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ventilatory efficiency

Samuel Wittekind, Wayne Mays, Yvette Gerdes, Sandra Knecht, John Hambrook, William Border, John Lynn Jefferies
Patients with a Fontan circulation have impaired exercise capacity. Cardiac rehabilitation (CR) has shown promise in enhancing peak exercise parameters in this population, but an improvement in submaximal exercise has not been consistently demonstrated. We assessed the hypothesis that participation in CR will be associated with more efficient oxygen extraction and ventilation during submaximal exercise. In this prospective study, pediatric Fontans completed two 60 min CR sessions per week for 12 weeks. Cardiopulmonary exercise testing and stress echocardiography were performed at baseline and last CR session, and then compared with a paired sample t test...
March 9, 2018: Pediatric Cardiology
Tiago Pereira-da-Silva, Rui M Soares, Ana Luísa Papoila, Iola Pinto, Joana Feliciano, Luís Almeida-Morais, Ana Abreu, Rui Cruz Ferreira
INTRODUCTION AND AIMS: Selecting patients for heart transplantation is challenging. We aimed to identify the most important risk predictors in heart failure and an approach to optimize the selection of candidates for heart transplantation. METHODS: Ambulatory patients followed in our center with symptomatic heart failure and left ventricular ejection fraction ≤40% prospectively underwent a comprehensive baseline assessment including clinical, laboratory, electrocardiographic, echocardiographic, and cardiopulmonary exercise testing parameters...
March 5, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Gul Gursel, Avsar Zerman, Burcu Basarik, Kamil Gonderen, Muge Aydogdu, Serriyye Memmedova
Auto-titrating noninvasive ventilation (NIV) has been developed as a new mode applying variable expiratory-positive airway pressure (EPAP) in addition to variable inspiratory pressures (IPAP), both to deliver targeted tidal volume (VT) and to eliminate upper airway resistance. The purpose of this study is to evaluate whether NIV with auto-titrating mode will decrease more PaCO2 within a shorter time compared to volume-assured mode in hypercapnic intensive care unit (ICU) patients. The hypercapnic respiratory failure patients treated with average volume assured pressure support- automated EPAP mode (group1) were compared with those treated with average volume-assured pressure support mode (group2)...
March 6, 2018: Internal and Emergency Medicine
Yuko Kato, Shinya Suzuki, Tokuhisa Uejima, Hiroaki Semba, Osamu Nagayama, Etsuko Hayama, Takuto Arita, Naoharu Yagi, Hiroto Kano, Shunsuke Matsuno, Takayuki Otsuka, Yuji Oikawa, Takashi Kunihara, Junji Yajima, Takeshi Yamashita
Background Ventilatory efficiency decreases with age. This study aimed to investigate the prognostic significance and cut-off value of the minute ventilation/carbon dioxide production (VE/VCO 2 ) slope according to age in patients with heart failure. Methods and results We analysed 1501 patients with heart failure from our observational cohort who performed maximal symptom-limited cardiopulmonary exercise testing and separated them into three age groups (≤55 years, 56-70 years and ≥71 years) in total and according to the three ejection fraction categories defined by European Society of Cardiology guidelines...
January 1, 2018: European Journal of Preventive Cardiology
Fernando Suarez Sipmann, Arnoldo Santos, Gerardo Tusman
Acute respiratory distress syndrome (ARDS) is the most severe form of acute respiratory failure characterized by diffuse alveolar and endothelial damage. The severe pathophysiological changes in lung parenchyma and pulmonary circulation together with the effects of positive pressure ventilation profoundly affect heart lung interactions in ARDS. The term pulmonary vascular dysfunction (PVD) refers to the specific involvement of the vascular compartment in ARDS and is expressed clinically by an increase in pulmonary arterial (PA) pressure and pulmonary vascular resistance both affecting right ventricular (RV) afterload...
January 2018: Annals of Translational Medicine
Julia Hock, Barbara Reiner, Rhoia C Neidenbach, Renate Oberhoffer, Alfred Hager, Peter Ewert, Jan Müller
OBJECTIVE: Children and adolescents with an univentricular heart after total cavopulmonary connection (TCPC) have functional impairments. This study assesses health-related physical fitness (HRPF) and exercise capacity, as well as their relation to health-related quality of life (HRQoL) in patients with an univentricular heart after total-pulmonary connection (TCPC). PATIENTS AND METHODS: Between July 2014 and October 2016 a total of 78 children and adolescents with TCPC (12...
March 15, 2018: International Journal of Cardiology
Eduardo Salazar-Martínez, Alfredo Santalla, José Naranjo Orellana, Jochen Strobl, Martin Burtscher, Verena Menz
The aim of this study was to investigate the effects of 3 weeks high-intensity interval training (HIIT) on ventilatory efficiency (VE/VCO2 slope) in endurance athletes. Sixteen male well-trained (67.72 ml kg min-1) athletes participated in this study. Each participant performed an incremental exercise test with gas analysis (i.e. VE, VO2) and a 400 m running field test (T400m) before and after the 3 weeks intervention period. HIIT group (HIITG) performed 11 HIIT sessions consisting of four 4-min interval bouts at an exercise intensity of 90-95% of the VO2max, separated by 4-min active recovery periods (work/rest ratio = 1:1)...
