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Airway physiology

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https://www.readbyqxmd.com/read/29349508/impact-of-intervention-time-on-hospital-survival-in-patients-requiring-emergent-airway-management-a-preliminary-study
#1
Kuo-Chuan Hung, Hsiu-Jung Lin, Shao-Wei Hsieh, Cheuk-Kwan Sun
BACKGROUND: The time in the day of intervention for physiological deterioration reportedly impacts patient outcomes. This study aimed at determining the impact of the time of ETI on hospital survival in critically ill patients. METHODS: Between January 2014 and December 2016, 151 patients who underwent emergency tracheal intubation (ETI) by the airway response team (ART) in the general wards of a tertiary referral center were retrospectively reviewed. Patients were divided into two groups based on the time of ETI (daytime group, 8:00 a...
January 18, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29345200/distinct-niches-within-the-extracellular-matrix-dictate-fibroblast-function-in-cell-free-3d-lung-tissue-cultures
#2
Gerald Burgstaller, Arunima Sengupta, Sarah Vierkotten, Gerhard Preissler, Michael Lindner, Jürgen Behr, Melanie Königshoff, Oliver Eickelberg
Instructive cues from the extracellular matrix (ECM) and their functional interplay with cells play pivotal roles for development, tissue repair, and disease. However, the precise nature of this interplay remains elusive. We used an innovative 3D cell culture ECM model by decellularizing ex vivo lung tissue scaffolds (d3D-LTCs) derived from diseased and healthy mouse lungs, which widely mimics the native (patho)physiological in vivo microenvironment. We successfully repopulated all d3D-LTCs with primary human and murine fibroblasts...
January 18, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29345194/transient-stretch-induces-cytoskeletal-fluidization-through-the-severing-action-of-cofilin
#3
Bo Lan, Ramaswamy Krishnan, Chan Y Park, Rodrigo Watanabe, Ronald Panganiban, James P Butler, Quan Lu, William C Cole, Jeffrey J Fredberg
With every deep inspiration (DI) or sigh the airway wall stretches, as do the airway smooth muscle cells that it contains. In response, the airway smooth muscle (ASM) cell undergoes rapid stretch-induced cytoskeletal fluidization. As a molecular mechanism underlying that ASM fluidization response, here we demonstrate a key role for the actin-severing protein, cofilin. Using primary human ASM cells, we simulated a DI by imposing a transient stretch of physiologic magnitude and duration. We measured the resulting changes in contractile forces using traction microscopy...
January 18, 2018: American Journal of Physiology. Lung Cellular and Molecular Physiology
https://www.readbyqxmd.com/read/29341986/pulmonary-dead-space-fraction-and-extubation-success-in-children-after-cardiac-surgery
#4
Renee L Devor, Paul Kang, Chasity Wellnitz, John J Nigro, Daniel A Velez, Brigham C Willis
OBJECTIVES: 1) Determine the correlation between pulmonary dead space fraction and extubation success in postoperative pediatric cardiac patients; and 2) document the natural history of pulmonary dead space fractions, dynamic compliance, and airway resistance during the first 72 hours postoperatively in postoperative pediatric cardiac patients. DESIGN: A retrospective chart review. SETTING: Cardiac ICU in a quaternary care free-standing children's hospital...
January 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29337268/the-double-sidedness-of-cough-in-the-elderly
#5
REVIEW
Ha-Kyeong Won, Sol-Ji Yoon, Woo-Jung Song
Cough is a physiological reflex to protect airways against aspiration, but also it is one of the most frequent problems that lead patients to seek medical care. Chronic cough is more prevalent in the elderly than younger subjects, and more challenging to manage due to frequent comorbidities and possible side effects from drug treatment. Meanwhile, cough reflex does not decrease with natural aging but is often impaired by pathologic conditions like stroke. The impairment in cough reflex may lead to fatal complication like aspiration pneumonia...
