Recovery of diaphragm function after laparotomy and chronic sonomicrometer implantation

1989 ◽  
Vol 66 (2) ◽  
pp. 613-621 ◽  
Author(s):  
P. A. Easton ◽  
J. W. Fitting ◽  
R. Arnoux ◽  
A. Guerraty ◽  
A. E. Grassino
Keyword(s):  
Tidal Volume ◽  
Respiratory Rate ◽  
Breathing Pattern ◽  
Recovery Process ◽  
Postoperative Recovery ◽  
Postmortem Examination ◽  
Midline Laparotomy ◽  
Left Hemidiaphragm ◽  
Direct Measurements ◽  
Phrenic Stimulation

If sonomicrometry transducers could be implanted permanently into the diaphragm, direct measurements of costal and crural length and shortening could be made during recovery from the laparotomy and then indefinitely in an awake, non-anesthetized mammal. We report results from six canines in which we successfully implanted transducers onto the left hemidiaphragm through a midline laparotomy and measured segmental shortening and ventilation at intervals through 22 days of postoperative recovery. After laparotomy, breathing pattern, including tidal volume, respiratory rate and mean inspiratory flow, stabilized by the 4th postoperative day (POD). Tidal shortening of costal and crural segments increased from 1.82 and 1.45% of end-expiratory length (%LFRC) on the 2nd POD to 5.32 and 8.56% LFRC, respectively, after a mean of 22 POD. Segmental shortening did not stabilize until 10 POD, and the recovery process displayed a sequence of segmental motions: lengthening, biphasic inspiratory lengthening-shortening, and increasing simple shortening. Three weeks after implantation, costal and crural segments were stable and shortening 5.32 and 8.56% LFRC, respectively, and capable of shortening 49% LFRC with maximal phrenic stimulation. In a pair of recovered animals, the initial postoperative dysfunction did not recur after a subsequent, simple laparotomy. At postmortem examination, the chronically implanted sonomicrometer transducers were found to have evoked only a thin fibrotic capsule within the diaphragm.

Effect of body position on spontaneous respiratory rate and tidal volume in patients with obesity, abdominal distension and ascites

1994 ◽  
Vol 3 (2) ◽  
pp. 102-106 ◽  
Author(s):  
SM Burns ◽  
MB Egloff ◽  
B Ryan ◽  
R Carpenter ◽  
JE Burns
Keyword(s):  
Tidal Volume ◽  
Respiratory Rate ◽  
Breathing Pattern ◽  
Body Position ◽  
Abdominal Distension ◽  
The Body ◽  
Abdominal Distention ◽  
Optimal Position ◽  
Nursing Textbooks ◽  
Spontaneously Breathing

BACKGROUND: Nursing textbooks and tradition suggest that the high-Fowler's position is best to optimize diaphragmatic excursion and effective breathing pattern. The optimal position for intubated patients with obesity, ascites or abdominal distention has yet to be determined but is important because weaning trial outcomes may reflect the effect of position rather than weaning trial tolerance. OBJECTIVE: To determine the body position that optimizes breathing pattern (tidal volume and respiratory rate) in spontaneously breathing, intubated patients with a large abdomen. METHODS: Nineteen intubated patients with abdominal distention, ascites or obesity who were on continuous positive airway pressure or the pressure support ventilation mode were studied in the 0 degrees, 45 degrees, 90 degrees and reverse Trendelenburg's at 45 degrees positions for 5 minutes prior to data collection. RESULTS: The RT at 45 degrees position resulted in a significantly larger tidal volume and lower respiratory rate than the 90 degrees position in intubated, spontaneously breathing patients with a large abdomen. The 45 degrees position resulted in a significantly lower respiratory rate than at 90 degrees; however, no difference in tidal volume was demonstrated. DISCUSSION: A high respiratory rate and low tidal volume potentiates atelectasis and ultimately failure to wean. It is important that the effect of positioning on breathing pattern in intubated patients be determined so that care planning results in optimal outcomes. CONCLUSIONS: The results of this study have implications for the selection of chair and bed positioning during weaning trials.

scholarly journals A journey to a new stable state—further development of the postoperative recovery concept from day surgical perspective: a qualitative study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037755
Author(s):  
Ulrica Nilsson ◽  
Maria Jaensson ◽  
Karin Hugelius ◽  
Erebouni Arakelian ◽  
Karuna Dahlberg
Keyword(s):  
Stable State ◽  
Recovery Process ◽  
Well Being ◽  
Day Surgery ◽  
Physical Symptoms ◽  
Postoperative Recovery ◽  
Four Dimensions ◽  
Adult Participants ◽  
Starting Point ◽  
Patients Experience

