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Schumann Stefan - - 2010
Flush perfusion of the pulmonary artery with organ protection solution is a standard procedure before lung explantation. However, rapid flush perfusion may cause pulmonary oedema which is deleterious in the lung transplantation setting. In this study we tested the hypotheses that high pulmonary perfusion pressure contributes to the development of ...
Marini John J - - 2010
Prevention of iatrogenic injury due to ventilation of a heterogeneous lung requires knowledge of dynamic regional events occurring within the tidal cycle. Quantitative bedside imaging techniques that are sensitive to regional mechanics and tidal events hold potential for information delivery that cannot be realized by pressure-volume monitoring alone.
Di Marco Fabiano - - 2010
OBJECTIVE: In acute respiratory distress syndrome, alveolar recruitment improves gas exchange only if perfusion of the recruited alveolar units is adequate. To evaluate functional recruitment induced by positive end-expiratory pressure, we assessed pulmonary conductance for gas exchange based on lung diffusion for carbon monoxide and its components, including pulmonary capillary ...
Wang H M - - 2010
The pathophysiological concept of acute lung injury (ALI) in combination with ventilator-associated lung injury (VALI) is still unclear. We characterized the histopathological features of intravenous injection of oleic acid (OAI) and lung lavage (LAV) combined with VALI. Pigs were randomized to the control, LAV or OAI group and ventilated by ...
Determann Rogier M - - 2010
INTRODUCTION: Recent cohort studies have identified the use of large tidal volumes as a major risk factor for development of lung injury in mechanically ventilated patients without acute lung injury (ALI). We compared the effect of conventional with lower tidal volumes on pulmonary inflammation and development of lung injury in ...
Krebs Joerg - - 2010
To test the hypothesis that open lung (OL) ventilatory strategies using high-frequency oscillatory ventilation (HFOV) or controlled mechanical ventilation (CMV) compared to CMV with lower positive end-expiratory pressure (PEEP) improve respiratory function while minimizing lung injury as well as systemic inflammation, a prospective randomized study was performed at a university ...
Bendjelid Karim - - 2010
A new system has been developed to assess global end-diastolic volume (GEDV), a volumetric marker of cardiac preload, and extravascular lung water (EVLW) from a transpulmonary thermodilution curve. Our goal was to compare this new system with the system currently in clinical use. Eleven anesthetized and mechanically ventilated pigs were ...
Schirrmann Kerstin - - 2010
Alveolar recruitment is a central strategy in the ventilation of patients with acute lung injury and other lung diseases associated with alveolar collapse and atelectasis. However, biomechanical insights into the opening and collapse of individual alveoli are still limited. A better understanding of alveolar recruitment and the interaction between alveoli ...
Loring Stephen H - - 2010
Acute lung injury can be worsened by inappropriate mechanical ventilation, and numerous experimental studies suggest that ventilator-induced lung injury is increased by excessive lung inflation at end inspiration or inadequate lung inflation at end expiration. Lung inflation depends not only on airway pressures from the ventilator but, also, pleural pressure ...
Beda Alessandro - - 2010
It is an accepted hypothesis that the amplitude of the respiratory-related oscillations of arterial partial pressure of oxygen (DeltaPaO2) is primarily modulated by fluctuations of pulmonary shunt (Deltas), the latter generated mainly by cyclic alveolar collapse/reopening, when present. A better understanding of the relationship between DeltaPaO2, Deltas, and cyclic alveolar ...
Kozian Alf - - 2010
Mechanical stress during one-lung ventilation (OLV) results in lung injury. This study compared the effects of mechanical ventilation, OLV, and surgical manipulation on diffuse alveolar damage (DAD) after application of different anesthetic regimens. Prospective, randomized, controlled, blinded animal experiment. University hospital. Twenty-one piglets. Animals (27.5 kg) were randomized into 4 ...
Albaiceta Guillermo M - - 2010
Mechanical ventilation is a life-saving therapy that can also damage the lungs. Ventilator-induced lung injury (VILI) promotes inflammation and up-regulates matrix metalloproteinases (MMPs). Among these enzymes, MMP-8 is involved in the onset of inflammation by processing different immune mediators. To clarify the role of MMP-8 in a model of VILI ...
Smith Adam - - 2009
Toxic industrial chemicals e.g., phosgene, are widely used as reactive intermediates in industrial processes. Inhalation exposure to these chemicals can result in life-threatening acute lung injury (ALI), to which no specific antidote exists. This study aimed to assess the potential benefit of steroids in treating phosgene induced ALI. Anesthetized pigs ...
