scholarly journals Mechanisms of inspiration that modulate cardiovascular control: the other side of breathing

2019 ◽  
Vol 127 (5) ◽  
pp. 1187-1196 ◽  
Author(s):  
Victor A. Convertino
Keyword(s):  
Chronic Obstructive Lung Disease ◽  
Intrathoracic Pressure ◽  
The Other ◽  
Chronic Obstructive ◽  
Human Experiments ◽  
Mueller Maneuver ◽  
Clinical Benefits ◽  
Life Threatening ◽  
Cardiac Filling ◽  
Clinical Conditions

The objective of this minireview is to describe the physiology and potential clinical benefits derived from inspiration. Recent animal and clinical studies demonstrate that one of the body’s natural mechanisms associated with inspiration is to harness the respiratory pump to enhance circulation to vital organs. There is evidence that large reductions in intrathoracic pressure (>20 cmH2O) caused by some inspiration maneuvers (e.g., Mueller maneuver) or pathophysiology (e.g., heart failure, chronic obstructive lung disease) can result in adverse hemodynamic effects. However, the respiratory pump can improve cardiovascular functions when a “sweet spot” for generation of negative intrathoracic pressure during inspiration can be maintained at or less than 10 cmH2O below normal inspiration. These beneficial physiological effects include greater cardiac filling and output, lower intracranial pressure, cardiac baroreflex resetting, greater cerebral blood flow oscillatory patterns, increased vascular pressure gradients, and promoting sustained feedback between sympathetic nerve activity and arterial pressure. In addition to promoting gas exchange, data obtained from numerous animal and human experiments have provided new insights into “the other side of breathing”: the modulation of circulation by reduced intrathoracic pressure generated during inspiration. The translation of these physiological relationships form the basis for the development and application of technologies designed to optimize the intrathoracic pump for treatment of clinical conditions associated with hypovolemia including cardiac arrest, orthostatic hypotension, hemorrhagic shock, and traumatic brain injury. Harnessing these fundamental mechanisms that control cardiopulmonary physiology provides opportunities to use inspiration as a potential tool to help treat significant and often life-threatening circulatory disorders.

scholarly journals Asthma mimic: Case report and literature review of vocal cord nodule associated with wheezing

2017 ◽  
Vol 5 ◽  
pp. 2050313X1774498
Author(s):  
Muhammad Kashif ◽  
Tushi Singh ◽  
Ahsan Aslam ◽  
Misbahuddin Khaja
Keyword(s):  
Vocal Cord ◽  
Upper Airway ◽  
Vocal Cord Dysfunction ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Diffuse Panbronchiolitis ◽  
Reactive Airway Dysfunction Syndrome ◽  
Retrosternal Goiter ◽  
Life Threatening ◽  
Clinical Conditions

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. Various clinical conditions can mimic asthma, such as foreign body aspiration, subglottic stenosis, congestive heart failure, diffuse panbronchiolitis, aortic arch anomalies, reactive airway dysfunction syndrome, chronic obstructive pulmonary disease, retrosternal goiter, vocal cord tumors, other airway tumors, and vocal cord dysfunction. Upper airway obstruction can be a life-threatening emergency. Here, we present the case of a 58-year-old female with recurrent hospital visits for wheezing and exacerbations of asthma, who was later found to have a vocal cord nodule confirmed to be squamous cell carcinoma, which was mimicking like asthma.

RESPIRATORY TUBERCULOSIS AND CHRONIC OBSTRUCTIVE LUNG DISEASE - FEATURES OF THE COMORBIDE STATE

2019 ◽  
Author(s):  
Anna Viktorovna Katicheva ◽  
Nikolai Andreyevich Brazhenko ◽  
Olga Nikolaevna Brazhenko ◽  
Anna Georgievna Chuikova
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Rapid Development ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Bronchial Obstruction ◽  
Obstructive Pulmonary Disease ◽  
Diffusion Capacity ◽  
Cardiovascular Pathology ◽  
Systemic Arterial Hypertension

In modern conditions, chronic tobacco intoxication and chronic obstructive pulmonary disease are widespread and affect the health and life expectancy of patients. Among patients with tuberculosis, chronic tobacco intoxication and COPD are also widespread. Against the background of smoking and chronic obstructive pulmonary disease in patients with tuberculosis of the respiratory system, bronchial obstruction, hypoxemia, impaired capillary pulmonary blood flow, and a decrease in the diffusion capacity of the lungs are determined. A comorbid state is accompanied by the development of oxidative stress, systemic inflammation, endothelial dysfunction. Such changes in combination with dyslipidemia contribute to the development of multifocal atherogenesis, systemic arterial hypertension and the rapid development of cardiovascular pathology

Hemodynamic Characteristics in Chronic Obstructive Lung Disease as Related to Cardiac Size

