Lung volume head ratio: A potential parameter for prediction of respiratory distress in newborn

2021 ◽  
Author(s):  
Shama Afreen ◽  
Manisha Kumar ◽  
Sushma Nangia
Keyword(s):  
Respiratory Distress ◽  
Lung Volume ◽  
Fetal Lung ◽  
The Novel ◽  
Clinical Value ◽  
Total Lung Volume ◽  
Significant Difference ◽  
Lung Area ◽  
Normal Outcome

Objective: To evaluate the role of fetal lung biometry profile including fetal lung volume head ratio (LVHR) in predicting the occurrence of respiratory distress (RD) in early preterm newborn. Material and Method: Prospective analytical cohort study was done to evaluate the clinical value of fetal sonographic measures such as the total lung area (TLA), total lung volume (TLV), total lung area head ratio (TLHR), lung volume head ratio (LVHR) was measured in pregnant women between 30 to 34 week gestation , expected to deliver within the next 72 hours. The cases with RD were compared with controls who had normal outcome. Result: Total 30(27.4%) out of 110 subjects undergoing early preterm delivery had RD rest 80(72.6%) were controls. The total lung area was 694.1±373.1 mm2 in cases whereas 1149.0 ± 506 .7 mm2 in controls, with significant difference between the two groups(p<0.001). Similarly the lung volume (p<0.001) and the lung volume head ratio was significantly less (P<0.001) in cases compared to controls. The total lung volume was a better parameter (sensitivity-73.7%; specificity-86.4%) compared to total lung area (Sensitivity - 68.4%, Specificity - 81.5%). Among the lung head ratios, LVHR had best sensitivity - 95.5%, Specificity - 80.3%, PPV-58.3%, NPV - 97.0% at the cut off of 46.5. Conclusion: Respiratory distress was observed in nearly one-third of the preterm infants born between 30 and 34 weeks and could be predicted accurately in over nine out of ten cases using the novel parameter TLVR.

End-expiratory and tidal volumes measured in conscious mice using single projection x-ray images

2008 ◽  
Vol 104 (2) ◽  
pp. 521-533 ◽  
Author(s):  
Stephen J. Lai-Fook ◽  
Pamela K. Houtz ◽  
Yih-Loong Lai
Keyword(s):  
Body Temperature ◽  
Lung Volume ◽  
Airway Resistance ◽  
X Rays ◽  
Airway Closure ◽  
Exposure Phase ◽  
X Ray ◽  
Total Lung Volume ◽  
Aerosol Exposure ◽  
Lung Area

The evaluation of airway resistance (Raw) in conscious mice requires both end-expiratory (Ve) and tidal volumes (Vt) (Lai-Fook SJ and Lai YL. J Appl Physiol 98: 2204–2218, 2005). In anesthetized BALB/c mice we measured lung area (AL) from ventral-to-dorsal x-ray images taken at FRC (Ve) and after air inflation with 0.25 and 0.50 ml (ΔVL). Total lung volume (VL) described by equation: VL = ΔVL + VFRC = KAL1.5 assumed uniform (isotropic) inflation. Total VFRC averaged 0.55 ml, consisting of 0.10 ml tissue, 0.21 ml blood and 0.24 ml air. K averaged 1.84. In conscious mice in a sealed box, we measured the peak-to-peak box pressure excursions (ΔPb) and x-rays during several cycles. K was used to convert measured AL1.5 to VL values. We calculated Ve and Vt from the plot of VL vs. cos(α − φ). Phase angle α was the minimum point of the Pb cycle to the x-ray exposure. Phase difference between the Pb and VL cycles (φ) was measured from ΔPb values using both room- and body-temperature humidified box air. A similar analysis was used after aerosol exposures to bronchoconstrictor methacholine (Mch), except that φ depended also on increased Raw. In conscious mice, Ve (0.24 ml) doubled after Mch (50–125 mg/ml) aerosol exposure with constant Vt, frequency (f), ΔPb, and Raw. In anesthetized mice, in addition to an increased Ve, repeated 100 mg/ml Mch exposures increased both ΔPb and Raw and decreased f to apnea in 10 min. Thus conscious mice adapted to Mch by limiting Raw, while anesthesia resulted in airway closure followed by diaphragm fatigue and failure.

scholarly journals Motion corrected fetal body MRI provides reliable 3D lung volumes in normal and abnormal fetuses

2021 ◽  
Author(s):  
Joseph Davidson ◽  
Alena Uus ◽  
Alexia Egloff Collado ◽  
Milou Van Poppel ◽  
Jacqueline Matthew ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Lung Volume ◽  
Fetal Mri ◽  
Fetal Lung ◽  
Lung Hypoplasia ◽  
Healthy Controls ◽  
Lung Volumes ◽  
Total Lung Volume ◽  
Volume Registration

