scholarly journals Impact of therapeutic thoracentesis and pleural pressure changes on breathing pattern, dyspnea, lung function and arterial blood gases

Author(s):  
Monika Zielinska-Krawczyk ◽  
Anna M. Stecka ◽  
Elzbieta M. Grabczak ◽  
Marcin Michnikowski ◽  
Krzysztof Zieliński ◽  
...  
PEDIATRICS ◽  
1977 ◽  
Vol 59 (6) ◽  
pp. 1012-1018
Author(s):  
Daniel C. Shannon ◽  
I. David Todres ◽  
Fergus M. B. Moylan

Arterial blood gases and regional lung function, measured with a 133xenon technique, were used to evaluate the physiological defects and follow the natural history of 16 infants with lobar hyperinflation ("emphysema"). Hypoxemia was due to V/Q inequality at rest. Worsening of hypoxemia (mean PaO2 Δ -26 mm Hg) with crying was due to shunting as a consequence of cessation of ventilation in the involved lobe. Surgery was necessary in three patients. Two deaths were caused by bronchopulmonary dysplasia after respiratory distress syndrome (RDS). In 12 of 14 infants, lung function was normal between the ages of 5 days and 1 year.


CHEST Journal ◽  
1997 ◽  
Vol 112 (6) ◽  
pp. 1466-1473 ◽  
Author(s):  
Michele Vitacca ◽  
Giuseppe Natalini ◽  
Sergio Cavaliere ◽  
Enrico Clini ◽  
Pierfranco Foccoli ◽  
...  

2009 ◽  
Vol 106 (2) ◽  
pp. 605-619 ◽  
Author(s):  
K. L. Krause ◽  
H. V. Forster ◽  
T. Kiner ◽  
S. E. Davis ◽  
J. M. Bonis ◽  
...  

Abrupt neurotoxic destruction of >70% of the pre-Bötzinger complex (preBötzC) in awake goats results in respiratory and cardiac failure (Wenninger JM, Pan LG, Klum L, Leekley T, Bastastic J, Hodges MR, Feroah TR, Davis S, Forster HV. J Appl Physiol 97: 1629–1636, 2004). However, in reduced preparations, rhythmic respiratory activity has been found in other areas of the brain stem (Huang Q, St. John WM. J Appl Physiol 64: 1405–1411, 1988; Janczewski WA, Feldman JL. J Physiol 570: 407–420, 2006; Lieske SP, Thoby-Brisson M, Telgkamo P, Ramierz JM. Nature Neurosci 3: 600–607, 2000; St. John WM, Bledsoe TA. J Appl Physiol 59: 684–690, 1985); thus we hypothesized that, when the preBötzC is destroyed incrementally over weeks, time-dependent plasticity within the respiratory network will result in a respiratory rhythm capable of maintaining normal blood gases. Microtubules were bilaterally implanted into the presumed preBötzC of seven goats. After recovery from surgery, studies were completed to establish baseline values for respiratory parameters. At weekly intervals, increasing volumes (in order 0.5, 1, 5, and 10 μl) of ibotenic acid (IA; 50 mM) were then injected into the preBötzC. All IA injections resulted in an acute tachypnea and dysrhythmia featuring augmented breaths, apneas, and increased breath-to-breath variation in breathing. In studies at night, apneas were nearly all central and occurred in the awake state. Breath-to-breath variation in breathing was greater ( P < 0.05) during wakefulness than during non-rapid eye movement sleep. However, one week after the final IA injection, the breathing pattern, breath-to-breath variation, and arterial blood gases and pH were unchanged from baseline, but there was a 20% decrease in respiratory frequency (f) and CO2 sensitivity ( P < 0.05), as well as a 40% decrease in the ventilatory response to hypoxia ( P < 0.001). In subsequent histological analysis of the presumed preBötzC region of lesioned goats, it was determined that there was a 90 and 92% reduction from control goats in total and neurokinin-1 receptor neurons, respectively. Therefore, it was concluded that 1) the dysrhythmic effects on breathing are state dependent; and 2) after incremental, near total destruction of the presumed preBötzC region, time-dependent plasticity within the respiratory network provides a rhythm capable of sustaining normal arterial blood gases.


1977 ◽  
Vol 68 (1) ◽  
pp. 99-107
Author(s):  
R. G. Boutilier ◽  
D. P. Toews

1. As Bufo marinus became progressively hypoxic over a period of 90 min, there was a rise in arterial pH, presumably brought about by hyperventilation. The alkalosis gradually disappeared when oxygen levels became very low. It is suggested that this is the result of a respiratory or a metabolic pH adjustment, or both. 2. Hypoxic animals developed a characteristic breathing pattern in which discrete periods of lung ventilations alternated with buccal oscillations or respiratory pauses. 3. A pronounced bradycardia was associated with the concomitant decline of inspired and arterial PO2. 4. Although respiratory rates were greater than normal resting values in the initial stages of post-hypoxia, the pre-exposure breathing pattern was quickly restored. Following recovery from bradycardia (60 min), the breathing rates, arterial blood gases and pHa returned to normal within 30 min.


2020 ◽  
Vol 8 (S1) ◽  
Author(s):  
Chiara Robba ◽  
Dorota Siwicka-Gieroba ◽  
Andras Sikter ◽  
Denise Battaglini ◽  
Wojciech Dąbrowski ◽  
...  

AbstractPost cardiac arrest syndrome is associated with high morbidity and mortality, which is related not only to a poor neurological outcome but also to respiratory and cardiovascular dysfunctions. The control of gas exchange, and in particular oxygenation and carbon dioxide levels, is fundamental in mechanically ventilated patients after resuscitation, as arterial blood gases derangement might have important effects on the cerebral blood flow and systemic physiology.In particular, the pathophysiological role of carbon dioxide (CO2) levels is strongly underestimated, as its alterations quickly affect also the changes of intracellular pH, and consequently influence metabolic energy and oxygen demand. Hypo/hypercapnia, as well as mechanical ventilation during and after resuscitation, can affect CO2 levels and trigger a dangerous pathophysiological vicious circle related to the relationship between pH, cellular demand, and catecholamine levels. The developing hypocapnia can nullify the beneficial effects of the hypothermia. The aim of this review was to describe the pathophysiology and clinical consequences of arterial blood gases and pH after cardiac arrest.According to our findings, the optimal ventilator strategies in post cardiac arrest patients are not fully understood, and oxygen and carbon dioxide targets should take in consideration a complex pattern of pathophysiological factors. Further studies are warranted to define the optimal settings of mechanical ventilation in patients after cardiac arrest.


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