Pulmonary and Ventilatory Effects of Trigger Modulation in Intubated ICU

Author(s):  
Keyword(s):  
1990 ◽  
Vol 78 (1) ◽  
pp. 25-31 ◽  
Author(s):  
T. L. Griffiths ◽  
S. J. Warren ◽  
A. D. B. Chant ◽  
S. T. Holgate

1. We have studied the carotid body contribution to hypoxic respiratory drive, using a hypoxic/hyperoxic switching technique, and the ventilatory response to intravenous infusion of adenosine, a recently described respiratory stimulant, in five patients with bilateral carotid endarterectomy. 2. The contribution made by the carotid bodies to total ventilatory drive during hypoxia varied from 2.5% to 45.9%. 3. The ventilatory response to adenosine infusion varied from a 7% decrease to a 25% increase in ventilation. 4. Those patients with intact hypoxic ventilatory drive showed respiratory stimulation, whereas of the two patients with attenuated chemoreflexes, one showed no stimulation and the other depression of ventilation in response to adenosine infusion. 5. We conclude that adenosine exerts its respiratory stimulant effect via an action on the peripheral chemoreceptors. This may coexist with a centrally mediated respiratory depression that is masked when the carotid bodies are intact.


1997 ◽  
Vol 11 (3) ◽  
pp. 179-183
Author(s):  
Seiji Ishikawa ◽  
Koshi Makita ◽  
Takeshi Sawa ◽  
Hidenori Toyooka ◽  
Keisuke Amaha

1988 ◽  
Vol 44 (6) ◽  
pp. 684-689 ◽  
Author(s):  
James B Skatrud ◽  
Robert L Begle ◽  
Michael A Busch

2004 ◽  
Vol 142 (2-3) ◽  
pp. 127-143 ◽  
Author(s):  
Keely Parisian ◽  
Page Wages ◽  
Ashlee Smith ◽  
John Jarosz ◽  
Amy Hewitt ◽  
...  

Author(s):  
G. M. Cooper ◽  
N. W. Goodman ◽  
C. Prys-Roberts ◽  
L. Jacobson ◽  
G. A. Douglas ◽  
...  
Keyword(s):  

1982 ◽  
Vol 52 (1) ◽  
pp. 131-140 ◽  
Author(s):  
A. J. Berger ◽  
K. A. Cooney

We studied in cats the long-term effects upon resting ventilation and the ventilatory responses to CO2 breathing of destruction of neuronal cell bodies within the ventrolateral nucleus of the tractus solitarius (vl-NTS) by kainic acid (KA) injection (KAI). Animals were studied in the awake state and under pentobarbital anesthesia both before and 8 wk after stereotaxic bilateral microinjection of the vl-NTS with mock cerebrospinal fluid (CSF) (controls, n = 2) or with KA in mock CSF (KAI, n = 5). KA reduced the number of cell bodies within the vl-NTS by 75%. Under anesthesia minute ventilation (VI) was reduced by 49% after KAI, due primarily to a 54% reduction in breathing frequency (f). Four of five anesthetized KAI animals exhibited a significantly reduced (P less than 0.01) ventilatory sensitivity to inspired CO2 under anesthesia. In the awake state some KAI animals had significant changes (P less than 0.01) in ventilation; VI reduced (2 of 5), tidal volume reduced (1 of 5), f reduced (3 of 5), and inspiratory and expiratory times increased (2 of 5). Decreases in the awake ventilatory CO2 sensitivity were not significant within individual KAI animals but were significant (P less than 0.05) when considered as a group. Thus following 75% neuronal loss within the vl-NTS, rhythmic ventilation was sustained during both anesthesia and wakefulness, although f was reduced in the former state. The vl-NTS may function to set most but not all of the ventilatory sensitivity to CO2 during anesthesia and to a lesser extent during wakefulness.