Della Rocca G - - 2009
Hypoxemia is considered to be the most important challenge during one-lung ventilation (OLV). Recent studies, however, have shown that one-lung ventilation can involve some lung damage and can therefore be per se a cause of hypoxemia. OLV can be associated to an injury: but the techniques used to improve oxygenation ...
Caironi Pietro - - 2010
RATIONALE: The effects of high positive end-expiratory pressure (PEEP) strictly depend on lung recruitability, which varies widely during acute respiratory distress syndrome (ARDS). Unfortunately, increasing PEEP may lead to opposing effects on two main factors potentially worsening the lung injury, that is, alveolar strain and intratidal opening and closing, being ...
Pellicano Anastasia - - 2009
PURPOSE: To compare four methods of volume recruitment upon initiation of high frequency oscillatory ventilation (HFOV). METHODS: Anesthetized intubated neonatal piglets (n = 10) underwent repeated saline lavage, followed by conventional mechanical ventilation (CMV). After transition to HFOV at a mean airway pressure 8 cmH2O above CMV (P(basal)), four methods ...
Esechie Aimalohi - - 2009
The present study investigated whether the pathophysiological changes induced by burn and smoke inhalation are modulated by parenteral administration of Na(2)S, a H(2)S donor. The study used a total of 16 chronically instrumented, adult female sheep. Na(2)S was administered 1 h post injury, as a bolus injection at a dose ...
Koschel Dirk - - 2010
OBJECTIVE: A case series evaluating the acute effects of noninvasive positive pressure ventilation (NPPV) in patients with chronic hypercapnic respiratory failure (HRF) secondary to interstitial lung diseases (ILD). PATIENTS AND METHODS: Ten patients with ILD were retrospectively evaluated. All had restrictive lung function (mean TLC, 47.6+/-12.6% predicted) and chronic hypercapnic ...
Ravikumar Priya - - 2009
Young canines born at sea level (SL) and raised for 5 mo at high altitude (HA, 3,800 m), followed by return to SL before somatic maturation, showed enhanced alveolar gas exchange and diffusing capacity at rest and exercise that persisted into adulthood (McDonough P, Dane DM, Hsia CC, Yilmaz C, ...
Rzezinski Andréia F - - 2009
The effects of prolonged recruitment manoeuvre (PRM) were compared with sustained inflation (SI) in paraquat-induced mild acute lung injury (ALI) in rats. Twenty-four hours after ALI induction, rats were anesthetized and mechanically ventilated with VT=6 ml/kg and positive end-expiratory pressure (PEEP)=5 cmH(2)O for 1h. SI was performed with an instantaneous ...
Saouti N - - 2009
The product of resistance, R, and compliance, C (RC time), of the entire pulmonary circulation is constant. It is unknown if this constancy holds for individual lungs. We determined R and C in individual lungs in chronic thromboembolic pulmonary hypertension (CTEPH) patients where resistances differ between both lungs. Also, the ...
Claessens Leon P A M - - 2009
In vivo visceral and skeletal kinematics of lung ventilation was examined using cineradiography in two palaeognaths, the emu (Dromaius novaehollandiae) and the Chilean tinamou (Nothoprocta perdicaria), and a basal neognath, the helmeted guinea fowl (Numida meleagris). Upon inspiration, the thorax expands in all dimensions. The vertebral ribs swing forward and ...
Quick Devon E - - 2009
Although crocodilian lung and cardiovascular organs are markedly less specialized than the avian heart and lung air-sac system, all living archosaurs possess four-chambered hearts and heterogeneously vascularized, faveolar lungs. In birds, normal lung function requires extensive, dorsally situated nonvascularized abdominal air-sacs ventilated by an expansive sternum and specially hinged costal ...
Claessens Leon P A M - - 2009
The skeletal and visceral kinematics of lung ventilation of the American alligator (Alligator mississippiensis) was examined using cineradiography, pneumotachometry, and intrapulmonary pressure recording. The respiratory pattern of A. mississippiensis is intermittent and diphasic. The inspiratory lung volume is retained during the non-ventilatory period through closure of the glottis. The aspiration ...
Schwarzkopf Konrad - - 2009
60 patients, ASA I-III, underwent one-lung ventilation for open or video-assisted thoracic surgery randomized either with intravenous anesthesia with propofol or with inhalational anesthesia with 1 MAC sevoflurane. Propofol was titrated during one-lung ventilation to achieve a mean arterial pressure of 75-80 mmHg. Blood gas analyses, hemodynamic and respiratory parameters ...