Abstract Objective:Evaluate deformable slice-to-volume registration (DSVR) to calculate 3D-segmented total lung volume (TLV) in fetuses with congenital diaphragmatic hernia, congenital lung lesions and healthy controls, with comparison to 2D-manual segmentation. Design:Pilot study Setting:Regional fetal medicine referral centre Sample:Fetal MRIs performed for clinical indications (abnormal cases) or as research participants (healthy controls) Methods:Sixteen MRI datasets of fetuses (22-32 weeks GA). Diagnosis: CDH(n=5), CPAM(n=2), CDH with BPS(n=1) and healthy control(n=8). DSVR was used for reconstruction of 3D isotropic (0.85 mm) volumes of fetal body followed by semi-automated lung segmentation. The resulting 3D TLV were compared to the traditional 2D-based volumetry, and a normogram of DSVR-derived fetal lung volumes from 100 cases was produced. Main Outcome Measures:Concordance with 2D-volumetry assessed with Bland-Altman analysis, results of segmentations presented visually. Observed/Expected values were calculated for abnormal cases based upon the normogram. Results:DSVR-derived TLV values have high correlation with the 2D-based measurements but with a consistently lower volume; bias -1.44cm3 [95% limits: -2.6 to -0.3] with improved resolution able to exclude hilar structures even in severe motion corruption or in cases of lung hypoplasia. Conclusions:Application of DSVR for fetal MRI provides a solution for analysis of motion corrupted scans and does not suffer from the interpolation error inherent in 2D-segmentation as per current clinical practice. It increases information content of acquired data in terms of visualising organs in 3D space and quantification of volumes, which we believe will have important value for counselling and surgical planning. Keywords:Fetal MRI; congenital diaphragmatic hernia; CPAM; lung volume

scholarly journals Possible Role of Adenosine in COVID-19 Pathogenesis and Therapeutic Opportunities

2020 ◽  
Vol 11 ◽  
Author(s):  
Jonathan D. Geiger ◽  
Nabab Khan ◽  
Madhuvika Murugan ◽  
Detlev Boison
Keyword(s):  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Adenosine Kinase ◽  
Nucleoside Transporter ◽  
The Novel ◽  
Equilibrative Nucleoside Transporter ◽  
Novel Coronavirus ◽  
End Stage

The outbreak of the novel coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) requires urgent clinical interventions. Crucial clinical needs are: 1) prevention of infection and spread of the virus within lung epithelia and between people, 2) attenuation of excessive lung injury in Advanced Respiratory Distress Syndrome, which develops during the end stage of the disease, and 3) prevention of thrombosis associated with SARS-CoV-2 infection. Adenosine and the key adenosine regulators adenosine deaminase (ADA), adenosine kinase (ADK), and equilibrative nucleoside transporter 1 may play a role in COVID-19 pathogenesis. Here, we highlight 1) the non-enzymatic role of ADA by which it might out-compete the virus (SARS-CoV-2) for binding to the CD26 receptor, 2) the enzymatic roles of ADK and ADA to increase adenosine levels and ameliorate Advanced Respiratory Distress Syndrome, and 3) inhibition of adenosine transporters to reduce platelet activation, thrombosis and improve COVID-19 outcomes. Depending on the stage of exposure to and infection by SARS-CoV-2, enhancing adenosine levels by targeting key adenosine regulators such as ADA, ADK and equilibrative nucleoside transporter 1 might find therapeutic use against COVID-19 and warrants further investigation.

Comparison of fetal lung area to head circumference ratio with lung volume in the prediction of postnatal outcome in diaphragmatic hernia

2007 ◽  
Vol 30 (6) ◽  
pp. 850-854 ◽  
Author(s):  
J. C. Jani ◽  
C. F. A. Peralta ◽  
R. Ruano ◽  
A. Benachi ◽  
E. Done ◽  
...  
Keyword(s):  
Diaphragmatic Hernia ◽  
Lung Volume ◽  
Head Circumference ◽  
Fetal Lung ◽  
Lung Area ◽  
Postnatal Outcome

Maintenance Therapies for Multiple Myeloma (MM): A Direct Meta-Analysis

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4271-4271
Author(s):  
Helen Mahony ◽  
Ambuj Kumar ◽  
Rahul Mhaskar ◽  
Branko Miladinovic ◽  
Keith Wheatley ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Meta Analysis ◽  
Phase Iii ◽  
Novel Agents ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
The Novel ◽  
Significant Difference ◽  
American Society

