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respiratory physiology ventilation

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https://www.readbyqxmd.com/read/29676798/afferent-neural-feedback-overrides-the-modulating-effects-of-arousal-hypercapnia-and-hypoxemia-on-neonatal-cardio-respiratory-control
#1
Kathleen J Lumb, Jennifer M Schneider, Thowfique Ibrahim, Anita Rigaux, Shabih U Hasan
KEY POINTS: Evidence at whole animal, organ-system, and cellular and molecular levels suggests that afferent volume feedback is critical for establishment of adequate ventilation at birth. Due to the irreversible nature of vagal ablation studies to date, it was difficult to quantify the roles of afferent volume input, arousal and changes in blood gas tensions on neonatal respiratory control. During reversible perineural vagal block, profound apneas, and hypoxemia and hypercarbia were observed necessitating termination of perineural blockade...
April 20, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29674333/intravenous-and-intratracheal-thyrotropin-releasing-hormone-and-its-analog-taltirelin-reverse-opioid-induced-respiratory-depression-in-isoflurane-anesthetized-rats
#2
James D Boghosian, Anita Luethy, Joseph F Cotten
Thyrotropin releasing hormone (TRH) is a tripeptide hormone and a neurotransmitter widely-expressed in the CNS that regulates thyroid function and that maintains physiologic homeostasis. Following injection in rodents, TRH has multiple effects including increased blood pressure and breathing. We tested the hypothesis that TRH and its long-acting analog, taltirelin, will reverse morphine-induced respiratory depression in anesthetized rats following intravenous(IV) or intratracheal(IT) administration. TRH (1 mg/kg plus 5 mg/kg/hour IV) and talitrelin (1 mg/kg IV), when administered to rats pretreated with morphine (5 mg/kg IV), increased ventilation from 50±6 to 131±7% and 45±6 to 168±13% (percent baseline; n=4±SEM), primarily through increased breathing rates (from 76+/-9 to 260±14% and 66±8 to 318±37%)...
April 19, 2018: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/29667182/breathing-regulation-and-blood-gas-homeostasis-after-near-complete-lesions-of-the-retrotrapezoid-nucleus-in-adult-rats
#3
George M P R Souza, Roy Kanbar, Daniel S Stornetta, Stephen B G Abbott, Ruth L Stornetta, Patrice G Guyenet
The retrotrapezoid nucleus (RTN) is one of several CNS nuclei that contribute, in various capacities (e.g. CO2 detection, neuronal modulation) to the central respiratory chemoreflex (CRC). Here we test how important the RTN is to PCO2 homeostasis and breathing during sleep or wake. RTN Nmb positive neurons were killed with targeted microinjections of substance-P-saporin conjugate in adult rats. Under normoxia, rats with large RTN lesions (92 ± 4 % cell loss) had normal blood pressure (BP) and arterial pH but were hypoxic (-8 mmHg PaO2 ) and hypercapnic (+10 mmHg PaCO2 )...
April 18, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29666293/fast-or-slow-rescue-ventilations-a-predictive-model-of-gastric-inflation
#4
John R Fitz-Clarke
BACKGROUND: Rescue ventilations are given during respiratory and cardiac arrest. Tidal volume must assure oxygen delivery; however, excessive pressure applied to an unprotected airway can cause gastric inflation, regurgitation, and pulmonary aspiration. The optimal technique provides mouth pressure and breath duration that minimize gastric inflation. It remains unclear if breath delivery should be fast or slow, and how inflation time affects the division of gas flow between the lungs and esophagus...
April 17, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29650311/an-object-oriented-computational-model-to-study-cardiopulmonary-hemodynamic-interactions-in-humans
#5
Chuong Ngo, Stephan Dahlmanns, Thomas Vollmer, Berno Misgeld, Steffen Leonhardt
BACKGROUND AND OBJECTIVE: This work introduces an object-oriented computational model to study cardiopulmonary interactions in humans. METHODS: Modeling was performed in object-oriented programing language Matlab Simscape, where model components are connected with each other through physical connections. Constitutive and phenomenological equations of model elements are implemented based on their non-linear pressure-volume or pressure-flow relationship. The model includes more than 30 physiological compartments, which belong either to the cardiovascular or respiratory system...
