Lung and chest wall impedances in the dog in normal range of breathing: effects of pulmonary edema

1992 ◽  
Vol 73 (3) ◽  
pp. 1040-1046 ◽  
Author(s):  
G. M. Barnas ◽  
D. Stamenovic ◽  
K. R. Lutchen
Keyword(s):  
Oleic Acid ◽  
Pulmonary Edema ◽  
Chest Wall ◽  
Mean Airway Pressure ◽  
Normal Range ◽  
Normal Ranges ◽  
Before And After ◽  
Measured Resistance ◽  
The Right ◽  
Severe Pulmonary Edema

We evaluated the effect of pulmonary edema on the frequency (f) and tidal volume (VT) dependences of respiratory system mechanical properties in the normal ranges of breathing. We measured resistance and elastance of the lungs (RL and EL) and chest wall of four anesthetized-paralyzed dogs during sinusoidal volume oscillations at the trachea (50–300 ml, 0.2–2 Hz), delivered at a constant mean airway pressure. Measurements were made before and after severe pulmonary edema was produced by injection of 0.06 ml/kg oleic acid into the right atrium. Chest wall properties were not changed by the injection. Before oleic acid, EL increased slightly with increasing f in each dog but was independent of VT. RL decreased slightly and was independent of VT from 0.2 to 0.4 Hz, but above 0.4 Hz it tended to increase with increasing flow, presumably due to the airway contribution. After oleic acid injection, EL and RL increased greatly. Large negative dependences of EL on VT and of RL on f were also evident, so that EL and RL after oleic acid changed two- and fivefold, respectively, within the ranges of f and VT studied. We conclude that severe pulmonary edema changes lung properties so as to make behavior VT dependent (i.e., nonlinear) and very frequency dependent in the normal range of breathing.

Lung tissue and airway impedances during pulmonary edema in normal range of breathing

1995 ◽  
Vol 78 (5) ◽  
pp. 1889-1897 ◽  
Author(s):  
G. M. Barnas ◽  
J. Sprung ◽  
R. Kahn ◽  
P. A. Delaney ◽  
M. Agarwal
Keyword(s):  
Oleic Acid ◽  
Pulmonary Edema ◽  
Lung Tissue ◽  
Airway Pressure ◽  
Alveolar Pressure ◽  
Mean Airway Pressure ◽  
Normal Range ◽  
Normal Breathing ◽  
The Right ◽  
Severe Pulmonary Edema

How pulmonary edema affects lung tissue and airway properties is not clear. From measurements of airway pressure and flow, we measured lung elastance (EL) and resistance (RL) in 5 anesthetized-paralyzed open-chested dogs during sinusoidal forcing in the frequency (f) and tidal volume (VT) ranges of normal breathing. RL was divided into its tissue (Rti) and airway (Raw) components from measurements of alveolar pressure through capsules glued to the lung surface. After induction of severe pulmonary edema by injection of oleic acid into the right atrium, forcing was repeated at the same mean airway pressure (Paw) as in control animals (11 cmH2O) and at a higher Paw (14 cmH2O), as would occur in closed-chested dogs during edema (G. M. Barnas, D. Stamenovic, and K. R. Lutchen. J. Appl. Physiol. 73: 1040–1046, 1992). Edema increased EL, and this increase was greater at Paw = 14 cmH2O (P < 0.05). The f dependences of EL and Rti were increased by edema (P < 0.05), and there was a large negative dependence of EL on VT at Paw = 14 cmH2O. Edema increased RL (P < 0.05), but this increase depended on f, VT, and Paw. The increase in RL was due largely to increases in Rti at Paw = 14 cmH2O and to increases in Raw at Paw = 11 cmH2O. We conclude that the functional effects of oleic acid-induced pulmonary edema on RL are due mostly to changes in lung tissue.

