scholarly journals Changes of Physiological parameters of the patient during laparoscopic gynaecology

2021 ◽  
Vol 7 (2) ◽  
pp. 500-503
Author(s):  
Nour Aldeen Jalal ◽  
Tamer Abdulbaki Alshirbaji ◽  
Paul D. Docherty ◽  
Thomas Neumuth ◽  
Bernhard Laufer ◽  
...  
Keyword(s):  
Peak Pressure ◽  
Pearson Correlation ◽  
Lung Compliance ◽  
Physiological Parameters ◽  
Abdominal Pressure ◽  
Hemodynamic Changes ◽  
Intermittent Mandatory Ventilation ◽  
Pressure Controlled Ventilation ◽  
The Mean ◽  
Pressure Controlled

Abstract Analysing and fusing data from the medical devices of different disciplines (anaesthesiology and surgery) inside the operating rooms may promote awareness during surgical procedures. In this work, the changes of physiological parameters of patients undergoing laparoscopic gynaecology procedures were analysed. The statistical relationship between the intra-abdominal pressure and airway peak pressure was evaluated. Patients ventilated with pressure-controlled ventilation (PCV) and intermittent mandatory ventilation (IMV) were included. The results demonstrated that increasing the intra-abdominal pressure (IAP) resulted in increasing the airway peak pressure and decreasing the lung compliance. The Pearson correlation coefficient between the IAP and the airway peak pressure was 0.910 in PCV-patients and 0.952 in IMV-patients when changes of the ventilation settings were considered. Additionally, major hemodynamic changes included alterations in the mean blood pressure (MBP), where the MBP increased after insufflating the abdomen and decreased after abdomen deflation.

scholarly journals Combined Ventilation Of Two Subjects With A Single Mechanical Ventilator Using A New Medical Device: An In Vitro Study

2021 ◽  
Author(s):  
Ignacio Lugones ◽  
Matias Ramos ◽  
Maria Fernanda Biancolini ◽  
Roberto Eduardo Orofino Giambastiani
Keyword(s):  
Tidal Volume ◽  
Lung Compliance ◽  
Positive End Expiratory Pressure ◽  
Controlled Ventilation ◽  
Pressure Controlled Ventilation ◽  
Volume Controlled Ventilation ◽  
Ventilation Modes ◽  
The Subject ◽  
Volume Controlled ◽  
Pressure Controlled

INTRODUCTION: The SARS-CoV2 pandemic has created a sudden lack of ventilators. DuplicAR® is a novel device that allows simultaneous and independent ventilation of two subjects with a single ventilator. The aims of this study are: a) to determine the efficacy of DuplicAR® to independently regulate the peak and positive-end expiratory pressures in each subject, both under pressure-controlled ventilation and volume-controlled ventilation, and b) to determine the ventilation mode in which DuplicAR® presents the best performance and safety. MATERIALS AND METHODS: Two test lungs are connected to a single ventilator using DuplicAR®. Three experimental stages are established: 1) two identical subjects, 2) two subjects with the same weight but different lung compliance, and 3) two subjects with different weight and lung compliance. In each stage, the test lungs are ventilated in two ventilation modes. The positive-end expiratory pressure requirements are increased successively in one of the subjects. The goal is to achieve a tidal volume of 7 ml/kg for each subject in all different stages through manipulation of the ventilator and the DuplicAR® controllers. RESULTS: DuplicAR® allows adequate ventilation of two subjects with different weight and/or lung compliance and/or PEEP requirements. This is achieved by adjusting the total tidal volume for both subjects (in volume-controlled ventilation) or the highest peak pressure needed (in pressure-controlled ventilation) along with the basal positive-end expiratory pressure on the ventilator, and simultaneously manipulating the DuplicAR® controllers to decrease the tidal volume or the peak pressure in the subject that needs less and/or to increase the positive-end expiratory pressure in the subject that needs more. While ventilatory goals can be achieved in any of the ventilation modes, DuplicAR® performs better in pressure-controlled ventilation, as changes experienced in the variables of one subject do not modify the other one. CONCLUSIONS: DuplicAR® is an effective tool to manage the peak inspiratory pressure and the positive-end expiratory pressure independently in two subjects connected to a single ventilator. The driving pressure can be adjusted to meet the requirements of subjects with different weight and lung compliance. Pressure-controlled ventilation has advantages over volume-controlled ventilation and is therefore the recommended ventilation mode.

