scholarly journals Improving lung aeration in ventilated newborn preterm rabbits with a partially aerated lung

2020 ◽  
Vol 129 (4) ◽  
pp. 891-900
Author(s):  
Emily J. Pryor ◽  
Marcus J. Kitchen ◽  
Michelle K. Croughan ◽  
Kelly J. Crossley ◽  
Megan J. Wallace ◽  
...  
Keyword(s):  
Phase Contrast ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Lung Mechanics ◽  
Positive Pressure ◽  
X Ray ◽  
Lung Aeration ◽  
X Ray Imaging ◽  
Optimal Approach ◽  
Preterm Newborns

Preterm newborns commonly receive intermittent positive pressure ventilation (iPPV) at birth, but the optimal approach that facilitates uniform lung aeration is unknown, particularly in a partially aerated lung. Using phase contrast X-ray imaging, we showed that combining a long inflation time (1.0 s) with surfactant improved lung mechanics and aeration in the immediate newborn period. The current clinical practice of using short inflation times during iPPV might be suboptimal, and a different approach is needed.

Management of an unusual presentation of foreign body aspiration

1992 ◽  
Vol 106 (8) ◽  
pp. 751-752 ◽  
Author(s):  
Hassan H. Ramadan ◽  
Nicolas Bu-Saba ◽  
Anis Baraka ◽  
Salman Mroueh
Keyword(s):  
Foreign Body ◽  
Subcutaneous Emphysema ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Foreign Body Aspiration ◽  
Positive Pressure ◽  
Review Of The Literature ◽  
X Ray ◽  
Post Surgery ◽  
Chest X Ray

AbstractForeign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

IMAGING LUNG AERATION AND LUNG LIQUID CLEARANCE AT BIRTH USING PHASE CONTRAST X-RAY IMAGING

2009 ◽  
Vol 36 (1) ◽  
pp. 117-125 ◽  
Author(s):  
Stuart B Hooper ◽  
Marcus J Kitchen ◽  
Melissa LL Siew ◽  
Robert A Lewis ◽  
Andreas Fouras ◽  
...  
Keyword(s):  
Phase Contrast ◽  
X Ray ◽  
Lung Aeration ◽  
X Ray Imaging ◽  
Lung Liquid

scholarly journals Elevated airway liquid volumes at birth: a potential cause of transient tachypnea of the newborn

2017 ◽  
Vol 123 (5) ◽  
pp. 1204-1213 ◽  
Author(s):  
Erin V. McGillick ◽  
Katie Lee ◽  
Shigeo Yamaoka ◽  
Arjan B. te Pas ◽  
Kelly J. Crossley ◽  
...  
Keyword(s):  
Respiratory Function ◽  
Phase Contrast ◽  
Structure And Function ◽  
X Ray ◽  
Lung Aeration ◽  
X Ray Imaging ◽  
Lung Structure ◽  
Near Term ◽  
Lung Liquid ◽  
And Function

Excessive liquid in airways and/or distal lung tissue may underpin the respiratory morbidity associated with transient tachypnea of the newborn (TTN). However, its effects on lung aeration and respiratory function following birth are unknown. We investigated the effect of elevated airway liquid volumes on newborn respiratory function. Near-term rabbit kittens (30 days gestation; term ~32 days) were delivered, had their lung liquid-drained, and either had no liquid replaced (control; n = 7) or 30 ml/kg of liquid re-added to the airways [liquid added (LA); n = 7]. Kittens were mechanically ventilated in a plethysmograph. Measures of chest and lung parameters, uniformity of lung aeration, and airway size were analyzed using phase contrast X-ray imaging. The maximum peak inflation pressure required to recruit a tidal volume of 8 ml/kg was significantly greater in LA compared with control kittens (35.0 ± 0.7 vs. 26.8 ± 0.4 cmH2O, P < 0.001). LA kittens required greater time to achieve lung aeration (106 ± 14 vs. 60 ± 6 inflations, P = 0.03) and had expanded chest walls, as evidenced by an increased total chest area (32 ± 9%, P < 0.0001), lung height (17 ± 6%, P = 0.02), and curvature of the diaphragm (19 ± 8%, P = 0.04). LA kittens had lower functional residual capacity during stepwise changes in positive end-expiratory pressures (5, 3, 0, and 5 cmH20). Elevated lung liquid volumes had marked adverse effects on lung structure and function in the immediate neonatal period and reduced the ability of the lung to aerate efficiently. We speculate that elevated airway liquid volumes may underlie the initial morbidity in near-term babies with TTN after birth. NEW & NOTEWORTHY Transient tachypnea of the newborn reduces respiratory function in newborns and is thought to result due to elevated airway liquid volumes following birth. However, the effect of elevated airway liquid volumes on neonatal respiratory function is unknown. Using phase contrast X-ray imaging, we show that elevated airway liquid volumes have adverse effects on lung structure and function in the immediate newborn period, which may underlie the pathology of TTN in near-term babies after birth.