Effect of pulmonary edema on transfer of gas from acinus to airways

1994 ◽  
Vol 76 (2) ◽  
pp. 560-564 ◽  
Author(s):  
G. M. Barnas ◽  
P. B. Randalls ◽  
F. C. Forrest ◽  
B. H. Hoff ◽  
P. L. Donahue ◽  
...  
Keyword(s):  
Oleic Acid ◽  
Pulmonary Edema ◽  
Rate Constant ◽  
Airway Pressure ◽  
Esophageal Pressure ◽  
Gas Transfer ◽  
Before And After ◽  
The Right ◽  
Severe Pulmonary Edema ◽  
133Xe Washout

We directly measured the effect of progressive pulmonary edema on gas transfer from the acinus by injecting 133Xe dissolved in saline through a pulmonary artery catheter into an acinar region with occluded blood flow and measuring 133Xe washout by gamma scintillation scanning. We measured washout in six anesthetized paralyzed dogs during mechanical ventilation with O2 before and after injection of 0.6 mg/kg of oleic acid into the right atrium, which induces severe pulmonary edema within 2 h. Changes in the elastance and resistance of the lung were also calculated from measurements of airway flow, airway pressure, and esophageal pressure. Before injection of oleic acid, the monoexponential rate constant for 133Xe washout was 3.6 +/- 1.4 (SE) min-1; from this we estimated that the rate of gas transfer of 133Xe from the acini was 1.0 l/min. The rate constant decreased gradually after the injection and was correlated with increases in elastance and resistance (r = -0.66) and decreases in alveolar PO2 (r = 0.71). At 2 h after injection, the rate constant (1.2 +/- 0.8 min-1) was lower than control (P < 0.01), and the rate of gas transfer of 133Xe from the acini was < 0.32 l/min. We conclude that resistance in the acini is increased during pulmonary edema and that it is correlated, in the oleic acid model, with changes in overall lung mechanical properties.

scholarly journals Primary hyperfibrinolysis as the presenting sign of prostate cancer: A case report

2016 ◽  
Vol 73 (9) ◽  
pp. 877-880 ◽  
Author(s):  
Andrijana Kulic ◽  
Zorica Cvetkovic ◽  
Vesna Libek
Keyword(s):  
Prostate Cancer ◽  
Case Report ◽  
Fibrinogen Level ◽  
Laboratory Diagnosis ◽  
Cancer Case ◽  
Normal Range ◽  
Normal Ranges ◽  
Assay Result ◽  
The Right ◽  
D Dimer

Introduction. A bleeding syndrome in the setting of primary hyperfibrinolysis in a prostate cancer patient is only 0.40? 1.65% of cases. The laboratory diagnosis of primary hyperfibrinolysis is based on the increase of biomarkers like D-dimer, fibrinogen split products, plasminogen, and euglobulin lysis test. These tests are not specific for primary hyperfibrinolysis. We reported a rare case of hemorrhagic syndrome caused by primary hyperfibrinolysis as the first clinical symptom of metastatic prostate cancer. Case report. A 64-year-old male was admitted to our hospital with large hematomas in the right pectoral and axillary areas (20 x 7 cm), right hemiabdomen (30 x 30 cm) and the left lumbal area, (25 x 5 cm). The patient had no subjective symptoms nor used any medication. Initial coagulation testing, prothrombin time (PT), and activated partial thromboplastin time (APTT) were within the normal range, while fibrinogen level was extremely low (1.068 g/L) (normal range 2.0?5.0) and the D-dimer assay result was high 1.122 mg/L (normal range < 0.23). The results obtained by rotation thrombelastometry pointed to primary fibrinolysis. Further clinical and laboratory examination indicated progressive malignant prostate disease. First line treatment for the patient was a combined administration of tranexamic acid (3 x 500 mg iv) and transfusion of ten units of cryoprecipitate (400 mL). Next day, fibrinolytic function measurements by rotation thrombelastometry were within the normal ranges. Fibrinogen level was normalized within two days (2.4 g/L). There were no newly developed hematomas. Conclusion. This case report shows primary hyperfibrinolysis with bleeding symptoms, which is an uncommon paraneoplastic phenomenon within expanded prostate malignancy. Rotation thrombelastometry in this severe complication helped to achieve the prompt and proper diagnosis and treatment.

scholarly journals Ventilation inhomogeneity in oleic acid-induced pulmonary edema

1997 ◽  
Vol 82 (4) ◽  
pp. 1040-1045 ◽  
Author(s):  
John Y. C. Tsang ◽  
Michael J. Emery ◽  
Michael P. Hlastala
Keyword(s):  
Oleic Acid ◽  
Pulmonary Edema ◽  
Phase Iii ◽  
Lung Water ◽  
Peripheral Airways ◽  
Ventilation Inhomogeneity ◽  
Distal Airway ◽  
Tissue Compliance ◽  
Permeability Pulmonary Edema ◽  
The Right