scholarly journals Evaluation of Occupational Exposure to Heat Stress and Physiological Responses of Workers in the Rolling Industry

2019 ◽  
Vol 12 (1) ◽  
pp. 114-120
Author(s):  
Farough Mohammadian ◽  
Ali Salehi Sahl Abadi ◽  
Omid Giahi ◽  
Jamshid Khoubi ◽  
Amin Allah Zarei ◽  
...  
Keyword(s):  
Heat Stress ◽  
Linear Relationship ◽  
Working Conditions ◽  
Pearson Correlation ◽  
Physiological Responses ◽  
Physiological Parameters ◽  
Rolling Industry ◽  
Significant Difference ◽  
The Mean ◽  
Globe Temperature

Background and Objective: Many indices are used to assess occupational heat stress at the work environments. The aim of this study was to evaluate heat stress using Wet Bulb Globe Temperature (WBGT) index and Discomfort Index (DI), and by measuring physiological responses in the workers of the rolling industry and comparing the appropriateness of these indices for measuring heat stress. Methods: This cross-sectional study was carried out on 90 healthy workers of a rolling industry in eastern Tehran in 2017. Physiological parameters of core body temperature (Tcr) and Heart Rate (HR) were measured during the working shift according to ISO9886 standard. At the same time, environmental variables such as the natural wet temperature (Tnw), dry temperature (Td) and globe temperature (Tg) were measured and recorded at the workstations. Then, the DI and the WBGT indices were calculated using the related formulae. Data were analyzed using SPSS v. 21, t-test and Pearson correlation coefficient. Results: The mean heat stress indices were significantly higher in working conditions than resting conditions, and there was a significant difference between the physiological parameters of Tcr and HR in resting and working conditions (P<0.001). According to the screening criteria of DI, 43.3% of the workers were exposed to the moderate level and 56.7% to the severe level of heat stress. There was a significant difference between the mean WBGT and the Threshold limit values (t= 4.903, P<0.001). Pearson correlation test showed that there was a significant and direct linear relationship between the WBGT and the physiological parameters of Tcr and HR (r=0.317, P=0.002; r=0.434, P<0.001, respectively). The DI index had a significant and direct linear relationship with HR; (r=0.229, P=0.03). Conclusion: The results showed that WBGT is a more appropriate index for evaluating the heat stress of workers in the rolling industry. High heat stress levels at the workstations along with heavy physical activity are health risks for workers in this industry; therefore, interventions must be undertaken to reduce exposure.

scholarly journals Comparison of Pressure-Controlled Ventilation with Volume Guarantee and Volume-Controlled Ventilation mode in Patients under Laparoscopic Surgery: A Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Author(s):  
Xiaoxiao Li ◽  
Xueli Lv ◽  
Zhenfei Jiang ◽  
Xinrui Nie ◽  
Su Liu
Keyword(s):  
Laparoscopic Surgery ◽  
Peak Pressure ◽  
Meta Analysis ◽  
Dynamic Compliance ◽  
Controlled Ventilation ◽  
Pressure Controlled Ventilation ◽  
Co2 Insufflation ◽  
Volume Controlled Ventilation ◽  
Volume Controlled ◽  
Pressure Controlled

