Search results for "Respiratory Physiology"
showing 10 items of 363 documents
Individualized versus fixed positive end-expiratory pressure for intraoperative mechanical ventilation in obese patients: a secondary analysis
2021
Background General anesthesia may cause atelectasis and deterioration in oxygenation in obese patients. The authors hypothesized that individualized positive end-expiratory pressure (PEEP) improves intraoperative oxygenation and ventilation distribution compared to fixed PEEP. Methods This secondary analysis included all obese patients recruited at University Hospital of Leipzig from the multicenter Protective Intraoperative Ventilation with Higher versus Lower Levels of Positive End-Expiratory Pressure in Obese Patients (PROBESE) trial (n = 42) and likewise all obese patients from a local single-center trial (n = 54). Inclusion criteria for both trials were elective laparoscopic abdominal…
Maximal degree of airway narrowing induced by methacholine and adenosine monophosphate: relationship with the decrease in forced vital capacity.
2010
Background Changes in forced vital capacity (FVC) may represent an indirect method for the detection of plateau in response to inhaled bronchoconstrictor agents. Objective To determine the relationship between the level of plateau obtained with either methacholine or adenosine monophosphate (AMP) and the decrease in FVC induced by each bronchoconstrictor agent. Methods Airway responsiveness to high concentrations of methacholine and AMP was determined in patients with intermittent asthma (n = 41) or allergic rhinitis (n = 26). Furthermore, allergen-induced changes in the response to each bronchoconstrictor agent were investigated in 18 pollen-sensitive patients. Concentration-response curve…
Aortic valve-sparing root replacement from inside the aorta using three Dacron skirts preserving the native Valsalva sinuses geometry and stabilizing…
2009
We present an alternative idea for valve-sparing technique combining the advantages of the reimplantation and the benefits of the remodeling techniques. We replace the sinuses of Valsalva using three Dacron skirts from inside of the aorta. The physiological anatomy of the Valsalva sinuses and their dynamic properties are preserved and the aortic commissures displacement avoided. The distal rim of each Dacron skirt was anchored to the aorto-ventricular junction using Ticron (2-0) U stitches placed from the ventricular side to the aortic side. We stabilize the base of the aortic annulus to prevent future dilation.
Fluticasone/formoterol combination therapy versus budesonide/formoterol for the treatment of asthma: a randomized, controlled, non-inferiority trial …
2012
The inhaled corticosteroid fluticasone propionate (fluticasone) and the long-acting β₂ agonist formoterol fumarate (formoterol) have been combined in a single aerosol inhaler fluticasone/formoterol (flutiform(®)). This study compared the efficacy and safety of fluticasone/formoterol with the combination product budesonide/formoterol (Symbicort(®) Turbohaler(®)).A randomized, double-blind, double-dummy, multicenter, Phase 3 study comprising a 7- (± 3) day screening, 2-4-week run-in, and 12-week treatment periods. Patients aged ≥ 12 years with moderate to severe persistent asthma for ≥ 6 months before screening and forced expiratory volume in one second (FEV₁) 50-80% predicted and ≥ 15% rever…
A Bench Evaluation of Eight Home-Care Ventilators
2021
BACKGROUND: The growing number of patients on home mechanical ventilation has driven considerable progress in the performance and functionality of ventilators, with features comparable with those used in the ICU. However, a publication gap exists in the evaluation and comparison of their performance and each ventilator choice depends on machine characteristics defined by manufacturers. METHODS: We bench tested 8 home-care ventilators that are currently available: Monnal T50, EOVE EO-150, Puritan Bennet 560, Weinmann, PrismaVent 50, Trilogy Evo, Astral 150, and Vivo 60 by using an active lung model. These devices were tested under 18 experimental conditions that combined 3 variables: respira…
Exploring Associations Between Respiratory Mechanics and Survival in Immunocompromised Patients With ARDS.
2020
Thanks to improvements in organ support strategies and to advances in the treatment of solid and hematological tumors, outcome of immunocompromised patients requiring ICU admission has improved impressively over the last decade . For this reason, the number of immunocompromised patients admitted to the ICU and deemed candidates for invasive therapies is steadily increasing. Acute respiratory failure (ARF) is the leading cause of hospital and ICU admission, but the optimal first-line reatment of respiratory failure in these patients remains to be determined
Influence of different interfaces on synchrony during pressure support ventilation in a pediatric setting: a bench study
2015
BACKGROUND: In adults and children, patient-ventilator synchrony is strongly dependent on both the ventilator settings and interface used in applying positive pressure to the airway. The aim of this bench study was to determine whether different interfaces and ventilator settings may influence patient-ventilator interaction in pediatric models of normal and mixed obstructive and restrictive respiratory conditions. METHODS: A test lung, connected to a pediatric mannequin using different interfaces (endotracheal tube [ETT], face mask, and helmet), was ventilated in pressure support ventilation mode testing 2 ventilator settings (pressurization time [Timepress]50%/cycling-off flow threshold [T…
Patient-Ventilator Asynchronies: Clinical Implications and Practical Solutions
2020
Mechanical ventilation is a supportive treatment commonly applied in critically ill patients. Whenever the patient is spontaneously breathing, the pressure applied to the respiratory system depends on the sum of the pressure generated by the respiratory muscles and the pressure generated by the ventilator. Patient-ventilator interaction is of utmost importance in spontaneously breathing patients, and thus the ventilator should be able to adapt to patient's changes in ventilatory demand and respiratory mechanics. Nevertheless, a lack of coordination between patient and ventilator due to a mismatch between neural and ventilator timing throughout the respiratory cycle may make weaning difficul…
Mechanostructural adaptations preceding postpneumonectomy lung growth
2012
In many species, pneumonectomy results in compensatory growth in the remaining lung. Although the late mechanical consequences of murine pneumonectomy are known, little is known about the anatomic adaptations and respiratory mechanics during compensatory lung growth. To investigate the structural and mechanical changes during compensatory growth, mice were studied for 21 days after left pneumonectomy using microCT and respiratory system impedance (FlexiVent). Anatomic changes after left pneumonectomy included minimal mediastinal shift or chestwall remodeling, but significant displacement of the heart and cardiac lobe. Mean displacement of the cardiac lobe centroid was 5.2 ± 0.8 mm. Lung imp…
Visit-to-visit blood pressure variability and renal outcomes: results from ONTARGET and TRANSCEND trials.
2020
AIMS There is conflicting evidence on whether in treated hypertensive patients the risk of renal outcomes is associated with visit-to-visit SBP variability. Furthermore, limited evidence is available on how important is SBP variability for prediction of renal outcomes compared with on-treatment mean SBP. We addressed these issues in 28 790 participants of the Ongoing Treatment Alone and in combination with Ramipril Global End point Trial and Telmisartan Randomized Assessment Study in ace iNtolerant Subjects with Cardiovascular Disease trials. METHODS AND RESULTS SBP variability was expressed as the coefficient of variation of the mean with which it showed no relationship. SBP variability an…