ObjectiveThis study aims to further develop the concept analysis by Allvin et al in 2007 and Lundmark et al in 2016 from the perspective of day-surgery patients. Also, to describe how patients experience postoperative recovery in relation to the identified dimensions and subdimensions and to interpret the findings in order to get a deeper understanding of the concept postoperative recovery.DesignDescriptive qualitative design with a theoretical thematic analysis.SettingSix day-surgery departments in Sweden.ParticipantsThirty-eight adult participants who had undergone day surgery in Sweden. Participants were purposively selected.ResultsFour dimensions—physical, psychological, social and habitual—were confirmed. A total of eight subdimensions were also confirmed, two from Allvin et al’s study and six from Lundmark et al’s study. Recovery included physical symptoms and challenges coping with and regaining control over symptoms and bodily functions. Both positive and negative emotions were present, and strategies on how to handle emotions and achieve well-being were established. Patients became dependent on others. They coped with and adapted to the recovery process and gradually stabilised, reaching a new stable state.ConclusionPostoperative recovery was described as a process with a clear starting point, and as a dynamic and individual process leading to an experience of a new stable state. The recovery process included physical symptoms, emotions and social and habitual consequences that challenges them. To follow-up and measure all four dimensions of postoperative recovery in order to support and understand the process of postoperative recovery is, therefore, recommended.

scholarly journals Expired Tidal Volume and Respiratory Rate during Postnatal Stabilization of Term Newborn Infants Born by Cesarean Delivery

2020 ◽  
pp. 100063
Author(s):  
Susana Baixauli-Alacreu ◽  
Celia Padilla-Sánchez ◽  
David Hervás-Marín ◽  
Inmaculada Lara-Cantón ◽  
Alvaro Solaz-García ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Respiratory Rate ◽  
Cesarean Delivery ◽  
Newborn Infants ◽  
Term Newborn

STUDIES OF RESPIRATORY PHYSIOLOGY IN CHILDREN

PEDIATRICS ◽  
1959 ◽  
Vol 24 (2) ◽  
pp. 181-193
Author(s):  
C. D. Cook ◽  
P. J. Helliesen ◽  
L. Kulczycki ◽  
H. Barrie ◽  
L. Friedlander ◽  
...  
Keyword(s):  
Tidal Volume ◽  
Respiratory Rate ◽  
Vital Capacity ◽  
Total Lung Capacity ◽  
Lung Compliance ◽  
Respiratory Physiology ◽  
Residual Volume ◽  
Lung Volumes ◽  
Lung Capacity ◽  
Residual Capacity

Tidal volume, respiratory rate and lung volumes have been measured in 64 patients with cystic fibrosis of the pancreas while lung compliance and resistance were measured in 42 of these. Serial studies of lung volumes were done in 43. Tidal volume was reduced and the respiratory rate increased only in the most severely ill patients. Excluding the three patients with lobectomies, residual volume and functional residual capacity were found to be significantly increased in 46 and 21%, respectively. These changes correlated well with the roentgenographic evaluation of emphysema. Vital capacity was significantly reduced in 34% while total lung capacity was, on the average, relatively unchanged. Seventy per cent of the 61 patients had a signficantly elevated RV/TLC ratio. Lung compliance was significantly reduced in only the most severely ill patients but resistance was significantly increased in 35% of the patients studied. The serial studies of lung volumes showed no consistent trends among the groups of patients in the period between studies. However, 10% of the surviving patients showed evidence of significant improvement while 15% deteriorated. [See Fig. 8. in Source Pdf.] Although there were individual discrepancies, there was a definite correlation between the clinical evaluation and tests of respiratory function, especially the changes in residual volume, the vital capacity, RV/ TLC ratio and the lung compliance and resistance.

Pleural pressure increases during inspiration in the zone of apposition of diaphragm to rib cage

1988 ◽  
Vol 65 (5) ◽  
pp. 2207-2212 ◽  
Author(s):  
W. F. Urmey ◽  
A. De Troyer ◽  
K. B. Kelly ◽  
S. H. Loring
Keyword(s):  
Esophageal Pressure ◽  
Pleural Pressure ◽  
Abdominal Pressure ◽  
Transdiaphragmatic Pressure ◽  
Rib Cage ◽  
Direct Measurements ◽  
Anesthetized Dogs ◽  
Theoretical Mechanism ◽  
Phrenic Stimulation ◽  
Anatomic Region

