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https://www.readbyqxmd.com/read/29452100/a-new-noninvasive-method-of-measuring-impaired-pulmonary-gas-exchange-in-lung-disease-an-outpatient-study
#1
John B West, Daniel R Crouch, Janelle M Fine, Dipen Makadia, Daniel L Wang, G Kim Prisk
BACKGROUND: It would be valuable to have a noninvasive method of measuring impaired pulmonary gas exchange in patients with lung disease and so reduce the need for repeated arterial punctures. Here we report the results of using a new test in a group of outpatients attending a pulmonary clinic. METHODS: Inspired and expired P O2 and P CO2 are continually measured by small, rapidly responding analyzers. The arterial P O2 is calculated from the oximeter Sp O2 and the oxygen dissociation curve...
February 13, 2018: Chest
https://www.readbyqxmd.com/read/29351442/measurements-of-pulmonary-gas-exchange-efficiency-using-expired-gas-and-oximetry-results-in-normal-subjects
#2
John B West, Daniel L Wang, Gordon Kim Prisk
We are developing a novel, noninvasive method for measuring the efficiency of pulmonary gas exchange in patients with lung disease. The patient wears an oximeter, and we measure the partial pressures of oxygen and carbon dioxide in inspired and expired gas using miniature analyzers. The arterial PO2 is then calculated from the oximeter reading and the oxygen dissociation curve, using the end-tidal PCO2 to allow for the Bohr effect. This calculation is only accurate when the oxygen saturation is below 94% and therefore these normal subjects breathed 12...
December 20, 2017: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29340500/respiratory-evaluation-through-volumetric-capnography-among-grade-iii-obese-and-eutrophic-individuals-a-comparative-study
#3
Débora Aparecida Oliveira Modena, Marcos Mello Moreira, Ilma Aparecida Paschoal, Mônica Corso Pereira, Luiz Cláudio Martins, Everton Cazzo, Elinton Adami Chaim
BACKGROUND: Excess trunk body fat in obese individuals influences respiratory physiological function. The aims of this study were to compare volumetric capnography findings (VCap) between severely obese patients and normal-weight subjects and to assess whether there is any association between neck circumference (NC), waist-hip ratio (WHR) and VCap among grade III obese individuals. DESIGN AND SETTING: Analytical observational case-matched cross-sectional study, University of Campinas...
January 15, 2018: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/29338821/factors-influencing-regional-cerebral-oxygen-saturation-during-one-lung-ventilation-in-thoracic-surgery
#4
Ya Hong Gong, Wei Jia Wang, Wei Wei, Yu Guang Huang
Objective To identify factors influencing regional cerebral oxygen saturation (rScO2) during one-lung ventilation (OLV) in thoracic surgery. Methods Totally 33 patients with an ASA physical status of 1-3 scheduled for elective thoracic surgery with one-lung ventilation under general anesthesia were recruited. After anesthesia was induced with propofol,fentanyl/sufentanil,and rocuronium. All patients received balanced anesthesia using sevoflurane. During OLV,volume-controlled ventilation was used with a tidal volume of 6-7 ml/kg and an inspiration:expiration ratio of 1:1...
December 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/29123389/alveolar-capillary-reserve-during-exercise-in-patients-with-chronic-obstructive-pulmonary-disease
#5
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
https://www.readbyqxmd.com/read/29037800/clinical-comparison-of-dexmedetomidine-and-medetomidine-for-isoflurane-balanced-anaesthesia-in-horses
#6
Muriel Sacks, Simone K Ringer, Andrea S Bischofberger, Sabrina M Berchtold, Regula Bettschart-Wolfensberger
OBJECTIVE: To compare the effects of two balanced anaesthetic protocols (isoflurane-dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses. STUDY DESIGN: Prospective, blinded, randomized clinical study. ANIMALS: Sixty healthy adult warm blood horses undergoing elective surgery. METHODS: Thirty horses each were sedated with dexmedetomidine 3.5 μg kg(-1) (group DEX) or medetomidine 7 μg kg(-1) (group MED) intravenously...