Tsang, John Y. C., Michael J. Emery, and Michael P. Hlastala. Ventilation inhomogeneity in oleic acid-induced pulmonary edema. J. Appl. Physiol.82(4): 1040–1045, 1997.—Oleic acid causes permeability pulmonary edema in the lung, resulting in impairment of gas-exchange and ventilation-perfusion heterogeneity and mismatch. Previous studies have shown that by using the multiple-breath helium washout (MBHW) technique, ventilation inhomogeneity (VI) can be quantitatively partitioned into two components, i.e., convective-dependent inhomogeneity (cdi) and diffusive-convective-dependent inhomogeneity (dcdi). Changes in VI, as represented by the normalized slope of the phase III alveolar plateau, were studied for 120 min in five anesthetized mongrel dogs that were ventilated under paralysis by a constant-flow linear motor ventilator. These animals received oleic acid (0.1 mg/kg) infusion into the right atrium at t = 0. MBHWs were done in duplicate for 18 breaths every 40 min afterward. Three other dogs that received only normal saline served as controls. The data show that, after oleic acid infusion, dcdi, which represents VI in peripheral airways, is responsible for the increasing total VI as lung water accumulates progressively over time. The cdi, which represents VI between larger conductive airways, remains relatively constant throughout. This observation can be explained by increases in the heterogeneity of tissue compliance in the periphery, distal airway closure, or by decreases in ventilation through collateral channels.

Systemic Absorption of Gentamicin Nasal Irrigations

2006 ◽  
Vol 20 (3) ◽  
pp. 251-254 ◽  
Author(s):  
W. Stites Whatley ◽  
Rakesh K. Chandra ◽  
C. Bruce MacDonald
Keyword(s):  
Otoacoustic Emissions ◽  
Pure Tone Audiometry ◽  
Sinus Surgery ◽  
Systemic Absorption ◽  
Normal Range ◽  
Nasal Irrigation ◽  
Distortion Product ◽  
Patient Reported ◽  
Before And After ◽  
The Right

Objective To determine if gentamicin nasal irrigation is systemically absorbed, and to identify any ototoxic side effects related to its use. Design Retrospective review of 12 patients treated with gentamicin nasal irrigations (30 cc of 80 mg/L solution used bilaterally twice daily). Methods Serum gentamicin levels were assayed after the course treatment. Pure tone audiometry (250–8000 Hz) and distortion product otoacoustic emissions (DP-OAEs) at 7280, 5133, 3640 and 2560 Hz were obtained before and after therapy. Results Twelve patients (age 4 to 74, mean 43) with chronic rhinosinusitis were treated for 3–15 weeks (mean 7 weeks). All patients had undergone previous endoscopic sinus surgery. Ten patients had pretreatment cultures that grew organisms sensitive to gentamicin (Pseudomonas, Proteus, or methacillin resistant Staphylococcus aureus), and three patients had cystic fibrosis. Ten of 12 patients (83%) had detectable posttreatment levels of gentamicin, with a mean serum level of 0.42 mcg/mL (range 0.3 to 0.7 mcg/mL). Four of 12 patients (33%) had serum gentamicin levels within the normal range for gentamicin trough (0.5 to 2 mcg/mL). Comparison of pre- and posttreatment audiologic data revealed no significant change in PTA or DP-OAE, except for the right ear at 8000 Hz on PTA (p = 0.035) where a mean of 7 dB loss was observed. No patient reported hearing loss or vertigo during treatment. Conclusion Gentamicin nasal irrigation may be systemically absorbed. Although the otologic consequences of this finding are questionable, patients receiving gentamicin nasal irrigations should be counseled regarding this hypothetical possibility.

