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  1. Article ; Online: Influence of Fractional Inspired Oxygen Tension on Lung Perfusion Distribution, Regional Ventilation, and Lung Volume during Mechanical Ventilation of Supine Healthy Swine.

    Ribeiro, Bruno M / Tucci, Mauro R / Victor Júnior, Marcus H / Melo, Jose R / Gomes, Susimeire / Nakamura, Maria A M / Morais, Caio C A / Beraldo, Marcelo A / Lima, Cristhiano A S / Alcala, Glasiele C / Amato, Marcelo B P

    Anesthesiology

    2024  Volume 140, Issue 4, Page(s) 752–764

    MeSH term(s) Animals ; Female ; Swine ; Respiration, Artificial/methods ; Lung/diagnostic imaging ; Lung Volume Measurements ; Pulmonary Atelectasis/diagnostic imaging ; Pulmonary Atelectasis/therapy ; Perfusion ; Oxygen
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2024-01-11
    Publishing country United States
    Document type Journal Article
    ZDB-ID 269-0
    ISSN 1528-1175 ; 0003-3022
    ISSN (online) 1528-1175
    ISSN 0003-3022
    DOI 10.1097/ALN.0000000000004903
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uk I Zs.133: Show issues Location:
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    Zs.MO 199: Show issues

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  2. Article ; Online: Regional Ventilation Displayed by Electrical Impedance Tomography as an Incentive to Decrease Positive End-Expiratory Pressure.

    Yoshida, Takeshi / Piraino, Thomas / Lima, Cristhiano A S / Kavanagh, Brian P / Amato, Marcelo B P / Brochard, Laurent

    American journal of respiratory and critical care medicine

    2019  Volume 200, Issue 7, Page(s) 933–937

    MeSH term(s) Aged ; Animals ; Electric Impedance ; Female ; Humans ; Lung/diagnostic imaging ; Male ; Middle Aged ; Positive-Pressure Respiration/methods ; Respiration, Artificial ; Respiratory Distress Syndrome, Adult/therapy ; Sus scrofa ; Swine ; Tomography/methods ; Ventilator-Induced Lung Injury/prevention & control
    Language English
    Publishing date 2019-08-09
    Publishing country United States
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201904-0797LE
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  3. Article ; Online: Esophageal Manometry and Regional Transpulmonary Pressure in Lung Injury.

    Yoshida, Takeshi / Amato, Marcelo B P / Grieco, Domenico Luca / Chen, Lu / Lima, Cristhiano A S / Roldan, Rollin / Morais, Caio C A / Gomes, Susimeire / Costa, Eduardo L V / Cardoso, Paulo F G / Charbonney, Emmanuel / Richard, Jean-Christophe M / Brochard, Laurent / Kavanagh, Brian P

    American journal of respiratory and critical care medicine

    2018  Volume 197, Issue 8, Page(s) 1018–1026

    Abstract: Rationale: Esophageal manometry is the clinically available method to estimate pleural pressure, thus enabling calculation of transpulmonary pressure (Pl). However, many concerns make it uncertain in which lung region esophageal manometry reflects local ...

    Abstract Rationale: Esophageal manometry is the clinically available method to estimate pleural pressure, thus enabling calculation of transpulmonary pressure (Pl). However, many concerns make it uncertain in which lung region esophageal manometry reflects local Pl.
    Objectives: To determine the accuracy of esophageal pressure (Pes) and in which regions esophageal manometry reflects pleural pressure (Ppl) and Pl; to assess whether lung stress in nondependent regions can be estimated at end-inspiration from Pl.
    Methods: In lung-injured pigs (n = 6) and human cadavers (n = 3), Pes was measured across a range of positive end-expiratory pressure, together with directly measured Ppl in nondependent and dependent pleural regions. All measurements were obtained with minimal nonstressed volumes in the pleural sensors and esophageal balloons. Expiratory and inspiratory Pl was calculated by subtracting local Ppl or Pes from airway pressure; inspiratory Pl was also estimated by subtracting Ppl (calculated from chest wall and respiratory system elastance) from the airway plateau pressure.
    Measurements and main results: In pigs and human cadavers, expiratory and inspiratory Pl using Pes closely reflected values in dependent to middle lung (adjacent to the esophagus). Inspiratory Pl estimated from elastance ratio reflected the directly measured nondependent values.
    Conclusions: These data support the use of esophageal manometry in acute respiratory distress syndrome. Assuming correct calibration, expiratory Pl derived from Pes reflects Pl in dependent to middle lung, where atelectasis usually predominates; inspiratory Pl estimated from elastance ratio may indicate the highest level of lung stress in nondependent "baby" lung, where it is vulnerable to ventilator-induced lung injury.
    MeSH term(s) Animals ; Cadaver ; Esophagus/physiopathology ; Humans ; Manometry/methods ; Models, Animal ; Positive-Pressure Respiration/methods ; Respiration, Artificial/methods ; Respiratory Function Tests ; Respiratory Mechanics/physiology ; Swine ; Ventilator-Induced Lung Injury/diagnosis ; Ventilator-Induced Lung Injury/physiopathology
    Language English
    Publishing date 2018-01-11
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201709-1806OC
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uh II Zs.80: Show issues Location:
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  4. Article ; Online: High Positive End-Expiratory Pressure Renders Spontaneous Effort Noninjurious.

