Mechanisms of airway protection after pharyngeal fluid infusion in healthy sleeping piglets

1995 ◽  
Vol 78 (5) ◽  
pp. 1942-1949 ◽  
Author(s):  
M. Page ◽  
H. E. Jeffery ◽  
V. Marks ◽  
E. J. Post ◽  
A. K. Wood

The airway protective mechanisms evoked after infusion of fluids into the pharynx were examined in the intact and healthy newborn piglet during sleep. Thirteen healthy normothermic piglets (3–6 days of age) were examined on 4 consecutive days during sleep. The fluids infused (0.05–1.5 ml) were 0.9% saline, distilled water, and HCl (pH 3 and pH 2). Respiratory rate, heart rate, oxygen saturation (SaO2), swallowing, and arousal were compared pre- and postinfusion during active (AS) and quiet sleep (QS) for each test fluid. The most common response in AS and QS was swallowing (90%) and then arousal (24%); however, no apnea occurred, and respiratory rate and SaO2 were always maintained. A significant difference occurred between HCl infusions of pH 2 and pH 3; at pH 2, the frequency of swallows and latency to the first swallow were reduced (P < 0.05) and the frequency of arousal was reduced in AS compared with that in QS (P < 0.01). Airway protection after pharyngeal fluid stimulation is achieved primarily by swallowing and arousal, without any effect on respiratory rate and SaO2. Attenuation of protective mechanisms occurred, however, when the infusate was at pH 2.

Author(s):  
A. E. Chernikova ◽  
Yu. P. Potekhina

Introduction. An osteopathic examination determines the rate, the amplitude and the strength of the main rhythms (cardiac, respiratory and cranial). However, there are relatively few studies in the available literature dedicated to the influence of osteopathic correction (OC) on the characteristics of these rhythms.Goal of research — to study the influence of OC on the rate characteristics of various rhythms of the human body.Materials and methods. 88 adult osteopathic patients aged from 18 to 81 years were examined, among them 30 men and 58 women. All patients received general osteopathic examination. The rate of the cranial rhythm (RCR), respiratory rate (RR) heart rate (HR), the mobility of the nervous processes (MNP) and the connective tissue mobility (CTM) were assessed before and after the OC session.Results. Since age varied greatly in the examined group, a correlation analysis of age-related changes of the assessed rhythms was carried out. Only the CTM correlated with age (r=–0,28; p<0,05) in a statistically significant way. The rank dispersion analysis of Kruskal–Wallis also showed statistically significant difference in this indicator in different age groups (p=0,043). With the increase of years, the CTM decreases gradually. After the OC, the CTM, increased in a statistically significant way (p<0,0001). The RCR varied from 5 to 12 cycles/min in the examined group, which corresponded to the norm. After the OC, the RCR has increased in a statistically significant way (p<0,0001), the MNP has also increased (p<0,0001). The initial heart rate in the subjects varied from 56 to 94 beats/min, and in 15 % it exceeded the norm. After the OC the heart rate corresponded to the norm in all patients. The heart rate and the respiratory rate significantly decreased after the OC (р<0,0001).Conclusion. The described biorhythm changes after the OC session may be indicative of the improvement of the nervous regulation, of the normalization of the autonomic balance, of the improvement of the biomechanical properties of body tissues and of the increase of their mobility. The assessed parameters can be measured quickly without any additional equipment and can be used in order to study the results of the OC.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Eslam Ahmed Mohamed Elsamahi ◽  
Bassem P Ghobrail ◽  
Ghada Mohamed Samir ◽  
Hany Victor Zaki

