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At least 811 records · Page 45Linked to original sources
PubMed1980

Gastric acid secretion (GAS) and hiatal hernia. II. Relationship between GAS and clinical results after hernia repair.

The indications for surgical procedures reducing gastric acid secretion in patients with hiatal hernia and symptomatic gastroesophageal reflux remain unclear. In a study of the postoperative results in 40 patients operated upon with modified Husfeldt hernia repair only, the results were assessed in relation to BAO and PAO. No correlation was found between the clinical results and BAO or PAO in patients in whom the reflux was successfully corrected by the procedure. It is concluded that gastric acid-reducing procedures are not indicated in patients in whom correction of reflux is anticipated.

Esophagus↗
PubMed1995

[Gas sterilization with gas hydrogen peroxide: a new technology in the pharmaceutical industry].

This article shows the bactericidal capacity of hydrogen peroxide vapor, particularly if used through VHP vaporizer (Vaporizer Hydrogen Peroxide) which was recently developed and used in the pharmaceutical sector. After a short description technologies and of the characteristics of the chemical agents used in these technics, will illustrate the machine (VHP), its functioning and its possible application fields. The review ends with the illustration of a number of experiments, tests and validation trials which stand out from technical point of view.

Drug Industry↗
PubMed1996

[Results of continuous gas measurements rabbit housing by using multi-gas monitoring].

Investigations of slatted floor keeping of rabbits in an air conditioned chamber with multigas monitoring over a period of more than two month have shown that the average values per week were on a low level between 575 and 685 ppm (carbon dioxide), 3.4 and 5.6 ppm (ammonia) resp. Concentration of ammonia reached in maximum 12.3 ppm for a short time. Nitrous oxide concentration was measured on a global value (253 up to 317 ppb). A slight tendency of increasing CO2 and NH3 values with the begin of light period--obviously related to increased locomotoric activity--approximately was observed. In slatted floor keeping calculated emission of ammonia was very low (0.23 gram per 500 kg an hour).

Air Conditioning↗
PubMed2002

Fundamental structural aspects and features in the bioengineering of the gas exchangers: comparative perspectives.