June 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29629989/an-open-loop-physiologic-model-based-decision-support-system-can-provide-appropriate-ventilator-settings
#6
Dan Stieper Karbing, Savino Spadaro, Nilanjan Dey, Riccardo Ragazzi, Elisabetta Marangoni, Francesca Dalla Corte, Federico Moro, David Lodahl, Niklas Schurmann Hansen, Robert Winding, Stephen Edward Rees, Carlo Alberto Volta
OBJECTIVES: To evaluate the physiologic effects of applying advice on mechanical ventilation by an open-loop, physiologic model-based clinical decision support system. DESIGN: Prospective, observational study. SETTING: University and Regional Hospitals' ICUs. PATIENTS: Varied adult ICU population. INTERVENTIONS: Advice were applied if accepted by physicians for a period of up to 4-8 hours. MEASUREMENTS AND MAIN RESULTS: Seventy-two patients were included for data analysis...
April 6, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29628583/pressure-controlled-volume-guaranteed-mode-improves-respiratory-dynamics-during-laparoscopic-cholecystectomy-a-comparison-with-conventional-modes
#7
Apoorwa Kothari, Deepa Baskaran
Background: Pneumoperitoneum and altered positioning 1in laparoscopic cholecystectomy predispose to alterations in cardiorespiratory physiology. We compared the effects of volume controlled, pressure controlled, and the newly introduced pressure controlled-volume guaranteed ventilation (PCV-VG) modes of ventilation on respiratory mechanics and oxygenation during laparoscopic cholecystectomy. Materials and Methods: Seventy-five physical status American Society of Anesthesiologists Classes I and II patients with normal lungs undergoing laparoscopic cholecystectomy were randomly allocated to receive volume controlled ventilation (VCV), pressure-controlled ventilation (PCV), or PCV-VG modes of ventilation during general anesthesia...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29627883/platelet-transfusion-increases-risk-for-acute-respiratory-distress-syndrome-in-non-massively-transfused-blunt-trauma-patients
#8
George Kasotakis, Nichole Starr, Erek Nelson, Bedabrata Sarkar, Peter Ashley Burke, Daniel George Remick, Ronald Gary Tompkins
PURPOSE: While damage control resuscitation is known to confer a survival advantage in severely injured patients, high-ratio blood component therapy should be initiated only in carefully selected trauma patients, due to the morbidity associated with blood product use. With this project, we aim to identify the effect of platelet transfusion in non-massively transfused bluntly injured patients. METHODS: The Glue Grant database was retrospectively queried and severely injured blunt trauma patients who underwent non-massive transfusion were identified...
April 7, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29625917/alfaxalone-anaesthesia-in-lemur-catta-following-dexmedetomidine-butorphanol-midazolam-sedation
#9
Eugenio Gaudio, Laura Voltan, Giulia Maria De Benedictis
OBJECTIVE: To evaluate the clinical effects and quality of sedation, induction, maintenance and recovery in Lemur catta after dexmedetomidine-butorphanol-midazolam sedation and alfaxalone anaesthesia. STUDY DESIGN: Prospective, observational study. ANIMALS: Six male L. catta weighing 3.0 ± 0.6 kg undergoing surgical castration. METHODS: Lemurs were sedated with intramuscular dexmedetomidine (0.015 mg kg-1 ), butorphanol (0...
February 3, 2018: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29622329/pediatric-emergency-noninvasive-ventilation
#10
REVIEW
Chad D Viscusi, Garrett S Pacheco
Noninvasive ventilation (NIV) has emerged as a powerful tool for the pediatric emergency management of acute respiratory failure (ARF). This therapy is safe and well tolerated and seems to frequently prevent both the need for invasive mechanical ventilation and the associated risks/complications. Although NIV can be the primary treatment of ARF resulting from multiple respiratory disease states, it must be meticulously monitored and, when unsuccessful, may aid in preoxygenation for prompt endotracheal intubation and invasive mechanical ventilation...
