检索结果-南通市图书馆

Respiratory Mechanics, Respiratory Muscle Strength, Control of ventilation and Gas Exchange in Patients with Autoimmune Liver Disease

引用

Open Journal of Respiratory Diseases 2024年第2期14卷 25-38页

作者： Ahmet Baydur Jacob Korula Divisions of Pulmonary Critical Care and Sleep Medicine Los Angeles USA Keck School of Medicine University of Southern California Los Angeles California USA Liver Diseases Rancho Los Amigos National Rehabilitation Center Downey California USA

Objectives: To assess respiratory elastance and resistive properties in patients with autoimmune liver disorders using the passive relaxation expiration technique and compare findings to a group of patients with non-autoimmune liver disease and control subjects. These findings were then related to control of ventilation and gas exchange. A secondary objective was to assess respiratory muscle strength and gas exchange and their relation to respiratory mechanics. Methods: Measurements included respiratory elastance and resistance using the passive relaxation method. Pulmonary function, gas exchange and control of ventilation were assessed using standard methods. Results: a) Compared to control subjects, Ers in patients with liver disease was on average 50% greater than in controls;b) mean respiratory resistance, expressed as the respiratory constants, K1 and K2 in the Rohrer relationship, Pao/V’ = K1 + K2V’, was not different from control resistance;c) mean maximal inspiratory and maximal expiratory pressures averaged 36% and 55% of their respective control values;d) inspiratory occlusion pressure in 0.1 sec (P0.1) was increased and negatively associated with FVC;and e) increases in P0.1, mean inspiratory flow (Vt/Ti) and presence of respiratory alkalosis confirmed the increase in ventilatory drive. Despite inspiratory muscle weakness in patients, P0.1/Pimax averaged 5-fold higher than in control subjects. Conclusions: Despite inspiratory muscle weakness and a V’E similar to that in normal subjects, central drive is increased in patients with chronic liver disease. The increase in ventilatory drive is related to smaller lung volumes and weakly associated with increase in respiratory elastance. Findings confirm that P0.1 is a reliable measure of central drive and is an approach that can be used in the evaluation of control of ventilation in patients with chronic liver dis

关键词： Autoimmune Liver Disease Control of ventilation Occlusion Pressure Passive Relaxation Method Primary Biliary Cirrhosis Respiratory Elastance Respiratory Resistance

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effect of noninvasive positive pressure ventilation on weaning success in patients receiving invasive mechanical ventilation： a meta-analysis

引用

Chinese Medical Journal 2013年第7期126卷 1337-1343页

作者： ZHU Fen LIU Zi-long LONG Xuan WU Xiao-dan ZHOU Jing BAI Chun-xue LI Shan-qun Department of Pulmonary Medicine Center of Snoring and Sleep Apnea Medicine Zhongshan Hospital Fudan University Shanghai 200032 China

Background Noninvasive positive pressure ventilation （NIPPV） has been proposed to shorten the duration of mechanical ventilation in intubated patients, especially those who fail initial weaning from invasive mechanical ventilation （IMV）. However, there are also some discrepancies in terms of weaning success or failure, incidence of re-intubation, complications observed during study and patient outcomes. The primary objective of this update was to specifically investigate the role of NIPPV on facilitating weaning and avoiding re-intubation in patients intubated for different etiologies of acute respiratory failure, by comparing with conventional invasive weaning approach. Methods We searched randomized controlled trials （RCTs） comparing noninvasive weaning of early extubation and immediate application of NIPPV with invasive weaning in intubated patients from PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Knowledge and Springerlink databases. Records from conference proceedings and reference lists of relevant studies were also identified. Results A total of 11 RCTs with 623 patients were available for the present analysis. Compared with IMV, NIPPV significantly increased weaning success rates （odds ratio （OR）： 2.50, 95% confidence interval （C/）： 1.46-4.30, P=0.0009）, decreased mortality （OR： 0.39, 95% CI： 0.20-0.75, P=0.005）, and reduced the incidence of ventilator associated pneumonia （VAP）（OR： 0.17, 95% CI： 0.08-0.37, P 〈0.00001） and complications （OR： 0.22, 95% CI： 0.07-0.72, P=0.01）. However, effect of NIPPV on re-intubation did not reach statistical difference （OR： 0.61, 95% CI： 0.33-1.11, P=0.11）. Conclusions Early extubation and immediate application of NIPPV is superior to conventional invasive weaning approach in increasing weaning success rates, decreasing the risk of mortality and reducing the incidence of VAP and complications, in patients who need weaning from IMV. However, it should be applied with caution, as there is insufficie

