Restoration of heart and respiration in rats after cooling to a body temperature of 9-10°C

The study was carried out on male Wistar rats anesthetized by urethane. The rats were cooled in water until breathing stopped; after 5 minutes, mechanical ventilation of the lungs was started, which activated the work of the heart. The animals were not removed from the water, the heart rate decreased, the heart stopped at rectal temperature (Tr) 9,6±0,7°, in the esophagus (Te) 11,9±0,6°C. Then the rats were taken out of the water, a saline heating pad (38-40 °C) was applied to the chest area. As a result, the heart temperature increased, the heart rate began to rise; their own respiration appeared at Tp 18,6±0,8° and Te 21,6±0,9°C. It is concluded that the supply of oxygen to the heart and warming contribute to the restoration of its work, and the resumption of its own breathing. Key words: hypothermia, rat, artificial respiration, heart, respiration.

Re-Print- Artificial Respiration in Severe COVID-19 Cases: A Beneficial or Deleterious Treatment

The world over artificial respiration is employed as one of the intensive care treatment measures in severe cases of COVID-19 because of the significant respiratory distress patients develop. Nevertheless, the outcome is poor. Lethality varies from country to country and clinic to clinic between 50% and 90%. So the question arises as to whether the use of oxygen can be a risk factor in the treatment of acute inflammatory diseases in general and of COVID-19 in particular. Oxidative stress is the first and oldest step of cellular defense and starts before the activation of the immune system. This leads to an increase of intracellular oxygen in the mitochondria, followed by an elevated electron flow and the formation of superoxide as well as other reactive oxygen species and reactive nitrogen species. Superoxide reacts with nitric oxide, which is always present in inflammation, forming peroxynitrite, the strongest inducer of oxidative stress. This step induces the activation of nuclear factor kB, followed by the production of proinflammatory cytokines. The elevated levels of inducible nitric oxide synthase keep this cycle running. High amounts of superoxide have to be compensated and catabolized by manganese-superoxide dismutase 2 into hydrogen peroxide and in a second step by catalase into water. When using artificial respiration, these steps are accelerated considerably in the inflamed tissue of the lung, leading to a significant increase of the electron flow as well as an elevation of superoxide, oxidative stress, and water. As SARS-CoV-2 generally induces the production of proteins (and not only those necessary for viral reproduction), the water will remain in the tissue, causing edema and thus a wet lung syndrome associated with a growing oxygen diffusion distance to red blood cells. Ultimately, patients do not suffocate in spite of, but because of, the presence of high levels of oxygen. The limited number of patients who survive this deleterious treatment describe it as having had a sensation of drowning. The reasons will be discussed.

Domestic devices for inhalation anesthesia and artificial respiration

The device UNA-1 for anesthesia with ether, cyclopropane, fluotane, nitrous oxide, trilene - in an open, half-open, half-closed and closed way, in a circulating and pendulum-like system - serves as a universal apparatus for carrying out all types of modern inhalation anesthesia.

Minimum irradiance required to inhibit microbial growth to prevent ventilatorassociated pneumonia by an endotracheal tube equipped with blue LEDs

Artificial respiration is saving lives especially in the COVID-19 pandemic, but it also carries the risk to cause ventilator-associated pneumonia (VAP). VAP is one of the most common and severe nosocomial infections, often leading to death and adding a major economic burden to the healthcare system. To prevent a proliferation of microbial pathogens that cause VAP, an endotracheal tube (ETT) equipped with blue LEDs (LED-ETT) was developed. This blue wavelength exhibits antimicrobial properties but may also harm human tracheal cells at higher irradiances. Therefore, the aim of this study was to find the minimal required irradiance for microbial reduction of 1 log level in 24 h by applying LED-ETTs. A LED-ETT with 48 blue LEDs (450 nm) was fixed in a glass tube, which served as a trachea model. The investigation was carried out with irradiations of 4.2, 6.6 and 13.4 mW/cm² at 37 °C for 24 h. The experiments were performed with Acinetobacter kookii as a surrogate of Acinetobacter baumannii, which is classified as critical by the WHO. Samples of A. kookii suspensions were taken every 4 h during irradiation from the trachea model. Bacteria concentrations were quantified by determining colony forming units (CFU)/ml. A homogeneous irradiance of only 4.2 mW/cm² generated by the blue LEDs, at a LED forward current of 3.125 mA, is sufficient to achieve a 1 log reduction of A. kookii within 24 h. The total irradiation dose within this period was 360 J/cm2. Human cells survive this dose without cellular damage. Previous studies revealed that the pathogen A. baumannii is even more sensitive to blue light than A. kookii. Therefore, blue LED-ETTs are expected to reduce A. baumannii without harming human tracheal cells.

