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Spontaneous Respiration (spontaneous + respiration)
Selected AbstractsCervical spinal cord injury following cephalic presentation and delivery by Caesarean sectionDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2001C Morgan MD MRCP MRCPCH We describe a term infant with an acute spinal cord injury following emergency Caesarean section. Foetal movements were normal on the day that the mother was admitted for postterm induction of labour. Caesarean section was performed because of foetal distress and failure to progress during labour. The initial clinical picture suggested acute birth asphyxia. The presence of a high cervical spine injury became more obvious as the clinical picture evolved over the next 7 days. A discontinuity of the cervical spinal cord at C4,5 was confirmed on MRI. Spontaneous respiration failed to develop and intensive care was withdrawn on day 15. No evidence of trauma, or a vascular, neurological, or congenital anomaly of the cervical spinal cord was found at post mortem. The absence of a similar case following cephalic presentation and Caesarean section made bereavement couselling of the parents especially difficult. [source] Awake fibrecapnic intubation: a novel technique for intubation in head and neck cancer patients with a difficult airway,ANAESTHESIA, Issue 5 2006J. M. Huitink Summary Awake fibreoptic intubation is the gold standard for difficult airway management but failures are reported in the literature in up to 13% of cases. In case of failure, a tracheotomy is often indicated. We describe a novel technique for intubation in head and neck cancer patients with a difficult airway that we call awake fibrecapnic intubation. The aim of this study was to investigate the feasibility of this technique. We studied prospectively 15 consecutive intubations in head and neck cancer patients before diagnostic or therapeutic surgical procedures. After topical anaesthesia, a fibrescope was introduced into the pharynx. Spontaneous respiration was maintained in all patients. Through the suction channel of the fibrescope a special suction catheter was advanced into the airway for carbon dioxide measurements. When four capnograms were obtained, the fibrescope was railroaded over the catheter and after identification of tracheal rings, a tracheal tube was placed. Tracheal intubation was successful in all patients without bleeding or complications, with a median (range) time to intubation of 3 (2,15) min. Identification of the vocal cords and glottis was difficult in four patients due to extensive anatomical abnormalities or poor visibility; even in these patients, a capnogram was obtained within 4 s. [source] Noninvasive Assessment of Influence of Resistant Respiration on Blood Flow Velocities Across the Cardiac Valves in Humans,A Quantification Study by EchocardiographyECHOCARDIOGRAPHY, Issue 5 2004Lijun Yuan M.D. The aim of our study is to quantitatively investigate influence of the intrathoracic pressure change on the four cardiac valves' velocities and further verify a new proposal of the mechanism of respiratory influence on hemodynamics. Methods: Thirty healthy volunteers with no cardiopulmonary diseases were included. The intrathoracic pressure changes were measured with self-designed device. The velocity across the four cardiac valves during spontaneous respiration and with the intrathoracic pressure change at ,4, ,8, and ,12 mmHg, respectively, were recorded simultaneously with the electrocardiogram and respiratory curve. The respiratory variation indices (RVIs) were calculated. The average RVIs of mitral, aortic, tricuspid, and pulmonary valves were 12.54%, 13.19%; 6.23%, 8.27%; 20.27%, 24.36%; and 6.45%, 7.69% with intrathoracic pressure change at ,8 mmHg and ,12 mmHg, respectively. All the above parameters have a significant difference from those during spontaneous respiration (P < 0.01 or P < 0.001). We concluded that it might be the respiratory intrathoracic pressure change that causes the change of the velocity across the valves. (ECHOCARDIOGRAPHY, Volume 21, July 2004) [source] Coma and respiratory failure due to moxidectin intoxication in a dogJOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 1 2008Alexander E. Gallagher DVM Abstract Objective: To describe the clinical consequences following ingestion by a dog of a moxidectin-containing equine deworming product. Few reports exist concerning the treatment and outcome of severe moxidectin toxicity. Treatment, known factors influencing intoxication, and prognosis are reviewed. Case summary: A 10-month-old female Border Collie ingested an unknown quantity of a moxidectin-containing equine deworming product several hours before presentation. Severe neurological signs subsequently developed and included: ataxia, seizures, coma, and respiratory failure. The dog was treated with supportive care including intravenous fluids, activated charcoal, and positive pressure ventilation. Normal spontaneous respiration returned in 34 hours and the patient was discharged 58 hours after ingestion. Full recovery occurred within 1 week of intoxication. New information provided: This report describes moxidectin intoxication and associated respiratory failure in a dog that required mechanical ventilation. The dog's recovery was rapid. Despite severity of signs, the prognosis for patients with moxidectin intoxication is good with appropriate supportive care. [source] Noninvasive detection of pulmonary tissue destruction in a mouse model of emphysema using hyperpolarized 129Xe MRS under spontaneous respirationMAGNETIC RESONANCE IN MEDICINE, Issue 4 2010Hirohiko Imai Abstract In the present study, a chemical shift saturation recovery method in hyperpolarized 129Xe MR spectroscopy measurements was applied to two groups of spontaneously breathing