Abstract Background In the modern medicine, upper gastrointestinal endoscopy has become a definitive tool for diagnosis and management of many diseases. It is usually preformed in separate unit as day-case procedure and for outpatient clinic. The search of a safe and effective sedation for these patients is still an open topic. Objective The aim of the study is to compare the use of propofol and dexmedetomedine in upper GI endoscopy regarding the hemodynamics, sedative effect and the patient satisfaction. Methods Double – blinded, randomized controlled trial with allocation ratio 1:1 arranged in two parallel groups. This study was conducted in the endoscopy unit of Ainshams University Hospital, Cairo, Egypt within a period of 6 months started from April 2019. All recruited patients were adults undergoing upper gastrointestinal endoscopy. They were included in the study according to the following criteria: Age 21-60 years; elective procedures under general anesthesia with patients who completed eight hours of fasting; and physical Status: ASA I and II Patients after taking written and informed consent. Results Concerning the results of the study, there was no statistically significant difference considering the heart rate in relation to base line readings. The changes of heart rate between the two groups were significantly different with dexmedetomidine associated with lower readings. Respiratory rate and oxygen saturation were insignificantly different in both groups. Time of induction was significantly shorter in propofol than dexmedetomidine (P &lt; 0.001) and time to reach full recovery identified by modified Alderete’s score 10/10 was significantly shorter in dexmedetomidine than propofol (P &lt; 0.014). There was a significant difference between the two dugs concerning the patients and endoscopists satisfaction. The patients were more satisfied with propofol (P 0.047), while the endoscopists were more satisfied with dexmedetomidine (P 0.034). Conclusion Dexmedetomidine and propofol are equally effective and safe to provide enough sedation for upper gastrointestinal endoscopy in a day-case manner. Advantages of dexmedetomidine were providing analgesic effect, rapid recovery from sedation and stability of respiratory rate and oxygen saturation. However, there were some disadvantages such as the bradycardia and patient dissatisfaction although the bradycardia can be utilized in cardiac patients as a safety factor against myocardial ischemia. Other point noticed that using dexmedetomidine for sedation was more costly than propofol and requires the usage of a syringe pump for accurate dosing. On the contrary, propofol is cheap and available in all centers with rabid onset of induction but it causes hypotension and respiratory depression which might be risky in cardiac patients.


2021 ◽  
Author(s):  
Endalkachew hailu ◽  
Gashaw Kasse

Abstract Background: Caudal epidural anesthesia commonly utilized in veterinary practice to allow diagnostic, obstetrical, and surgical interventions in the perineal region of cows. An experimental study conducted on epidural anesthesia from October 2018 to March 2019 on 6 cows with repeated treatments after one week by two groups of anesthetic drugs. Methods and materias First Lignocaine is given for Group-I of cows in the first intercoccygeal space and then the same animals after one week injected Lignocaine-Xylazine together in the intercoccygeal space. The Clinical-physiological parameters such as the onset of analgesia, duration of analgesia, ataxia, sedation, heart rate, respiratory rate, and rectal temperature between the two groups studied by compression. Finally, the significance of the change in the study unit between Lignocaine and Lignocaine-Xylazine analyzed according to SPSS version 19 for t-test and P-value <0.05 taken as statistically significant. Results: There was no significant change that appeared between the onset of analgesia of Lignocaine (4.3±0.6min) alone and Lignocaine-Xylazine (4.9±1.1min) injection together (t=1.17; P>0.05). This indicates that the addition of Xylazine to Lignocaine does not significantly delay the onset of anesthesia. However, there was a significant difference observed in the duration of analgesia between two groups (t=13.2; P<0.05) with Lignocaine-Xylazine (259.5±12.38min) longer duration than Lignocaine alone (84±4.05min). This indicates that Lignocaine and Xylazine have an additive effect on the duration of analgesia. In the case of physiological parameters, there were significant variations in heart rate (t=7.5; P<0.05) with Group II cows lower in heart rate than Group I cows. Statistically, a significant difference was also observed on respiratory rate (t=2.13; P<0.05) in which the addition of Xylazine on Lignocaine significantly lower breathing rate than Lignocaine injection alone. Finally, on rectal temperature, there was no statistically significant difference appeared (t=1.7; P>0.005) with rectal temperature in Group I cows (0.15± 0.28 OC) and in Group II cows (0.9±0.31 OC) which indicate that addition of Xylazine to Lignocaine lower rectal temperature similar to Lignocaine injection alone. Mild ataxia was observed in three groups I, cows, and there was no sedation and salivation noted at all. In Group II, cows mild to severe ataxia, deep sedation, salivation, and falling observed. In both groups, there was no anesthetic complication during epidural analgesia and after recovery noted.Conclusion: generally this study showed that, combination of Lignocaine and Xylazine have an additive effect on the duration and quality of analgesia.


