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https://www.readbyqxmd.com/read/28875324/-extreme-obesity-particular-aspect-of-invasive-and-noninvasive-ventilation
#1
REVIEW
M Deppe, P Lebiedz
The obesity rate is increasing worldwide and the percentage of obese patients in the intensive care unit (ICU) is rising concomitantly. Ventilatory support strategies in obese patients must take into account the altered pathophysiological conditions. Unfortunately, prospective randomized multicenter trials on this subject are lacking. Therefore, current strategies are based on the individual experiences of ICU physicians and single-center studies. Noninvasive ventilation (NIV) in critically ill patients with acute respiratory failure and obesity hypoventilation syndrome (OHS) is an efficient treatment option and should be provided as early as possible is an effort to avoid intubation...
September 5, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28867128/severely-impaired-cardiorespiratory-fitness-in-patients-with-recently-decompensated-systolic-heart-failure
#2
Justin McNair Canada, Cory Ross Trankle, Leo Francis Buckley, Salvatore Carbone, Nayef Antar Abouzaki, Dinesh Kadariya, Keyur Shah, Richard Cooke, Michael Christopher Kontos, Jaideep Patel, Pranav Mankad, Aaron Schatz, Amit Bhatnagar, Ross Arena, Benjamin Wallace Van Tassell, Antonio Abbate
Hospital admission for decompensated heart failure marks a critical inflection point in a patient's health. Despite the improvement in signs or symptoms during hospitalization, patients have a high likelihood of readmission, reflecting a lack of resolution of the underlying condition. Surprisingly, no studies have characterized the cardiorespiratory fitness of such patients. Fifty-two patients (38 [73%] male, age 57 [52 to 65] years, left ventricular ejection fraction 31% [24 to 38]) underwent cardiopulmonary exercise testing 4 (1 to 10) days after hospital discharge, when stable and without overt signs of volume overload...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862962/inspiratory-muscle-training-is-associated-with-improved-inspiratory-muscle-strength-resting-cardiac-output-and-the-ventilatory-efficiency-of-exercise-in-patients-with-a-fontan-circulation
#3
Karina Laohachai, David Winlaw, Hiran Selvadurai, Ganesh Kumar Gnanappa, Yves d'Udekem, David Celermajer, Julian Ayer
BACKGROUND: Patients with a Fontan circulation have reduced exercise capacity and respiratory muscle strength. Inspiratory muscle training (IMT) improves exercise capacity and quality of life in adults with heart failure. We assessed whether 6 weeks of a home-based program of IMT improves inspiratory muscle strength and the ventilatory efficiency of exercise in adolescent patients with a Fontan circulation. METHODS AND RESULTS: Twenty-three adolescent participants (aged 16±2 years) with a Fontan circulation underwent 6 weeks of IMT for 30 minutes daily...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28857391/estimated-peak-functional-capacity-an-accurate-method-for-assessing-change-in-peak-oxygen-consumption-after-cardiac-rehabilitation
#4
S Nichols, D O Gleadall-Siddall, R Antony, A L Clark, J G F Cleland, S Carroll, L Ingle
OBJECTIVE: Cardiopulmonary exercise testing (CPET) is the 'gold standard' method of determining VO2peak . When CPET is unavailable, VO2peak may be estimated from treadmill or cycle ergometer workloads and expressed as estimated metabolic equivalents (METs). Cardiac rehabilitation (CR) programmes use estimated VO2peak (METs) to report changes in cardiorespiratory fitness (CRF). However, the accuracy of determining changes in VO2peak based on estimated functional capacity is not known. METHODS: A total of 27 patients with coronary heart disease (88·9% male; age 59·5 ± 10·0 years, body mass index 29·6 ± 3·8 kg m(-2) ) performed maximal CPET before and after an exercise-based CR intervention...
August 30, 2017: Clinical Physiology and Functional Imaging
https://www.readbyqxmd.com/read/28840941/acute-fall-and-long-term-rise-in-oxygen-saturation-in-response-to-meditation
#5
Nicolò F Bernardi, Marco Bordino, Lucio Bianchi, Luciano Bernardi
The effects of meditation on arterial and tissue oxygenation are unknown and difficult to assess because respiration is often altered, directly or indirectly, during meditation practice. Thus, changes in respiration may affect cardiovascular responses independently from meditation. In this study, we aim to isolate the specific effect of meditation on arterial and tissue oxygenation and other cardiorespiratory indexes while systematically controlling for the role of respiration. Furthermore, we aim to clarify to what extent prior expertise in meditation practice is needed to observe reliable changes...
