, inelastic pericardium restricts ventricular diastolic expansion. Affected patients present with heart failure with predominant right-sided symptoms and signs. The key to diagnosis is identification of the unique hemodynamic properties associated with constriction: dissociation of intrathoracic and intracardiac pressures and enhanced ventricular interaction. Comprehensive echocardiography with Doppler imaging is useful, but invasive hemodynamic assessment and cross-sectional imaging may be required for confirmation...
November 2017: Cardiology Clinics
https://www.readbyqxmd.com/read/28991100/laughter-induced-transient-vision-loss-in-a-patient-with-silent-sinus-syndrome
#11
Sara N Reggie, Krishna Kalyam, John B Holds, Sophia M Chung
BACKGROUND: To report a patient with silent sinus syndrome (SSS) who experienced transient ipsilateral monocular vision loss during intense laughter. METHODS: Case report. RESULTS: Our patient's transient vision loss completely resolved after maxillary sinus decompression and during 7 months of follow-up. CONCLUSIONS: Although the precise mechanism of our patient's vision loss remains undetermined, we suspect that the vascular supply to the eye and/or the optic nerve was compromised as the result of the combination of laughter (causing Valsalva maneuver and increased intrathoracic pressure) and SSS...
October 4, 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
https://www.readbyqxmd.com/read/28935330/acute-delayed-tension-pneumopericardium-the-first-reported-case-after-elective-lobectomy
#12
Salvatore Torre, Jennifer Lee, Stephen O'Connor, Sarah A Early, Ronan Ryan
Pneumopericardium is an overall rare condition caused by increased intrathoracic positive pressure. Different mechanisms can contribute to its development. It can be observed in both pediatric and adult populations. Only a small percentage of patients have cardiac tamponade. We describe the first case of delayed tension pneumopericardium after elective lobectomy. Sudden symptom onset and clinical management are discussed. Only an accurate and quick patient assessment allowed diagnosing this condition and, hence, its correct treatment...
October 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28856802/esophagogastric-junction-cancer-successfully-treated-by-laparoscopic-proximal-gastrectomy-and-lower-esophagectomy-with-intrathoracic-double-flap-technique-a-case-report
#13
Kei Hosoda, Keishi Yamashita, Hiromitsu Moriya, Marie Washio, Hiroaki Mieno, Akira Ema, Masahiko Watanabe
A 66-year-old man was referred to our hospital for treatment of esophagogastric junction cancer. He was diagnosed as cT2N0M0, and the esophageal invasion was found to be 1 cm from the esophagogastric junction. He underwent laparoscopy-assisted proximal gastrectomy and lower esophagectomy with esophagogastrostomy using the intrathoracic double-flap technique through the transhiatal approach. The operative time was 662 min (suturing time was 198 min), and blood loss was 200 mL. The operative time was much longer for this procedure than for esophagogastrostomy with the conventional (intra-abdominal) double-flap technique...
August 30, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28855978/a-case-of-shunting-postoperative-patent-foramen-ovale-under-mechanical-ventilation-controlled-by-different-ventilator-settings
#14
Claudio Pragliola, Sara Di Michele, Domenico Galzerano
A 56-year old male with ischemic heart disease and an unremarkable preoperative echocardiogram underwent surgical coronary revascularization. An intraoperative post pump trans-esophageal echocardiogram (TOE) performed while the patient was being ventilated at a positive end expiratory pressure (PEEP) of 8 cm H2O demonstrated a right to left interatrial shunt across a patent foramen ovale (PFO). Whereas oxygen saturation was normal, a reduction of the PEEP to 3 cm H2O led to the complete resolution of the shunt with no change in arterial blood gases...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28841915/expiratory-central-airway-collapse-in-stable-copd-and-during-exacerbations
#15
Paul Leong, Anne Tran, Jhanavi Rangaswamy, Laurence E Ruane, Michael W Fernando, Martin I MacDonald, Kenneth K Lau, Philip G Bardin
BACKGROUND: Tracheal obstruction resulting from expiratory tracheal deformation has been associated with respiratory symptoms and severe airway exacerbations. In chronic obstructive pulmonary disease (COPD), acute exacerbations (AECOPD) create large intrathoracic pressure swings which may increase tracheal deformation. Excessive central airway collapse (ECAC) may be diagnosed when the tracheal area on expiration is less than 50% of that on inspiration. The prevalence of ECAC in AECOPD and its temporal course have not been systematically studied...