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e14-e15
Author(s):  
Daryl Cheng ◽  
Caitlyn Hui ◽  
Kate Langrish ◽  
Carolyn Beck

Abstract BACKGROUND Paediatric intermediate care units (IC) function to provide a higher level of inpatient paediatric care such as frequent monitoring or nursing intervention compared to routine inpatient general paediatric care. A small subset of these patients in IC deteriorate further and require transfer to the paediatric intensive care unit (PICU). By identifying patient characteristics at the time of admission that predict secondary transfer, specific monitoring, resource allocation and early intervention may be implemented in order to improve quality of care. Appropriate and timely patient flow and length of stay (LOS) can also be optimized. DESIGN/METHODS The IC at our tertiary care institution admits predominantly general paediatric patients. Its admission criteria have been designed with input from stakeholders, and comprise a range of physiologic and resource based measures. Data were collected on patients who were admitted to IC, including those subsequently transferred to PICU, between July 2016 - June 2017. Patients whose index IC admission was from the PICU were excluded. Data included demographic and physiologic characteristics (heart rate, respiratory rate, temperature, oxygen therapy) and the bedside paediatric early warning system (BPEWS) score, a validated score based on vital signs. Quantitative and qualitative data were analyzed using Fisher and Mann-Whitney tests respectively. RESULTS 210 patient visits occurred in this time period, with 44 (20.95%) transferred to PICU (Table 1). Transferred patients showed no significant difference in age or sex. However, they had significantly higher median BPEWS, heart rate, respiratory rate and mean body temperature compared to non-transferred patients, as well as a significantly higher rate of respiratory support and shorter LOS on IC. There was a non-significant trend toward admission directly from the Emergency Department (ED) in transferred patients. Admission criteria and main organ systems affected were similar amongst both groups, with a predominance of respiratory conditions. PICU transfer was predicted by most physiological characteristics, including BPEWS. This coupled with a significantly shorter length of stay is a likely reflection of higher disease acuity in this group of patients and higher risk of deterioration and subsequent transfer to PICU. CONCLUSION The need for close monitoring of physiologic parameters remains paramount in predicting the need for transfer from the IC to PICU.


2013 ◽  
Vol 16 (3) ◽  
pp. 154-160 ◽  
Author(s):  
Rahmadevita S.A.M ◽  
Yeni Rustina ◽  
Elfi Syahreni

AbstrakNeonatus yang menggunakan ventilasi mekanik akibat gangguan pernapasan mengalami masalah oksigenisasi dan frekuensi denyut jantung. Berbagai upaya perlu dilakukan agar neonates tenang sehingga kebutuhan oksigen dapat diminimalkan, salah satu upaya tersebut adalah terapi musik. Penelitian ini bertujuan untuk menguji pengaruh terapi musik terhadap saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan neonatus yang menggunakan ventilasi mekanik. Penelitian kuasi eksperimen dengan rancangan pretest-posttest without control meibatkan 13 neonatus yang dipilih secara konsekutif. Intervensi yang diberikan adalah terapi musik dengan Brahm’s Lullaby selama 30 menit dengan headphone. Pengumpulan data menggunakan observasi dan dianalisis dengan Paired t test. Hasil penelitian menunjukkan adanya perbedaan bermakna antara rerata saturasi oksigen, frekuensi denyut jantung dan frekuensi pernafasan sebelum dan setelah pemberian terapi musik. Pada saturasi oksigen terjadi peningkatan, sedangkan pada frekuensi denyut jantung dan pernapasan mengalami penurunan. Terapi musik dapat digunakan sebagai pendamping terapi medis untuk memperbaiki oksigenisasi pada neonatus yang menggunakan ventilasi mekanik.Kata kunci: denyut jantung neonatus, pernapasan, saturasi oksigen, terapi musik, ventilasi mekanikAbstractImproving Oxygen Saturation, Heart Rate, and Respiratory Rate of Neonates Using Mechanical Ventilation with Music Therapy. Neonates using mechanical ventilation cause of respiratory disorder experience oxygenation and heart rate problems. Interventions should be made in order to calm neonates so that the need of oxygen can be minimized, one of these interventions is music therapy. This study aimed to identify the effect of music therapy on oxygen saturation, heart rate and respiratory rate of neonates using mechanical ventilation. This quasi experiment study with a pretest-posttest design without control involved 13 neonates selected by consecutive sampling. Data collected through observation and analyzed by paired t test. There was a significant difference on the average of oxygen saturation, heart rate and respiratory rate of infants using mechanical ventilation before and after music therapy (p value <0,05). Music therapy can be used as a complementary medical therapies to improve oxygenation in neonates using mechanical ventilation.Key words: heart rate, mechanical ventilation, music therapy, neonate, oxygen saturation, respiratory rate


2007 ◽  
Vol 102 (4) ◽  
pp. 1429-1438 ◽  
Author(s):  
Marie St-Hilaire ◽  
Nathalie Samson ◽  
Elise Nsegbe ◽  
Charles Duvareille ◽  
François Moreau-Bussière ◽  
...  