Respiration ◽  
1981 ◽  
Vol 41 (1) ◽  
pp. 25-32 ◽  
Author(s):  
J. Hutsebaut ◽  
G. Scano ◽  
P. Garcia-Herreros ◽  
S. Degré ◽  
A. De Coster ◽  
...  
Keyword(s):  
Lung Disease ◽  
Obstructive Lung Disease ◽  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Hemodynamic Characteristics

scholarly journals Senkung des intrakraniellen Drucks durch Senkung des zentralvenösen Drucks: Bewertung möglicher Gegenmaßnahmen zum Raumfahrt-assoziierten neuro-okulären Syndrom

2021 ◽  
pp. 1-2
Author(s):  
Sebastian Siebelmann
Keyword(s):  
Intracranial Pressure ◽  
Venous Pressure ◽  
Intrathoracic Pressure ◽  
Free Breathing ◽  
Optic Disc Edema ◽  
Threshold Device ◽  
Inspiratory Resistance ◽  
Minimal Reduction ◽  
Clinical Conditions ◽  
Impedance Threshold Device

Spaceflight-associated neuro-ocular syndrome (SANS) involves unilateral or bilateral optic disc edema, widening of the optic nerve sheath, and posterior globe flattening. Owing to posterior globe flattening, it is hypothesized that microgravity causes a disproportionate change in intracranial pressure (ICP) relative to intraocular pressure. Countermeasures capable of reducing ICP include thigh cuffs and breathing against inspiratory resistance. Owing to the coupling of central venous pressure (CVP) and intracranial pressure, we hypothesized that both ICP and CVP will be reduced during both countermeasures. In four male participants (32 ± 13 yr) who were previously implanted with Ommaya reservoirs for treatment of unrelated clinical conditions, ICP was measured invasively through these ports. Subjects were healthy at the time of testing. CVP was measured invasively by a peripherally inserted central catheter. Participants breathed through an impedance threshold device (ITD, −7 cmH<sub>2</sub>O) to generate negative intrathoracic pressure for 5 min, and subsequently, wore bilateral thigh cuffs inflated to 30 mmHg for 2 min. Breathing through an ITD reduced both CVP (6 ± 2 vs. 3 ± 1 mmHg; <i>P</i> = 0.02) and ICP (16 ± 3 vs. 12 ± 1 mmHg; <i>P</i> = 0.04) compared to baseline, a result that was not observed during the free breathing condition (CVP, 6 ± 2 vs. 6 ± 2 mmHg, <i>P</i> = 0.87; ICP, 15 ± 3 vs. 15 ± 4 mmHg, <i>P</i> = 0.68). Inflation of the thigh cuffs to 30 mmHg caused no meaningful reduction in CVP in all four individuals (5 ± 4 vs. 5 ± 4 mmHg; <i>P</i> = 0.1), coincident with minimal reduction in ICP (15 ± 3 vs. 14 ± 4 mmHg; <i>P =</i>0.13). The application of inspiratory resistance breathing resulted in reductions in both ICP and CVP, likely due to intrathoracic unloading.

scholarly journals Classification of COPD patients and compliance to recommended treatment in Greece according to GOLD 2017 report: the RELICO study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nikolaos Tzanakis ◽  
Nikolaos Koulouris ◽  
Katerina Dimakou ◽  
Konstantinos Gourgoulianis ◽  
Epameinondas Kosmas ◽  
...  
Keyword(s):  
Chronic Obstructive Lung Disease ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Medical Practitioners ◽  
Recommended Treatment ◽  
Copd Patients ◽  
Assessment Approach ◽  
Impaired Lung Function ◽  
Group B

Abstract Background Chronic obstructive pulmonary disease (COPD) is a multifactorial clinical condition, characterized by chronic progressive (or worsening) respiratory symptoms, structural pulmonary abnormalities, and impaired lung function, and is often accompanied by multiple, clinically significant comorbid disorders. In 2017, the Global Initiative for Chronic Obstructive Lung Disease (GOLD) issued a new report on COPD prevention, diagnosis and management, aiming at personalizing the maintenance therapeutic approach of the stable disease, based on the patients’ symptoms and history of exacerbations (ABCD assessment approach). Our objective was to evaluate the implementation of GOLD suggestions in everyday clinical practice in Greece. Methods This was a cross-sectional observational study. Sixty-five different variables (demographics, vital sign measurements, COPD-related medical history parameters, comorbidities, vaccination data, COPD severity based on spirometry measurements, COPD stage based on the ABCD assessment approach, COPD treatments) were collected from 3615 nation-wide COPD patients (Greece). Results The mean age at the time of initial COPD diagnosis was 63.8 (± 10.2). Almost 60% of the subjects were classified into group B, while the remaining patients were falling into groups A (18%) and D (21%), and only a small minority of patients belonged to Group C, according to the ABCD assessment approach. The compliance of respiratory physicians to the GOLD 2017 therapeutic suggestions is problematic, especially when it comes to COPD patients belonging to Group A. Conclusion Our data provide valuable information regarding the demographic and medical profile of COPD patients in Greece, the domains which the revised ABCD assessment approach may show some clinical significance on, and the necessity for medical practitioners dealing with COPD patients to adhere closer to international recommendations for the proper management of the disease.

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