January 11, 2018: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/29331337/elastin-in-lung-development-and-disease-pathogenesis
#6
REVIEW
Robert P Mecham
Elastin is expressed in most tissues that require elastic recoil. The protein first appeared coincident with the closed circulatory system, and was critical for the evolutionary success of the vertebrate lineage. Elastin is expressed by multiple cell types in the lung, including mesothelial cells in the pleura, smooth muscle cells in airways and blood vessels, endothelial cells, and interstitial fibroblasts. This highly crosslinked protein associates with fibrillin-containing microfibrils to form the elastic fiber, which is the physiological structure that functions in the extracellular matrix...
January 10, 2018: Matrix Biology: Journal of the International Society for Matrix Biology
https://www.readbyqxmd.com/read/29325586/high-frequency-percussive-ventilation-increases-alveolar-recruitment-in-early-acute-respiratory-distress-syndrome-an-experimental-physiological-and-ct-scan-study
#7
Thomas Godet, Matthieu Jabaudon, Raïko Blondonnet, Aymeric Tremblay, Jules Audard, Benjamin Rieu, Bruno Pereira, Jean-Marc Garcier, Emmanuel Futier, Jean-Michel Constantin
BACKGROUND: High frequency percussive ventilation (HFPV) combines diffusive (high frequency mini-bursts) and convective ventilation patterns. Benefits include enhanced oxygenation and hemodynamics, and alveolar recruitment, while providing hypothetic lung-protective ventilation. No study has investigated HFPV-induced changes in lung aeration in patients with early acute respiratory distress syndrome (ARDS). METHODS: Eight patients with early non-focal ARDS were enrolled and five swine with early non-focal ARDS were studied in prospective computed tomography (CT) scan and animal studies, in a university-hospital tertiary ICU and an animal laboratory...
January 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29317806/profile-of-sugammadex-for-reversal-of-neuromuscular-blockade-in-the-elderly-current-perspectives
#8
REVIEW
Michele Carron, Francesco Bertoncello, Giovanna Ieppariello
The number of elderly patients is increasing worldwide. This will have a significant impact on the practice of anesthesia in future decades. Anesthesiologists must provide care for an increasing number of elderly patients, who have an elevated risk of perioperative morbidity and mortality. Complications related to postoperative residual neuromuscular blockade, such as muscle weakness, airway obstruction, hypoxemia, atelectasis, pneumonia, and acute respiratory failure, are more frequent in older than in younger patients...
2018: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29317351/a-new-physiological-model-for-studying-the-effect-of-chest-compression-and-ventilation-during-cardiopulmonary-resuscitation-the-thiel-cadaver
#9
Emmanuel Charbonney, Stéphane Delisle, Dominique Savary, Gilles Bronchti, Marceau Rigollot, Adrien Drouet, Bilal Badat, Paul Ouellet, Patrice Gosselin, Alain Mercat, Laurent Brochard, Jean-Christophe M Richard
BACKGROUND: Studying ventilation and intrathoracic pressure (ITP) induced by chest compressions (CC) during Cardio Pulmonary Resuscitation is challenging and important aspects such as airway closure have been mostly ignored. We hypothesized that Thiel Embalmed Cadavers could constitute an appropriate model. METHODS: We assessed respiratory mechanics and ITP during CC in 11 cadavers, and we compared it to measurements obtained in 9 out-of-hospital cardiac arrest patients and to predicted values from a bench model...
January 6, 2018: Resuscitation
https://www.readbyqxmd.com/read/29316977/the-lung-tissue-microbiota-of-mild-and-moderate-chronic-obstructive-pulmonary-disease
#10
Alexa A Pragman, Tianmeng Lyu, Joshua A Baller, Trevor J Gould, Rosemary F Kelly, Cavan S Reilly, Richard E Isaacson, Chris H Wendt
BACKGROUND: Oral taxa are often found in the chronic obstructive pulmonary disease (COPD) lung microbiota, but it is not clear if this is due to a physiologic process such as aspiration or experimental contamination at the time of specimen collection. METHODS: Microbiota samples were obtained from nine subjects with mild or moderate COPD by swabbing lung tissue and upper airway sites during lung lobectomy. Lung specimens were not contaminated with upper airway taxa since they were obtained surgically...
