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Gattinoni Luciano L aDipartimento di Anestesia, Rianimazione ed Emergenza Urgenza, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlinico, Milan bDipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan cDipartimento di Scienze Chirurgiche, Microchirurgiche e Mediche, Università degli Studi di Sassari, Sassari dUnità Operativa Complessa di Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria di Sassari, Sassari, - - 2014
Early acute respiratory distress syndrome (ARDS) is characterized by protein-rich inflammatory lung edema often associated with a hydrostatic component. Mechanical ventilation with positive intrathoracic pressure further induces salt and water retention, while impairing the pathways designed for edema clearance. In this framework, we will review the recent findings on fluid ...
Fleming John - - 2014
Determination of regional lung air volume has several clinical applications. This study investigates the use of mid-tidal breathing CT scans to provide regional lung volume data. Low resolution CT scans of the thorax were obtained during tidal breathing in 11 healthy control male subjects, each on two separate occasions. A ...
Hartmann E K EK Department of Anaesthesiology, Medical Centre of the Johannes Gutenberg-University, Mainz, - - 2014
During cardiopulmonary resuscitation (CPR) the ventilation/perfusion distribution (VA /Q) within the lung is difficult to assess. This experimental study examines the capability of multiple inert gas elimination (MIGET) to determine VA /Q under CPR conditions in a pig model. Twenty-one anaesthetised pigs were randomised to three fractions of inspired oxygen ...
Lozano-Zahonero Sara S Department of Anesthesiology and Intensive Care Medicine, Division for Experimental Anesthesiology, University Medical Center Freiburg, Freiburg, - - 2014
The analysis of non-linear respiratory system mechanics under the dynamic conditions of controlled mechanical ventilation is affected by systemic disturbances of the respiratory signals. Cardio-pulmonary coupling induces cardiogenic oscillations to the respiratory signals, which appear prominently in the second half of expiration. We hypothesized that breathing phase-selective filtering of expiratory ...
Boukhettala Nabile N 1 Centre d'Etude des Pathologies Respiratoires INSERM, Université François Rabelais de Tours , F-37032 Tours, France - - 2014
Abstract Background: During mechanical ventilation, different aerosol generators are employed with various interfaces. The objective of this study was to evaluate the performance of a range of spacers, including a new device called Combihaler(®) designed for connection with both nebulizers and pressurized Metered-Dose Inhalers (pMDIs). Methods: To assess the spacers, ...
Farrero Marta M Heart Failure and Heart Transplantation program, Cardiology, Hospital Clínic, Barcelona, Spain - - 2014
-Pulmonary hypertension and collagen metabolism abnormalities are prevalent in patients with HFpEF. Peripheral endothelial dysfunction (PED) has been described in heart failure (HF), as well as in pulmonary arterial hypertension. Our aim is to determine whether pulmonary hypertension is associated with PED and impaired collagen metabolism in patients with heart ...
Cressoni Massimo M From the Dipartimento di Anestesia, Rianimazione (Intensiva e Subintensiva) e Terapia del Dolore, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (D.C., P.C., L.G.); Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Milan, Italy (M.C., E.C., C.C., M.A., M.B., L.G.); and Department of Anaesthesiology, Emergency and Intensive Care Medicine, Georg-August University of Göttingen, Göttingen, Germany - - 2014
It has been suggested that higher positive end-expiratory pressure (PEEP) should be used only in patients with higher lung recruitability. In this study, the authors investigated the relationship between the recruitability and the PEEP necessary to counteract the compressive forces leading to lung collapse. Fifty-one patients with acute respiratory distress ...
Gustafsson Per M PM Central Hospital Skövde - - 2014
Imaging studies describe significant ventilation defects across a wide range of cystic fibrosis (CF) related lung disease severity. These are unfortunately poorly reflected by phase III slope analysis-derived Scond and Sacin from multiple breath washout (MBW). Methodology extending previous two-lung compartment model-based analysis is presented describing size and function of ...
Lutz Dennis D Hannover Medical School, Institute of Functional and Applied Anatomie, Hannover, Germany ; - - 2014
Rationale: Idiopathic pulmonary fibrosis (IPF) and bleomycin-induced pulmonary fibrosis are associated with surfactant-system dysfunction, alveolar collapse (derecruitment), and collapse induration (irreversible collapse). These events play undefined roles in the loss of lung function. Objective: To quantify how surfactant inactivation, alveolar collapse and collapse induration lead to degradation of lung function. ...