The zone of apposition of diaphragm to rib cage provides a theoretical mechanism that may, in part, contribute to rib cage expansion during inspiration. Increases in intra-abdominal pressure (Pab) that are generated by diaphragmatic contraction are indirectly applied to the inner rib cage wall in the zone of apposition. We explored this mechanism, with the expectation that pleural pressure in this zone (Pap) would increase during inspiration and that local transdiaphragmatic pressure in this zone (Pdiap) must be different from conventionally determined transdiaphragmatic pressure (Pdi) during inspiration. Direct measurements of Pap, as well as measurements of pleural pressure (Ppl) cephalad to the zone of apposition, were made during tidal inspiration, during phrenic stimulation, and during inspiratory efforts in anesthetized dogs. Pab and esophageal pressure (Pes) were measured simultaneously. By measuring Ppl's with cannulas placed through ribs, we found that Pap consistently increased during both maneuvers, whereas Ppl and Pes decreased. Whereas changes in Pdi of up to -19 cmH2O were measured, Pdiap never departed from zero by greater than -4.5 cmH2O. We conclude that there can be marked regional differences in Ppl and Pdi between the zone of apposition and regions cephalad to the zone. Our results support the concept of the zone of apposition as an anatomic region where Pab is transmitted to the interior surface of the lower rib cage.

scholarly journals Contactless Monitoring of Breathing Patterns and Respiratory Rate at the Pit of the Neck: A Single Camera Approach

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Carlo Massaroni ◽  
Daniel Simões Lopes ◽  
Daniela Lo Presti ◽  
Emiliano Schena ◽  
Sergio Silvestri
Keyword(s):  
Respiratory Rate ◽  
Frequency Domain ◽  
Time Domain ◽  
Breathing Pattern ◽  
Vital Signs ◽  
Image Resolution ◽  
Measuring System ◽  
Respiratory Pattern ◽  
Breathing Patterns ◽  
Vital Signs Monitoring

Vital signs monitoring is pivotal not only in clinical settings but also in home environments. Remote monitoring devices, systems, and services are emerging as tracking vital signs must be performed on a daily basis. Different types of sensors can be used to monitor breathing patterns and respiratory rate. However, the latter remains the least measured vital sign in several scenarios due to the intrusiveness of most adopted sensors. In this paper, we propose an inexpensive, off-the-shelf, and contactless measuring system for respiration signals taking as region of interest the pit of the neck. The system analyses video recorded by a single RGB camera and extracts the respiratory pattern from intensity variations of reflected light at the level of the collar bones and above the sternum. Breath-by-breath respiratory rate is then estimated from the processed breathing pattern. In addition, the effect of image resolution on monitoring breathing patterns and respiratory rate has been investigated. The proposed system was tested on twelve healthy volunteers (males and females) during quiet breathing at different sensor resolution (i.e., HD 720, PAL, WVGA, VGA, SVGA, and NTSC). Signals collected with the proposed system have been compared against a reference signal in both the frequency domain and time domain. By using the HD 720 resolution, frequency domain analysis showed perfect agreement between average breathing frequency values gathered by the proposed measuring system and reference instrument. An average mean absolute error (MAE) of 0.55 breaths/min was assessed in breath-by-breath monitoring in the time domain, while Bland-Altman showed a bias of −0.03 ± 1.78 breaths/min. Even in the case of lower camera resolution setting (i.e., NTSC), the system demonstrated good performances (MAE of 1.53 breaths/min, bias of −0.06 ± 2.08 breaths/min) for contactless monitoring of both breathing pattern and breath-by-breath respiratory rate over time.

Normoxic and hypoxic breathing pattern in newborn grey seals

1989 ◽  
Vol 67 (2) ◽  
pp. 483-487 ◽  
Author(s):  
Jacopo P. Mortola ◽  
Clement Lanthier
Keyword(s):  
Tidal Volume ◽  
Breathing Pattern ◽  
Halichoerus Grypus ◽  
Breathing Rate ◽  
Allometric Relationships ◽  
Breathing Patterns ◽  
Hypoxic Conditions ◽  
Regulation Of Breathing ◽  
Expiratory Flow

We studied the breathing patterns of three newborn grey seals (Halichoerus grypus) at 2 – 3 days of age under normoxic and hypoxic conditions with the barometric technique, which does not require the animal to be restrained. Normoxic tidal volume was deeper and breathing rate slower than expected for newborns of this size on the basis of previously published allometric relationships. In addition, two characteristics were readily apparent: (i) occasional sudden long apneas, often exceeding 30 s in duration, and (ii) consistent brief interruptions of expiratory flow. Neither aspect is common in terrestrial newborns of this age, but both have been previously observed in adult seals. During hypoxia (10 min of 15% O2 and 10 min of 10% O2), ventilation increased markedly and steadily, at variance with what occurs in newborns of other species, indicating a precocial development of the regulation of breathing. This latter result also suggests that the blunted response to hypoxia previously reported in adult seals may be acquired postnatally with diving experience.