May 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29602814/polysomnography-versus-limited-respiratory-monitoring-and-nurse-led-titration-to-optimise-non-invasive-ventilation-set-up-a-pilot-randomised-clinical-trial
#11
Maxime Patout, Gill Arbane, Antoine Cuvelier, Jean Francois Muir, Nicholas Hart, Patrick Brian Murphy
Polysomnography (PSG) is recommended for non-invasive ventilation (NIV) set-up in patients with chronic respiratory failure. In this pilot randomised clinical trial, we compared the physiological effectiveness of NIV set-up guided by PSG to limited respiratory monitoring (LRM) and nurse-led titration in patients with COPD-obstructive sleep apnoea (OSA) overlap. The principal outcome of interest was change in daytime arterial PaO2 of carbon dioxide (PaCO2 ) at 3 months. Fourteen patients with daytime PaCO2 >6 kPa and body mass index >30 kg/m2 were recruited...
March 30, 2018: Thorax
https://www.readbyqxmd.com/read/29596015/continuous-negative-abdominal-pressure-mechanism-of-action-and-comparison-with-prone-position
#12
Takeshi Yoshida, Doreen Engelberts, Gail Otulakowski, Bhushan Katira, Niall D Ferguson, Laurent Brochard, Marcelo B P Amato, Brian P Kavanagh
We recently reported that continuous negative abdominal pressure (CNAP) could recruit dorsal atelectasis in experimental lung injury, and that oxygenation improved at different transpulmonary pressure values compared with increases in airway pressure (31). The mechanism of recruitment with CNAP is uncertain; and, its impact compared with a commonly proposed alternative approach to recruitment -prone positioning- is not known. We hypothesized that CNAP recruits lung by decreasing the vertical Ppl gradient (i...
March 29, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29575588/exercise-on-transition-uncoupling-of-ventilatory-gas-exchange-and-cardiac-hemodynamic-kinetics-accompany-pulmonary-oxygen-stores-depletion-to-impact-exercise-intolerance-in-human-heart-failure
#13
Erik H Van Iterson, Joshua R Smith, Thomas P Olson
AIM: In contrast to knowledge that heart failure (HF) demonstrate peak exercise uncoupling across ventilation, gas-exchange, and cardiac hemodynamics, whether this dyssynchrony follows that at the exercise on-transition is unclear. This study tested whether exercise on-transition temporal lag for ventilation relative to gas-exchange and oxygen pulse (O2 pulse) couples with effects from abnormal pulmonary gaseous oxygen store (O2store ) contributions to V̇O2 to interdependently precipitate persistently elevated ventilatory demand and low oxidative metabolic capacity in HF...
March 25, 2018: Acta Physiologica
https://www.readbyqxmd.com/read/29561442/comparison-of-patients-with-avian-influenza-a-h7n9-and-influenza-a-h1n1-complicated-by-acute-respiratory-distress-syndrome
#14
Hongyan Li, Heng Weng, Changqing Lan, Hongying Zhang, Xinhang Wang, Jianguang Pan, Lulu Chen, Jinbao Huang
The aim of this study was to compare the clinical features of patients with avian influenza A (H7N9) and influenza A (H1N1) complicated by acute respiratory distress syndrome (ARDS).The clinical data of 18 cases of H7N9 and 26 cases of H1N1 with ARDS were collected and compared in the respiratory intensive care unit (RICU) of Fuzhou Pulmonary Hospital of Fujian from March 2014 to December 2016.Patients with H7N9 had a higher acute physiology and chronic health evaluation-II score (P < .05) and lung injury score (P < ...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29555580/the-effects-of-morphine-on-gas-exchange-ventilation-pattern-and-ventilatory-responses-to-hypercapnia-and-hypoxia-in-dwarf-caiman-paleosuchus-palpebrosus
#15
Christian Lind Malte, Jonas Bundgaard, Michael Schou Jensen, Mads Frost Bertelsen, Tobias Wang
Morphine and other opioids cause respiratory depression in high doses and lower the ventilatory responses to hypoxia and hypercapnia in mammals. Recent studies indicate that turtles respond similarly, but although they are used routinely for post-surgical analgesia, little is known about the physiological effects of opioids in reptiles. We therefore investigated the effects of morphine (10 and 20 mg kg-1 ) on gas exchange and ventilation in six dwarf caiman (Paleosuchus palpebrosus) using pneumotachography in a crossover design...