    Morais, Caio C A / Koyama, Yukiko / Yoshida, Takeshi / Plens, Glauco M / Gomes, Susimeire / Lima, Cristhiano A S / Ramos, Ozires P S / Pereira, Sérgio M / Kawaguchi, Naomasa / Yamamoto, Hirofumi / Uchiyama, Akinori / Borges, João B / Vidal Melo, Marcos F / Tucci, Mauro R / Amato, Marcelo B P / Kavanagh, Brian P / Costa, Eduardo L V / Fujino, Yuji

    American journal of respiratory and critical care medicine

    2017  Volume 197, Issue 10, Page(s) 1285–1296

    Abstract: Rationale: In acute respiratory distress syndrome (ARDS), atelectatic solid-like lung tissue impairs transmission of negative swings in pleural pressure (Ppl) that result from diaphragmatic contraction. The localization of more negative Ppl ... ...

    Abstract Rationale: In acute respiratory distress syndrome (ARDS), atelectatic solid-like lung tissue impairs transmission of negative swings in pleural pressure (Ppl) that result from diaphragmatic contraction. The localization of more negative Ppl proportionally increases dependent lung stretch by drawing gas either from other lung regions (e.g., nondependent lung [pendelluft]) or from the ventilator. Lowering the level of spontaneous effort and/or converting solid-like to fluid-like lung might render spontaneous effort noninjurious.
    Objectives: To determine whether spontaneous effort increases dependent lung injury, and whether such injury would be reduced by recruiting atelectatic solid-like lung with positive end-expiratory pressure (PEEP).
    Methods: Established models of severe ARDS (rabbit, pig) were used. Regional histology (rabbit), inflammation (positron emission tomography; pig), regional inspiratory Ppl (intrabronchial balloon manometry), and stretch (electrical impedance tomography; pig) were measured. Respiratory drive was evaluated in 11 patients with ARDS.
    Measurements and main results: Although injury during muscle paralysis was predominantly in nondependent and middle lung regions at low (vs. high) PEEP, strong inspiratory effort increased injury (indicated by positron emission tomography and histology) in dependent lung. Stronger effort (vs. muscle paralysis) caused local overstretch and greater tidal recruitment in dependent lung, where more negative Ppl was localized and greater stretch was generated. In contrast, high PEEP minimized lung injury by more uniformly distributing negative Ppl, and lowering the magnitude of spontaneous effort (i.e., deflection in esophageal pressure observed in rabbits, pigs, and patients).
    Conclusions: Strong effort increased dependent lung injury, where higher local lung stress and stretch was generated; effort-dependent lung injury was minimized by high PEEP in severe ARDS, which may offset need for paralysis.
    MeSH term(s) Animals ; Disease Models, Animal ; Lung/physiopathology ; Positive-Pressure Respiration/methods ; Rabbits ; Respiration, Artificial/adverse effects ; Respiration, Artificial/methods ; Respiratory Distress Syndrome, Adult/complications ; Respiratory Distress Syndrome, Adult/therapy ; Swine
    Language English
    Publishing date 2017-12-12
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1180953-x
    ISSN 1535-4970 ; 0003-0805 ; 1073-449X
    ISSN (online) 1535-4970
    ISSN 0003-0805 ; 1073-449X
    DOI 10.1164/rccm.201706-1244OC
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uh II Zs.80: Show issues Location:
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