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Positive Pressure (positive + pressure)
Terms modified by Positive Pressure Selected AbstractsBaroreflex Sensitivity: Measurement and Clinical ImplicationsANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 2 2008Maria Teresa La Rovere M.D. Alterations of the baroreceptor-heart rate reflex (baroreflex sensitivity, BRS) contribute to the reciprocal reduction of parasympathetic activity and increase of sympathetic activity that accompany the development and progression of cardiovascular diseases. Therefore, the measurement of the baroreflex is a source of valuable information in the clinical management of cardiac disease patients, particularly in risk stratification. This article briefly recalls the pathophysiological background of baroreflex control, and reviews the most relevant methods that have been developed so far for the measurement of BRS. They include three "classic" methods: (i) the use of vasoactive drugs, particularly the ,-adrenoreceptor agonist phenylephrine, (ii) the Valsalva maneuver, which produces a natural challenge for the baroreceptors by voluntarily increasing intrathoracic and abdominal pressure through straining, and (iii) the neck chamber technique, which allows a selective activation/deactivation of carotid baroreceptors by application of a negative/positive pressure to the neck region. Two more recent methods based on the analysis of spontaneous oscillations of systolic arterial pressure and RR interval are also reviewed: (i) the sequence method, which analyzes the relationship between increasing/decreasing ramps of blood pressure and related increasing/decreasing changes in RR interval through linear regression, and (ii) spectral methods, which assess the relationship (in terms of gain) between specific oscillatory components of the two signals. The limitations of the coherence criterion for the computation of spectral BRS are discussed, and recent proposals for overcoming them are presented. Most relevant clinical applications of BRS measurement are finally reviewed with particular reference to patients with myocardial infarction and heart failure. [source] Development of equine upper airway fluid mechanics model for Thoroughbred racehorsesEQUINE VETERINARY JOURNAL, Issue 3 2008V. RAKESH Summary Reason for performing study: Computational fluid dynamics (CFD) models provide the means to evaluate airflow in the upper airways without requiring in vivo experiments. Hypothesis: The physiological conditions of a Thoroughbred racehorse's upper airway during exercise could be simulated. Methods: Computed tomography scanned images of a 3-year-old intact male Thoroughbred racehorse cadaver were used to simulate in vivo geometry. Airway pressure traces from a live Thoroughbred horse, during exercise was used to set the boundary condition. Fluid-flow equations were solved for turbulent flow in the airway during inspiratory and expiratory phases. The wall pressure turbulent kinetic energy and velocity distributions were studied at different cross-sections along the airway. This provided insight into the general flow pattern and helped identify regions susceptible to dynamic collapse. Results: The airflow velocity and static tracheal pressure were comparable to data of horses exercising on a high-speed treadmill reported in recent literature. The cross-sectional area of the fully dilated rima glottidis was 7% greater than the trachea. During inspiration, the area of highest turbulence (i.e. kinetic energy) was in the larynx, the rostral aspect of the nasopharynx was subjected to the most negative wall pressure and the highest airflow velocity is more caudal on the ventral aspect of the nasopharynx (i.e. the soft palate). During exhalation, the area of highest turbulence was in the rostral and mid-nasopharynx, the maximum positive pressure was observed at the caudal aspect of the soft palate and the highest airflow velocity at the front of the nasopharynx. Conclusions and clinical relevance: In the equine upper airway collapsible area, the floor of the rostral aspect of the nasopharynx is subjected to the most significant collapsing pressure with high average turbulent kinetic during inhalation, which may lead to palatal instability and explain the high prevalence of dorsal displacement of the soft palate (DDSP) in racehorses. Maximal abduction of the arytenoid cartilage may not be needed for optimal performance, since the trachea cross-sectional area is 7% smaller than the rima glottidis. [source] DESIGN, CONSTRUCTION AND VALIDATION OF A SANITARY GLOVE BOX PACKAGING SYSTEM FOR PRODUCT