Abstract Abstract 4271 Background: The role of various maintenance therapies in the management of MM is unclear and evidence on the efficacy of these regimens is conflicting. In order to provide the totality of available randomized evidence on the role of maintenance therapy in MM, we conduct a comprehensive systematic review and meta-analysis of all RCTs studying maintenance therapy. Here, we report the pooled results of trials which directly examined the novel agents of bortezomib, lenalidomide, or thalidomide and reported the outcomes of overall survival (OS) and/or progression-free survival (PFS). Methods: A comprehensive literature search of MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), and meetings abstracts from American Society of Hematology, American Society of Clinical Oncology, European Society for Medical Oncology and European Hematology Association was undertaken to identify all phase III randomized controlled trials (RCTs) of maintenance therapy published until July 2012. We extracted data on OS and PFS. Time to event data were pooled under the random effects model as hazard ratios (HR) and its corresponding 95% confidence interval (CI). Heterogeneity was assessed using the chi square test and I2statistic. All analyses were done in Review Manager 5.1. Results: Twenty-two RCTs met the inclusion criteria. (Figure 1) However, only data from the following RCTs were able to be pooled for the direct head-to-head comparison: 2 RCTs of bortezomib maintenance therapy enrolling 792 patients, 5 RCTs of lenalidomide maintenance therapy enrolling 1776 patients, 11 RCTs of thalidomide maintenance therapy enrolling 3952 patients. The pooled HR and 95% CI, number of RCTs, and number of patients for each comparison are presented in Figure 2. Only two trials compared the novel agents of bortezomib and thalidomide head-to-head. There was no significant different in terms of PFS. For the novel agent of lenalidomide, there was no significant difference is OS compared to placebo. The pooled PFS was in favor of lenalidomide maintenance compared to placebo. For thalidomide, OS was significantly in favor of the intervention when compared to placebo or prednisone/dexamethasone. There was no significant difference in OS between thalidomide maintenance when compared to interferon control. For the outcome of PFS, the pooled results favored thalidomide when compared to prednisone/dexamethasone or interferon control. There was no significant difference between thalidomide and placebo. Conclusion: To date, the largest number of trials has been among thalidomide as maintenance therapy. In our meta-analysis, thalidomide is the only agent which improves survival compared to no treatment. Other novel agents have been evaluated in a smaller number of trials and current data does not allow for firm conclusions that any agent is superior to the other. An indirect, network meta-analysis is called for to provide additional insights regarding comparative efficacy of the novel agents as the maintenance treatment for MM. Disclosures: No relevant conflicts of interest to declare.

Role of absolute lung volume to assess alveolar recruitment in acute respiratory distress syndrome patients

2010 ◽  
Vol 38 (5) ◽  
pp. 1300-1307 ◽  
Author(s):  
Nicolò Patroniti ◽  
Giacomo Bellani ◽  
Barbara Cortinovis ◽  
Giuseppe Foti ◽  
Elena Maggioni ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Lung Volume ◽  
Distress Syndrome ◽  
Alveolar Recruitment

scholarly journals Lung inhomogeneities, inflation and [18F]2-fluoro-2-deoxy-D-glucose uptake rate in acute respiratory distress syndrome

2015 ◽  
Vol 47 (1) ◽  
pp. 233-242 ◽  
Author(s):  
Massimo Cressoni ◽  
Davide Chiumello ◽  
Chiara Chiurazzi ◽  
Matteo Brioni ◽  
Ilaria Algieri ◽  
...  
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Lung Volume ◽  
Distress Syndrome ◽  
Total Lung Volume ◽  
Fdg Uptake ◽  
Positron Emission ◽  
Lung Compartment ◽  
Nondependent Lung

The aim of the study was to determine the size and location of homogeneous inflamed/noninflamed and inhomogeneous inflamed/noninflamed lung compartments and their association with acute respiratory distress syndrome (ARDS) severity.In total, 20 ARDS patients underwent 5 and 45 cmH2O computed tomography (CT) scans to measure lung recruitability. [18F]2-fluoro-2-deoxy-d-glucose ([18F]FDG) uptake and lung inhomogeneities were quantified with a positron emission tomography-CT scan at 10 cmH2O. We defined four compartments with normal/abnormal [18F]FDG uptake and lung homogeneity.The homogeneous compartment with normal [18F]FDG uptake was primarily composed of well-inflated tissue (80±16%), double-sized in nondependent lung (32±27% versus 16±17%, p<0.0001) and decreased in size from mild, moderate to severe ARDS (33±14%, 26±20% and 5±9% of the total lung volume, respectively, p=0.05). The homogeneous compartment with high [18F]FDG uptake was similarly distributed between the dependent and nondependent lung. The inhomogeneous compartment with normal [18F]FDG uptake represented 4% of the lung volume. The inhomogeneous compartment with high [18F]FDG uptake was preferentially located in the dependent lung (21±10% versus 12±10%, p<0.0001), mostly at the open/closed interfaces and related to recruitability (r2=0.53, p<0.001).The homogeneous lung compartment with normal inflation and [18F]FDG uptake decreases with ARDS severity, while the inhomogeneous poorly/not inflated compartment increases. Most of the lung inhomogeneities are inflamed. A minor fraction of healthy tissue remains in severe ARDS.

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