RESPIRATORY RATE, TIDAL VOLUME AND VENTILATION OF NEWBORN INFANTS IN THE PRONE AND SUPINE POSITIONS

PEDIATRICS ◽  
1961 ◽  
Vol 28 (3) ◽  
pp. 388-393
Author(s):  
W. T. Bruns ◽  
K. O. Loken ◽  
A. A. Siebens
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Tidal Volume ◽  
Respiratory Rate ◽  
Prone Position ◽  
Congenital Heart ◽  
Newborn Infants ◽  
Periodic Breathing ◽  
Continuous Recording ◽  
Body Plethysmograph

The respiratory rate, tidal volume and ventilation were measured in newborn infants with a body plethysmograph. A continuous recording revealed that, with one exception, no significant change occurred in these parameters when seven mature infants were turned from supine to prone position or vice versa. Two mature infants with periodic breathing, one of whom had congenital heart disease, exhibited periods of apnea when placed from the supine into the prone position.

Gambaran Frekuensi Napas Pasien Asma Dewasa: Literature review

2021 ◽  
Vol 1 ◽  
pp. 1103-1110
Author(s):  
Didi Rethodi ◽  
Dian Kartikasari
Keyword(s):  
Literature Review ◽  
Respiratory Rate ◽  
Full Text ◽  
Breathing Pattern ◽  
Google Scholar ◽  
Educational Institutions ◽  
Nursing Interventions ◽  
Shortness Of Breath ◽  
Difficulty Breathing ◽  
Review Study

AbstractAsthma causes narrowing of the airways, which leads to various symptoms such as whezzing, coughing, and shortness of breath (dyspnea) in sufferers. Patients with asthma often complain of experiencing sudden shortness of breath, difficulty breathing, and pain when taking a breath. These conditions can causes the patient to become stressed, anxious and the breathing pattern in no longer effective. As a result, the prognosis of disease is poor. The purpose of this literature review study was to picture the frequency of breathing in asthma patients.This literature review highlighted five articles searched from 2011-2021 throught Garba Garuda and Google Scholar. The obtained articles were apprassied using the JBI (Joanna Briggs Institute) instrument before being analyzed. This study revealed that the respiratory rate in patients with asthma increases over 20x/minutes.The conclusion from this literature review is that patients with asthma have tachypnea. This literature review may be used as a reference for hospitals, educational institutions, and other researchers to determine appropriate nursing interventions for asthma patients.Keywords:Asthma; respiratoryrate. AbstrakPenyakit asma dapat menyebabkan penyempitan pada saluran napas dan hal ini dapat menimbulkan gejala seperti mengi, batuk, dan sesak napas (dyspnea) pada penderitanya. Keluhan pasien asma yaitu sering mengalami sesak napas yang dating secara mendadak, sulit untuk bernafas, nyeri saat menarik napas. Hal ini dapat menyebabkan pasien menjadi stress, cemas dan pola napas tidak lagi efektif dan prognosis penyakitnya menjadi buruk. Tujuan dari penelitian literature review ini adalah untuk mengetahui Gambaran Frekuensi Napas Pada Pasien Asma. Metode penelitian menggunakan metode deskriptif dengan pengumpulan data literature review. Pencarian artikel dari tahun 2011-2021 melalui penelusuran Garba Garuda, dan Google Shcolar dengan kriteria inklusi populasi pasien asma dewasa, tahun artikel 2011-2021, penelitian kuantitatif. Hasil pencarian yang didapatkan berupa full text dan pdf, kemudian direview dengan menggunakan instrument JBI (Joanna Briggs Institute), didapatkan 5 artikel dari tahun 2012-2021, diekstraksi kemudian dibahas dan disimpulkan .Hasil penelitian literature review dari 5 atikel menunjukkan bahwa frekuensi napas pada pasien dengan kejadian asma mengalami peningkatan pernafasan >20x/menit. Simpulan dari literature review ini yaitu pasien dengan kejadian asma mengalami peningkatan frekuensi pernapasan. Penelitian literature review ini diharapkan dapat menjadi refrensi bagi pihak rumah sakit, institusi pendidikan maupun penelitilainnya sebagai pertimbangan untuk menentukan intervensi keperawatan yang tepat bagi pasien asma.Kata kunci : Asma, Respirasi

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