SHELF-LIFE STUDIESJOURNAL OF FOOD PROCESSING AND PRESERVATION, Issue 3 2001ZEHRA AYHAN A glove box has been constructed as pan of an integrated pilot plant scale pulsed electric field processing and packaging system to facilitate studies of product shelf-life with selected packaging materials. The glove box was sanitized using combination of hydrogen peroxide and germicidal UV light. A HEPA air filter provided positive pressure of bacteria-free air. Nonselective nutrient broth was sterilized and filled into presanitized bottles inside the glove box. Negative and positive controls were included in the experiment. All bottles were incubated at 22C and 37C for two weeks and checked for rnicrobial growth by measuring optical density at 600 nm using a spectrophotometer and by plating on plate count agar and potato dextrose agar for total aerobic and, yeast and mold counts, respectively. No turbidity or microbial growth was observed in the media filled in the sanitized bottles using the sanitized glove box at 22 and 37C. PEF processed orange juice using this system had a shelf-life of more than 16 weeks at 4C. [source] Volume targeted ventilation (volume guarantee) in the weaning phase of premature newborn infantsPEDIATRIC PULMONOLOGY, Issue 10 2007F. Scopesi MD Abstract Objective Several options are currently available in neonatal mechanical ventilation: complete breathing synchronization (patient triggered ventilation, synchronized intermittent positive pressure ventilation,SIPPV); positive pressure flow-cycled ventilation (pressure support ventilation, PSV); and volume targeted positive pressure ventilation (volume guarantee, VG). The software algorithm for the guarantee volume attempts to deliver a tidal volume (Vt) as close as possible to what has been selected by the clinician as the target volume. Main objectives of the present study were to compare patient,ventilator interactions and Vt variability in premature infants recovering from respiratory distress syndrome (RDS) who were weaned by various ventilator modes (SIMV/PSV,+,VG/SIPPV,+,VG and SIMV,+,VG). Methods This was a short-term crossover trial in which each infant served as his/her own control. Ten premature infants born before the 32nd week of gestation in the recovery phase of RDS were enrolled in the study. All recruited infants started ventilation with SIPPV and in the weaning phase were switched to synchronized intermittent mandatory ventilation (SIMV). Baseline data were collected during an initial 20-min period of monitoring with the infant receiving SIMV alone, then they were switched to SIPPV,+,VG for a 20-min period and then switched back to SIMV for 15 min. Next, they were switched to PSV,+,VG for the study period and switched back to SIMV for a further 15 min. Finally, they were switched to SIMV,+,VG and, at the end of monitoring, they were again switched back to SIMV alone. Results Each mode combined with VG discharged comparable Vts, which were very close to the target volume. Among the VG-combined modes, mean variability of Vt from preset Vt was significantly different. Variability from the target value was significantly lower in SIPPV and PSV modes than in SIMV (P,<,0.0001 and P,<,0.04 respectively). SIPPV,+,VG showed greater stability of Vt, fewer large breaths, lower respiratory rate, and allowed for lower peak inspiratory pressure than what was delivered by the ventilator during other modes. No significant changes in blood gases were observed after each of the study periods. Conclusions With regards to the weaning phase, among combined modes, both of the ones in which every breath is supported (SIPPV/PSV) are likely to be the most effective in the delivery of stable Vt using a low working pressure, thus, at least in the short term, likely more gentle for the neonatal lung. In summary, we can suggest that the VG option, when combined with traditional, patient triggered ventilation, adheres very closely to the proposed theoretical algorithm, achieving highly effective ventilation. Pediatr Pulmonol. 