Laryngeal chemoreflexes (LCR) are triggered by the contact of liquids with the laryngeal mucosa. In the mature organism, LCR trigger lower airway protective responses (coughing, effective swallowing, and arousal) to prevent aspiration. General belief holds that LCR are responsible for apnea and bradycardia in the newborn mammal, including humans. Our laboratory has recently shown that LCR in full-term lambs are consistently analogous to the mature LCR reported in adult mammals, without significant apneas and bradycardias (St-Hilaire M, Nsegbe E, Gagnon-Gervais K, Samson N, Moreau-Bussiere F, Fortier PH, and Praud J-P. J Appl Physiol 98: 2197–2203, 2005). The aim of the present study was to assess LCR in nonsedated, newborn preterm lambs born at 132 days of gestation (term = 147 days). The preterm lambs were instrumented for recording glottal adductor electromyogram, electroencephalogram, eye movements, heart rate, respiration, and oximetry. A chronic supraglottal catheter was used for injecting 0.5 ml of saline, distilled water, and HCl (pH 2) during quiet sleep, active sleep, and wakefulness on postnatal days 7 (D7) and 14 (D14). Laryngeal stimulation by water or HCl on D7 induced significant apneas, bradycardia, and desaturation, which, at times, appeared potentially life-threatening. No significant apneas, bradycardias, or desaturation were observed on D14. No consistent effects of sleep state could be shown in the present study. In conclusion, laryngeal stimulation by liquids triggers potentially dangerous LCR in preterm lambs on D7, but not on D14. It is proposed that maturation of the LCR between D7 and D14 is partly involved in the disappearance of apneas/bradycardias of prematurity with postnatal age.


2020 ◽  
Vol 9 (12) ◽  
pp. 4062
Author(s):  
Ángela Río-González ◽  
Ester Cerezo-Téllez ◽  
Cristina Gala-Guirao ◽  
Laura González-Fernández ◽  
Raquel Díaz-Meco Conde ◽  
...  

The aim of this study is to describe the short-term effects of manual lymph drainage (MLD) isolated in supraclavicular area in healthy subjects. A 4-week cross-sectional, double-blinded randomized clinical trial was conducted. Participants: 24 healthy participants between 18 and 30 years old were recruited from Universidad Europea de Madrid from December 2018 to September 2019. A total of four groups were studied: control, placebo, Vodder, and Godoy. The order of the interventions was randomized. Resting Heart Rate and Oxygen Saturation, blood pressure, pressure pain threshold of trapezius muscle, respiratory rate, range of active cervical movements were measured before and after every intervention. All the participants fulfilled four different interventions with a one-week-wash-out period. No statistically significant differences were found between groups in descriptive data; neither in saturation of oxygen, diastolic blood pressure and cervical range of motion. Significant differences were found in favor of Vodder (p = 0.026) in heart rate diminution and in cardiac-rate-reduction. A significant difference in respiratory rate diminution is found in favor of the Godoy group in comparison with the control group (p = 0.020). A significant difference is found in favor of the Godoy group in systolic blood pressure decrease (p = 0.015) even in pressure pain threshold (p < 0.05). MLD decreases systolic blood pressure in healthy participants. However, it does not produce any changes in other physiologic outcomes maintaining physiologic values, which may suggest the safety of the technique in patients suffering from other pathologies.


2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e24-e24
Author(s):  
Matthew Speckert ◽  
Andrei-Alexandru Szigiato ◽  
Jeanne zielonka ◽  
Kathleen Hollamby ◽  
Eugene Ng ◽  
...  