April 26, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28807576/evaluation-of-three-tidal-volumes-10-12-and-15%C3%A2-ml%C3%A2-kg-1-in-dogs-for-controlled-mechanical-ventilation-assessed-by-volumetric-capnography-a-randomized-clinical-trial
#7
Seline Bumbacher, Johannes P Schramel, Martina Mosing
OBJECTIVE: To evaluate three routinely used tidal volumes (VT; 10, 12 and 15 mL kg(-1)) for controlled mechanical ventilation (CMV) in lung-healthy anaesthetized dogs by assessing alveolar ventilation (VTalv) and dead space (DS). STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: A total of 36 client-owned dogs. METHODS: Dogs were randomly allocated to a VT of 10 (G10), 12 (G12) or 15 (G15) mL kg(-1). After induction CMV was started...
May 8, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28495814/automated-control-of-mechanical-ventilation-during-general-anaesthesia-study-protocol-of-a-bicentric-observational-study-avas
#8
Dirk Schädler, Georg Miestinger, Tobias Becher, Inéz Frerichs, Norbert Weiler, Christoph Hörmann
INTRODUCTION: Automated control of mechanical ventilation during general anaesthesia is not common. A novel system for automated control of most of the ventilator settings was designed and is available on an anaesthesia machine. METHODS AND ANALYSIS: The 'Automated control of mechanical ventilation during general anesthesia study' (AVAS) is an international investigator-initiated bicentric observational study designed to examine safety and efficacy of the system during general anaesthesia...
May 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28413511/application-of-dead-space-fraction-to-titrate-optimal-positive-end-expiratory-pressure-in-an-ards-swine-model
#9
Weishuai Bian, Wei Chen, Yangong Chao, Lan Wang, Liming Li, Jian Guan, Xuefeng Zang, Jie Zhen, Bo Sheng, Xi Zhu
This study aimed to apply the dead space fraction [ratio of dead space to tidal volume (VD/VT)] to titrate the optimal positive end-expiratory pressure (PEEP) in a swine model of acute respiratory distress syndrome (ARDS). Twelve swine models of ARDS were constructed. A lung recruitment maneuver was then conducted and the PEEP was set at 20 cm H2O. The PEEP was reduced by 2 cm H2O every 10 min until 0 cm H2O was reached, and VD/VT was measured after each decrement step. VD/VT was measured using single-breath analysis of CO2, and calculated from arterial CO2 partial pressure (PaCO2) and mixed expired CO2 (PeCO2) using the following formula: VD/VT = (PaCO2 - PeCO2)/PaCO2...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28407251/investigating-hyperventilation-syndrome-in-patients-suffering-from-empty-nose-syndrome
#10
David Mangin, Emilie Bequignon, Francoise Zerah-Lancner, Daniel Isabey, Bruno Louis, Serge Adnot, Jean-François Papon, André Coste, Laurent Boyer, Marie Devars du Mayne
OBJECTIVES/HYPOTHESIS: Patients with empty nose syndrome (ENS) following turbinate surgery often complain about breathing difficulties. We set out to determine if dyspnea in patients with ENS was associated with hyperventilation syndrome (HVS). We hypothesized that lower airway symptoms in ENS could be explained by HVS. STUDY DESIGN: Observational prospective study. METHODS: All consecutive patients referred to our center for ENS over 1 year were invited to participate...
September 2017: Laryngoscope
https://www.readbyqxmd.com/read/28368939/application-of-the-novel-ventilation-mode-flow-controlled-expiration-flex-a-crossover-proof-of-principle-study-in-lung-healthy-patients
#11
Steffen Wirth, Sebastian Springer, Johannes Spaeth, Silke Borgmann, Ulrich Goebel, Stefan Schumann
BACKGROUND: Traditionally, mechanical ventilation is achieved via active lung inflation during inspiration and passive lung emptying during expiration. By contrast, the novel FLEX (FLow-controlled EXpiration) ventilator mode actively decreases the rate of lung emptying. We investigated whether FLEX can be used during intraoperative mechanical ventilation of lung-healthy patients. METHODS: In 30 adult patients scheduled for neurosurgical procedures, we studied respiratory system mechanics, regional ventilation, oxygenation, and hemodynamics during ventilation with and without FLEX at positive end-expiratory pressure (PEEP) of 5 and 7 cm H2O...