2007; 42:864,870. © 2007 Wiley-Liss, Inc. [source] Noninvasive ventilation in the pediatric intensive care unit for children with acute respiratory failure,,PEDIATRIC PULMONOLOGY, Issue 6 2003W. Gerald Teague MD Abstract Noninvasive ventilation, a novel treatment to increase alveolar ventilation, is accomplished with either subatmospheric or positive pressure administered via an external interface. In adults with acute respiratory failure, noninvasive positive pressure ventilation (NPPV) is superior to standard therapy in preventing intubation and reducing mortality. The role of NPPV in pediatric-age patients with acute respiratory distress is not as well established. Early case reports showed that NPPV treatment does acutely improve both the clinical manifestations of respiratory distress and respiratory gas exchange in children with respiratory distress. However, it is not clear whether NPPV in this setting can prevent vs. delay endotracheal intubation. Other uses of NPPV in the pediatric intensive care unit include the treatment of upper airway obstruction, atelectasis, and exacerbations of neuromuscular disorders, and to facilitate weaning from invasive mechanical ventilation. Successful use of NPPV in young infants with respiratory distress is impeded by the lack of suitable size interfaces, and the response characteristics of commercially available bilevel ventilators. Despite these challenges, NPPV is a promising alternate to standard therapies in the treatment of acute respiratory distress in the pediatric-age patient. Pediatr Pulmonol. 2003; 35:418,426. © 2003 Wiley-Liss, Inc. [source] Multiple system atrophy as a cause of upper airway obstructionANAESTHESIA, Issue 11 2007Y. S. Lim Summary A patient presented to the ear, nose and throat department with inspiratory stridor, dysphagia and a sore throat. Clinical and radiological examination was normal. During induction of anaesthesia for a planned microlaryngoscopy, the patient developed complete upper airway obstruction that was overcome by applying positive pressure via a facepiece until awake. He subsequently developed respiratory failure, requiring mechanical ventilatory support. An elective tracheostomy was inserted for his symptoms. Neurological opinion confirmed the diagnosis of multiple system atrophy with akinetic rigid syndrome. We review this obscure condition and how it may occasionally present to anaesthetists. [source] Long-distance transport of gases in plants: a perspective on internal aeration and radial oxygen loss from rootsPLANT CELL & ENVIRONMENT, Issue 1 2003T. D. COLMER ABSTRACT Internal transport of gases is crucial for vascular plants inhabiting aquatic, wetland or flood-prone environments. Diffusivity of gases in water is approximately 10 000 times slower than in air; thus direct exchange of gases between submerged tissues and the environment is strongly impeded. Aerenchyma provides a low-resistance internal pathway for gas transport between shoot and root extremities. By this pathway, O2 is supplied to the roots and rhizosphere, while CO2, ethylene, and methane move from the soil to the shoots and atmosphere. Diffusion is the mechanism by which gases move within roots of all plant species, but significant pressurized through-flow occurs in stems and rhizomes of several emergent and floating-leaved wetland plants. Through-flows can raise O2 concentrations in the rhizomes close to ambient levels. In general, rates of flow are determined by plant characteristics such as capacity to generate positive pressures in shoot tissues, and resistance to flow in the aerenchyma, as well as environmental conditions affecting leaf-to-air gradients in humidity and temperature. O2 diffusion in roots is influenced by anatomical, morphological and physiological characteristics, and environmental conditions. Roots of many (but not all) wetland species contain large volumes of aerenchyma (e.g. root porosity can reach 55%), while a barrier impermeable to radial O2 loss (ROL) often occurs in basal zones. These traits act synergistically to enhance the amount of O2 diffusing to the root apex and enable the development of an aerobic rhizosphere around the root tip, which enhances root penetration into anaerobic substrates. The barrier to ROL in roots of some species is induced by growth in stagnant conditions, whereas it is constitutive in others. An inducible change in the resistance to O2 across the hypodermis/exodermis is hypothesized to be of adaptive significance to plants inhabiting transiently waterlogged soils. Knowledge on the anatomical basis of the barrier to ROL in various species is scant. Nevertheless, it has been suggested that the barrier may also impede influx of: (i) soil-derived gases, such as CO2, methane, and ethylene; (ii) potentially toxic substances (e.g. reduced metal ions) often present in waterlogged soils; and (iii) nutrients and water. Lateral roots, that remain permeable to O2, may be the main surface for exchange of substances between the roots and rhizosphere in wetland species. Further work is required to determine whether diversity in structure and function in roots of wetland species can be related to various niche habitats. [source] | ||||||||||