Abstract Background：In traditional Volume-Controlled Ventilation (VCV) mode, the creation of pneumoperitoneum during laparoscopic surgery may lead to Ventilator-Associated Lung Injury (VALI). Pressure-Controlled Ventilation with Volume Guarantee (PCV-VG) mode ensures providing adequate oxygen supply to patients while reducing the risk of lung injury. Methods：Eligible randomized clinical trials (RCTs) were searched in Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Sino Med, China National Knowledge Infrastructure (CNKI) and Wan-Fang MED without language restriction up to March 2019. The primary outcome of this meta-analysis was airway peak pressure (Ppeak) at 30, 60 or 90 mins after complete CO2 insufflation. This meta-analysis was followed the recommendations of the PRISMA statement. Results：Finally, 9 articles were included. The Ppeak in the PCV-VG group was lower than that in the VCV group, and the difference was statistically significant at 30mins [Mean Difference (MD)= -3.55, 95% Confidence Interval (CI)= -5.13 to -1.98, I2=83%], 60mins [MD= -5.76, 95%CI= -8.15-3.36, I2=93%], 90 mins [MD= -4.59, 95%CI= -5.43-3.74, I2=30%] after complete CO2 insufflation. Meanwhile, PCV-VG mode could effectively reduce airway mean pressure (Pmean) and improve dynamic compliance (Cdyn) of patients after complete CO2 insufflation in laparoscopic surgery compared to VCV mode. However, no significant difference was found in PetCO2, HR, MAP, PH, PaO2, and PaCO2 between the two-ventilation modes. Conclusions: PCV-VG mode are superior to VCV mode in providing adequate oxygenation at lower airway peak pressure and greater dynamic compliance in patients under laparoscopic surgery.

scholarly journals Towards Understanding Variability in Droughts in Response to Extreme Climate Conditions over the Different Agro-Ecological Zones of Pakistan

2021 ◽  
Vol 13 (12) ◽  
pp. 6910
Author(s):  
Adil Dilawar ◽  
Baozhang Chen ◽  
Arfan Arshad ◽  
Lifeng Guo ◽  
Muhammad Irfan Ehsan ◽  
...  
Keyword(s):  
Pearson Correlation ◽  
Principal Component ◽  
Mitigation Strategies ◽  
Precipitation Extremes ◽  
Climate Mitigation ◽  
Mean Annual Temperature ◽  
Climate Extreme ◽  
Ecological Zones ◽  
The Mean ◽  
Agro Ecological Zones

Here, we provided a comprehensive analysis of long-term drought and climate extreme patterns in the agro ecological zones (AEZs) of Pakistan during 1980–2019. Drought trends were investigated using the standardized precipitation evapotranspiration index (SPEI) at various timescales (SPEI-1, SPEI-3, SPEI-6, and SPEI-12). The results showed that droughts (seasonal and annual) were more persistent and severe in the southern, southwestern, southeastern, and central parts of the region. Drought exacerbated with slopes of −0.02, −0.07, −0.08, −0.01, and −0.02 per year. Drought prevailed in all AEZs in the spring season. The majority of AEZs in Pakistan’s southern, middle, and southwestern regions had experienced substantial warming. The mean annual temperature minimum (Tmin) increased faster than the mean annual temperature maximum (Tmax) in all zones. Precipitation decreased in the southern, northern, central, and southwestern parts of the region. Principal component analysis (PCA) revealed a robust increase in temperature extremes with a variance of 76% and a decrease in precipitation extremes with a variance of 91% in the region. Temperature and precipitation extremes indices had a strong Pearson correlation with drought events. Higher temperatures resulted in extreme drought (dry conditions), while higher precipitation levels resulted in wetting conditions (no drought) in different AEZs. In most AEZs, drought occurrences were more responsive to precipitation. The current findings are helpful for climate mitigation strategies and specific zonal efforts are needed to alleviate the environmental and societal impacts of drought.

scholarly journals Comparison of Volume-Guaranteed or -Targeted, Pressure-Controlled Ventilation with Volume-Controlled Ventilation during Elective Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (6) ◽  
pp. 1276
Author(s):  
Volker Schick ◽  
Fabian Dusse ◽  
Ronny Eckardt ◽  
Steffen Kerkhoff ◽  
Simone Commotio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elective Surgery ◽  
Meta Analysis ◽  
Lung Ventilation ◽  
One Lung Ventilation ◽  
Controlled Ventilation ◽  
Pressure Controlled Ventilation ◽  
Volume Controlled Ventilation ◽  
Volume Controlled ◽  
Pressure Controlled