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28177206/propofol-sedation-reduces-diaphragm-activity-in-spontaneously-breathing-patients-ultrasound-assessment
#12
Monica Rocco, Luigi Maggi, Giorgio Ranieri, Giovanni Ferrari, Cesare Gregoretti, Giorgio Conti, Roberto A DE Blasi
BACKGROUND: The diaphragm is the most important respiratory muscle in humans, and the close relationship between inspired volume and diaphragmatic movement in normal subjects has led to investigations into diaphragmatic activity using ultrasound, during spontaneous breathing and sedative drug infusion. METHODS: A total of 36 consecutive patients undergoing diagnostic procedures under deep propofol sedation were studied. Ultrasound measurements included the following: diaphragmatic thickening end-inspiration (TEI) and end-expiration (TEE)...
March 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28074492/confirmation-of-resting-state-bold-fluctuations-in-the-human-brainstem-and-spinal-cord-after-identification-and-removal-of-physiological-noise
#13
Shreyas Harita, Patrick W Stroman
PURPOSE: Resting-state functional MRI (rs-fMRI) has been used to investigate networks within the cortex, but its use in the brainstem (BS) and spinal cord (SC) has been limited. This region presents challenges for fMRI, partly because of sources of physiological noise. This study aims to quantify noise contributions to rs-fMRI, and to obtain evidence of resting-state blood oxygenation level-dependent (BOLD) fluctuations. METHODS: Resting-state-fMRI data were obtained from the BS/SC in 16 participants, at 3 Tesla, with T2 -weighted single-shot fast spin-echo imaging...
January 11, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28003556/a-comparison-of-different-techniques-for-interfacing-capnography-with-adult-and-pediatric-supplemental-oxygen-masks
#14
COMPARATIVE STUDY
Justin S Phillips, Lance P Pangilinan, Earl R E Mangalindan, Joseph L Booze, Richard H Kallet
BACKGROUND: Accurately measuring the partial pressure of end-tidal CO2 (PETCO2 ) in non-intubated patients is problematic due to dilution of expired CO2 at high O2 flows and mask designs that may either cause CO2 rebreathing or inadequately capture expired CO2. We evaluated the performance of 2 capnographic O2 masks (Cap-ONE and OxyMask) against a clinically expedient method using a standard O2 mask with a flow-directed nasal cannula used for capnography (CapnoLine) in a spontaneous breathing model of an adult and child under conditions of normal ventilation, hypoventilation, and hyperventilation...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/28003555/redesign-of-an-open-system-oxygen-face-mask-with-mainstream-capnometer-for-children
#15
Natalie Napolitano, Akira Nishisaki, Hayley S Buffman, Jessica Leffelman, Matthew R Maltese, Vinay M Nadkarni
BACKGROUND: Partial pressure of end-tidal carbon dioxide (PETCO2 ) monitoring in children is important to detect apnea or hypopnea early to intervene before hypoxemia develops. Monitoring PETCO2 in children without a tracheal tube is challenging. To improve PETCO2 measurement accuracy in a commercially available mask with a mainstream CO2 detector, we implemented design changes with deform-and-hold shaping technology and anterior-posterior adjustment of the expiratory gas flow cup. METHODS: Two sizes of redesigned face masks (small for 7-20 kg, medium for 10-40 kg) were evaluated...