August 25, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28829494/pneumopericardium-pneumomediastinum-and-pneumorrachis-complicating-acute-respiratory-syncytial-virus-bronchiolitis-in-children
#16
C Fantacci, P Ferrara, F Franceschi, A Chiaretti
OBJECTIVE: We report 2 children with Respiratory Syncytial Virus (RSV) infection complicated with spontaneous pneumopericardium (PP) and pneumomediastinum (PM), one also associated with pneumorrhachis (PR). PATIENTS AND METHODS: Two previously healthy children presented with fever, violent dry cough, dyspnea, and tachypnea. Chest X-ray and CT scans showed sizeable PP and PM in both patients. One of them also presented PR. Children were initially treated with intravenous antibiotics, antipyretics, and a cough sedative...
August 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28827669/cerebral-blood-volume-and-oxygen-supply-uniformly-increase-following-various-intrathoracic-pressure-strains
#17
Zhongxing Zhang, Nina Bolz, Marco Laures, Margit Oremek, Christoph Schmidt, Ming Qi, Ramin Khatami
Intrathoracic pressure (ITP) swings challenge many physiological systems. The responses of cerebral hemodynamics to different ITP swings are still less well-known due to the complexity of cerebral circulation and methodological limitation. Using frequency-domain near-infrared spectroscopy and echocardiography, we measured changes in cerebral, muscular and cardiac hemodynamics in five graded respiratory maneuvers (RM), breath holding, moderate and strong Valsalva maneuvers (mVM/sVM) with 20 and 40 cmH2O increments in ITP, moderate and strong Mueller maneuvers (mMM/sMM) with 20 and 40 cmH2O decrements in ITP controlled by esophageal manometry...
August 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28820609/cardio-pulmonary-interactions-physiologic-basis-and-clinical-applications
#18
Michael R Pinsky
The hemodynamic effects of ventilation can be grouped into three concepts: 1) spontaneous ventilation is exercise; 2) changes in lung volume alter autonomic tone, pulmonary vascular resistance, and can compress the heart in the cardiac fossa; 3) spontaneous inspiratory efforts decrease intrathoracic pressure (ITP) increasing venous return and impeding left ventricular (LV) ejection; whereas positive pressure ventilation decreases venous return and unloads LV ejection. Spontaneous inspiratory efforts may induce acute LV failure and cardiogenic pulmonary edema...
August 18, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28800887/evaluation-of-the-boussignac-cardiac-arrest-device-b-card-during-cardiopulmonary-resuscitation-in-an-animal-model
#19
Johanna C Moore, Lionel Lamhaut, Alice Hutin, Kenneth W Dodd, Aaron E Robinson, Michael C Lick, Bayert J Salverda, Mason B Hinke, José Labarere, Guillaume Debaty, Nicolas Segal
AIM OF THE STUDY: The purpose of this study was to examine continuous oxygen insufflation (COI) in a swine model of cardiac arrest. The primary hypothesis was COI during standard CPR (S-CPR) should result in higher intrathoracic pressure (ITP) during chest compression and lower ITP during decompression versus S-CPR alone. These changes with COI were hypothesized to improve hemodynamics. The second hypothesis was that changes in ITP with S-CPR+COI would result in superior hemodynamics compared with active compression decompression (ACD) + impedance threshold device (ITD) CPR, as this method primarily lowers ITP during chest decompression...
August 9, 2017: Resuscitation
https://www.readbyqxmd.com/read/28777657/impact-of-intrathoracic-pressure-in-the-assessment-of-pulmonary-hypertension-in-overweight-patients
#20
Ahmed Jawad, Adriano R Tonelli, Robert L Chatburn, Xiaofeng Wang, Umur Hatipoğlu
No abstract text is available yet for this article.
December 2017: Annals of the American Thoracic Society
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