关键词： noninvasive positive pressure ventilation invasive mechanical ventilation weaning meta-analysis

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Dead Space Breathing in Patients with Malignancies: Determination by Cardiopulmonary Exercise Testing

引用

Open Journal of Respiratory Diseases 2022年第1期12卷 15-36页

作者： Harrison Ngue Maranda Ngue Ian Lee Ching-Fei Chang Ahmet Baydur Division of Pulmonary Critical Care and Sleep Medicine Keck School of Medicine University of Southern California Medical Center Los Angeles CA USA

Rationale: Patients with cancer commonly experience dyspnea originating from ventilatory, circulatory and musculoskeletal sources, and dyspnea is best determined by cardiopulmonary exercise testing (CPET). Objectives: In this retrospective pilot study, we evaluated patients with hematologic and solid malignancies by CPET to determine the primary source of their dyspnea. Methods: Subjects were exercised on a cycle ergometer with increasing workloads. Minute ventilation, heart rate, breathing reserve, oxygen uptake (V’O2), O2-pulse, ventilatory equivalents for carbon dioxide and oxygen (V’E/V’CO2 and V’E/V’O2, respectively) were measured at baseline and peak exercise. The slope and intercept for V’E/V’CO2 was computed for all subjects. Peak V’O2 4% predicted indicated a circulatory or ventilatory limitation. Results: Complete clinical and physiological data were available for 36 patients (M/F 20/16);32 (89%) exhibited ventilatory or circulatory limitation as shown by a reduced peak V’O2 and 10 subjects with normal physiologic data. The largest cohort comprised the pulmonary vascular group (n = 18) whose mean ± SD peak V’O2 was 61% ± 17% predicted. There were close associations between V’O2 and spirometric values. Peak V’E/V’O2 and V’E/V’CO2 were highest in the circulatory and ventilatory cohorts, consistent with increase in dead space breathing. The intercept of the V’E-V’CO2 relationship was lowest in patients with cardiovascular impairment. Conclusion: Dyspneic patients with malignancies exhibit dead space breathing, many exhibiting a circulatory source for exercise limitation with a prominent pulmonary vascular component. Potential factors include effects of chemo- and radiation therapy on cardiac function and pulmonary vascular endothelium.

关键词： Cardiopulmonary Exercise Testing Cardiovascular Limitation Dead Space Breathing Dyspnea Malignancies Oxygen Uptake Pulmonary Vascular Limitation Ventilatory Equivalents

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effects of obstructive sleep apnea and its treatment over the erectile function： a systematic review

引用

Asian Journal of Andrology 2017年第3期19卷 303-310页

作者： Felix Campos-Juanatey Marcos Fernandez-Barriales Monica Gonzalez Jose A Portillo-Martin Urology Department Marques de Valdecilla University Hospital Santander 39008 Spain Institute of Investigation Marques de Valdecilla Santander 39011 Spain Oral and Maxillofacial Surgery Department Araba University Hospital Araba 01004 Spain sleep and ventilation Unit Marques de Valdecilla University Hospital Santander 39008 Spain Medical and Surgical Sciences Department School of Medicine University of Cantabria Santander 39011 Spain.

Erectile dysfunction （ED） is considered a condition with a broad range of etiologies. Obstructive sleep apnea （OSA） syndrome is one of the lesser studied risk factors for ED. We intend to summarize the current evidence on the relationship between OSA and sexual impairment, focusing on the results in terms of erectile function of the different therapies offered to OSA patients. A systematic review was conducted, selecting articles related to the physiology of OSA and ED, and to the treatments of OSA syndrome and their reported outcomes in erectile and sexual function. Higher prevalences of ED in the OSA groups have been published. However, whether this effect on the erectile function occurs in the entire range of OSA severities remains unclear. Several hypotheses were proposed to explain the physiology of this association. Continuous Positive Airway Pressure as a treatment for OSA patients with ED has achieved a significative improvement in the sexual parameters in most of the studies. Phosphodiesterase type 5 inhibitors （iPDE5） on demand are useful as a treatment for ED in this subgroup of patients, with high satisfaction rates. The surgical treatment for the OSA evidenced benefits over the erectile function, and the effect on the sexual satisfaction of the therapy using Mandibular Advancement Devices is still undefined.

