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Intrathoracic pressure

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https://www.readbyqxmd.com/read/28820609/cardio-pulmonary-interactions-physiologic-basis-and-clinical-applications
#1
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
#2
Johanna C Moore, Lionel Lamhaut, Alice Hutin, Kenneth W Dodd, Aaron E Robinson, Michael C Lick, Bayert J Salverda, Mason B Hinke, Jose Larabere, 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 8, 2017: Resuscitation
https://www.readbyqxmd.com/read/28777657/impact-of-intrathoracic-pressure-in-the-assessment-of-pulmonary-hypertension-in-overweight-patients
#3
Ahmed Jawad, Adriano R Tonelli, Robert L Chatburn, Xiaofeng Wang, Umur Hatipoğlu
No abstract text is available yet for this article.
August 4, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28729396/acute-volume-loading-exacerbates-direct-ventricular-interaction-in-a-model-of-copd
#4
William Spencer Cheyne, Alexandra Mackenzie Williams, Megan I Harper, Neil Derek Eves
Volume loading increases left ventricular (LV) stroke volume (LVSV) through series interaction but may paradoxically reduce LVSV in the presence of large increases in right ventricular (RV) afterload due to direct ventricular interaction (DVI). RV afterload is often increased in COPD as a result of pathological changes to respiratory mechanics, namely increased negative intrathoracic pressure (nITP), dynamic lung hyperinflation (DH) and increased pulmonary vascular resistance (PVR). These hallmarks of COPD negatively impact LV hemodynamics in normovolemia...
July 20, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28722077/invasive-haemodynamic-evaluation-of-the-pulmonary-circulation-in-pulmonary-hypertension
#5
Alberto Pagnamenta, Andrea Azzola, Maurice Beghetti, Frédéric Lador, On Behalf Of The Swiss Society Of Pulmonary Hypertension
The term pulmonary hypertension refers to a serious condition characterised by high pulmonary vascular pressure, mainly as a consequence of various cardiac and respiratory diseases. Current clinical classification of pulmonary hypertension considers five distinct groups. Transthoracic echocardiography represents the first and most important noninvasive screening tool for estimating the probability of pulmonary hypertension. The diagnostic approach to pulmonary hypertension is supported by a proposed algorithm, which identifies the underlying cause...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28690295/high-frequency-of-acute-adverse-cardiovascular-events-after-lung-transplantation-in-patients-with-pulmonary-arterial-hypertension-receiving-preoperative-long-term-intravenous-prostacyclin
#6
Satoshi Akagi, Takahiro Oto, Motomu Kobayashi, Kentaroh Miyoshi, Seiichiro Sugimoto, Masaomi Yamane, Kazufumi Nakamura, Toshihiro Sarashina, Shinichiro Miyoshi, Hiroshi Ito
Adverse cardiovascular events after lung transplantation (LT) increase the mortality in patients with pulmonary arterial hypertension (PAH). Long-term intravenous prostacyclin is the usual treatment in severe patients with PAH, but it may increase the risk of hemorrhage due to its antiplatelet aggregation effect or thrombocytopenia. We investigated the impact of length of intravenous prostacyclin therapy on acute adverse cardiovascular events including hemorrhagic complication after LT. We retrospectively compared the incidence of adverse events (death, intrathoracic hematoma and bleeding, cardiac congestion or shock, cerebral infarction and pulmonary embolism) within 30 days after LT between no/short-term (median 0...
August 3, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28682836/a-technique-of-awake-bronchoscopic-endotracheal-intubation-for-respiratory-failure-in-patients-with-right-heart-failure-and-pulmonary-hypertension
#7
Jimmy Johannes, David A Berlin, Parimal Patel, Edward J Schenck, Frances Mae West, Rajan Saggar, Igor Z Barjaktarevic
OBJECTIVE: Patients with pulmonary hypertension and right heart failure have a high risk of clinical deterioration and death during or soon after endotracheal intubation. The effects of sedation, hypoxia, hypoventilation, and changes in intrathoracic pressure can lead to severe hemodynamic instability. In search for safer approach to endotracheal intubation in this cohort of patients, we evaluate the safety and feasibility of an alternative intubation technique. DATA SOURCES: Retrospective data analysis...
