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  1. Article ; Online: Weaning patients with obesity from ventilatory support.

    Kacmarek, Robert M / Wanderley, Hatus V / Villar, Jesús / Berra, Lorenzo

    Current opinion in critical care

    2022  Volume 27, Issue 3, Page(s) 311–319

    Abstract: Purpose of review: Obesity prevalence is increasing in most countries in the world. In the United States, 42% of the population is obese (body mass index (BMI) > 30) and 9.2% is obese class III (BMI > 40). One of the greatest challenges in critically ... ...

    Abstract Purpose of review: Obesity prevalence is increasing in most countries in the world. In the United States, 42% of the population is obese (body mass index (BMI) > 30) and 9.2% is obese class III (BMI > 40). One of the greatest challenges in critically ill patients with obesity is the optimization of mechanical ventilation. The goal of this review is to describe respiratory physiologic changes in patients with obesity and discuss possible mechanical ventilation strategies to improve respiratory function.
    Recent findings: Individualized mechanical ventilation based on respiratory physiology after a decremental positive end-expiratory pressure (PEEP) trial improves oxygenation and respiratory mechanics. In a recent study, mortality of patients with respiratory failure and obesity was reduced by about 50% when mechanical ventilation was associated with the use of esophageal manometry and electrical impedance tomography (EIT).
    Summary: Obesity greatly alters the respiratory system mechanics causing atelectasis and prolonged duration of mechanical ventilation. At present, novel strategies to ventilate patients with obesity based on individual respiratory physiology showed to be superior to those based on standard universal tables of mechanical ventilation. Esophageal manometry and EIT are essential tools to systematically assess respiratory system mechanics, safely adjust relatively high levels of PEEP, and improve chances for successful weaning.
    MeSH term(s) Electric Impedance ; Humans ; Obesity/complications ; Obesity/therapy ; Positive-Pressure Respiration ; Pulmonary Atelectasis ; Respiration, Artificial/adverse effects
    Language English
    Publishing date 2022-07-01
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000000823
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4999: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  2. Article ; Online: Development of nitric oxide generators to produce high-dose nitric oxide for inhalation therapy.

    Yu, Binglan / Wanderley, Hatus V / Gianni, Stefano / Carroll, Ryan W / Ichinose, Fumito / Zapol, Warren M / Berra, Lorenzo

    Nitric oxide : biology and chemistry

    2023  Volume 138-139, Page(s) 17–25

    Abstract: Background: Several nitric oxide (NO) generating devices have been developed to deliver NO between 1 part per million (ppm) and 80 ppm. Although inhalation of high-dose NO may exert antimicrobial effects, the feasibility and safety of producing high- ... ...

    Abstract Background: Several nitric oxide (NO) generating devices have been developed to deliver NO between 1 part per million (ppm) and 80 ppm. Although inhalation of high-dose NO may exert antimicrobial effects, the feasibility and safety of producing high-dose (more than 100 ppm) NO remains to be established. In the current study, we designed, developed, and tested three high-dose NO generating devices.
    Methods: We constructed three NO generating devices: a double spark plug NO generator, a high-pressure single spark plug NO generator, and a gliding arc NO generator. The NO and NO
    Results: The double spark plug NO generator produced 200 ± 2 ppm (mean ± SD) of NO at gas flow of 8 L/min (or 320 ± 3 ppm at gas flow of 5 L/min) with electrode gap of 3 mm. The nitrogen dioxide (NO
    Conclusions: Our results demonstrated that it is feasible to enhance NO production (more than 100 ppm) while maintaining NO
    MeSH term(s) Nitric Oxide ; Nitrogen Dioxide ; Respiratory Therapy ; Lung ; Administration, Inhalation ; Oxygen
    Chemical Substances Nitric Oxide (31C4KY9ESH) ; Nitrogen Dioxide (S7G510RUBH) ; Oxygen (S88TT14065)
    Language English
    Publishing date 2023-06-03
    Publishing country United States
    Document type Journal Article ; Research Support, U.S. Gov't, Non-P.H.S. ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1362794-6
    ISSN 1089-8611 ; 1089-8603
    ISSN (online) 1089-8611
    ISSN 1089-8603
    DOI 10.1016/j.niox.2023.05.007
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4677: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (2.OG)
    ab Jg. 2022: Lesesaal (EG)

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  3. Article ; Online: Hyperbaric phototherapy augments blood carbon monoxide removal.