关键词： continuous positive airway pressure erectile dysfunction obstructive sleep apnea operative surgical procedures phosphodiesterase type 5 inhibitors

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Pulmonary hypertension and chronic hypoventilation in ROHHAD syndrome treated with average-volume assured pressure support

引用

Pediatric Investigation 2019年第4期3卷 253-256页

作者： Robert C.Stowe Olufunke Afolabi-Brown Division of Neurology Children's Hospital of PhiladelphiaPhiladelphiaPAUSA Children's Hospital of Philadelphia sleep center PhiladelphiaPAUSA Division of Pulmonary and sleep Medicine Children's Hospital of PhiladelphiaPhiladelphiaPAUSA

Introduction:Rapid-onset obesity with hypothalamic dysfunction,hypoventilation,and autonomic dysregulation(ROHHAD)syndrome is an exceptionally rare clinical entity with significant morbidity and high mortality with challenging-to-treat *** presentation:An 11-year-old morbidly obese Chinese female presented with a putative diagnosis of ROHHAD associated with a left psoas *** polysomnography showed severe obstructive sleep apnea and *** was not adherent to prescribed non-invasive positive pressure ventilation(NIPPV).Echocardiography demonstrated evidence of pulmonary hypertension,likely secondary to chronic *** behavioral modification and trial of average volume-assured pressure support(AVAPS),adherence improved with eventual improvement of her pulmonary ***:AVAPS may improve ventilation and NIPPV adherence in central hypoventilation disorders such as ROHHAD,reducing risk of morbidity and mortality.

关键词： Pulmonary hypertension Hypoventilation Positive pressure ventilation sleep Apnea,Obstructive,Polysomnography ROHHAD

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Impact of initial fluid resuscitation volume on clinical outcomes in patientswith heart failure and septic shock

引用

Journal of Intensive Medicine 2023年第3期3卷 254-260页

作者： Adam L.Wiss Bruce A.Doepker Brittany Hoyte Logan M.Olson Kathryn A.Disney Eric M.McLaughlin Vincent Esguerra Jessica L.Elefritz Department of Pharmacy Ascension Saint Thomas Hospital WestNashvilleTN 37205USA Department of Pharmacy The Ohio State University Wexner Medical CenterColumbusOH 43210USA Department of Pharmacy Corewell HealthGrand RapidsMI 49503USA Department of Pharmacy Nebraska MedicineOmahaNE 68105USA Department of Pharmacy Huntsman Cancer Institute at the University of UtahSalt Lake CityUT 84112USA center for Biostatistics The Ohio State UniversityColumbusOH 43210USA Division of Pulmonary AllergyCritical Careand Sleep Medicine.The Ohio State University Wexner Medical CenterColumbusOH 43210USA

Background:Fluid resuscitation is a key treatment for sepsis,but limited data exists in patients with existing heartfailure(HF)and septic *** objective of this study was to determine the impact of initial fluid resuscitationvolume on outcomes in HF patients with reduced or mildly reduced left ventricular ejection fraction(LVEF)withseptic ***:This multicenter,retrospective,cohort study included patients with known HF(LVEF≤50%)presentingwith septic *** were divided into two groups based on the volume of fluid resuscitation in the first 6 h;ventilation,and length of stay(LOS).All related data were collected and compared between the two groups.A generalized logistic mixed model was used to assess the association between fluid groups and the primaryoutcome while adjusting for baseline LVEF,Acute Physiology and Chronic Health Evaluation(APACHE)II score,inappropriate empiric antibiotics,and receipt of ***:One hundred and fifty-four patients were included(93 patients inventilation,and longer hospital ***:In patients with known reduced or mildly reduced LVEF presenting with septic shock,no differencewas detected for in-hospital mortality or RRT in patients who received≥30 mL/kg of resuscitation fluid comparedto less fluid,although this study was underpowered to detect a ***

关键词： Sepsis Septic shock Heart failure Fluid resuscitation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Trauma and syncope-evidence for further sleep study? A case report

引用

World Journal of Cardiology 2015年第3期7卷 161-166页

作者： Erik Skobel Andreas Bell Dang Quan Nguyen Holger Woehrle Michael Dreher Clinic for Cardiac and Pulmonary Rehabilitation "An der Rosenquelle" Department of Surgery Marienhospital Department of Internal Medicine Marienhospital sleep and ventilation center blaubeuren Respiratory Center Ulm Department of Cardiology PneumologyAngiology and Intensive Care MedicineUniversity Hospital

We report on an 83-year-old male with traumatic brain injury after syncope with a fall in the morning. He had a history of seizures, coronary artery disease and paroxysmal atrial fibrillation(AF). No medical cause for seizures and syncope was determined. During rehabilitation, the patient still complained of seizures, and also reported sleepiness and snoring. sleep apnea diagnostics revealed obstructive sleep apnea(SA) with an apnea-hypopnoea index of 35/h, and sudden onset of tachycardia with variations of heart rate based on paroxysmal atrial fibrillation. Additional tests showed nocturnal AF which spontaneously converted to sinus rhythm mid-morning with an arrest of 5 s(sick sinus syndrome) and seizures. A DDD-pacer was implanted and no further seizures occurred. SA therapy with nasal continuous positive airway pressure was refused by the patient. Our findings suggests that screening for SA may offer the possibility to reveal causes of syncope and may introduce additional therapeutic options as arrhythmia and SA often occur together which in turn might be responsible for trauma due to syncope episodes.