Lung and chest wall impedances in the dog: effects of frequency and tidal volume

1992 ◽  
Vol 72 (1) ◽  
pp. 87-93 ◽  
Author(s):  
G. M. Barnas ◽  
D. Stamenovic ◽  
K. R. Lutchen ◽  
C. F. Mackenzie
Keyword(s):  
Tidal Volume ◽  
Chest Wall ◽  
Respiratory System ◽  
Peak Flow ◽  
Data Capture ◽  
Normal Range ◽  
Flow Dependence ◽  
Normal Ranges ◽  
Airways Resistance

Dependences of the mechanical properties of the respiratory system on frequency (f) and tidal volume (VT) in the normal ranges of breathing are not clear. We measured, simultaneously and in vivo, resistance and elastance of the total respiratory system (Rrs and Ers), lungs (RL and EL), and chest wall (Rcw and Ecw) of five healthy anesthetized paralyzed dogs during sinusoidal volume oscillations at the trachea (50–300 ml, 0.2–2 Hz) delivered at a constant mean lung volume. Each dog showed the same f and VT dependences. The Ers and Ecw increased with increasing f to 1 Hz and decreased with increasing VT up to 200 ml. Although EL increased slightly with increasing f, it was independent of VT. The Rcw decreased from 0.2 to 2 Hz at all VT and decreased with increasing VT. Although the RL decreased from 0.2 to 0.6 Hz and was independent of VT, at higher f RL tended to increase with increasing f and VT (i.e., as peak flow increased). Finally, the f and VT dependences of Rrs were similar to those of Rcw below 0.6 Hz but mirrored RL at higher f. These data capture the competing influences of airflow nonlinearities vs. tissue nonlinearities on f and VT dependence of the lung, chest wall, and total respiratory system. More specifically, we conclude that 1) VT dependences in Ers and Rrs below 0.6 Hz are due to nonlinearities in chest wall properties, 2) above 0.6 Hz, the flow dependence of airways resistance dominates RL and Rrs, and 3) lung tissue behavior is linear in the normal range of breathing.

Effects of acute pleural effusion on respiratory system mechanics in dogs

1985 ◽  
Vol 59 (5) ◽  
pp. 1458-1463 ◽  
Author(s):  
W. S. Krell ◽  
J. R. Rodarte
Keyword(s):  
Chest Wall ◽  
Shape Change ◽  
Lower Lobe ◽  
Esophageal Pressure ◽  
Elastic Recoil ◽  
Cross Sectional ◽  
Before And After ◽  
Residual Capacity ◽  
Upward Displacement ◽  
The Right

We determined regional (Vr) and overall lung volumes in six head-up anesthetized dogs before and after the stepwise introduction of saline into the right pleural space. Functional residual capacity (FRC), as determined by He dilution, and total lung capacity (TLC) decreased by one-third and chest wall volume increased by two-thirds the saline volume added. Pressure-volume curves showed an apparent increase in lung elastic recoil and a decrease in chest wall elastic recoil with added saline, but the validity of esophageal pressure measurements in these head-up dogs is questionable. Vr was determined from the positions of intraparenchymal markers. Lower lobe TLC and FRC decreased with added saline. The decrease in upper lobe volume was less than that of lower lobe volume at FRC and was minimal at TLC. Saline increased the normal Vr gradient at FRC and created a gradient at TLC. During deflation from TLC to FRC before saline was added, the decrease in lung volume was accompanied by a shape change of the lung, with greatest distortion in the transverse (ribs to mediastinum) direction. After saline additions, deflation was associated with deformation of the lung in the cephalocaudal and transverse directions. The deformation with saline may be a result of upward displacement of the lungs into a smaller cross-sectional area of the thoracic cavity.

Increased cardiac output increases shunt: role of pulmonary edema and perfusion

1985 ◽  
Vol 59 (4) ◽  
pp. 1313-1321 ◽  
Author(s):  
P. H. Breen ◽  
P. T. Schumacker ◽  
J. Sandoval ◽  
I. Mayers ◽  
L. Oppenheimer ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Oleic Acid ◽  
Pulmonary Edema ◽  
Lung Edema ◽  
Base Line ◽  
Lung Water ◽  
Arteriovenous Fistulas ◽  
Anesthetized Dogs ◽  
The Right

In low-pressure pulmonary edema increased cardiac output (QT) increases shunt (Qs/QT); we tested whether the mechanism is an increase in extravascular lung water in turn mediated by the accompanying increase in microvascular pressure. In six pentobarbital sodium-anesthetized dogs ventilated with O2 we administered oleic acid into the right atrium. From base line to 2 h post-oleic acid we measured concurrent significant increases in Qs/QT (6–29%, O2 technique) and extravascular thermal volume (ETV, 2.6–7.1 ml/g dry intravascular blood-free lung wt, thermal-green dye indicator technique) that were stable by 90 min. Then, bilateral femoral arteriovenous fistulas were opened and closed in 30-min periods to cause reversible increases in QT and associated Qs/QT. When fistulas were open the time-averaged QT increased from 5.1 to 6.9 min (P less than 0.05), the simultaneous Qs/QT rose from 30.7 to 38.4% (P less than 0.05), but ETV did not increase. We conclude that increasing lung edema does not account for our rise in Qs/QT when QT increased.