Kirschbaum A A Klinik für Viszeral-, Thorax- und Gefäßchirurgie, Uniklinik Giessen und Marburg GmbH (UKCM), Philipps University Marburg, Baldingerstrasse, 35033, Marburg, Germany, - - 2014
Almost every pulmonary lobe resection requires cutting the lung parenchyma in the area of a lung fissure. A monopolar cutter or stapler is often used for this purpose. The seal should be absolutely airtight to prevent post-operative pulmonary fistulas. In the present study, the bipolar sealing technique was evaluated regarding ...
Marhong Jonathan D JD Department of Medicine, University of Toronto, 500 University Avenue, Suite 602, Toronto, ON, M5G 1V7, Canada, - - 2014
Acute respiratory distress syndrome (ARDS) is common following aneurysmal subarachnoid hemorrhage (SAH), but the influence of mechanical ventilator settings on its development is unclear. We sought to determine adherence to lung protective thresholds in ventilated patients with SAH and describe the association between ventilator settings and subsequent development of ARDS. ...
Tachon Aurélie - - 2014
The aim of this work is to identify which law governs oxygen transfer through cork: Knudsen or Fick's mechanism. This is important to better understand wine oxidation during post bottling aging. Oxygen transfer through cork wafers is measured at 298 K using a manometric permeation technique. Depending on the mechanism, ...
Blankman P P Department of Adult Intensive Care, Erasmus MC, Rotterdam, The - - 2014
Inhomogeneous ventilation is an important contributor to ventilator-induced lung injury. Therefore, this study examines homogeneity of lung ventilation by means of electrical impedance tomography (EIT) measurements during pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) using the same ventilation pressures. Twenty mechanically ventilated patients were studied after cardiac surgery. On ...
Makiyama A M AM Department of Material Science and Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, United States. Electronic address: - - 2014
Lung parenchyma surrounding an atelectatic region is thought to be subjected to increased stress compared with the rest of the lung. Using 37 hexagonal cells made of linear springs, Mead et al. (1970) measured a stress concentration greater than 30% in the springs surrounding a stiffer central cell. We re-examine ...
Pellegrino Riccardo R Allergology and Respiratory Physiopathology, S. Croce e Carle Hospital, Cuneo, - - 2014
During forced expiration, alveolar pressure (PALV ) increases and intrathoracic gas is compressed. Thus, 1-s forced expiratory volume measured by spirometry (FEV1-sp ) is smaller than 1-s forced expiratory volume measured by plethysmography (FEV1-pl ). Thoracic gas compression volume (TGCV) depends on the amount of gas within the lung when ...
Poh Paula Y S PY US Army Institute of Surgical Research, Fort Sam Houston, TX, 78234, - - 2014
. Intrathoracic pressure regulation (IPR) represents a therapy for increasing systemic circulation through the creation of negative intrathoracic pressure. We hypothesized that utilizing this 'respiratory pump' effect would slow the diminution of the physiological reserve to compensate during progressive reductions in central blood volume. The Compensatory Reserve Index (CRI) algorithm ...
Jacek Sein Anand SA Medical University of Gdansk, Gdansk, Poland Department of Clinical Toxicology Head: Sein Anand Jacek M.D., Ph.D; Pomeranian Centre of Toxicology, Gdansk, Poland Head: Waldman Wojciech M.D., - - 2014
The aims of this study were to examine selected respiratory and gasometric parameters during hyperventilation with and without isocapnia and to identify the possible mechanism by which isocapnic hyperventilation might be useful in the elimination of volatile substances, including CO. Ten healthy non-smoking volunteers were studied, and each underwent two ...
Cvetkovic Draginja D New York Medical College-Westchester Medical Center, Valhalla, NY, USA - - 2014
Over the course of the past 4 decades, the survival of patients with the Fontan circulation has improved and today they often present for noncardiac surgery anesthesia care. In patients with the Fontan circulation, pulmonary blood flow is passive and anesthetic management is directed at reducing pulmonary vascular resistance and ...
Lang Justin A R JA Monash - - 2014
Background: At birth, the transition to newborn life is triggered by lung aeration, which stimulates a large increase in pulmonary blood flow (PBF). Current theories predict that the increase in PBF is spatially related to ventilated lung regions as they aerate after birth. Using simultaneous phase contrast X-ray imaging and ...