For perioperative mechanical ventilation under general anesthesia, modern respirators aim at combining the benefits of pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) in modes typically named “volume-guaranteed” or “volume-targeted” pressure-controlled ventilation (PCV-VG). This systematic review and meta-analysis tested the hypothesis that PCV-VG modes of ventilation could be beneficial in terms of improved airway pressures (Ppeak, Pplateau, Pmean), dynamic compliance (Cdyn), or arterial blood gases (PaO2, PaCO2) in adults undergoing elective surgery under general anesthesia. Three major medical electronic databases were searched with predefined search strategies and publications were systematically evaluated according to the Cochrane Review Methods. Continuous variables were tested for mean differences using the inverse variance method and 95% confidence intervals (CI) were calculated. Based on the assumption that intervention effects across studies were not identical, a random effects model was chosen. Assessment for heterogeneity was performed with the χ2 test and the I2 statistic. As primary endpoints, Ppeak, Pplateau, Pmean, Cdyn, PaO2, and PaCO2 were evaluated. Of the 725 publications identified, 17 finally met eligibility criteria, with a total of 929 patients recruited. Under supine two-lung ventilation, PCV-VG resulted in significantly reduced Ppeak (15 studies) and Pplateau (9 studies) as well as higher Cdyn (9 studies), compared with VCV [random effects models; Ppeak: CI −3.26 to −1.47; p < 0.001; I2 = 82%; Pplateau: −3.12 to −0.12; p = 0.03; I2 = 90%; Cdyn: CI 3.42 to 8.65; p < 0.001; I2 = 90%]. For one-lung ventilation (8 studies), PCV-VG allowed for significantly lower Ppeak and higher PaO2 compared with VCV. In Trendelenburg position (5 studies), this effect was significant for Ppeak only. This systematic review and meta-analysis demonstrates that volume-targeting, pressure-controlled ventilation modes may provide benefits with respect to the improved airway dynamics in two- and one-lung ventilation, and improved oxygenation in one-lung ventilation in adults undergoing elective surgery.

scholarly journals Effect of pressure-controlled ventilation-volume guaranteed mode combined with individualized positive end-expiratory pressure on respiratory mechanics, oxygenation and lung injury in patients undergoing laparoscopic surgery in Trendelenburg position

2021 ◽  
Author(s):  
Jianli Li ◽  
Saixian Ma ◽  
Xiujie Chang ◽  
Songxu Ju ◽  
Meng Zhang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Lung Injury ◽  
Respiratory Mechanics ◽  
Lung Mechanics ◽  
Trial Registry ◽  
Positive End Expiratory Pressure ◽  
Clinical Trial Registry ◽  
Trendelenburg Position ◽  
Pressure Controlled Ventilation ◽  
Pressure Controlled

AbstractThe study aimed to investigate the efficacy of PCV-VG combined with individual PEEP during laparoscopic surgery in the Trendelenburg position. 120 patients were randomly divided into four groups: VF group (VCV plus 5cmH2O PEEP), PF group (PCV-VG plus 5cmH2O PEEP), VI group (VCV plus individual PEEP), and PI group (PCV-VG plus individual PEEP). Pmean, Ppeak, Cdyn, PaO2/FiO2, VD/VT, A-aDO2 and Qs/Qt were recorded at T1 (15 min after the induction of anesthesia), T2 (60 min after pneumoperitoneum), and T3 (5 min at the end of anesthesia). The CC16 and IL-6 were measured at T1 and T3. Our results showed that the Pmean was increased in VI and PI group, and the Ppeak was lower in PI group at T2. At T2 and T3, the Cdyn of PI group was higher than that in other groups, and PaO2/FiO2 was increased in PI group compared with VF and VI group. At T2 and T3, A-aDO2 of PI and PF group was reduced than that in other groups. The Qs/Qt was decreased in PI group compared with VF and VI group at T2 and T3. At T2, VD/VT in PI group was decreased than other groups. At T3, the concentration of CC16 in PI group was lower compared with other groups, and IL-6 level of PI group was decreased than that in VF and VI group. In conclusion, the patients who underwent laparoscopic surgery, PCV-VG combined with individual PEEP produced favorable lung mechanics and oxygenation, and thus reducing inflammatory response and lung injury.Clinical Trial registry: chictr.org. identifier: ChiCTR-2100044928

scholarly journals The features of the coastal fronts in the Eastern Guangdong coastal waters during the downwelling-favorable wind period