    Fischbach, Anna / Traeger, Lisa / Farinelli, William A / Ezaka, Mariko / Wanderley, Hatus V / Wiegand, Steffen B / Franco, Walfre / Bagchi, Arayna / Bloch, Donald B / Anderson, R Rox / Zapol, Warren M

    Lasers in surgery and medicine

    2021  Volume 54, Issue 3, Page(s) 426–432

    Abstract: Background and objectives: Carbon monoxide (CO) poisoning is responsible for nearly 50,000 emergency department visits and 1200 deaths per year. Compared to oxygen, CO has a 250-fold higher affinity for hemoglobin (Hb), resulting in the displacement of ... ...

    Abstract Background and objectives: Carbon monoxide (CO) poisoning is responsible for nearly 50,000 emergency department visits and 1200 deaths per year. Compared to oxygen, CO has a 250-fold higher affinity for hemoglobin (Hb), resulting in the displacement of oxygen from Hb and impaired oxygen delivery to tissues. Optimal treatment of CO-poisoned patients involves the administration of hyperbaric 100% oxygen to remove CO from Hb and to restore oxygen delivery. However, hyperbaric chambers are not widely available and this treatment requires transporting a CO-poisoned patient to a specialized center, which can result in delayed treatment. Visible light is known to dissociate CO from carboxyhemoglobin (COHb). In a previous study, we showed that a system composed of six photo-extracorporeal membrane oxygenation (ECMO) devices efficiently removes CO from a large animal with CO poisoning. In this study, we tested the hypothesis that the application of hyperbaric oxygen to the photo-ECMO device would further increase the rate of CO elimination.
    Study design/material and methods: We developed a hyperbaric photo-ECMO device and assessed the ability of the device to remove CO from CO-poisoned human blood. We combined four devices into a "hyperbaric photo-ECMO system" and compared its ability to remove CO to our previously described photo-ECMO system, which was composed of six devices ventilated with normobaric oxygen.
    Results: Under normobaric conditions, an increase in oxygen concentration from 21% to 100% significantly increased CO elimination from CO-poisoned blood after a single pass through the device. Increased oxygen pressure within the photo-ECMO device was associated with higher exiting blood PO
    Conclusion: This study demonstrates the feasibility and efficacy of using a hyperbaric photo-ECMO system to increase the rate of CO elimination from CO-poisoned blood. This technology could provide a simple portable emergency device and facilitate immediate treatment of CO-poisoned patients at or near the site of injury.
    MeSH term(s) Animals ; Carbon Monoxide ; Carbon Monoxide Poisoning/complications ; Carbon Monoxide Poisoning/therapy ; Carboxyhemoglobin ; Hemoglobins ; Humans ; Oxygen ; Phototherapy/methods
    Chemical Substances Hemoglobins ; Carbon Monoxide (7U1EE4V452) ; Carboxyhemoglobin (9061-29-4) ; Oxygen (S88TT14065)
    Language English
    Publishing date 2021-10-17
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 604493-1
    ISSN 1096-9101 ; 0196-8092
    ISSN (online) 1096-9101
    ISSN 0196-8092
    DOI 10.1002/lsm.23486
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1603: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article ; Online: Electronic cigarette vaping with aged coils causes acute lung injury in mice.

    Goto, Shunsaku / Grange, Robert M H / Pinciroli, Riccardo / Rosales, Ivy A / Li, Rebecca / Boerboom, Sophie L / Ostrom, Katrina F / Marutani, Eizo / Wanderley, Hatus V / Bagchi, Aranya / Colvin, Robert B / Berra, Lorenzo / Minaeva, Olga / Goldstein, Lee E / Malhotra, Rajeev / Zapol, Warren M / Ichinose, Fumito / Yu, Binglan

    Archives of toxicology

    2022  Volume 96, Issue 12, Page(s) 3363–3371

    Abstract: Electronic cigarettes (e-cigarettes) have been used widely as an alternative to conventional cigarettes and have become particularly popular among young adults. A growing body of evidence has shown that e-cigarettes are associated with acute lung injury ... ...