Proportionality between chest wall resistance and elastance

1991 ◽  
Vol 70 (2) ◽  
pp. 511-515 ◽  
Author(s):  
G. M. Barnas ◽  
D. Stamenovic ◽  
J. J. Fredberg
Keyword(s):  
Tidal Volume ◽  
Chest Wall ◽  
Narrow Range ◽  
Respiratory Muscles ◽  
External Forcing ◽  
Breathing Frequency ◽  
Normal Range ◽  
Normal Ranges ◽  
Wide Range ◽  
The Relationship

Fredberg and Stamenovic (J. Appl. Physiol. 67: 2408-2419, 1989) demonstrated a relatively robust phenomenological relationship between resistance (R) and elastance (E) of lung tissue during external forcing. The relationship can be expressed as omega R = eta E, where omega = 2 pi times forcing frequency and eta is hysteresivity; they found eta to be remarkably invariant under a wide range of circumstances. From data gathered in previous experiments, we have tested the adequacy and utility of this phenomenological description for the chest wall (eta w) and its major compartments, the rib cage (eta rc), diaphragm-abdomen (eta d-a), and belly wall (eta bw+). For forcing frequencies and tidal volumes within the normal range of breathing, we found that eta w remained in a relatively narrow range (0.27-0.37) and that neither eta w nor the compartmental eta's changed much with frequency or tidal volume. Compared with eta w, eta rc tended to be slightly low, whereas eta d-a tended to be slightly higher than eta w. However, at higher frequencies (greater than 1 Hz) all eta's increased appreciably with frequency. During various static nonrespiratory maneuvers involving use of respiratory muscles, eta w increased up to twofold. We conclude that in the normal ranges of breathing frequency and tidal volume 1) elastic and dissipative processes within the chest wall appear to be coupled, 2) eta's of the various component parts of the chest wall are well matched, 3) respiratory muscle contraction increases the ratio of cyclic dissipative losses to energy storage, and 4) R of the relaxed chest wall can be estimated from E.(ABSTRACT TRUNCATED AT 250 WORDS)

scholarly journals Improvement of masticatory kinematic parameters after correction of unilateral posterior crossbite: Reasons for functional retention

2017 ◽  
Vol 87 (6) ◽  
pp. 871-877 ◽  
Author(s):  
Maria Grazia Piancino ◽  
Maria Cordero-Ricardo ◽  
Rosangela Cannavale ◽  
Teresa Vallelonga ◽  
Umberto Garagiola ◽  
...  
Keyword(s):  
Kinematic Parameters ◽  
Functional Appliance ◽  
Normal Range ◽  
Posterior Crossbite ◽  
Before And After ◽  
The Right ◽  
The University

ABSTRACT Objective: To evaluate reverse-sequencing chewing cycles (RSCC) and their kinematic parameters on both sides before and after correction with the Function Generating Bite (FGB) appliance. Materials and Methods: Forty-seven patients, 8.3 ± 1.1 (mean ± SD) years of age, with unilateral posterior crossbite (35 on the right side, 12 on the left side) and 18 age-matched controls (9.1 ± 0.8 years) were selected for the study from the orthodontic division of the University of Turin, Italy. The crossbite was corrected in all patients using FGB, and mandibular motion was recorded with a kinesiograph K-7 (Myotronics, Tukwila, Wash), during chewing on both sides of a soft and a hard bolus before and after correction. Results: After correction, the percentage of RSCC significantly decreased for soft and hard (P &lt; .001) boluses and fell within the normal range for 75% of the patients. The indices of the chewing pattern (closure angle, axis, maximum lateral excursion) significantly improved (P &lt; .001), becoming symmetric between sides. Conclusions: The results of this study showed that the functional appliance, FGB, was able to lower the percentage of RSCC significantly, bringing them back to the normal range in 75% of cases, and to improve the kinematic parameters that become symmetric between sides.

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