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  1. Article ; Online: Electrical Impedance Tomography during Abdominal Laparoscopic Surgery

    Michela Rauseo / Savino Spadaro / Lucia Mirabella / Antonella Cotoia / Donato Laforgia / Gennaro Gaudino / Francesca Vinella / Giuseppe Ferrara / Adriana Gattullo / Livio Tullo / Gilda Cinnella

    Journal of Clinical Medicine, Vol 12, Iss 23, p

    A Physiological Pilot Study

    2023  Volume 7467

    Abstract: Background: Both general anesthesia and pneumoperitoneum insufflation during abdominal laparoscopic surgery can lead to atelectasis and impairment in oxygenation. Setting an appropriate level of external PEEP could reduce the occurrence of atelectasis ... ...

    Abstract Background: Both general anesthesia and pneumoperitoneum insufflation during abdominal laparoscopic surgery can lead to atelectasis and impairment in oxygenation. Setting an appropriate level of external PEEP could reduce the occurrence of atelectasis and induce an improvement in gas exchange. However, in clinical practice, it is common to use a fixed PEEP level (i.e., 5 cmH 2 O), irrespective of the dynamic respiratory mechanics. We hypothesized setting a PEEP level guided by EIT in order to obtain an improvement in oxygenation and respiratory system compliance in lung-healthy patients than can benefit a personalized approach. Methods: Twelve consecutive patients scheduled for abdominal laparoscopic surgery were enrolled in this prospective study. The EIT Timpel Enlight 1800 was applied to each patient and a dedicated pneumotachograph and a spirometer flow sensor, integrated with EIT, constantly recorded respiratory mechanics. Gas exchange, respiratory mechanics and hemodynamics were recorded at five time points: T0, baseline; T1, after induction; T2, after pneumoperitoneum insufflation; T3, after a recruitment maneuver; and T4, at the end of surgery after desufflation. Results: A titrated mean PEEP of 8 cmH 2 O applied after a recruitment maneuver was successfully associated with the “best” compliance (58.4 ± 5.43 mL/cmH 2 O), with a low percentage of collapse (10%), an acceptable level of hyperdistention (0.02%). Pneumoperitoneum insufflation worsened respiratory system compliance, plateau pressure, and driving pressure, which significantly improved after the application of the recruitment maneuver and appropriate PEEP. PaO 2 increased from 78.1 ± 9.49 mmHg at T0 to 188 ± 66.7 mmHg at T4 ( p < 0.01). Other respiratory parameters remained stable after abdominal desufflation. Hemodynamic parameters remained unchanged throughout the study. Conclusions: EIT, used as a non-invasive intra-operative monitor, enables the rapid assessment of lung volume and regional ventilation changes in patients undergoing ...
    Keywords mechanical ventilation ; laparoscopy ; recruitment maneuver ; positive end-expiratory pressure ; electrical impedance tomography ; anesthesia ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Inhibition of Galectins and the P2X7 Purinergic Receptor as a Therapeutic Approach in the Neurovascular Inflammation of Diabetic Retinopathy

    Caterina Claudia Lepre / Marina Russo / Maria Consiglia Trotta / Francesco Petrillo / Fabiana Anna D’Agostino / Gennaro Gaudino / Giovanbattista D’Amico / Maria Rosaria Campitiello / Erminia Crisci / Maddalena Nicoletti / Carlo Gesualdo / Francesca Simonelli / Michele D’Amico / Anca Hermenean / Settimio Rossi

    International Journal of Molecular Sciences, Vol 24, Iss 9721, p

    2023  Volume 9721

    Abstract: Diabetic retinopathy (DR) is the most frequent microvascular retinal complication of diabetic patients, contributing to loss of vision. Recently, retinal neuroinflammation and neurodegeneration have emerged as key players in DR progression, and therefore, ...

    Abstract Diabetic retinopathy (DR) is the most frequent microvascular retinal complication of diabetic patients, contributing to loss of vision. Recently, retinal neuroinflammation and neurodegeneration have emerged as key players in DR progression, and therefore, this review examines the neuroinflammatory molecular basis of DR. We focus on four important aspects of retinal neuroinflammation: (i) the exacerbation of endoplasmic reticulum (ER) stress; (ii) the activation of the NLRP3 inflammasome; (iii) the role of galectins; and (iv) the activation of purinergic 2X7 receptor (P2X7R). Moreover, this review proposes the selective inhibition of galectins and the P2X7R as a potential pharmacological approach to prevent the progression of DR.
    Keywords diabetic retinopathy ; neuroinflammation ; ROS ; ER stress ; NLRP3 inflammasome ; galectins ; Biology (General) ; QH301-705.5 ; Chemistry ; QD1-999
    Language English
    Publishing date 2023-06-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

    More links

    Kategorien

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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