关键词： sleep apnea Syncope Atrial fibrillation Trauma

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Pneumoscrotum in a Patient with Pneumocystis jirovecii Pneumonia: A Case Report

引用

Open Journal of Respiratory Diseases 2022年第4期12卷 83-87页

作者： Chongiin Kim Rodrigo García-Tomé Ahmet Baydur Division of General Medicine Department of Internal Medicine University of Southern California Los Angeles USA Los Angeles County + University of Southern California Medical center Los Angeles USA Division of Pulmonary Critical Care and Sleep Medicine University of Southern California Los Angeles USA

Pneumoscrotum is a rare condition described as the accumulation of air within the scrotum. We report the case of a patient with acquired immune deficiency syndrome (AIDS) with Pneumocystis jirovecii pneumonia who deve... 详细信息

关键词： Mechanical ventilation Pneumomediastinum Pneumoscrotum Pneumothorax Volutrauma

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Effects of diabetic ketoacidosis in the respiratory system

引用

World Journal of Diabetes 2019年第1期10卷 16-22页

作者： Alice Gallo de Moraes Salim Surani Department of Medicine Division of Pulmonary and Critical Care Medicine Division of Pulmonary Critical Care and Sleep Medicine Texas A and M University

Diabetes affects approximately 30 million persons in the United States. Diabetes ketoacidosis is one of the most serious and acute complications of diabetes. At the time of presentation and during treatment of diabetic ketoacidosis(DKA), several metabolic and electrolyte derangements can ultimately result in respiratory compromise. Most commonly, hypokalemia, hypomagnesemia and hypophosphatemia can eventually lead to respiratory muscles ***, tachypnea, hyperpnea and more severely, Kussmaul breathing pattern can develop. Also, hydrostatic and non-hydrostatic pulmonary edema can occur secondary to volume shifts into the extracellular space and secondary to increased permeability of the pulmonary capillaries. The presence of respiratory failure in patients with DKA is associated with higher morbidity and mortality. Being familiar with the causes of respiratory compromise in DKA, and how to treat them, may represent better outcomes for patients with DKA.

关键词： Diabetes ketoacidosis Respiratory physiology Mechanical ventilation metabolic acidosis Hyperventilation Kussmaul breathing Respiratory failure

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Review of recent guidelines for the management of severesepsis and septic shock

引用

Frontiers of Medicine 2010年第1期4卷 54-58页

作者： Jin-Nong ZHANG Bo PENG Jamile WOODS Wei PENG Pulmonary Division of Union Hospital Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China Department of Pulmonary and sleep Medicine Salt Lake Regional Medical CenterIasis HealthcareSalt Lake CityUT 84102USA

Severe sepsis and septic shock affect millions of patients and are major causes of mortality *** in treatment and disease management led to a decline in in-hospital mortality from 27.8%(1979–1984)to 17.9%(1995 to 2000).In this article,we systemically review recent guidelines for the management of severe sepsis and septic shock published in 2008 by the International Surviving Sepsis Campaign Guidelines *** 2008 Surviving Sepsis guidelines recom-mend protocolized resuscitation with goals to maintain central venous pressure≥8–12 mmHg,mean arterial pressure≥65 mmHg,urine output≥0.5 mL$kg–1$h–1 and central venous oxygen saturation≥70%(or mixed venous≥65%).Furtherﬂuid administration,transfusion of packed red blood cells to achieve a hematocrit of≥30%and/or infusion of dobutamine max 20µg$kg–1$min–1 are advised if venous O2 saturations remain below 70%.In patients with decreased ventricular compliance or mechanical ventilation,a target central venous pressure of 12–15 mmHg is *** antibiotic administration within theﬁrst hour of recognizing severe sepsis and septic shock is essential,while use of corticosteroids in sepsis is *** mechanisms by which activated protein C improves clinical outcomes in sepsis are *** with activated protein C is approved for patients with severe sepsis and an increased risk of death[Acute Physiology and Chronic Health Evaluation II(APACHE II)>25].Bicarbonate therapy is *** insulin should be used to control hyperglycemia in patients with severe sepsis following stabilization in the intensive care unit.

关键词： sepsis septic shock hemodynamics guide-lines

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：