mice, an elastase-induced emphysema model and a control group. Parameters detected were those related to lung structures and functions, such as alveolar septal thickness, h, the ratio of the alveolar septal volume relative to gas space volume, Vs/Va, and the transit time of blood through the gas exchange region, ,. To investigate the potential of these parameters as biomarkers, an attempt was made to detect physiologic changes in the lungs of elastase-treated mice. Our results showed that Vs/Va was significantly reduced in elastase-treated mice, reflecting emphysema-like destruction of the alveolar wall. Compared with histologic results, this degree of reduction was shown to reflect the severity of wall destruction. On the other hand, significant changes in other parameters, h and ,, were not shown. This study is the first application of hyperpolarized 129Xe MR spectroscopy to a mouse model of emphysema and shows that the Vs/Va volume ratio is an effective biomarker for emphysema that could become useful in drug research and development through noninvasive detection of pathologic changes in small rodents. Magn Reson Med, 2010. © 2010 Wiley-Liss, Inc. [source] Brain death: an important paradigm shift in the 20th centuryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2003G. Settergren The description of death in medical or pathophysiological terms changed during the last century. The focus of attention shifted from the condition of the heart to the state of the brain. The current paper investigates the time period from 1866, when the effects of an increased intracranial pressure (ICP) were studied experimentally, to 1967, when the first heart transplantation was performed. Between 1894 and 1965 four neurosurgeons: Horsley in England, Cushing in USA, Wertheimer in France and Frykholm in Sweden made important contributions. Documented discussions, if ventilator treatment should be stopped in patients with a dead brain and a beating heart, began in 1959. However, already during the latter part of the 19th century it was shown that the heart could continue to beat if artificial ventilation was performed, when spontaneous respiration had ceased due to a high ICP. Furthermore, brain death was by chance implemented in clinical practice in heart surgery with cardiopulmonary bypass (CPB) some years before the expressions ,death of the nervous system' and ,brain death' were coined. [source] Endoscopic Laryngotracheal Cleft Repair Without Tracheotomy or IntubationTHE LARYNGOSCOPE, Issue 4 2006Kishore Sandu MD Abstract Objectives: The objectives of this study are to present the technique and results of endoscopic repair of laryngotracheoesophageal clefts (LTEC) extending caudally to the cricoid plate into the cervical trachea and to revisit the classification of LTEC. Methods: The authors conducted a retrospective case analysis consisting of four infants with complete laryngeal clefts (extending through the cricoid plate in three cases and down into the cervical trachea in one case) treated endoscopically by CO2 laser incision of the mucosa and two-layer endoscopic closure of the cleft without postoperative intubation or tracheotomy. Results: All four infants resumed spontaneous respiration without support after a mean postoperative period of 3 days with continuous positive airway pressure (CPAP). They accepted oral feeding within 5 postoperative days (range, 3,11 days). No breakdown of endoscopic repair was encountered. After a mean follow up of 48 months (range, 3 mos to 7 y), all children have a good voice, have no sign of residual aspiration, but experience a slight exertional dyspnea. Conclusion: This limited experience on the endoscopic repair of extrathoracic LTEC shows that a minimally invasive approach sparing the need for postoperative intubation or tracheotomy is feasible and safe if modern technology (ultrapulse CO2 laser, endoscopic suturing, and postoperative use of CPAP in the intensive care unit) is available. [source] Respiratory effects on the reproducibility of cardiovascular autonomic parametersCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 4 2007Éva Zöllei Summary The aim of this study was to assess the influence of breathing pattern on the reproducibility of the most commonly used heart rate and blood pressure variability parameters and baroreflex indices. 5,5 min ECG and blood pressure recordings were made and repeated for 10 healthy volunteers in supine rest on 10 consecutive days during spontaneous and 6 min,1 patterned breathing. We investigated the following parameters: mean RR interval (RRI); the standard deviation of RR intervals (SDRR); the root mean square of successive differences in RRI (RMSSD); the percentage of RRIs which differed by 50% from the proceeding RRI (PNN50); mean systolic arterial pressure (SAP); the standard deviation of SAP (SAP SD); mean mean arterial pressure (MAP); mean diastolic blood pressure (DAP) and baroreflex indices from spontaneous sequence method (upBRS and downBRS) and from cross spectral analysis (LF alpha, HF alpha). To assess reproducibility for each parameter within- and between-subject variability values were calculated and the ratio of within- and between-subject variability was assessed. In addition, we calculated intraclass correlation coefficient (ICC). Compared to spontaneous respiration during 6 min,1 patterned breathing the heart rate and blood pressure variability increased; upBRS, LF alpha and HF alpha increased, downBRS did not change. However, ICC showed good reproducibility for most parameters, which did not improve further with controlled breathing. In conclusion, respiration had a strong influence on the most widely used cardiovascular autonomic parameters. The controlling of breathing did not result in consistent improvement in their reproducibility. [source] | ||||||||||