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  • 1
    Online Resource
    Online Resource
    Effect of PEEP and I:E ratio on cerebral oxygenation in ARDS: an experimental study in anesthetized rabbit
    Springer Science and Business Media LLC ; 2019
    In:  BMC Anesthesiology Vol. 19, No. 1 ( 2019-12)
    Details
    In: BMC Anesthesiology, Springer Science and Business Media LLC, Vol. 19, No. 1 ( 2019-12)
    Type of Medium: Online Resource
    ISSN: 1471-2253
    URL: Article
    DOI: 10.1186/s12871-019-0782-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2019
    detail.hit.zdb_id: 2091252-3
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  • 2
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    End‐expiratory lung volume assessment using helium and carbon dioxide in an experimental model of pediatric capnoperitoneum
    Wiley ; 2020
    In:  Acta Anaesthesiologica Scandinavica Vol. 64, No. 8 ( 2020-09), p. 1106-1113
    Details
    In: Acta Anaesthesiologica Scandinavica, Wiley, Vol. 64, No. 8 ( 2020-09), p. 1106-1113
    Abstract: Capnoperitoneum during laparoscopy leads to cranial shift of the diaphragm, loss in lung volume, and risk of impaired gas exchange. Infants are susceptible to these changes and bedside assessment of lung volume during laparoscopy might assist with optimizing the ventilation. Thus, the primary aim was to investigate the monitoring value of a continuous end‐expiratory lung volume (EELV) assessment method based on CO 2 dynamics ( ) in a pediatric capnoperitoneum model by evaluating the correlation and trending ability against helium washout (EELV He ). Methods Intra‐abdominal pressure (IAP) was randomly varied between 0, 6, and 12 mm Hg with CO 2 insufflation, while positive end‐expiratory pressure (PEEP) levels of 3, 6, and 9 cm H 2 O were randomly applied in eight anesthetized and mechanically ventilated chinchilla rabbits. Concomitant and EELV He and lung clearance index (LCI) were obtained under each experimental condition. Results Significant correlations were found between and EELV He before capnoperitoneum ( r  = .85, P   〈  .001), although increased IAP distorted this relationship. The negative influence of IAP was counteracted by the application of PEEP 9, which restored the correlation between and EELV He and resulted in 100% concordance rate between the methods regarding changes in lung volume. EELV He and LCI showed a curvilinear relationship, and an EELV He of approximately 20 mL kg −1 , determined with a receiver operating characteristic curve, was associated with near‐normal LCI values. Conclusion In this animal model of pediatric capnoperitoneum, reliable assessment of changes in EELV based on requires an open lung strategy, defined as EELV above approximately 20 mL kg −1 .
    Type of Medium: Online Resource
    ISSN: 0001-5172 , 1399-6576
    URL: Issue
    URL: Article
    DOI: 10.1111/aas.v64.8
    DOI: 10.1111/aas.13607
    RVK:
    XA 11250
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2004319-3
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  • 3
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    Online Resource
    Airway mechanics and lung tissue viscoelasticity: effects of altered blood hematocrit in the pulmonary circulation
    American Physiological Society ; 2016
    In:  Journal of Applied Physiology Vol. 121, No. 1 ( 2016-07-01), p. 261-267
    Details
    In: Journal of Applied Physiology, American Physiological Society, Vol. 121, No. 1 ( 2016-07-01), p. 261-267
    Type of Medium: Online Resource
    ISSN: 8750-7587 , 1522-1601
    URL: Article
    DOI: 10.1152/japplphysiol.01103.2015
    RVK:
    WA 15000
    RVK:
    XA 52094
    Language: English
    Publisher: American Physiological Society
    Publication Date: 2016
    detail.hit.zdb_id: 1404365-8
    SSG: 12
    SSG: 31
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  • 4
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    Benefit of Flow-Controlled Over Pressure-Regulated Volume Control Mode During One-Lung Ventilation: A Randomized Experimental Crossover Study
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Anesthesia & Analgesia Vol. 136, No. 3 ( 2023-03), p. 605-612
    Details
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 136, No. 3 ( 2023-03), p. 605-612
