Search results for "Respiratory system"
showing 10 items of 1829 documents
Respiratory Mechanics and Gas Exchange in Thoracic Surgery: Changes in Classical Knowledge in Respiratory Physiology
2020
Respiratory mechanics describe the lung function through pressure and flow and the interplay between the two during the respiratory cycle. Derived indices are volume, compliance and resistance (Hess, Respir Care 59(11):1773–1794, 2014). Thoracic surgery in most cases requires the separation of the lungs in order to allow surgery of or near one lung and ventilation of the other lung, while the perfusion to the non-ventilated lung is continued. This has profound implications for the gas exchange and respiratory mechanics.
Physiologie und Pathophysiologie des respiratorischen Systems
2006
Positive pressure ventilation in children is associated with problems similar to those in the adults: development of atelectasis and barotrauma. During anesthesia atelectasis develop in up to 90% of patients, requiring the use of higher inspiratory pressure to recruit the collapsed lung regions. Especially in the preterm, newborn and younger infants, prolonged ventilation disturbs the anatomical structure of the soft and vulnerable immature airways and their subsequent growth and development, leading to tracheomegaly, tracheal collapse, and bronchopulmonary dysplasia and predisposing to bronchial obstruction. On the basis of pathophysiologic knowledge and studies of ventilation in children,…
Review of difficult airway management in thoracic surgery
2018
The management of difficult airway (DA) in thoracic surgery is more difficult due to the need for lung separation or isolation and frequent presence of associated upper and lower airway problems. We performed an article review analysing 818 papers published with clinical evidence indexed in Pubmed that allowed us to develop an algorithm. The best airway management in predicted DA is tracheal intubation and independent bronchial blockers guided by fibroscopy maintaining spontaneous ventilation. For unpredicted DA, the use of videolaryngoscopes is recommended initially, and adequate neuromuscular relaxation (rocuronium/sugammadex), among other maneuvers. In both cases, double lumen tubes shou…
Computertomographische Funktionsuntersuchung der Lunge nach einseitiger Lungentransplantation mit axialer und koronarer Akquisition
1996
After single-lung transplantation in a patient suffering from obstructive emphysema lung function parameters worsened during follow-up. To complement the routine high-resolution CT (HRCT) scans acquired in inspiration, additional scans were obtained to evaluate regional lung function. The comparison of HRCT scans acquired in inspiration and in expiration revealed different ventilation conditions of both lungs, continuous acquisition in a single slice (dynamic multiscan acquisition) in the axial and coronal plane demonstrated mediastinal shifting and the movement of the diaphragm during the whole breathing cycle. Both modalities can provide important information concerning regional differenc…
Repräsentiert der HRCT-Emphysemindex die gesamte Lunge?
2005
Purpose: Comparison of emphysema index derived of thin section MD-CT of the entire lung volume and HRCT, simulated by calculation of every twentieth image of the whole data-set. Materials and Methods: Pulmonary emphysema was quantified by semiautomatic, segmentation of lung borders and assessment of lung volume and emphysema volume within these borders. The emphysema index (pixel index) was calculated. Statistical analysis was done by the sign-test and Bland-Altman-analysis. Results: Median lung volume, emphysema volume and emphysema index are significantly higher in simulated HRCT. Median lung volume (emphysema volume) calculated by HRCT is 5118 ml (407 ml) and 5040 ml (367 ml) calculated …
Complications in the treatment with alveolar extraosseous distractors: literature review
2014
Background To review the literature that analyses the types and frequency of complications associated with the use of extraosseous alveolar distraction from 2007 to 2013. Material and Methods Review of the literature in PubMed, using these keywords; alveolar ridge, alveolar distraction osteogenesis, complication, literature review. Inclusion criteria were: articles published between 2007 and 2013 that included the distraction protocol, the complications encountered and the time when they occurred. Results According to the above criteria, 12 articles were included in this review, where 334 extraosseous distractors were placed and 395 complications were encountered, of which 19 (4.81%) were i…
Impact of increased mean arterial pressure on skin microcirculatory oxygenation in vasopressor-requiring septic patients: an interventional study
2019
Abstract Background Heterogeneity of microvascular blood flow leading to tissue hypoxia is a common finding in patients with septic shock. It may be related to suboptimal systemic perfusion pressure and lead to organ failure. Mapping of skin microcirculatory oxygen saturation and relative hemoglobin concentration using hyperspectral imaging allows to identify heterogeneity of perfusion and perform targeted measurement of oxygenation. We hypothesized that increasing mean arterial pressure would result in improved oxygenation in areas of the skin with most microvascular blood pooling. Methods We included adult patients admitted to the intensive care unit within the previous 24 h with sepsis a…
Arterial Load and Norepinephrine Are Associated With the Response of the Cardiovascular System to Fluid Expansion
2021
BackgroundFluid responsiveness has been extensively studied by using the preload prism. The arterial load might be a factor modulating the fluid responsiveness. The norepinephrine (NE) administration increases the arterial load and modifies the vascular properties. The objective of the present study was to determine the relationship between fluid responsiveness, preload, arterial load, and NE use. We hypothesized that as a preload/arterial load, NE use may affect fluid responsiveness.MethodsThe retrospective multicentered analysis of the pooled data from 446 patients monitored using the transpulmonary thermodilution before and after fluid expansion (FE) was performed. FE was standardized be…
Efficacy and Safety of Using High-Flow Nasal Oxygenation in Patients Undergoing Rapid Sequence Intubation
2017
Objective To assess the efficacy and safety of high-flow nasal oxygen (HFNO) therapy in patients undergoing rapid sequence intubation (RSI) for emergency abdominal surgery. Methods HFNO of 60 L.min-1 at an inspiratory oxygen fraction of 1 was delivered 4 min before laryngoscopy and maintained until the patient was intubated, and correct intubation was verified by the appearance of the end-tidal CO2 (EtCO2) waveform. Transcutaneous oxygenation (SpO2), heart rate and non-invasive mean arterial pressure were monitored at baseline (T0), after 4 min on HFNO (T1) and at the time of laryngoscopy (T2) and endotracheal intubation (ETI) (T3). An SpO2 of <3% from baseline was recorded at any sampled t…
High-Speed Video Microscopy for Primary Ciliary Dyskinesia Diagnosis: A Study of Ciliary Motility Variations with Time and Temperature
2021
Este artículo se encuentra disponible en la siguiente URL: https://www.mdpi.com/2075-4418/11/7/1301 Este artículo de investigación pertenece al número especial "Progress in Diagnosing and Managing Primary Ciliary Dyskinesia". Primary ciliary dyskinesia (PCD) is a rare disease resulting from a defect in ciliary function that generates, among other issues, chronic upper and lower respiratory tract infections. European guidelines recommend studying ciliary function (pattern (CBP) and frequency (CBF)), together with characteristic clinical symptoms, as one of the definitive tests. However, there is no “gold standard”. The present study aims to use high-speed video microscopy to describe how CBF…