Inspiration regulates the rate and temporal pattern of lung liquid clearance and lung aeration at birth

2009 ◽  
Vol 106 (6) ◽  
pp. 1888-1895 ◽  
Author(s):  
Melissa L. Siew ◽  
Megan J. Wallace ◽  
Marcus J. Kitchen ◽  
Robert A. Lewis ◽  
Andreas Fouras ◽  
...  
Keyword(s):  
Gas Exchange ◽  
Cesarean Section ◽  
Temporal Pattern ◽  
Phase Contrast ◽  
X Ray ◽  
Lung Aeration ◽  
X Ray Imaging ◽  
Residual Capacity ◽  
Near Term ◽  
Lung Liquid

At birth, the initiation of pulmonary gas exchange is dependent on air entry into the lungs, and recent evidence indicates that pressures generated by inspiration may be involved. We have used simultaneous plethysmography and phase-contrast X-ray imaging to investigate the contribution of inspiration and expiratory braking maneuvers (EBMs) to lung aeration and the formation of a functional residual capacity (FRC) after birth. Near-term rabbit pups ( n = 26) were delivered by cesarean section, placed in a water plethysmograph, and imaged during the initiation of spontaneous breathing. Breath-by-breath changes in lung gas volumes were measured using plethysmography and visualized using phase-contrast X-ray imaging. Pups rapidly (1–5 breaths) generate a FRC (16.2 ± 1.2 ml/kg) by inhaling a greater volume than they expire (by 2.9 ± 0.4 ml·kg−1·breath−1 over the first 5 breaths). As a result, 94.8 ± 1.4% of lung aeration occurred during inspiration over multiple breaths. The incidence of EBMs was rare early during lung aeration, with most (>80%) occurring after >80% of max FRC was achieved. Although EBMs were associated with an overall increase in FRC, 34.8 ± 5.3% of EBMs were associated with a decrease in FRC. We conclude that lung aeration is predominantly achieved by inspiratory efforts and that EBMs help to maintain FRC following its formation.

scholarly journals Principles of Different X-ray Phase-Contrast Imaging: A Review

2021 ◽  
Vol 11 (7) ◽  
pp. 2971
Author(s):  
Siwei Tao ◽  
Congxiao He ◽  
Xiang Hao ◽  
Cuifang Kuang ◽  
Xu Liu
Keyword(s):  
Biological Samples ◽  
Phase Contrast ◽  
Recent Progress ◽  
Phase Contrast Imaging ◽  
Contrast Imaging ◽  
X Ray ◽  
X Ray Imaging ◽  
Internal Structures ◽  
X Ray Absorption ◽  
Made In

Numerous advances have been made in X-ray technology in recent years. X-ray imaging plays an important role in the nondestructive exploration of the internal structures of objects. However, the contrast of X-ray absorption images remains low, especially for materials with low atomic numbers, such as biological samples. X-ray phase-contrast images have an intrinsically higher contrast than absorption images. In this review, the principles, milestones, and recent progress of X-ray phase-contrast imaging methods are demonstrated. In addition, prospective applications are presented.

Nasal Intermittent Positive Pressure Ventilation versus Continuous Positive Airway Pressure and Apnea of Prematurity: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Bayane Sabsabi ◽  
Ava Harrison ◽  
Laura Banfield ◽  
Amit Mukerji
Keyword(s):  
Systematic Review ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Primary Outcome ◽  
Positive Pressure Ventilation ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Intermittent Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Apnea Of Prematurity

Objective The study aimed to systematically review and analyze the impact of nasal intermittent positive pressure ventilation (NIPPV) versus continuous positive airway pressure (CPAP) on apnea of prematurity (AOP) in preterm neonates. Study Design In this systematic review and meta-analysis, experimental studies enrolling preterm infants comparing NIPPV (synchronized, nonsynchronized, and bi-level) and CPAP (all types) were searched in multiple databases and screened for the assessment of AOP. Primary outcome was AOP frequency per hour (as defined by authors of included studies). Results Out of 4,980 articles identified, 18 studies were included with eight studies contributing to the primary outcome. All studies had a high risk of bias, with significant heterogeneity in definition and measurement of AOP. There was no difference in AOPs per hour between NIPPV versus CPAP (weighted mean difference = −0.19; 95% confidence interval [CI]: −0.76 to 0.37; eight studies, 456 patients). However, in a post hoc analysis evaluating the presence of any AOP (over varying time periods), the pooled odds ratio (OR) was lower with NIPPV (OR: 0.46; 95% CI: 0.32–0.67; 10 studies, 872 patients). Conclusion NIPPV was not associated with decrease in AOP frequency, although demonstrated lower odds of developing any AOP. However, definite recommendations cannot be made based on the quality of the published evidence. Key Points

scholarly journals Visualization Ability of Phase-Contrast Synchrotron-Based X-Ray Imaging Using an X-Ray Interferometer in Soft Tissue Tumors

2021 ◽  
Vol 20 ◽  
pp. 153303382110101
Author(s):  
Thet-Thet Lwin ◽  
Akio Yoneyama ◽  
Hiroko Maruyama ◽  
Tohoru Takeda
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Spatial Resolution ◽  
Phase Contrast ◽  
Soft Tissue Tumors ◽  
X Ray ◽  
3 Dimensional ◽  
Computed Tomography Images ◽  
X Ray Imaging ◽  
X Ray Computed

Phase-contrast synchrotron-based X-ray imaging using an X-ray interferometer provides high sensitivity and high spatial resolution, and it has the ability to depict the fine morphological structures of biological soft tissues, including tumors. In this study, we quantitatively compared phase-contrast synchrotron-based X-ray computed tomography images and images of histopathological hematoxylin-eosin-stained sections of spontaneously occurring rat testicular tumors that contained different types of cells. The absolute densities measured on the phase-contrast synchrotron-based X-ray computed tomography images correlated well with the densities of the nuclear chromatin in the histological images, thereby demonstrating the ability of phase-contrast synchrotron-based X-ray imaging using an X-ray interferometer to reliably identify the characteristics of cancer cells within solid soft tissue tumors. In addition, 3-dimensional synchrotron-based phase-contrast X-ray computed tomography enables screening for different structures within tumors, such as solid, cystic, and fibrous tissues, and blood clots, from any direction and with a spatial resolution down to 26 μm. Thus, phase-contrast synchrotron-based X-ray imaging using an X-ray interferometer shows potential for being useful in preclinical cancer research by providing the ability to depict the characteristics of tumor cells and by offering 3-dimensional information capabilities.

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