Azarbar Sayena S *Department of Medicine, Montreal Heart Institute, Université de Montréal, 5000 Belanger Street, Montreal, Quebec, Canada, H1T - - 2014
The lungs are the primary organs affected in LHD (left heart disease). Increased left atrial pressure leads to pulmonary alveolar-capillary stress failure, resulting in cycles of alveolar wall injury and repair. The reparative process causes the proliferation of MYFs (myofibroblasts) with fibrosis and extracellular matrix deposition, resulting in thickening of ...
Matsuoka Shin S 1Department of Radiology, St. Marianna University School of Medicine , Kawasaki , - - 2014
Abstract Background: In patients with emphysema, increased intrathoracic pressure is closely related to hyperinflation and leads to hemodynamic impairments. Both intrathoracic pressure and hemodynamics such as venous return are affected by the respiratory phase. Therefore, respiratory variations in hemodynamics may be associated with the extent of emphysema that causes increased ...
Marhong Jonathan D JD University of Toronto, Toronto, Ontario, - - 2014
Background: In patients with severe, acute respiratory failure undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO), the optimal strategy for mechanical ventilation is unclear. Our objective was to describe ventilation practices used in centers registered with the Extracorporeal Life Support Organization (ELSO). Methods: We conducted an international cross-sectional survey of medical directors ...
López-Candales Angel A From the Division of Cardiovascular Diseases, University of Cincinnati College of Medicine, Cincinnati, - - 2014
Right ventricular (RV) dilatation and systolic dysfunction are known remodeling changes occurring in chronic pulmonary hypertension and are likely the result of increases in pulmonary vascular resistance (PVR). It remains unclear whether PVR affects primarily the main RV chamber (mRVc) or the RV outflow tract (RVOT). Standard echocardiography data were ...
West John B JB Department of Medicine, University of California San Diego, La Jolla, California - - 2014
Robert Hooke (1635-1703) was a polymath who made important contributions to respiratory physiology and many other scientific areas. With Robert Boyle, he constructed the first air pump that allowed measurements on small animals at a reduced atmospheric pressure, and this started the discipline of high-altitude physiology. He also built the ...
Fares Khaled M - - 2014
Thoracic epidural analgesia (TEA) has a well-known effect on neurohormonal response. Attenuation of stress response by post-operative epidural analgesia has shown beneficial effects such as lower pain scores and less immunological alterations. Investigation of the combined effects of TEA and protective lung ventilation on pro-inflammatory cytokines and patients' outcome after ...
de la Osa Agustín Mendiola AM From the Anaesthesia Department, Universitary General Hospital of Ciudad Real (AMDLO), Anaesthesia and Critical Care Department, Puerta de Hierro University Hospital, Majadahonda Experimental Unit, La Paz University Hospital, Madrid (JGF), Paediatric Intensive Care Unit, Department of Paediatrics, Reina Sofia University Hospital, Maimónides Institute for Biomedical Research of Cordoba (IMIBIC), University of Cordoba (FJLC, MGC, MJDLTA, IIDLR, JLPN), Unit of Methodology in Investigation, Instituto Maimo[Combining Acute Accent]nides de Investigacio[Combining Acute Accent]n Biome[Combining Acute Accent]dica de Co[Combining Acute Accent]rdoba, Cordoba, Spain (IMIBIC) - - 2014
Lung recruitment manoeuvres in neonates during anaesthesia are not performed routinely due to concerns about causing barotrauma, haemodynamic instability and oxidative stress. To assess the influence of recruitment manoeuvres and positive end-expiratory pressure (PEEP) on haemodynamics, oxidative stress, oxygenation and lung mechanics. A prospective experimental study. Experimental Unit, La Paz ...
Kharge Angana Banerjee AB Stevens Institute of - - 2014
In the acute respiratory distress syndrome, plasma proteins in alveolar edema liquid are thought to inactivate lung surfactant and raise surface tension, T. However plasma protein-surfactant interaction has been assessed only in vitro, during unphysiologically large surface area compression (%ΔA). Here, we investigate whether plasma proteins raise T in situ ...
Mireles-Cabodevila Eduardo E Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.University of Arkansas for Medical Sciences, Little Rock, Arkansas. - - 2014
Mid-frequency ventilation (MFV) is a mode of pressure control ventilation based on an optimal targeting scheme that maximizes alveolar ventilation and minimizes tidal volume (VT). This study was designed to compare the effects of conventional mechanical ventilation using a lung-protective strategy with MFV in a porcine model of lung injury. ...
Qi Shouliang - - 2014
Left pulmonary artery sling (LPAS) is a rare but severe congenital anomaly, in which the stenoses are formed in the trachea and/or main bronchi. Multi-detector computed tomography (MDCT) provides useful anatomical images, but does not offer functional information. The objective of the present study is to quantitatively analyze the airflow ...