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chaoyu Yang ◽  
Haibin Ye
Keyword(s):  
Coastal Waters ◽  
Meteorological Data ◽  
Pearson Correlation ◽  
Ocean Model ◽  
Ekman Pumping ◽  
Zonal Distribution ◽  
Factors Affecting ◽  
China Sea ◽  
Hybrid Coordinate Ocean Model ◽  
The Mean

AbstractA coastal front was detected in the eastern Guangdong (EGD) coastal waters during a downwelling-favorable wind period by using the diffuse attenuation coefficient at 490 nm (Kd(490)). Long-term satellite data, meteorological data and hydrographic data collected from 2003 to 2017 were jointly utilized to analyze the environmental factors affecting coastal fronts. The intensities of the coastal fronts were found to be associated with the downwelling intensity. The monthly mean Kd(490) anomalies in shallow coastal waters less than 25 m deep along the EGD coast and the monthly mean Ekman pumping velocities retrieved by the ERA5 dataset were negatively correlated, with a Pearson correlation of − 0.71. The fronts started in October, became weaker and gradually disappeared after January, extending southwestward from the southeastern coast of Guangdong Province to the Wanshan Archipelago in the South China Sea (SCS). The cross-frontal differences in the mean Kd(490) values could reach 3.7 m−1. Noticeable peaks were found in the meridional distribution of the mean Kd(490) values at 22.5°N and 22.2°N and in the zonal distribution of the mean Kd(490) values at 114.7°E and 114.4°E. The peaks tended to narrow as the latitude increased. The average coastal surface currents obtained from the global Hybrid Coordinate Ocean Model (HYCOM) showed that waters with high nutrient and sediment contents in the Fujian and Zhejiang coastal areas in the southern part of the East China Sea could flow into the SCS. The directions and lengths of the fronts were found to be associated with the flow advection.

Lung regional stress and strain as a function of posture and ventilatory mode

2011 ◽  
Vol 110 (5) ◽  
pp. 1374-1383 ◽  
Author(s):  
Gaetano Perchiazzi ◽  
Christian Rylander ◽  
Antonio Vena ◽  
Savino Derosa ◽  
Debora Polieri ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Volume Control ◽  
Dynamic Strain ◽  
Positive Pressure ◽  
Stress And Strain ◽  
Prone Positioning ◽  
Ventilatory Mode ◽  
Controlled Ventilation ◽  
Pressure Controlled Ventilation ◽  
Pressure Controlled

During positive-pressure ventilation parenchymal deformation can be assessed as strain (volume increase above functional residual capacity) in response to stress (transpulmonary pressure). The aim of this study was to explore the relationship between stress and strain on the regional level using computed tomography in anesthetized healthy pigs in two postures and two patterns of breathing. Airway opening and esophageal pressures were used to calculate stress; change of gas content as assessed from computed tomography was used to calculate strain. Static stress-strain curves and dynamic strain-time curves were constructed, the latter during the inspiratory phase of volume and pressure-controlled ventilation, both in supine and prone position. The lung was divided into nondependent, intermediate, dependent, and central regions: their curves were modeled by exponential regression and examined for statistically significant differences. In all the examined regions, there were strong but different exponential relations between stress and strain. During mechanical ventilation, the end-inspiratory strain was higher in the dependent than in the nondependent regions. No differences between volume- and pressure-controlled ventilation were found. However, during volume control ventilation, prone positioning decreased the end-inspiratory strain of dependent regions and increased it in nondependent regions, resulting in reduced strain gradient. Strain is inhomogeneously distributed within the healthy lung. Prone positioning attenuates differences between dependent and nondependent regions. The regional effects of ventilatory mode and body positioning should be further explored in patients with acute lung injury.

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