March 16, 2018: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
https://www.readbyqxmd.com/read/29543134/inspiratory-muscle-training-reduces-diaphragm-activation-and-dyspnea-during-exercise-in-copd
#16
Daniel Langer, Casey E Ciavaglia, Azmy Faisal, Katherine A Webb, J Alberto Neder, Rik Gosselink, Sauwaluk Dacha, Marko Topalovic, Anna Ivanova, Denis E O'Donnell
Among patients with COPD, those with the lowest maximal inspiratory pressures experience greater breathing discomfort (dyspnea) during exercise. In such individuals, inspiratory muscle training (IMT) may be associated with improvement of dyspnea but the mechanisms for this are poorly understood. Therefore, we aimed to identify physiological mechanisms of improvement in dyspnea and exercise endurance following inspiratory muscle training (IMT) in patients with COPD and low maximal inspiratory pressure (Pi,max)...
March 15, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29535993/placental-transfusion-and-cardiovascular-instability-in-the-preterm-infant
#17
REVIEW
Zbynĕk Straňák, Simona Feyereislová, Peter Korček, Eugene Dempsey
Postnatal adaptation in preterm newborn comprises complex physiological processes that involve significant changes in the circulatory and respiratory system. Increasing hemoglobin level and blood volume following placental transfusion may be of importance in enhancing arterial oxygen content, increasing cardiac output, and improving oxygen delivery. The European consensus on resuscitation of preterm infants recommends delayed cord clamping (DCC) for at least 60 s to promote placenta-fetal transfusion in uncompromised neonates...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29531444/profile-of-patients-with-active-tuberculosis-admitted-to-a-respiratory-intensive-care-unit-in-a-tertiary-care-center-of-north-india
#18
Valliappan Muthu, Sahajal Dhooria, Ritesh Agarwal, Kuruswamy Thurai Prasad, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal
Background: There is a paucity of literature regarding outcome of critically ill patients with tuberculosis (TB) from India. Herein, we describe our experience of patients with active TB admitted to a Respiratory Intensive Care Unit (RICU) of a tertiary care hospital. Methods: This was a retrospective analysis of all the patients admitted with active TB. The baseline clinical, demographic, ICU parameters and mortality were recorded. A multivariate logistic regression analysis was performed to identify factors predicting mortality...
February 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29528526/minocycline-alters-expression-of-inflammatory-markers-in-autonomic-brain-areas-and-ventilatory-responses-induced-by-acute-hypoxia
#19
Talita M Silva, Laiali J Chaar, Reinaldo C Silva, Ana C Takakura, Niels O Câmara, Vagner R Antunes, Thiago S Moreira
NEW FINDINGS: What is the central question of this study? Microglia are presumably the source of inflammatory mediators, which contribute to hypoxia-induced neuroinflammation. However, the relationship between microglia activity during hypoxia and inflammatory responses in specific autonomic brain regions is not well understood. Therefore, we hypothesize that acute hypoxia (AH) initiates an immune response in the central nervous system elicited by an increased expression of inflammatory mediators in specific brain areas related to autonomic control...
March 12, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29519925/impact-of-sleep-alterations-on-weaning-duration-in-mechanically-ventilated-patients-a-prospective-study
#20
Arnaud W Thille, Faustine Reynaud, Damien Marie, Stéphanie Barrau, Ludivine Rousseau, Christophe Rault, Véronique Diaz, Jean-Claude Meurice, Rémi Coudroy, Jean-Pierre Frat, René Robert, Xavier Drouot
Sleep is markedly altered in intensive care unit (ICU) patients and may alter respiratory performance. Our objective was to assess the impact of sleep alterations on weaning duration. We conducted a prospective physiological study performed in a French teaching hospital. ICU-patients intubated at least 24 h and difficult-to-wean were included. Complete polysomnography was performed after the first spontaneous breathing trial failure. Presence of atypical sleep, duration of sleep stages particularly rapid eye movement (REM) sleep, and electroencephalogram (EEG) reactivity at eye opening were assessed by a neurologist...
March 8, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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