January 9, 2018: Microbiome
https://www.readbyqxmd.com/read/29313715/fluid-balance-is-associated-with-clinical-outcomes-and-extravascular-lung-water-in-children-with-acute-asthma-exacerbation
#11
David B Kantor, Eliotte L Hirshberg, Molly C McDonald, Jonathan Griffin, Tess Buccigrosso, Nicole Stenquist, Craig D Smallwood, Kyle A Nelson, David Zurakowski, Wanda Phipatanakul, Joel N Hirschhorn
RATIONALE: The effects of fluid administration during acute asthma exacerbation are likely unique in this patient population: highly negative inspiratory intrapleural pressure resulting from increased airway resistance may interact with excess fluid administration to favor the accumulation of extravascular lung water, leading to worse clinical outcomes. OBJECTIVES: Investigate how fluid balance influences clinical outcomes in children hospitalized for asthma exacerbation...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29313707/sputum-eosinophilia-and-mri-ventilation-heterogeneity-in-severe-asthma
#12
Sarah Svenningsen, Rachel L Eddy, Hui Fang Lim, P Gerard Cox, Parameswaran Nair, Grace Parraga
RATIONALE: Inflammation and smooth muscle dysfunction are integral components of severe asthma that contribute to luminal obstruction causing airflow limitation, ventilation heterogeneity and symptoms. This is important for guiding treatment decisions directed at inflammatory (eg. anti-Th2 monoclonal antibodies) and non-inflammatory, smooth muscle-mediated (eg. bronchial thermoplasty) components of severe asthma. OBJECTIVE: To investigate the contribution of eosinophilic-bronchitis and smooth muscle dysfunction to magnetic-resonance-imaging (MRI) ventilation heterogeneity in severe asthmatics...
January 9, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29305603/assessing-airflow-sensitivity-to-healthy-and-diseased-lung-conditions-in-a-computational-fluid-dynamics-model-validated-in-vitro
#13
Bora Sul, Zachary Oppito, Shehan Jayasekera, Brian Vanger, Amy Zeller, Michael Morris, Kai Ruppert, Talissa Altes, Vineet Rakesh, Steven Day, Risa J Robinson, Jaques Reifman, Anders Wallqvist
Computational models are useful for understanding respiratory physiology. Crucial to such models are the boundary conditions specifying the flow conditions at truncated airway branches (terminal flow rates). However, most studies make assumptions about these values, which are difficult to obtain in vivo. We developed a computational fluid dynamics (CFD) model of airflows for steady expiration to investigate how terminal flows affect airflow patterns in respiratory airways. First, we measured in vitro airflow patterns in a physical airway model, using particle image velocimetry...
January 5, 2018: Journal of Biomechanical Engineering
https://www.readbyqxmd.com/read/29304863/gm-csf-overexpression-after-influenza-a-virus-infection-prevents-mortality-and-moderates-m1-like-airway-monocyte-macrophage-polarization
#14
E Scott Halstead, Todd M Umstead, Michael L Davies, Yuka Imamura Kawasawa, Patricia Silveyra, Judie Howyrlak, Linlin Yang, Weichao Guo, Sanmei Hu, Eranda Kurundu Hewage, Zissis C Chroneos
BACKGROUND: Influenza A viruses cause life-threatening pneumonia and lung injury in the lower respiratory tract. Application of high GM-CSF levels prior to infection has been shown to reduce morbidity and mortality from pathogenic influenza infection in mice, but the mechanisms of protection and treatment efficacy have not been established. METHODS: Mice were infected intranasally with influenza A virus (PR8 strain). Supra-physiologic levels of GM-CSF were induced in the airways using the double transgenic GM-CSF (DTGM) or littermate control mice starting on 3 days post-infection (dpi)...
January 5, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29303905/effect-of-pressure-controlled-inverse-ratio-ventilation-on-dead-space-during-robot-assisted-laparoscopic-radical-prostatectomy-a-randomised-crossover-study-of-three-different-ventilator-modes
#15
Go Hirabayashi, Yukihiko Ogihara, Shoichi Tsukakoshi, Kiyoshi Daimatsu, Masaaki Inoue, Kiyoyasu Kurahashi, Koichi Maruyama, Tomio Andoh
BACKGROUND: Pressure-controlled inverse inspiratory to expiratory ratio ventilation (PC-IRV) is thought to be beneficial for reducing the dead space volume. OBJECTIVE: To investigate the effects of PC-IRV on the components of dead space during robot-assisted laparoscopic radical prostatectomy (RLRP). DESIGN: A randomised crossover study of three different ventilator modes. SETTING: A single university hospital from September 2014 to April 2015...