January 30, 2018: Respiratory Physiology & Neurobiology
Sertaç Yakal, Sevtün Sofyalı, Berker Özkan, Safinaz Yıldız, Alper Toker, Erdem Kasikcioglu
OBJECTIVE: Peak oxygen consumption is a very valuable cardiopulmonary functional parameter in pre-operative evaluation of patients with lung cancer. However, it has several critical limitations for operability decision due to failure in achieving maximal level of exercise test for cases. The aim of this study was to reveal the importance of more accurate cardiopulmonary parameters that can be calculated from data of submaximal level test, such as oxygen uptake efficiency slope (OUES) and to determine whether it could be used in the operability decision phase for borderline cases by means of morbidity and mortality...
January 18, 2018: Lung
Leo F Buckley, Justin M Canada, Marco G Del Buono, Salvatore Carbone, Cory R Trankle, Hayley Billingsley, Dinesh Kadariya, Ross Arena, Benjamin W Van Tassell, Antonio Abbate
BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome that presents clinicians with a diagnostic challenge. The use of natriuretic peptides to exclude a diagnosis of HFpEF has been proposed. We sought to compare HFpEF patients with N-terminal pro-brain natriuretic peptide (NT-proBNP) level above and below the proposed cut-off. METHODS: Stable patients (n = 30) with left ventricular (LV) ejection fraction ≥ 50% were eligible if they had a diagnosis of HF according to the European Society of Cardiology diagnostic criteria...
January 18, 2018: ESC Heart Failure
Hagen Bomberg, Thomas Volk, Heinrich V Groesdonk, Andreas Meiser
The circle system has been in use for more than a 100 years, whereas the first clinical application of an anaesthetic reflector was reported just 15 years ago. Its functional basis relies on molecular sieves such as zeolite crystals or activated carbon. In a circle system, the breathing gas is rebreathed after carbon dioxide absorption; a reflector on the other hand specifically retains the anaesthetic during expiration and resupplies it during the next inspiration. Reflection systems can be used in conjunction with intensive care ventilators and do not need the permanent presence of trained qualified staff...
January 4, 2018: Journal of Clinical Monitoring and Computing
Stine Maren Riksfjord, Siri Merete Brændvik, Ola D Røksund, Inger-Lise Aamot
Objectives: To assess ventilatory efficiency and aerobic capacity in people with multiple sclerosis and whether treadmill walking or progressive strength training has an effect on these parameters in this population. Methods: In all, 24 adults with multiple sclerosis with an Expanded Disability Status Scale score of ≤6 completed a cardiopulmonary exercise test before and after 8 weeks of exercise. They were randomized to treadmill walking of low-to-moderate intensity (50%-70% of peak heart rate) or progressive strength training (six repetitions × two at 80% of one repetition maximum)...
2017: SAGE Open Medicine
Katrin Bauer, Eliram Nof, Josué Sznitman
BACKGROUND: High frequency oscillatory ventilation is often used for lung support in premature neonates suffering from respiratory distress syndrome. Despite its broad use in neonatal intensive care units, there are to date no accepted protocols for the choice of appropriate ventilation parameter settings. In this context, the underlying mass transport mechanisms are still not fully understood. METHODS: We revisit the question of flow phenomena under conventional mechanical ventilation and high frequency oscillatory ventilation in an anatomically-inspired model of neonatal conductive airways spanning the first few airway generations...
November 28, 2017: Clinical Biomechanics
Allison R Webel, Joseph Perazzo, Christopher T Longenecker, Trevor Jenkins, Abdus Sattar, Margaret Rodriguez, Nate Schreiner, Richard A Josephson
BACKGROUND: Lifestyle physical activity (ie, moderate physical activity during routine daily activities most days of the week) may benefit human immunodeficiency virus (HIV)-positive adults who are at high risk for cardiovascular disease. OBJECTIVE: The aims of this study were to describe lifestyle physical activity patterns in HIV-positive adults and to examine the influence of lifestyle physical activity on markers of cardiovascular health. Our secondary objective was to compare these relationships between HIV-positive adults and well-matched HIV-uninfected adults...
November 16, 2017: Journal of Cardiovascular Nursing
Sherin Hassan M Mehani, Heba Ahmed A Abdeen
[Purpose] Ventilatory limitation is a common problem in patients with chronic heart failure and pulmonary hypertension. Excess ventilation may arise from augmented ventilatory drive, over activity of chemoreceptors and muscle ergoreceptors, or premature onset of lactic acidosis. Exertional dyspnea can cause limitations in the activities of daily living and as a result, reduced quality of life for these patients. The aim of the present study was to evaluate the effect of cardiopulmonary rehabilitation program on ventilatory efficiency for these patients...