August 25, 2017: Psychophysiology
https://www.readbyqxmd.com/read/28838335/comparative-determination-of-ventilatory-efficiency-from-constant-load-and-incremental-exercise-testing
#6
S Algul, F A Ugur, A Ayar, O Ozcelik
The analysis of the relationships between minute ventilation (VE) to CO2 output (VCO2), referred to as ventilatory efficiency, in response to incremental exercise testing, is considered a useful index for assessing the presence and severity of cardiopulmonary and metabolic diseases. The effects of constant load exercise testing performed at work intensity associated with anaerobic threshold (AT) and respiratory compensation points (RCP), on the accurate measurements of ventilatory efficiency are not well known...
August 15, 2017: Cellular and Molecular Biology
https://www.readbyqxmd.com/read/28808334/cardiorespiratory-optimization-during-improvised-singing-and-toning
#7
N F Bernardi, S Snow, I Peretz, H D Orozco Perez, N Sabet-Kassouf, A Lehmann
We evaluated the effect of different forms of singing on cardiorespiratory physiology, and we aimed at disentangling the role of breathing from that of vocal production. Cardiorespiratory recordings were obtained from 20 healthy adults at rest and during: a) singing of familiar slow songs as in the standard form of Western culture; b) improvised vocalization of free vowel sounds, known as toning. To disentangle the role of breathing from that of vocal production, we compared the vocal conditions with matched breathing-only conditions...
August 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28805258/impact-of-beta-blockers-on-cardiopulmonary-exercise-testing-in-patients-with-advanced-liver-disease
#8
M P Wallen, A Hall, K A Dias, J S Ramos, S E Keating, A J Woodward, T L Skinner, G A Macdonald, R Arena, J S Coombes
BACKGROUND: Patients with advanced liver disease may develop portal hypertension that can result in variceal haemorrhage. Beta-blockers reduce portal pressure and minimise haemorrhage risk. These medications may attenuate measures of cardiopulmonary performance, such as the ventilatory threshold and peak oxygen uptake measured via cardiopulmonary exercise testing. AIM: To determine the effect of beta-blockers on cardiopulmonary exercise testing variables in patients with advanced liver disease...
August 14, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28770545/how-to-reduce-cisatracurium-consumption-in-ards-patients-the-tof-ards-study
#9
Sami Hraiech, Jean-Marie Forel, Christophe Guervilly, Romain Rambaud, Samuel Lehingue, Mélanie Adda, Pierre Sylla, Sabine Valera, Julien Carvelli, Marc Gainnier, Laurent Papazian, Jérémy Bourenne
BACKGROUND: Neuromuscular blocking agents (NMBAs) have been shown to improve the outcome of the most severely hypoxemic, acute respiratory distress syndrome (ARDS) patients. However, the recommended dosage as well as the necessity of monitoring the neuromuscular block is unknown. We aimed to evaluate the efficiency of a nurse-directed protocol of NMBA administration based on a train-of-four (TOF) assessment to ensure a profound neuromuscular block and decrease cisatracurium consumption compared to an elevated and constant dose regimen...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28751866/ventilatory-efficiency-in-children-and-adolescents-born-extremely-preterm
#10
Julie Hestnes, Hedda Hoel, Ole J Risa, Hanna O Romstøl, Ola Røksund, Bente Frisk, Einar Thorsen, Thomas Halvorsen, Hege H Clemm
Purpose: Children and adolescents born extremely preterm (EP) have lower dynamic lung volumes and gas transfer capacity than subjects born at term. Most studies also report lower aerobic capacity. We hypothesized that ventilatory efficiency was poorer and that breathing patterns differed in EP-born compared to term-born individuals. Methods: Two area-based cohorts of participants born with gestational age ≤28 weeks or birth weight ≤1000 g in 1982-85 (n = 46) and 1991-92 (n = 35) were compared with individually matched controls born at term...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28743318/benefits-of-manometer-in-non-invasive-ventilatory-support
#11
Rodrigo Silva Lacerda, Fernando Cesar Anastácio de Lima, Leonardo Pereira Bastos, Anderson Fardin Vinco, Felipe Britto Azevedo Schneider, Yves Luduvico Coelho, Heitor Gomes Costa Fernandes, João Marcus Ramos Bacalhau, Igor Matheus Simonelli Bermudes, Claudinei Ferreira da Silva, Luiza Paterlini da Silva, Rogério Pezato
Introduction Effective ventilation during cardiopulmonary resuscitation (CPR) is essential to reduce morbidity and mortality rates in cardiac arrest. Hyperventilation during CPR reduces the efficiency of compressions and coronary perfusion. Problem How could ventilation in CPR be optimized? The objective of this study was to evaluate non-invasive ventilator support using different devices. METHODS: The study compares the regularity and intensity of non-invasive ventilation during simulated, conventional CPR and ventilatory support using three distinct ventilation devices: a standard manual resuscitator, with and without airway pressure manometer, and an automatic transport ventilator...