1991 ◽  
Vol 71 (4) ◽  
pp. 1254-1260 ◽  
Author(s):  
L. Daristotle ◽  
M. J. Engwall ◽  
W. Z. Niu ◽  
G. E. Bisgard

We utilized selective carotid body (CB) perfusion while changing inspired O2 fraction in arterial isocapnia to characterize the non-CB chemoreceptor ventilatory response to changes in arterial PO2 (PaO2) in awake goats and to define the effect of varying levels of CB PO2 on this response. Systemic hyperoxia (PaO2 greater than 400 Torr) significantly increased inspired ventilation (VI) and tidal volume (VT) in goats during CB normoxia, and systemic hypoxia (PaO2 = 29 Torr) significantly increased VI and respiratory frequency in these goats. CB hypoxia (CB PO2 = 34 Torr) in systemic normoxia significantly increased VI, VT, and VT/TI; the ventilatory effects of CB hypoxia were not significantly altered by varying systemic PaO2. We conclude that ventilation is stimulated by systemic hypoxia and hyperoxia in CB normoxia and that this ventilatory response to changes in systemic O2 affects the CB O2 response in an additive manner.


1979 ◽  
Vol 57 (3) ◽  
pp. 21P-22P
Author(s):  
P. M. A. Calverley ◽  
R. H. Robson ◽  
P. K. Wraith ◽  
L. F. Prescott ◽  
D. C. Flenley

2008 ◽  
Vol 2008 ◽  
pp. 1-8 ◽  
Author(s):  
María F. Martín-Cancho ◽  
Verónica Crisóstomo ◽  
Federico Soria ◽  
Carmen Calles ◽  
Francisco M. Sánchez-Margallo ◽  
...  

The aim of this study was to compare the hemodynamic and ventilatory effects of prolonged infrarenal aortic cross-clamping in pigs undergoing either laparotomy or laparoscopy. 18 pigs were used for this study. Infrarenal aortic crossclamping was performed for 60 minutes in groups I (laparotomy,n=6) and II (laparoscopy,n=6). Group III (laparoscopy,n=6) underwent a 120-minute long pneumoperitoneum in absence of aortic clamping (sham group). Ventilatory and hemodynamic parameters and renal function were serially determined in all groups. A significant decrease in pH and significant increase inPaCO2were observed in group II, whereas no changes in these parameters were seen in group I and III. All variables returned to values similar to baseline in groups I and II 60 minutes after declamping. A significant increase in renal resistive index was evidenced during laparoscopy, with significantly higher values seen in Group II. Thus a synergic effect of pneumoperitoneum and aortic cross-clamping was seen in this study. These two factors together cause decreased renal perfusion and acidosis, thus negatively affecting the patient's general state during this type of surgery.


1992 ◽  
Vol 72 (5) ◽  
pp. 1717-1723 ◽  
Author(s):  
L. J. Teppema ◽  
F. Rochette ◽  
M. Demedts

In normoxemic cats, acetazolamide (ACTZ) has been shown to cause a large rise in ventilation (VE) but a decrease in peripheral chemoreceptor activity. The relative contribution of the peripheral chemoreceptors to ventilation is higher during hypoxemia than during normoxemia. Therefore, what are the effects of ACTZ during steady-state hypoxemia? The aims of this study in anesthetized cats were 1) to study the effect of ACTZ (50 mg/kg iv) on mean hypoxemic [arterial PO2 (PaO2) approximately 6 kPa] ventilation and 2) to study the effect of ACTZ on the isocapnic hypoxic ventilatory response. In the first study, in six cats with an inspiratory CO2 fraction of 0, ACTZ led to an insignificant rise in mean VE of 119 ml.min-1.kg-1 after 1 h. In five other cats maintained at an inspiratory CO2 fraction of 0.015, ACTZ resulted in a significantly larger response in VE (268 and 373 ml.min-1.kg-1 after 1 and 2 h, respectively). In the second study, before infusion in five cats, an isocapnic fall in mean PaO2 from 13 to 4.7 kPa led to a significant rise in mean VE of 385 ml.min-1.kg-1; 1 h later, the response (at the same mean alveolar PCO2) was reduced to an insignificant rise of 38 ml.min-1.kg-1. Before infusion four other cats showed a significant rise in mean VE of 390 ml.min-1.kg-1 when mean PaO2 was lowered isocapnically from 12.4 to 6.8 kPa; 2 h after infusion, an isocapnic fall in mean PaO2 from 13.9 to 7.2 kPa led to an insignificant rise of 112 ml.min-1.kg-1.(ABSTRACT TRUNCATED AT 250 WORDS)


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