January 4, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29301136/assessment-of-the-airway-smooth-muscle-relaxant-effect-of-drotaverine
#16
Zoltán Patai, András Guttman, Endre G Mikus
BACKGROUND: Drotaverine, a type 4 cyclic nucleotide phosphodiesterase (PDE4) inhibitor, blocks the degradation of 3',5'-cyclic adenosine monophosphate. However, published receptor binding data showed that drotaverin also binds to the L-type voltage-operated calcium channel (L-VOCC). Based on these molecular mechanisms of action, a direct and indirect (by blocking the constrictor response) relaxant effect on airway smooth muscle can be predicted, which has not yet been assessed. SUMMARY: Accordingly, drotaverine and reference agents were tested both on the histamine-, methacholine-, or KCl-induced contraction response and on precontracted guinea pig tracheal preparations...
January 4, 2018: Pharmacology
https://www.readbyqxmd.com/read/29298528/s-nitrosoglutathione-formation-at-gastric-ph-is-augmented-by-ascorbic-acid-and-by-the-antioxidant-vitamin-complex-resiston
#17
Vitali I Stsiapura, Ilya Bederman, Ivan I Stepuro, Tatiana S Morozkina, Stephen J Lewis, Laura Smith, Benjamin Gaston, Nadzeya Marozkina
CONTEXT: Exogenous nitrogen oxides must be made bioavailable to sustain normal physiology because nitric oxide synthase (NOS) deficient mice are viable. In the stomach, S-nitrosoglutathione (GSNO) is formed from ingested nitrite and high levels of airway glutathione (GSH) that are cleared and swallowed. However, gastric GSNO may be broken down by nutrients like ascorbic acid (AA) before it is absorbed. OBJECTIVE: To study the effect of AA on GSNO formation and stability...
December 2018: Pharmaceutical Biology
https://www.readbyqxmd.com/read/29297718/evaluation-of-physiologic-alterations-during-prehospital-paramedic-performed-rapid-sequence-intubation
#18
Robert G Walker, Lynn J White, Geneva N Whitmore, Alexander Esibov, Michael K Levy, Gregory C Cover, Joel D Edminster, James M Nania
OBJECTIVE: Physiologic alterations during rapid sequence intubation (RSI) have been studied in several emergency airway management settings, but few data exist to describe physiologic alterations during prehospital RSI performed by ground-based paramedics. To address this evidence gap and provide guidance for future quality improvement initiatives in our EMS system, we collected electronic monitoring data to evaluate peri-intubation vital signs changes occurring during prehospital RSI...
January 3, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29297365/regional-physiology-of-ards
#19
REVIEW
Luciano Gattinoni, Tommaso Tonetti, Michael Quintel
The acute respiratory distress (ARDS) lung is usually characterized by a high degree of inhomogeneity. Indeed, the same lung may show a wide spectrum of aeration alterations, ranging from completely gasless regions, up to hyperinflated areas. This inhomogeneity is normally caused by the presence of lung edema and/or anatomical variations, and is deeply influenced by the gravitational forces.For any given airway pressure generated by the ventilator, the pressure acting directly on the lung (i.e., the transpulmonary pressure or lung stress) is determined by two main factors: 1) the ratio between lung elastance and the total elastance of the respiratory system (which has been shown to vary widely in ARDS patients, between 0...
December 28, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29290508/the-emergency-medicine-evaluation-and-management-of-the-patient-with-cirrhosis
#20
REVIEW
Brit Long, Alex Koyfman
BACKGROUND: Cirrhosis is a significant cause of death in the U.S. and has a variety of causes, most commonly Hepatitis C and alcohol. Liver fibrosis and nodule formation result in significant complications due to portal system hypertension. There are several deadly complications emergency physicians must consider. OBJECTIVE OF THE REVIEW: Provide an evidence-based update for the resuscitation of decompensating cirrhotic patients and an overview of cirrhosis complications...
December 23, 2017: American Journal of Emergency Medicine
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