July 26, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28741716/influence-of-lateral-position-and-pneumoperitoneum-on-oropharyngeal-leak-pressure-with-two-types-of-laryngeal-mask-airways
#12
S Lan, Y Zhou, J T Li, Z Z Zhao, Y Liu
BACKGROUND: An important parameter to monitor adequate ventilation for laryngeal mask airway (LMA) is its oropharyngeal leak pressure (OLP). This study was designed to evaluate and compare the effect of lateral position and pneumoperitoneum on the OLP and ventilation efficiency between LMA™ Proseal (PLMA) and LMA™ Supreme (SLMA). METHODS: Patients were randomized to receive either the PLMA or the SMLA. The OLP was assessed in both the supine position and the lateral position with or without pneumoperitoneum...
July 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28741667/an-evaluation-of-the-validity-of-the-pre-operative-oxygen-uptake-efficiency-slope-as-an-indicator-of-cardiorespiratory-fitness-in-elderly-patients-scheduled-for-major-colorectal-surgery
#13
B C Bongers, A E Berkel, J M Klaase, N L van Meeteren
This study aimed to investigate the validity of the oxygen uptake efficiency slope as an objective and submaximal indicator of cardiorespiratory fitness in elderly patients scheduled for major colorectal surgery. Patients ≥ 60 years of age, with a metabolic equivalent score using the Veterans Activity Questionnaire ≤ 7 and scheduled for major colorectal surgery participated in a pre-operative cardiopulmonary exercise test. The oxygen uptake efficiency slope was calculated up to different exercise intensities, using 100%, 90% and 80% of the exercise data...
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28727673/exercise-training-improves-ventilatory-efficiency-in-patients-with-a-small-abdominal-aortic-aneurysm-a-randomized-controlled-study
#14
Ricardo M Lima, Baruch Vainshelboim, Rucha Ganatra, Ronald Dalman, Khin Chan, Jonathan Myers
PURPOSE: To investigate the effects of exercise training on ventilatory efficiency and physiological responses to submaximal exercise in subjects with small abdominal aortic aneurysm (AAA). METHODS: Sixty-five male patients (72.3 ± 7.0 years) were randomized to exercise training (n = 33) or usual care group (n = 32). Exercise subjects participated in a training groups for 3 mo. Cardiopulmonary exercise testing was performed before and after the study period and peak VO2, the ventilatory threshold (VT), the oxygen uptake efficiency slope (OUES), and the VE2/VCO2 slope were identified...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28695974/what-determine-the-quality-of-life-of-adult-patients-after-fontan-procedure
#15
Monika Smaś-Suska, Natalia Dłużniewska, Piotr Weryński, Jacek Pająk, Wojciech Płazak, Maria Olszowska, Piotr Podolec, Lidia Tomkiewicz-Pająk
BACKGROUND: Despite the low early mortality of Fontan procedures, Fontan patients are prone to various cardiac and extra-cardiac complications in the long term. This may influence patient perception of their health and outcome. The aim of the study was to assess the relationship of multi-organ complications and physical efficiency with self-reported health-related quality of life (QOL) in adult Fontan patients. METHODS: Quality of life was assessed with the Short Form-36 questionnaire...
July 11, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28681553/contractile-reserve-and-cardiopulmonary-exercise-parameters-in-patients-with-dilated-cardiomyopathy-the-two-dimensions-of-exercise-testing
#16
Kegan J Moneghetti, Yukari Kobayashi, Jeffrey W Christle, Miyuki Ariyama, Bojan Vrtovec, Tatiana Kouznetsova, Andrew Wilson, Euan Ashley, Matthew T Wheeler, Johnathan Myers, Francois Haddad
BACKGROUND: Left ventricular (LV) contractile reserve assessed using imaging and cardiopulmonary exercise testing (CPX) has been shown to predict outcome in patients with dilated cardiomyopathy (DCM). Few clinical studies have, however, analyzed the relationship between them. METHODS: A cohort of 75 ambulatory patients with DCM underwent stress treadmill echocardiography with CPX. LV contractile reserve was calculated as absolute change (ΔLVEF=LVEFpeak -LVEFrest ) and percent change (%LVEF=[(LVEFpeak -LVEFrest )/LVEFpeak) ]×100) in LVEF, circumferential and longitudinal strain (LS)...