Abstract BACKGROUND Retinopathy of prematurity (ROP) is a disorder of retinal development in the low birthweight preterm infant. Eye screening is routinely performed for infants at risk of developing this disorder. While these examinations help prevent blindness, they can be physiologically stressful for infants, with changes in oxygen saturation, blood pressure and heart rate occurring during the exam and increased apneic episodes reported the 24–48 hours period afterward. The cause of these increased apneic episodes is not currently known. OBJECTIVES To evaluate the effect of decreasing light simulation during mydriasis on the frequency of stressful episodes after ROP screening. DESIGN/METHODS Multi-centre randomized study. This study was approved by hospital ethics boards at all sites. After informed consent was obtained, infants with a birthweight <1500g or gestational age of ≤32 weeks and scheduled for their first ROP screening were randomized to receive either standard of care or a phototherapy mask during pupil dilation, in addition to routine care. Dilated retinal exams were performed by retinal surgeons and fellows. The primary outcome was the frequency of any desaturation, bradycardic event, or apneic event 12 hours following the examination, compared to a baseline rate 12 hours prior to the exam. Heart rate, respiratory rate and oxygen saturation were recorded for up to 48 hours following the examination and compared to baseline. RESULTS A total of 51 infants were enrolled; 28 randomized to the masked group and 23 to the control group. 10 and 13 infants were on ventilator support at the time of examination in each group, respectively. There was a 57.7% decrease in the total number of all stressful events in the masked group compared to controls in the 12 hour post exam period (Rate Ratio 0.42, 95% CI 0.2–0.9, P=0.024). There was a 61.3% decrease in the number of bradycardic events in the masked group compared to controls (RR 0.39, 95% CI 0.2–1.0, P=0.042). Heart rate was significantly higher in both groups after the exam (Effect by time P=0.04), with no difference in between groups (Effect by group P=0.31). There was no significant difference seen in either group in respiratory rate or oxygen saturation at 2 or 4 hours after the ROP examination compared to baseline. Risk factors that were associated with increased stress included: younger gestational age (RR=1.32 95%CI [1.2–1.5] per week), lower birthweight (RR=1.39 [1.2–1.5] per 100g), ventilator support around the time of exam (RR=2.67 [1.3–5.6]), diagnosis of intraventricular hemorrhage (RR=3.78 [1.9–7.3]), and hyponatremia (RR=3.42 [1.8–6.6]). No adverse events occurred while using eye masks. CONCLUSION The infants who wore a phototherapy mask during pupillary dilation had lower rates of stressful episodes following screening for retinopathy of prematurity, particularly lower episodes of bradycardia.


PEDIATRICS ◽  
1978 ◽  
Vol 62 (1) ◽  
pp. 91-95 ◽  
Author(s):  
Peter G. Katona ◽  
John R. Egbert

The heart rate and respiratory rate of eight preterm (average gestational age, 33.3 ± 2.2 weeks) and 13 full-term infants were determined during quiet sleep at home during the first year of life. Both heart rate and respiratory rate were greater in preterm infants throughout the first six months. The difference was maximum at age 10 weeks (21.1 beats per minute and 13.7 breaths per minute), with the difference being statistically significant, at least at the P &lt; .01 level at ages 10, 12, and 14 weeks, while P ≥.01 at all other ages. The 10-to 14-week period is precisely the same period during which the incidence of sudden infant death syndrome (SIDS) has been reported to be maximum. These results support the concept that SIDS is linked to a vulnerable phase of cardiorespiratory maturation.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Welcy Cassiano de Oliveira Tobinaga ◽  
Cirlene de Lima Marinho ◽  
Vera Lucia Barros Abelenda ◽  
Paula Morisco de Sá ◽  
Agnaldo José Lopes

Background. In the neonatal intensive care unit (NICU) environment, preterm newborns are subject to environmental stress and numerous painful interventions. It is known that hydrokinesiotherapy promotes comfort and reduces stress because of the physiological properties of water.Objective. To evaluate the short-term effects of hydrokinesiotherapy on reducing stress in preterm newborns admitted to the NICU.Materials and Methods. Fifteen preterm newborns underwent salivary cortisol measurement, pain evaluation using the Neonatal Infant Pain Scale (NIPS), and heart rate, respiratory rate, and peripheral oxygen saturation measurements before and after the application of hydrokinesiotherapy.Results. The mean gestational age of the newborns was34.2±1.66weeks, and the mean weight was1823.3±437.4 g. Immediately after application of hydrokinesiotherapy, a significant reduction was observed in salivary cortisol(p=0.004), heart rate(p=0.003), and respiratory rate(p=0.004)and a significant increase was observed in peripheral oxygen saturation(p=0.002). However, no significant difference was observed in the NIPS score(p>0.05).Conclusion. In the present study, neonatal hydrotherapy promoted short-term relief from feelings of stress. Neonatal hydrokinesiotherapy may be a therapeutic alternative. However, this therapy needs to be studied in randomized, crossover, and blinded trials. This trial is registered withNCT02707731.


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