October 2017: Journal of Physical Therapy Science
Ayman El-Menyar, Rafael Consunji, Hassan Al-Thani, Ahammed Mekkodathil, Gaby Jabbour, Khalid A Alyafei
Background: The epidemiologic characteristics and outcomes of pediatric traumatic brain injury (pTBI) have not been adequately documented from the rapidly developing countries in the Arab Middle East. We aimed to describe the hospital-based epidemiologic characteristics, injury mechanisms, clinical presentation, and outcomes of pTBI and analyze key characteristics and determinant of pTBI that could help to make recommendations for policies to improve their care. Methods: We conducted a retrospective observational study in a level 1 trauma center (2010-2014) for all pTBI patients...
2017: World Journal of Emergency Surgery: WJES
José R Alvero Cruz, Mauro Ronconi, Jerónimo Garcia Romero, José Naranjo Orellana
BACKGROUND: This study investigated the effects of detraining on breathing pattern. The aim of this study was to evaluate the effect of a sixweek detraining period on breathing patterns and ventilatory efficiency. METHODS: Fourteen young soccer players were evaluated at the end of a competitive season and after a sixweek detraining period. Assessment of respiratory efficiency was based on VE/VCO2 slope changes below 70% of exercise intensity. All participants underwent twice an incremental graded exercise test up to exhaustion...
November 17, 2017: Journal of Sports Medicine and Physical Fitness
Benjamin W Van Tassell, Justin Canada, Salvatore Carbone, Cory Trankle, Leo Buckley, Claudia Oddi Erdle, Nayef A Abouzaki, Dave Dixon, Dinesh Kadariya, Sanah Christopher, Aaron Schatz, Jessica Regan, Michele Viscusi, Marco Del Buono, Ryan Melchior, Pranav Mankad, Juan Lu, Robin Sculthorpe, Giuseppe Biondi-Zoccai, Edward Lesnefsky, Ross Arena, Antonio Abbate
BACKGROUND: An enhanced inflammatory response predicts worse outcomes in heart failure (HF). We hypothesized that administration of IL-1 (interleukin-1) receptor antagonist (anakinra) could inhibit the inflammatory response and improve peak aerobic exercise capacity in patients with recently decompensated systolic HF. METHODS AND RESULTS: We randomly assigned 60 patients with reduced left ventricular ejection fraction (<50%) and elevated C-reactive protein levels (>2 mg/L), within 14 days of hospital discharge, to daily subcutaneous injections with anakinra 100 mg for 2 weeks, 12 weeks, or placebo...
November 2017: Circulation. Heart Failure
Seyed Mohammadreza Hashemian, Esmaeil Mortaz, Hamidreza Jamaati, Leila Bagheri, Seyed Amir Mohajerani, Johan Garssen, Masoud Movassaghi, Peter J Barnes, Nicholas S Hill, Ian M Adcock
INTRODUCTION: Mechanical ventilatory support is life-saving therapy for patients with respiratory failure in intensive care units (ICU) but is linked to ventilator-associated pneumonia and other nosocomial infections. Interventions that improve the efficiency of weaning from mechanical ventilation may improve patient outcomes. OBJECTIVE: To determine whether inhaled budesonide decreases time-to-weaning in COPD stage 4 difficult-to-wean patients and reduces the release of pro-inflammatory cytokines in ICU patients...
October 31, 2017: Journal of Critical Care
Mehrdad Behnia, Courtney M Wheatley, Alberto Avolio, Bruce D Johnson
Background: Factors limiting exercise in patients with COPD are complex. With evidence for accelerated pulmonary vascular aging, destruction of alveolar-capillary bed, and hypoxic pulmonary vasoconstriction, the ability to functionally expand surface area during exercise may become a primary limitation. Purpose: To quantify measures of alveolar-capillary recruitment during exercise and the relationship to exercise capacity in a cohort of COPD patients. Methods: Thirty-two subjects gave consent (53% male, with mean ± standard deviation age 66±9 years, smoking 35±29 pack-years, and Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification of 0-4: 2...
2017: International Journal of Chronic Obstructive Pulmonary Disease
Neeltje A E Allard, Tom J J Schirris, Rebecca J Verheggen, Frans G M Russel, Richard J Rodenburg, Jan A M Smeitink, Paul D Thompson, Maria T E Hopman, Silvie Timmers
Context: Statin myopathy is linked to disturbances in mitochondrial function and exercise intolerance. Objectives: To determine whether differences exist in exercise performance, muscle function, and muscle mitochondrial oxidative capacity and content between symptomatic and asymptomatic statin users, and control subjects. Design: Cross-sectional study. Setting: Department of Physiology, Radboud University Medical Center...
January 1, 2018: Journal of Clinical Endocrinology and Metabolism
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