    Abstract Electronic cigarettes (e-cigarettes) have been used widely as an alternative to conventional cigarettes and have become particularly popular among young adults. A growing body of evidence has shown that e-cigarettes are associated with acute lung injury and adverse effects in multiple other organs. Previous studies showed that high emissions of aldehydes (formaldehyde and acetaldehyde) in aerosols were associated with increased usage of the same e-cigarette coils. However, the impact on lung function of using aged coils has not been reported. We investigated the relationship between coil age and acute lung injury in mice exposed to experimental vaping for 1 h (2 puffs/min, 100 ml/puff). The e-liquid contains propylene glycol and vegetable glycerin (50:50, vol) only. The concentrations of formaldehyde and acetaldehyde in the vaping aerosols increased with age of the nichrome coils starting at 1200 puffs. Mice exposed to e-cigarette aerosols produced from 1800, but not 0 or 900, puff-aged coils caused acute lung injury, increased lung wet/dry weight ratio, and induced lung inflammation (IL-6, TNF-α, IL-1β, MIP-2). Exposure to vaping aerosols from 1800 puff-aged coils decreased heart rate, respiratory rate, and oxygen saturation in mice compared to mice exposed to air or aerosols from new coils. In conclusion, we observed that the concentration of aldehydes (formaldehyde and acetaldehyde) increased with repeated and prolonged usage of e-cigarette coils. Exposure to high levels of aldehyde in vaping aerosol was associated with acute lung injury in mice. These findings show significant risk of lung injury associated with prolonged use of e-cigarette devices.
    MeSH term(s) Animals ; Mice ; Acetaldehyde ; Acute Lung Injury/chemically induced ; Aldehydes/toxicity ; Electronic Nicotine Delivery Systems ; Formaldehyde/toxicity ; Glycerol ; Interleukin-6 ; Propylene Glycol/toxicity ; Respiratory Aerosols and Droplets ; Tumor Necrosis Factor-alpha ; Vaping
    Chemical Substances Acetaldehyde (GO1N1ZPR3B) ; Aldehydes ; Formaldehyde (1HG84L3525) ; Glycerol (PDC6A3C0OX) ; Interleukin-6 ; Propylene Glycol (6DC9Q167V3) ; Tumor Necrosis Factor-alpha
    Language English
    Publishing date 2022-10-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 124992-7
    ISSN 1432-0738 ; 0340-5761
    ISSN (online) 1432-0738
    ISSN 0340-5761
    DOI 10.1007/s00204-022-03388-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

    Uf I Zs.90: Show issues Location:
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  5. Article ; Online: Electronic cigarette vaping with aged coils causes acute lung injury in mice

    Goto, Shunsaku / Grange, Robert M. H. / Pinciroli, Riccardo / Rosales, Ivy A. / Li, Rebecca / Boerboom, Sophie L. / Ostrom, Katrina F. / Marutani, Eizo / Wanderley, Hatus V. / Bagchi, Aranya / Colvin, Robert B. / Berra, Lorenzo / Minaeva, Olga / Goldstein, Lee E. / Malhotra, Rajeev / Zapol, Warren M. / Ichinose, Fumito / Yu, Binglan

    Arch Toxicol. 2022 Dec., v. 96, no. 12, p. 3363-3371

    2022  , Page(s) 3363–3371

    Abstract: Electronic cigarettes (e-cigarettes) have been used widely as an alternative to conventional cigarettes and have become particularly popular among young adults. A growing body of evidence has shown that e-cigarettes are associated with acute lung injury ... ...

    Abstract Electronic cigarettes (e-cigarettes) have been used widely as an alternative to conventional cigarettes and have become particularly popular among young adults. A growing body of evidence has shown that e-cigarettes are associated with acute lung injury and adverse effects in multiple other organs. Previous studies showed that high emissions of aldehydes (formaldehyde and acetaldehyde) in aerosols were associated with increased usage of the same e-cigarette coils. However, the impact on lung function of using aged coils has not been reported. We investigated the relationship between coil age and acute lung injury in mice exposed to experimental vaping for 1 h (2 puffs/min, 100 ml/puff). The e-liquid contains propylene glycol and vegetable glycerin (50:50, vol) only. The concentrations of formaldehyde and acetaldehyde in the vaping aerosols increased with age of the nichrome coils starting at 1200 puffs. Mice exposed to e-cigarette aerosols produced from 1800, but not 0 or 900, puff-aged coils caused acute lung injury, increased lung wet/dry weight ratio, and induced lung inflammation (IL-6, TNF-α, IL-1β, MIP-2). Exposure to vaping aerosols from 1800 puff-aged coils decreased heart rate, respiratory rate, and oxygen saturation in mice compared to mice exposed to air or aerosols from new coils. In conclusion, we observed that the concentration of aldehydes (formaldehyde and acetaldehyde) increased with repeated and prolonged usage of e-cigarette coils. Exposure to high levels of aldehyde in vaping aerosol was associated with acute lung injury in mice. These findings show significant risk of lung injury associated with prolonged use of e-cigarette devices.
    Keywords acetaldehyde ; aerosols ; electronic equipment ; formaldehyde ; glycerol ; heart rate ; inflammation ; interleukin-6 ; lung function ; lungs ; oxygen ; propylene glycol ; respiratory rate ; risk ; vegetables
    Language English
    Dates of publication 2022-12
    Size p. 3363-3371
    Publishing place Springer Berlin Heidelberg
    Document type Article ; Online
    ZDB-ID 124992-7
    ISSN 1432-0738 ; 0340-5761
    ISSN (online) 1432-0738
    ISSN 0340-5761
    DOI 10.1007/s00204-022-03388-x
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