    Abstract: Application of a ventilation modality that ensures adequate gas exchange during one-lung ventilation (OLV) without inducing lung injury is of paramount importance. Due to its beneficial effects on respiratory mechanics and gas exchange, flow-controlled ventilation (FCV) may be considered as a protective alternative mode of traditional pressure- or volume-controlled ventilation during OLV. We investigated whether this new modality provides benefits compared with conventional ventilation modality for OLV. METHODS: Ten pigs were anaesthetized and randomly assigned in a crossover design to be ventilated with FCV or pressure-regulated volume control (PRVC) ventilation. Arterial partial pressure of oxygen (Pa o 2 ), carbon dioxide (Pa co 2 ), ventilation and hemodynamical parameters, and lung aeration measured by electrical impedance tomography were assessed at baseline and 1 hour after the application of each modality during OLV using an endobronchial blocker. RESULTS: Compared to PRVC, FCV resulted in increased Pa o 2 (153.7 ± 12.7 vs 169.9 ± 15.0 mm Hg; P = .002) and decreased Pa co 2 (53.0 ± 11.0 vs 43.2 ± 6.0 mm Hg; P 〈 .001) during OLV, with lower respiratory elastance (103.7 ± 9.5 vs 77.2 ± 10.5 cm H 2 O/L; P 〈 .001) and peak inspiratory pressure values (27.4 ± 1.9 vs 22.0 ± 2.3 cm H 2 O; P 〈 .001). No differences in lung aeration or hemodynamics could be detected between the 2 ventilation modalities. CONCLUSIONS: The application of FCV in OLV led to improvement in gas exchange and respiratory elastance with lower ventilatory pressures. Our findings suggest that FCV may offer an optimal, protective ventilation modality for OLV.
    Type of Medium: Online Resource
    ISSN: 0003-2999
    URL: Article
    DOI: 10.1213/ANE.0000000000006322
    RVK:
    XA 22250
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2018275-2
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  • 5
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    Online Resource
    Effect of Permissive Mild Hypercapnia on Cerebral Vasoreactivity in Infants: A Randomized Controlled Crossover Trial
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Anesthesia & Analgesia Vol. 133, No. 4 ( 2021-10), p. 976-983
    Details
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. 4 ( 2021-10), p. 976-983
    Abstract: Mechanical ventilation interferes with cerebral perfusion via changes in intrathoracic pressure and/or as a consequence of alterations in CO 2 . Cerebral vascular vasoreactivity is dependent on CO 2 , and hypocapnia can potentially lead to vasoconstriction and subsequent decrease in cerebral blood flow. Thus, we aimed at characterizing whether protective ventilation with mild permissive hypercapnia improves cerebral perfusion in infants. METHODS: Following ethical approval and parental consent, 19 infants were included in this crossover study and randomly assigned to 2 groups for which the initial ventilation parameters were set to achieve an end-tidal carbon dioxide (Et co 2 ) of 6.5 kPa (group H: mild hypercapnia, n = 8) or 5.5 kPa (group N: normocapnia, n = 11). The threshold was then reversed before going back to the initial set value of normo- or hypercapnia. At each step, hemodynamic, respiratory, and near-infrared spectroscopy (NIRS)–derived parameters, including tissue oxygenation index (TOI) and tissue hemoglobin index (THI), concentration of deoxygenated hemoglobin (HHb) and oxygenated hemoglobin (O 2 Hb), were collected. Concomitantly, sevoflurane maintenance concentration, ventilatory (driving pressure) and hemodynamic parameters, as mean arterial pressure (MAP), were recorded. RESULTS: Targeting an Et co 2 of 5.5 kPa resulted in significantly higher mean driving pressure than an Et co 2 of 6.5 kPa ( P 〈 .01) with no difference between the groups in end-tidal sevoflurane, MAP, and heart rate. A large scatter was observed in NIRS-derived parameters, with no evidence for difference in Et co 2 changes between or within groups. A mild decrease with time was observed in THI and MAP in infants randomly assigned to group N ( P 〈 .036 and P 〈 .017, respectively). When pooling all groups together, a significant correlation was found between the changes in MAP and TOI ( r = 0.481, P 〈 .001). CONCLUSIONS: Allowing permissive mild hypercapnia during mechanical ventilation of infants led to lower driving pressure and comparable hemodynamic, respiratory, and cerebral oxygenation parameters than during normocapnia. Whereas a large scatter in NIRS-derived parameters was observed at all levels of Et co 2 , the correlation between TOI and MAP suggests that arterial pressure is an important component of cerebral oxygenation at mild hypercapnia.