Dellaca Raffaele L - - 2009
PURPOSE: ALI and ARDS are associated with lung volume derecruitment, usually counteracted by PEEP and recruitment maneuvers (RM), which should be accurately tailored to the patient's needs. The aim of this study was to investigate the possibility of monitoring the amount of derecruited lung by the forced oscillation technique (FOT). ...
Kubiak Brian D - - 2010
BACKGROUND: ARDSnet standards limit plateau pressure (Pplat) to reduce ventilator induced lung injury (VILI). Transpulmonary pressure (Ptp) [Pplat-pleural pressure (Ppl)], not Pplat, is the distending pressure of the lung. Lung distention can be affected by increased intra-abdominal pressure (IAP) and atelectasis. We hypothesized that the changes in distention caused by ...
Yilmaz Cuneyt - - 2009
To quantify the in vivo magnitude and distribution of regional compensatory lung growth following extensive lung resection, we performed high-resolution computed tomography at 15- and 30-cmH(2)O transpulmonary pressures and measured air and tissue (including microvascular blood) volumes within and among lobes in six adult male foxhounds, before and after balanced ...
Eagan Christina - - 2009
OBJECTIVE: To observe the effect of naloxone on the lung function of potential lung transplant donors with neurogenic pulmonary edema. DESIGN AND INTERVENTIONS: Donors aged 16 to 55 years without any factors to contraindicate lung donation (pneumonia, pulmonary contusion, etc) were included. Ventilator settings were standardized to a tidal volume ...
Jauncey-Cooke Jacqui I - - 2009
Recruitment manoeuvres play an important role in minimising ventilator associated lung injury (VALI) particularly when lung protective ventilation strategies are employed and as such clinicians should consider their application. This paper provides evidence-based recommendations for clinical practice with regard to alveolar recruitment. It includes recommendations for timing of recruitment, strategies ...
Zhou Bin - - 2009
BACKGROUND: At present, the most effective treatment for pulmonary alveolar proteinosis (PAP) remains whole-lung lavage in spite of the usually accompanying severe hypoxemia, which is expected to be prevented by hyperoxygenated solution improving oxygen supply during lavage. In this study, the efficacy and safety of the effect of hyperoxygenated solution ...
Muellenbach Ralf M - - 2009
BACKGROUND: Although low-tidal ventilation may reduce mortality in acute respiratory distress syndrome (ARDS), it can also result in severe respiratory acidosis and lung derecruitment. This study tested the hypothesis that combining "open-lung" ventilation and arteriovenous extracorporeal lung assist (av-ECLA) allows for maximal tidal volume (VT) reduction without the development of ...
Fujita Yasuki - - 2009
BACKGROUND: Assuming that HFOV (high frequency oscillatory ventilation) with hypercapnia could be more protective than normocapnia, in a rat model of lung injury, we evaluated the effect of hypercapnic acidosis during HFOV. MATERIAL/METHODS: After inducing lung injury by intratracheal instillation of hydrochloric acid (HCl), we randomly assigned the animals to ...
Stirling S L - - 2009
The case histories are presented of three adults who had severe hypercapnic acidosis despite mechanical ventilation with what were considered to be injurious tidal volumes and airway pressures. The use of a percutaneously inserted arteriovenous extracorporeal carbon dioxide removal (AV-ECCO(2)R) device facilitated a dramatic reduction in the amount of ventilatory ...
Gaio Eduardo - - 2009
OBJECTIVE: To evaluate the stability of hemodynamic, respiratory and gas exchange variables in an animal model of oleic acid-induced acute lung injury. METHODS: This was an experimental study involving 10 mongrel dogs. The variables were measured at baseline, as well as at 30, 60, 90 and 120 min after the ...
Tsang John Y C - - 2009
Previous studies reported that regional CO(2) tension might affect regional ventilation (V) following acute pulmonary thromboembolism (APTE). We investigated the pathophysiology and magnitude of these changes. Eight anesthetized and ventilated piglets received autologous clots at time = 0 min until mean pulmonary artery pressure was 2.5 times baseline. The distribution ...
Reoma Junewai L - - 2009
Extracorporeal cardiopulmonary support (ECS) of donors after cardiac death (DCD) has been shown to improve abdominal organs for transplantation. This study assesses whether pulmonary congestion occurs during ECS with the heart arrested and describes an in vivo method to assess if lungs are suitable for transplantation from DCD donors after ...