January 2017: Respiratory Care
https://www.readbyqxmd.com/read/27899896/respiratory-function-in-voluntary-participating-patagonia-sea-lions-otaria-flavescens-in-sternal-recumbency
#16
Andreas Fahlman, Johnny Madigan
We measured esophageal pressures (n = 4), respiratory flow rates (n = 5), and expired O2 and CO2 (n = 4) in five adult Patagonia sea lions (Otaria flavescens, body mass range 94.3-286.0 kg) during voluntary breaths while laying down out of water. The data were used to estimate the dynamic specific lung compliance (sCL), the O2 consumption rate ([Formula: see text]O2) and CO2 production rates ([Formula: see text]CO2) during rest. Our results indicate that the resting tidal volume in Patagonia sea lions is approximately 47-73% of the estimated total lung capacity...
2016: Frontiers in Physiology
https://www.readbyqxmd.com/read/27609188/pulse-pressure-variation-shows-a-direct-linear-correlation-with-tidal-volume-in-anesthetized-healthy-patients
#17
Yi Liu, Jing-Sheng Lou, Wei-Dong Mi, Wei-Xiu Yuan, Qiang Fu, Min Wang, Jing Qu
BACKGROUND: The settings of mechanical ventilation, like tidal volume (VT), occasionally need to be adjusted in the process of anesthesia for some special reasons. The aim of this study was therefore to assess the relationship between pulse pressure variations (PPVs) in different settings of VT in anesthetized healthy patients under mechanical ventilation. METHODS: Sixty nine ASA I-II patients scheduled for gastrointestinal surgery under general anesthesia were included in this prospective study...
September 8, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/27440637/an-appropriate-inspiratory-flow-pattern-can-enhance-co2-exchange-facilitating-protective-ventilation-of-healthy-lungs
#18
L W Sturesson, G Malmkvist, S Allvin, M Collryd, M Bodelsson, B Jonson
BACKGROUND: In acute lung injury, CO2 exchange is enhanced by prolonging the volume-weighted mean time for fresh gas to mix with resident alveolar gas, denoted mean distribution time (MDT), and by increasing the flow rate immediately before inspiratory flow interruption, end-inspiratory flow (EIF). The objective was to study these effects in human subjects without lung disease and to analyse the results with respect to lung-protective ventilation of healthy lungs. METHODS: During preparation for intracranial surgery, the lungs of eight subjects were ventilated with a computer-controlled ventilator, allowing breath-by-breath modification of the inspiratory flow pattern...
August 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27344663/typical-patterns-of-expiratory-flow-and-carbon-dioxide-in-mechanically-ventilated-patients-with-spontaneous-breathing
#19
S E Rees, S Larraza, N Dey, S Spadaro, J B Brohus, R W Winding, C A Volta, D S Karbing
Incomplete expiration of tidal volume can lead to dynamic hyperinflation and auto-PEEP. Methods are available for assessing these, but are not appropriate for patients with respiratory muscle activity, as occurs in pressure support. Information may exist in expiratory flow and carbon dioxide measurements, which, when taken together, may help characterize dynamic hyperinflation. This paper postulates such patterns and investigates whether these can be seen systematically in data. Two variables are proposed summarizing the number of incomplete expirations quantified as a lack of return to zero flow in expiration (IncExp), and the end tidal CO2 variability (varETCO2), over 20 breaths...
August 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27042039/copd-phenotypes-on-computed-tomography-and-its-correlation-with-selected-lung-function-variables-in-severe-patients
#20
Silvia Maria Doria da Silva, Ilma Aparecida Paschoal, Eduardo Mello De Capitani, Marcos Mello Moreira, Luciana Campanatti Palhares, Mônica Corso Pereira
BACKGROUND: Computed tomography (CT) phenotypic characterization helps in understanding the clinical diversity of chronic obstructive pulmonary disease (COPD) patients, but its clinical relevance and its relationship with functional features are not clarified. Volumetric capnography (VC) uses the principle of gas washout and analyzes the pattern of CO2 elimination as a function of expired volume. The main variables analyzed were end-tidal concentration of carbon dioxide (ETCO2), Slope of phase 2 (Slp2), and Slope of phase 3 (Slp3) of capnogram, the curve which represents the total amount of CO2 eliminated by the lungs during each breath...
2016: International Journal of Chronic Obstructive Pulmonary Disease
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