    Type of Medium: Online Resource
    ISSN: 0003-2999
    URL: Article
    DOI: 10.1213/ANE.0000000000005325
    RVK:
    XA 22250
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2018275-2
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  • 6
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    Different contributions from lungs and chest wall to respiratory mechanics in mice, rats, and rabbits
    American Physiological Society ; 2019
    In:  Journal of Applied Physiology Vol. 127, No. 1 ( 2019-07-01), p. 198-204
    Details
    In: Journal of Applied Physiology, American Physiological Society, Vol. 127, No. 1 ( 2019-07-01), p. 198-204
    Abstract: Changes in lung mechanics are frequently inferred from intact-chest measures of total respiratory system mechanics without consideration of the chest wall contribution. The participation of lungs and chest wall in respiratory mechanics has not been evaluated systematically in small animals commonly used in respiratory research. Thus, we compared these contributions in intact-chest mice, rats, and rabbits and further characterized the influence of positive end-expiratory pressure (PEEP). Forced oscillation technique was applied to anesthetized mechanically ventilated healthy animals to obtain total respiratory system impedance (Z rs ) at 0, 3, and 6 cmH 2 O PEEP levels. Esophageal pressure was measured by a catheter-tip micromanometer to separate Z rs into pulmonary (Z L ) and chest wall (Z cw ) components. A model containing a frequency-independent Newtonian resistance (R N ), inertance, and a constant-phase tissue damping (G) and elastance (H) was fitted to Z rs , Z L , and Z cw spectra. The contribution of Z cw to R N was negligible in all species and PEEP levels studied. However, the participation of Z cw in G and H was significant in all species and increased significantly with increasing PEEP and animal size (rabbit 〉 rat 〉 mice). Even in mice, the chest wall contribution to G and H was still considerable, reaching 47.0 ± 4.0(SE)% and 32.9 ± 5.9% for G and H, respectively. These findings demonstrate that airway parameters can be assessed from respiratory system mechanical measurements. However, the contribution from the chest wall should be considered when intact-chest measurements are used to estimate lung parenchymal mechanics in small laboratory models (even in mice), particularly at elevated PEEP levels. NEW & NOTEWORTHY In species commonly used in respiratory research (rabbits, rats, mice), esophageal pressure-based estimates revealed negligible contribution from the chest wall to the Newtonian resistance. Conversely, chest wall participation in the viscoelastic tissue mechanical parameters increased with body size (rabbit 〉 rat 〉 mice) and positive end-expiratory pressure, with contribution varying between 30 and 50%, even in mice. These findings demonstrate the potential biasing effects of the chest wall when lung tissue mechanics are inferred from intact-chest measurements in small laboratory animals.
    Type of Medium: Online Resource
    ISSN: 8750-7587 , 1522-1601
    URL: Article
    DOI: 10.1152/japplphysiol.00048.2019
    RVK:
    WA 15000
    RVK:
    XA 52094
    Language: English
    Publisher: American Physiological Society
    Publication Date: 2019
    detail.hit.zdb_id: 1404365-8
    SSG: 12
    SSG: 31
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  • 7
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    Online Resource
    Expiratory high-frequency percussive ventilation: a novel concept for improving gas exchange
    Springer Science and Business Media LLC ; 2022
    In:  Respiratory Research Vol. 23, No. 1 ( 2022-10-15)
    Details
    In: Respiratory Research, Springer Science and Business Media LLC, Vol. 23, No. 1 ( 2022-10-15)
    Abstract: Although high-frequency percussive ventilation (HFPV) improves gas exchange, concerns remain about tissue overdistension caused by the oscillations and consequent lung damage. We compared a modified percussive ventilation modality created by superimposing high-frequency oscillations to the conventional ventilation waveform during expiration only (eHFPV) with conventional mechanical ventilation (CMV) and standard HFPV. Methods Hypoxia and hypercapnia were induced by decreasing the frequency of CMV in New Zealand White rabbits (n = 10). Following steady-state CMV periods, percussive modalities with oscillations randomly introduced to the entire breathing cycle (HFPV) or to the expiratory phase alone (eHFPV) with varying amplitudes (2 or 4 cmH 2 O) and frequencies were used (5 or 10 Hz). The arterial partial pressures of oxygen (PaO 2 ) and carbon dioxide (PaCO 2 ) were determined. Volumetric capnography was used to evaluate the ventilation dead space fraction, phase 2 slope, and minute elimination of CO 2 . Respiratory mechanics were characterized by forced oscillations. Results The use of eHFPV with 5 Hz superimposed oscillation frequency and an amplitude of 4 cmH 2 O enhanced gas exchange similar to those observed after HFPV. These improvements in PaO 2 (47.3 ± 5.5 vs. 58.6 ± 7.2 mmHg) and PaCO 2 (54.7 ± 2.3 vs. 50.1 ± 2.9 mmHg) were associated with lower ventilation dead space and capnogram phase 2 slope, as well as enhanced minute CO 2 elimination without altering respiratory mechanics. Conclusions These findings demonstrated improved gas exchange using eHFPV as a novel mechanical ventilation modality that combines the benefits of conventional and small-amplitude high-frequency oscillatory ventilation, owing to improved longitudinal gas transport rather than increased lung surface area available for gas exchange.