August 2017: Echocardiography
https://www.readbyqxmd.com/read/28669689/effects-of-erythropoietin-on-cycling-performance-of-well-trained-cyclists-a-double-blind-randomised-placebo-controlled-trial
#17
Jules A A C Heuberger, Joris I Rotmans, Pim Gal, Frederik E Stuurman, Juliëtte van 't Westende, Titiaan E Post, Johannes M A Daniels, Matthijs Moerland, Peter L J van Veldhoven, Marieke L de Kam, Herman Ram, Olivier de Hon, Jelle J Posthuma, Jacobus Burggraaf, Adam F Cohen
BACKGROUND: Substances that potentially enhance performance (eg, recombinant human erythropoietin [rHuEPO]) are considered doping and are therefore forbidden in sports; however, the scientific evidence behind doping is frequently weak. We aimed to determine the effects of rHuEPO treatment in well trained cyclists on maximal, submaximal, and race performance and on safety, and to present a model clinical study for doping research on other substances. METHODS: We did this double-blind, randomised, placebo-controlled trial at the Centre for Human Drug Research in Leiden (Netherlands)...
August 2017: Lancet Haematology
https://www.readbyqxmd.com/read/28666570/dead-space-ventilation-is-linked-to-exercise-capacity-and-survival-in-distal-chronic-thromboembolic-pulmonary-hypertension
#18
Laurent Godinas, Caroline Sattler, Edmund M Lau, Xavier Jaïs, Yu Taniguchi, Mitja Jevnikar, Jason Weatherald, Olivier Sitbon, Laurent Savale, David Montani, Gérald Simonneau, Marc Humbert, Pierantonio Laveneziana, Gilles Garcia
BACKGROUND: Cardiopulmonary exercise testing (CPET) is frequently used for the evaluation of patients with pulmonary hypertension (PH). Non-operable distal chronic thromboembolic pulmonary hypertension (CTEPH) represents a unique subgroup of PH where microvascular disease resembling pulmonary arterial hypertension (PAH) may predominate and efficacious medical therapy is now available. However, little is known regarding the detailed CPET profile of patients with distal CTEPH, and whether ventilation and gas exchange responses are different from PAH...
May 22, 2017: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/28665692/excess-ventilation-in-copd-heart-failure-overlap-implications-for-dyspnea-and-exercise-intolerance
#19
Alcides Rocha, Flavio F Arbex, Priscilla A Sperandio, Aline Souza, Ligia Biazzim, Frederico Mancuso, Danilo C Berton, Bruno Hochhegger, Maria Clara N Alencar, Luiz E Nery, Denis E O'Donnell, J Alberto Neder
BACKGROUND: An increased ventilatory response to exertional metabolic demand (high ventilation (⩒E)-carbon dioxide output (⩒CO2) relationship) is a common finding in patients with coexistent COPD-heart failure. We aimed to determine the mechanisms underlying high ⩒E-⩒CO2 and its impact on operating lung volumes, dyspnea and exercise tolerance in these patients. METHODS: Twenty-two ex-smokers with combined COPD and heart failure with reduced left ventricular ejection fraction (LVEF) undertook, after careful treatment optimization, a progressive cycle exercise test with capillary (c) blood gas collection...
June 30, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28640773/salivary-mitochondrial-dna-copy-number-is-associated-with-exercise-ventilatory-efficiency
#20
Yang Chen, Helene Z Hill, Gudrun Lange, Michael J Falvo
Chen, Y, Hill, HZ, Lange, G, and Falvo, MJ. Salivary mitochondrial DNA copy number is associated with exercise ventilatory efficiency. J Strength Cond Res 31(7): 2000-2004, 2017-Mitochondrial DNA copy number (mtDNAcn) is an index of mitochondrial content and is responsive to changes in exercise training volume. Therefore, assessment of mtDNAcn may help to optimize exercise prescription and aid in athlete monitoring. Although previous work has assessed mtDNAcn derived from skeletal muscle and blood using invasive approaches, no study has examined salivary mtDNAcn and its relationship with sport performance...
July 2017: Journal of Strength and Conditioning Research
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