Barklin Anne - - 2009
BACKGROUND: Increased intracranial pressure induces neurogenic pulmonary edema (NPE), potentially explaining why only lungs from less than 20% of brain dead organ donors can be used for transplantation. This study investigated the underlying mechanisms of NPE, focusing on neuropeptides, which potently induce vasoconstriction, vasodilatation, and neurogenic inflammation. METHODS: Brain death ...
Grasso Salvatore - - 2009
RATIONALE: The open lung strategy aims at reopening (recruitment) of nonaerated lung areas in patients with acute respiratory distress syndrome, avoiding tidal alveolar hyperinflation in the limited area of normally aerated tissue (baby lung). OBJECTIVES: We tested the hypothesis that recruited lung areas do not resume elastic properties of adjacent ...
Karzai Waheedullah - - 2009
When switching from two-lung to one-lung ventilation (OLV), shunt fraction increases, oxygenation is impaired, and hypoxemia may occur. Hypoxemia during OLV may be predicted from measurements of lung function, distribution of perfusion between the lungs, whether the right or the left lung is ventilated, and whether the operation will be ...
Kubiak Brian D - - 2010
BACKGROUND: Patients with acute respiratory distress syndrome (ARDS) are often ventilated with high airway pressure. Brief loss of airway pressure may lead to an extended loss of oxygenation. While using high frequency oscillatory ventilation (HFOV) in a porcine acute lung injury model, two animals became disconnected from the ventilator with ...
O'Neill James - - 2011
Self-inflating resuscitators (SIRs) are often used in pediatric resuscitation. Improper setup of the SIR can lead to inadequate ventilation and oxygenation. To present clinical scenarios in which SIRs delivered inadequate tidal volumes due to improper use. Second, to evaluate tidal volumes delivered using SIRs at varying lung compliances with the ...
Guo Zhong-liang - - 2009
To investigate the effect of partial liquid ventilation (PLV) at low inflation pressures on acute lung injury (ALI), endotoxin was administered to healthy anesthetized juvenile piglets. The animals were randomly assigned to two groups, n=6 each: (1) conventional mechanical ventilation (MV) and (2) PLV with perfluorodecalin (10 mL kg(-1)). Compared ...
Dixon Dani-Louise - - 2009
RATIONALE: Chronic elevation of pulmonary microvascular pressure in chronic heart failure results in compensatory changes in the lung that reduce alveolar fluid filtration and protect against pulmonary microvascular rupture. OBJECTIVES: To determine whether these compensatory responses may have maladaptive effects on lung function. METHODS: Six weeks after myocardial infarction (chronic ...
Ko Raynauld - - 2009
BACKGROUND: Collapse of the ipsilateral lung facilitates surgical exposure during thoracic procedures. The use of different gas mixtures during two-lung ventilation (2LV) may improve or impede surgical conditions during subsequent one-lung ventilation (OLV) by increasing or delaying lung collapse. We investigated the effects of three different gas mixtures during 2LV ...
Alvarez Francisco J - - 2009
Our aim was to develop a computerized system for real-time monitoring of lung mechanics measurements during both gas and liquid ventilation. System accuracy was demonstrated by calculating regression and percent error of the following parameters compared to standard device: airway pressure difference (Delta P(aw)), respiratory frequency (f(R) ), tidal volume ...
Garutti Ignacio - - 2009
OBJECTIVE: The objective of the present study was to investigate respiratory and hemodynamic changes by measuring continuous cardiac output, cardiac filling, and stroke volume variation after lung recruitment in thoracic surgery. DESIGN: A prospective, observational study. SETTING: A tertiary care university hospital single institution. PARTICIPANTS: Forty patients undergoing thoracotomy for ...
Webster Natalie - - 2009
The purpose of this study was to assess radiographic heart size in anesthetized dogs, comparing radiographs made with the patient breathing spontaneously to radiographs obtained using positive pressure manual lung inflation. The hypothesis was that manual inflation would cause reduction in the cardiac size. With dogs in right recumbency a ...
Varpula Tero - - 2009
Maintenance of spontaneous breathing superimposed on mechanical ventilation is suggested to improve gas exchange in patients with acute lung injury. The aim of this study was to evaluate the long-term effects of airway pressure release ventilation with maintained unsupported spontaneous breathing (APRV) and synchronized intermittent mandatory ventilation with pressure support ...
De Troyer André - - 2009
The present study was designed to test the hypothesis that the expansion of a particular lung during breathing is partly related to the action of the hemidiaphragm on the opposite side. Two endotracheal tubes were inserted in the right and left main stem bronchi of anesthetized dogs, and the changes ...
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