    Type of Medium: Online Resource
    ISSN: 1465-993X
    URL: Article
    DOI: 10.1186/s12931-022-02215-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041675-1
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  • 8
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    Online Resource
    Fluid replacement and respiratory function : comparison of whole blood with colloid and crystalloid
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  European Journal of Anaesthesiology Vol. 33, No. 1 ( 2016-01), p. 34-41
    Details
    In: European Journal of Anaesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 1 ( 2016-01), p. 34-41
    Type of Medium: Online Resource
    ISSN: 0265-0215
    URL: Article
    DOI: 10.1097/EJA.0000000000000251
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2004964-X
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  • 9
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    Online Resource
    Table_1.docx
    Frontiers Media SA ; 2019
    In:  Frontiers in Physiology Vol. 10 ( 2019-6-26)
    Details
    In: Frontiers in Physiology, Frontiers Media SA, Vol. 10 ( 2019-6-26)
    Type of Medium: Online Resource
    ISSN: 1664-042X
    URL: Article
    URL: Article
    DOI: 10.3389/fphys.2019.00803
    DOI: 10.3389/fphys.2019.00803.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2019
    detail.hit.zdb_id: 2564217-0
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  • 10
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    Online Resource
    Reversing Cholinergic Bronchoconstriction by Common Inotropic Agents: A Randomized Experimental Trial on Isolated Perfused Rat Lungs
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Anesthesia & Analgesia Vol. 129, No. 3 ( 2019-09), p. 745-752
    Details
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. 3 ( 2019-09), p. 745-752
    Abstract: The ability of inotropic agents to alter airway reactivity and lung tissue mechanics has not been compared in a well-controlled experimental model. Therefore, we compared the potential to alter lung tissue viscoelasticity and bronchodilator effects of commonly used inotropic agents in an isolated perfused rat lung model. METHODS: After achieving steady state lung perfusion, sustained bronchoconstriction was induced by acetylcholine (ACh). Isolated rat lungs were then randomly allocated to 6 groups treated with either saline vehicle (n = 8) or incremental concentrations of inotropes (adrenaline, n = 8; dopamine, n = 7; dobutamine, n = 7; milrinone, n = 8; or levosimendan, n = 6) added to the whole-blood perfusate. Airway resistance (Raw), lung tissue damping (G), and elastance were measured under baseline conditions, during steady-state ACh-induced constriction and for each inotrope dose. RESULTS: No change in Raw was observed after addition of the saline vehicle. Raw was significantly lower after addition of dopamine (maximum difference [95% CI] of 29 [12–46] % relative to the saline control, P = .004), levosimendan (58 [39–77]%, P 〈 .001), and adrenaline (37 [21–53]%, P 〈 .001), whereas no significant differences were observed at any dose of milrinone (5 [−12 to 22]%) and dobutamine (4 [−13 to 21] %). Lung tissue damping (G) was lower in animals receiving the highest doses of adrenaline (difference: 22 [7–37]%, P = .015), dobutamine (20 [5–35]%, P = .024), milrinone (20 [6–34]%, P = .026), and levosimendan (36 [19–53]%, P 〈 .001) than in controls. CONCLUSIONS: Although dobutamine and milrinone did not reduce cholinergic bronchoconstriction, they reversed the ACh-induced elevations in lung tissue resistance. In contrast, adrenaline, dopamine, and levosimendan exhibited both potent bronchodilatory action against ACh and diminished lung tissue damping. Further work is needed to determine whether these effects are clinically relevant in humans.
    Type of Medium: Online Resource
    ISSN: 0003-2999
    URL: Article
    DOI: 10.1213/ANE.0000000000003502
    RVK:
    XA 22250
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2018275-2
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