July 4, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28679570/cardiopulmonary-physiology-why-the-heart-and-lungs-are-inextricably-linked
#8
Kevin Verhoeff, Jamie R Mitchell
Because the heart and lungs are confined within the thoracic cavity, understanding their interactions is integral for studying each system. Such interactions include changes in external constraint to the heart, blood volume redistribution (venous return), direct ventricular interaction (DVI), and left ventricular (LV) afterload. During mechanical ventilation, these interactions can be amplified and result in reduced cardiac output. For example, increased intrathoracic pressure associated with mechanical ventilation can increase external constraint and limit ventricular diastolic filling and, therefore, output...
September 1, 2017: Advances in Physiology Education
https://www.readbyqxmd.com/read/28669704/low-pressure-robot-assisted-radical-prostatectomy-with-the-airseal-system-at-olv-hospital-results-from-a-prospective-study
#9
Sabrina La Falce, Giacomo Novara, Giorgio Gandaglia, Paolo Umari, Geert De Naeyer, Frederiek D'Hondt, Jean Beresian, Rik Carette, Martin Penicka, Yujiing Mo, Geert Vandenbroucke, Alexandre Mottrie
BACKGROUND: Limited studies examined effects of pneumoperiotneum during robot-assisted radical prostatectomy (RARP) and with AirSeal. The aim of this study was to assess the effect on hemodynamics of a lower pressure pneumoperitoneum (8 mmHg) with AirSeal, during RARP in steep Trendelenburg 45° (ST). MATERIALS AND METHODS: This is an institutional review board-approved, prospective, interventional, single-center study including patients treated with RARP at OLV Hospital by one extremely experienced surgeon (July 2015-February 2016)...
June 2, 2017: Clinical Genitourinary Cancer
https://www.readbyqxmd.com/read/28660205/pneumothoraces-in-collagen-vi-related-dystrophy-a-case-series-and-recommendations-for-management
#10
Kristin L Fraser, Scott Wong, A Reghan Foley, Sameer Chhibber, Carsten G Bönnemann, Daniel J Lesser, Carla Grosmann, Anne Rutkowski
Collagen VI-related dystrophy (collagen VI-RD) is a rare neuromuscular condition caused by mutations in the COL6A1, COL6A2 or COL6A3 genes. The phenotypic spectrum includes early-onset Ullrich congenital muscular dystrophy, adult-onset Bethlem myopathy and an intermediate phenotype. The disorder is characterised by distal hyperlaxity and progressive muscle weakness, joint contractures and respiratory insufficiency. Respiratory insufficiency is attributed to chest wall contractures, scoliosis, impaired diaphragmatic function and intercostal muscle weakness...
April 2017: ERJ Open Research
https://www.readbyqxmd.com/read/28654638/increased-inspiratory-resistance-affects-the-dynamic-relationship-between-blood-pressure-changes-and-subarachnoid-space-width-oscillations
#11
Magdalena Wszedybyl-Winklewska, Jacek Wolf, Ewa Swierblewska, Katarzyna Kunicka, Kamila Mazur, Marcin Gruszecki, Pawel J Winklewski, Andrzej F Frydrychowski, Leszek Bieniaszewski, Krzysztof Narkiewicz
BACKGROUND AND OBJECTIVE: Respiration is known to affect cerebrospinal fluid (CSF) movement. We hypothesised that increased inspiratory resistance would affect the dynamic relationship between blood pressure (BP) changes and subarachnoid space width (SAS) oscillations. METHODS: Experiments were performed in a group of 20 healthy volunteers undergoing controlled intermittent Mueller Manoeuvres (the key characteristic of the procedure is that a studied person is subjected to a controlled, increased inspiratory resistance which results in marked potentiation of the intrathoracic negative pressure)...
2017: PloS One
https://www.readbyqxmd.com/read/28641752/congenital-diaphragmatic-hernia-associated-pulmonary-hypertension
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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