Dabaghyan Mikayel M Mirtech, Inc., Brockton, MA, - - 2014
In this work, we report initial results from a light-weight, low field magnetic resonance device designed to make relative pulmonary density measurements at the bedside. The development of this device necessarily involves special considerations for the magnet, RF and data acquisition schemes as well as a careful analysis of what ...
Ventetuolo Corey E CE Alpert Medical School of Brown University, Providence, - - 2014
-While frequently assessed in trials and clinical practice, hemodynamic response to therapy has never been validated as a surrogate endpoint for clinical events in pulmonary arterial hypertension (PAH). -We performed a patient-level pooled analysis of four randomized placebo-controlled trials to determine if treatment-induced changes in hemodynamic values at 12 weeks ...
Ryan John J JJ From the Division of Cardiovascular Medicine, Department of Medicine, University of Utah, Salt Lake City (J.J.R.); and Department of Medicine, Queen's University, Kingston, Ontario, Canada - - 2014
The right ventricle (RV) is the major determinant of functional state and prognosis in pulmonary arterial hypertension. RV hypertrophy (RVH) triggered by pressure overload is initially compensatory but often leads to RV failure. Despite similar RV afterload and mass some patients develop adaptive RVH (concentric with retained RV function), while ...
Maci Eliana E Department of Medical Oncology, University Campus Bio-Medico , - - 2014
Background: Tobacco smoke causes lung disfunction and inflammation. Methods: Twenty-two consecutive smokers with undetermined lung nodules were included. All underwent a baseline imaging, exhaled carbon monoxide level evaluation and spirometry, repeated at three months from smoking cessation therapy. Results: A significant reduction in size of the lung nodules was reported ...
Hallberg Christopher J - - 2014
Respiratory disease accounts for three of the ten leading causes of death worldwide. Many of these diseases can be treated and diagnosed using a nebulizer. Nebulizers can also be used to safely and efficiently deliver vaccines. Unfortunately, commercially available nebulizers are not designed for use in regions of the world ...
Joshi Suchita S Department of Child Health, Cardiff University, Cardiff, - - 2014
Although increased pulmonary arterial pressure is common in infancy in preterm infants who develop chronic lung disease of prematurity (CLD), it is unknown if the increase persists into childhood. We, therefore, assessed if 8-12-year-old children with documented CLD in infancy had evidence of right ventricular dysfunction or pulmonary arterial hypertension ...
Santos Cíntia Lourenco - - 2014
Mechanical ventilation with high positive end-expiratory pressure (PEEP) has been used in patients with acute respiratory distress syndrome (ARDS) and intra-abdominal hypertension (IAH), but the role of PEEP in minimizing lung injury remains controversial. We hypothesized that in the presence of acute lung injury (ALI) with IAH: 1) higher PEEP ...
LeVarge Barbara L BL Dept of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center, Boston, MA, - - 2014
Current guidelines recommend measurement of pulmonary artery wedge pressure (PAWP) at end-expiration. However, this recommendation is not universally followed and may not be physiologically appropriate. We investigated the performance of end-expiratory PAWP in the evaluation of precapillary pulmonary hypertension patients. 329 spontaneously breathing patients undergoing right heart catheterisation were retrospectively ...
Sueta Shinichi S Kidney Disease Center, Japanese Red Cross Nagoya Daini Hospital, 2-9, Myoken-cho, Showa-ku, Nagoya, 466-8650, Japan, - - 2014
Vitamin D deficiency is common among patients with chronic kidney disease (CKD). However, the benefits of vitamin D supplementation versus vitamin D receptor activator (VDRA) administration have yet to be established. Recently, an association between activated vitamin D and cardiovascular factors was reported. To evaluate the benefits of VDRA in ...
Toishi Masayuki M Department of Thoracic Surgery, Shinshu University School of Medicine, Matsumoto, - - 2014
Vessel-sealing devices (VSDs) are widely used for various surgical procedures, including thoracoscopic surgery, but very few reports have compared their safety and usefulness with human thoracoscopic lobectomy procedures not employing VSDs. Primary lung cancer patients for whom a thoracoscopic lobectomy involving mediastinal lymph node dissection was planned in our department ...
Mu Lina L Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, SUNY, 270 Farber Hall, Buffalo, NY 14214, USA. Electronic address: - - 2014
This study aims to examine whether changes in short-term exposures to particulate matter are associated with changes in lung function, breath rate, and blood pressure among healthy adults and whether smoking status modifies the association. We took advantage of the artificially controlled changes in air pollution levels that occurred during ...