DIAPHRAGMATIC ULTRASONOGRAPHY AS A PREDICTOR OF VENTILATORY WEANING: A SYSTEMATIC REVIEW

Objectives: To review the evidence on Diaphragmatic Ultrasonography as a predictor of success in ventilatory weaning. Methodology:Systematically review using the PICO methodology and keywords: Ultrasound, Ultrasound, Diagnostic imaging, Diaphragm, Weaning, Intensive Care Unit, Artificial Respiration, Mechanical Ventilation, Ventilator Weaning. Published cohort studies were used without language and year restrictions that addressed the use of ultrasound to predict success in weaning and ventilatory extubation. Studies with patients under 18 years of age, case reports, literature reviews, results that do not bring a cutoff value for thickness and diaphragmatic excursion and the definition of failure in the weaning and extubation process were excluded. In addition, the Boolean operators “and” and “or” were used. Results:459 were found, which after exclusion due to duplication and reading of titles and abstract, only 11 were selected by the inclusion criteria. The samples ranged from 34 to 193 individuals. We can evidence that the use of USG to assess the thickness and excursion of the diaphragm in patients undergoing invasive ventilatory support is effective in predicting success in the weaning and extubation process. Conclusion: It is concluded that Diaphragmatic Ultrasonography has great applicability to assess the ability to predict success or failure in removing invasive ventilatory support.

Mini-review on SARS-CoV-2 infection and neurological manifestations: A Perspective

: The Coronavirus, also known as SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus-19), due to its depth impact on acute respiratory dysfunction and mortality, has thrown the world into chaos with its splendid rate of transmission. Recent research findings suggest that the loss of involuntary breathing control in the brainstem, which leads to death, is a clear indicator of neurological involvement.The nose to brain entry is the promising gateway of SARS-CoV-2 to reach the brain via systemic circulatory distribution subsequent infection of the lung. The loss of involuntary control of breathing is a result of an active gateway of systemic blood circulation through the lungs into the brain. Early neurological symptoms like loss of smell, convulsions, and ataxia are the clues of neurological involvement and central nervous system entry of SARS-CoV-2 that further become fatal, life-threatening and require artificial respiration and emergency admissions. As per studies investigated on Wuhan hospitalized patients of SARS-CoV-2, the involvement of SARS-CoV-2 in the central nervous system (CNS) has three major gateways: Direct involvement into CNS includes headache, ataxia, dizziness, altered or impaired consciousness, acute stroke or seizures; peripheral involvement includes impaired taste, smell, vision and altered nociception; and skeletal muscle impairment like skeletal muscle disorders, acute paralysis in a particular area of the body. In the previous era, most studied and researched viruses were beta coronavirus and mouse hepatitis virus, which were studied for acute and chronic encephalitis and multiple sclerosis (MS). Although the early symptoms of SARS-CoV are respiratory pathogenesis, the differential diagnosis should always be considered for neurological perspective to stop mortalities.

Minimally invasive surgery for sternal and bilateral rib fractures

Sternal bone fractures with bilateral multiple rib fractures cause serious instability of the anterior chest wall, and prolonged mechanical ventilation may be required. A 45-year-old man was injured in a motor vehicle collision. He suffered from a bilateral flail chest injury accompanied by a transverse sternal fracture. Minimally invasive surgical stabilisation of the anterior chest wall was performed using two bars as per the Nuss procedure. Two days after surgery, he was extubated from artificial respiration and was ultimately discharged without any complications.

Modeling of pressure–volume controlled artificial respiration with local derivatives

We attempt to motivate utilization of some local derivatives of arbitrary orders in clinical medicine. For this purpose, we provide two efficient solution methods for various problems that occur in nature by employing the local proportional derivative defined by the proportional derivative (PD) controller. Under some necessary assumptions, a detailed exposition of the instantaneous volume in a lung is furnished by conformable derivative and such modified conformable derivatives as truncated M-derivative and proportional derivative. Moreover, we wish to investigate the performance of the above-mentioned operators in applications by plotting several graphs of the governing equations.

The Impact of ABO Blood Grouping on COVID-19 Vulnerability and Seriousness: A Retrospective Cross-Sectional Controlled Study among the Arab Community

Background and Objectives: Studies have noted that some ABO blood types are more susceptible to COVID-19 virus infection. This study aimed to further confirm the relationship between different blood groups on the vulnerability, symptoms, cure period, and severity among COVID-19 recovered patients. Subjects and Methods: This cross-sectional study approached the participants from the Arab community via social media (mainly Facebook and WhatsApp). The data were collected through two Google Form questionnaires, one for COVID-19 recovered patients (COVID-19 group, n = 726), and the other for the healthy people (Control group, n = 707). Results: The subjects with blood group O were the least likely to be infected with the COVID-19 virus, while those with blood group A were not likely to be the most susceptible. There were significant differences among different ABO blood groups regarding the distribution of oxygen saturation percentage, myalgia, and recovery time after COVID-19 infection (p < 0.01, 0.01, and 0.05, respectively). The blood group A showed the highest percentage of patients who experienced an oxygen saturation range of 90–100%, whereas the blood group O showed the highest percentage of patients who experienced an oxygen saturation range of 70–80%. The blood group A showed the lowest percentage of patients who required artificial respiration, whereas the blood group O showed the highest percentage of patients who required artificial respiration. The blood group B showed the lowest percentage of patients who experienced myalgia and exhibited the lowest percentage of patients who needed 3 weeks or more to recover. Conclusion: The people of blood group O may be the least likely to be infected with COVID-19, however, they may be the more in need of treatment in hospital and artificial respiration compared to the other blood groups.