Henderson Ashley G - - 2014
The pathogenesis of mucoinfective lung disease in cystic fibrosis (CF) patients likely involves poor mucus clearance. A recent model of mucus clearance predicts that mucus flow depends on the relative mucin concentration of the mucus layer compared with that of the periciliary layer; however, mucin concentrations have been difficult to ...
Titosky Jordan T F JT Department of Mechanical Engineering, University of Alberta, Edmonton, Alberta, T6G 2T8, - - 2014
The purpose of the study is to understand the effect of altitude on the performance of selected pressurized metered dose inhalers (pMDIs) and dry powder inhalers (DPIs). A testing apparatus that created consistent breath profiles through the Alberta Idealized Throat was designed to test five pMDIs and two DPIs at ...
Esquinas Antonio M AM 1Intensive Care Unit and Non Invasive Ventilatory Unit, Hospital Morales Meseguer , Murcia , - - 2014
Abstract Method to improve minute ventilation (MV) during spontaneous breathing (SB) in stable severe chronic obstructive pulmonary disease (COPD) have a great clinical relevant in long term outcome. In this scenario, recommendations of early use of high-Intensity non-invasive Positive pressure Ventilation (HI-NPPV) or intelligent Volume Assured Pressure (iVAP) Support in ...
Radcliffe Robin W - - 2014
It was observed previously that end-expired carbon dioxide (P(E)CO2) decreased when immobilized black rhinoceroses (Diceros bicornis) were moved from sternal to lateral recumbency. These experiments were designed to test whether greater alveolar ventilation or greater pulmonary dead space in lateral recumbency explains this postural difference in P(E)CO2. Twenty-one (9 male, ...
Belhadj Zoubida Z UDL Sidi Bel Abbes, Sidi Bel Abbes, - - 2014
To evaluate the influence of occupational exposure to ultrafine particles on cardiopulmonary parameters. Changes in ventilatory and haemodynamic parameters during occupational exposure to ultrafine particles summers studied using a survey-type retrospective cohort exposed unexposed conducted in a company producing agricultural equipment for a period of five month period from January ...
Mitchell J J Department of Neonatal Medicine, Royal Children's Hospital, Melbourne, Australia Department of Neonatal Medicine, Royal Hospital for Sick Children, Glasgow, - - 2014
Pulmonary artery hypertension (PAH) is common in newborn infants with hypoxia, infection and pulmonary mal-development. Clinical estimation of pulmonary artery pressure (PAP) is frequently performed echocardiographically by measuring the maximal velocity of the tricuspid regurgitation jet (TRmax) and/or flow in the patent ductus arteriosus (PDA). Challenges exist that may affect ...
Shujaat Adil A Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida, Jacksonville, Florida, - - 2014
Pulmonary hypertension (PH) in overweight or obese patients with obstructive sleep apnea (OSA) may be multifactorial. The effect of pulmonary artery hypertension (PAH)-specific drugs on PH and exercise capacity in such patients is unknown. We performed a retrospective review of overweight or obese patients with OSA and PH who were ...
Toney Brent M BM Department of Medicine, Division of Pulmonary, Allergy, Critical Care, Occupational and Sleep Medicine, Indiana University, Indianapolis, Indiana, - - 2014
Endothelin-1 is a potent mediator of sepsis-induced pulmonary hypertension (PH). The pulmonary vascular effects of selective blockade of endothelin receptor subtype A (ETAR) during endotoxemia remain unknown. We hypothesized that selective ETAR antagonism attenuates endotoxin-induced PH and improves pulmonary artery (PA) vasoreactivity. Adult male Sprague-Dawley rats (250-450 g) received lipopolysaccharide ...
Tedford Ryan J RJ Department of Medicine, Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, - - 2014
Right ventricular (RV) afterload consists of both resistive and capacitive (pulsatile) components. Total afterload can be measured directly with pulmonary artery input impedance spectra or estimated, either with lumped-parameter modeling or by pressure-volume analysis. However, the inverse, hyperbolic relationship between resistance and compliance in the lung would suggest that the ...
- - 2014
The role of positive end-expiratory pressure in mechanical ventilation during general anaesthesia for surgery remains uncertain. Levels of pressure higher than 0 cm H2O might protect against postoperative pulmonary complications but could also cause intraoperative circulatory depression and lung injury from overdistension. We tested the hypothesis that a high level ...
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