Over its life, an organism's survival and success are determined by the inventory of vital adaptations that its progenitors have creatively appropriated, devised and harnessed along the evolutionary pathway. Such conserved attributes provide the armamentarium necessary for withstanding the adverse effects of natural selection. Refinements of the designs of the respiratory organs have been critical for survival and phylogenetic advancement of animal life. Gas exchangers have changed in direct response to the respiratory needs of whole organisms in different environmental states and conditions. Nowhere else is the dictum that in biology 'there are no rules but only necessities' more manifest than in the evolutionary biology of the gas exchangers. The constructions have been continually fashioned and refined to meet specific needs. Solutions to common respiratory needs have been typified by profound structural convergence. Over the evolutionary continuum, as shifts in environmental situations occurred, infinitely many designs should theoretically have emerged. Moreover, without specific selective pressures and preference for certain designs, considering that there are only two naturally occurring respirable fluid media (air and water), air-lungs, water-lungs, air-gills and water-gills would have formed to similar extents. Factors such as body size, phylogenetic level of development, respiratory medium utilized and habitats occupied have permutatively prescribed the design of the gas exchangers. The construction of the modern gas exchangers has eventuated through painstaking cost-benefit analysis. Trade-offs and compromises have decreed only a limited number of structurally feasible and functionally competent outcomes. The morphological congruity (analogy) of the gas exchangers indicates that similar selective pressures have compelled the designs. Solutions to metabolic demands for molecular O2 have only differed in details. Passive physical diffusion, for example, is the ubiquitous method of transfer of O2 across biological tissues. Gills, evaginated gas exchangers, were the primordial respiratory organs that evolved for water breathing, whereas lungs (invaginated gas exchangers) developed for terrestrial (air) breathing. Transitional (= bimodal = amphibious) breathing has evolved in animals with specialized organs that extract O2 from both water and air. Lungs are tidally (= bidirectionally) ventilated, while gills are unidirectionally ventilated, a feature that allows the highly efficient counter-current disposition between blood and water. Since animals occupy inconstant environmental milieus and their metabolic states vary, gas exchangers are designed to operate optimally across a spectrum of conditions that range from resting to exercise and even under hypoxia. Inbuilt structural and functional flexibility provides the requisite safety factors that allow adjustments to modest pressures. The fundamental structural features that determine the respiratory function of a gas exchanger are respiratory surface area, thickness of the blood-water/gas (tissue) barrier and volume of the pulmonary capillary blood. The diffusing capacity of a gas exchanger correlates directly with the surface area and inversely with the thickness of the blood-water/gas (tissue) barrier. An extensive surface area is generated in gills by extensive stratification of the gas exchanger and in lungs by profuse internal subdivision. Compartmentalization yields small terminal gas exchange compartments that compel greater commitment of energy to ventilate. The surfactant, a phospholipid lining, reduces the forces of surface tension at the air-water interface. This attenuates the propensity of physical collapse of the minute gas exchange units and minimizes the cost of ventilation. The surfactant characterizes all the gas exchangers derived from the piscine air bladder. In the lower air-breathing vertebrates, such as the lungfishes (Dipnoi), amphibians and certain reptiles, the pneumocytes are not differentiated into type I and II cells, as is the case in the lungs of the higher vertebrates-birds and mammals. It is envisaged that in endotherms, the overall numerical density of the pneumocytes and hence the O2 consumption of the gas exchangers may be reduced and a thin blood-gas (tissue) barrier generated, factors that enhance respiratory efficiency. The thin blood-gas (tissue) barriers, for example, those of the mammalian (in the respiratory sections of the interalveolar septum) and avian lungs, consist of an epithelial cell and an endothelial cell with a common basement membrane. An interstitial space occurs in the blood-air/water (tissue) barriers of the gas exchangers of fish gills and lungs of lungfishes, amphibians, reptiles and in the supportive parts of the interalveolar septum of the mammalian lung. Collagen, elastic tissue, nerves, lymphatic vessels and smooth muscle elements are found in the interstitial space. The thickness of the blood-air/water (tissue) barrier allometrically changes very little. This suggests that the thicknesses of the blood-water/air (tissue) barriers have been optimized. The presentation and exposure to the gas exchange media (water/air to blood), features dictated by the geometry and arrangements of the structural components of the gas exchangers, contribute greatly to respiratory efficiency. The countercurrent presentation between water and blood in fish gills is the most efficient design in the evolved gas exchangers: It was imperative for survival in water, a medium that contains relatively less O2 and is more expensive to breathe. In the evolved vertebrate gas exchangers, the exposure of blood to air is best manifested in the diffuse design of the avian lung, where the capillary blood is literally suspended in a three-dimensional air space, the blood being exposed to air virtually across the entire blood-gas (tissue) barrier. A double capillary design occurs in the lungs of amphibians and generally those of reptiles, whereas a single capillary design commonly occurs in those of adult mammals. The capillary loading (the ratio of the volume of the capillary blood to the surface area across which blood is exposed to air) in lungs with a double capillary arrangement is high and manifests a poor design. On the other hand, the low capillary loading that characterizes the single capillary system indicates better exposure of blood to air and greater respiratory capacity. Fractal geometry features in the construction of the gas exchangers. The highly versatile design allows the gas exchangers to function optimally under different conditions and circumstances and to maintain congruent morphologies over a wide range of body size, shape and metabolic capacities. At the gas exchange level, sheet-flow design preponderates in the evolved gas exchangers; blood is efficiently exposed to the external respiratory medium. The respiratory capacity of a gas exchanger is comprehensively granted by refinements of structural features and functional processes. Modelling, mathematical integration of structural and functional parameters, provides a holistic view of the essence of the design of a gas exchanger.

Animals↗
PubMed1996

Perfluorocarbon-associated gas exchange in normal and acid-injured large sheep.

OBJECTIVES: We hypothesized that a) perfluorocarbon-associated gas exchange could be accomplished in normal large sheep; b) the determinants of gas exchange would be similar during perfluorocarbon-associated gas exchange and conventional gas ventilation; c)in large animals with lung injury, perfluorocarbon-associated gas exchange could be used to enhance gas exchange without adverse effects on hemodynamics; and d) the large animal with lung injury could be supported with an FIO2 of <1.0 during perfluorocarbon-associated gas exchange. DESIGN: Prospective, observational animal study and prospective randomized, controlled animal study. SETTING: An animal laboratory in a university setting. SUBJECTS: Thirty adult ewes. MEASUREMENT AND MAIN RESULTS: Five normal ewes (61.0 +/- 4.0 kg) underwent perfluorocarbon-associated gas exchange to ascertain the effects of tidal volume, end-inspiratory pressure, and positive end-expiratory pressure (PEEP) on oxygenation. Respiratory rate, tidal volume, and minute ventilation were studied to determine their effects on CO2 clearance. Sheep, weighing 58.9 +/- 8.3 kg, had lung injury induced by instilling 2 mL/kg of 0.05 Normal hydrochloric acid into the trachea. Five minutes after injury, PEEP was increased to 10 cm H2O. Ten minutes after injury, sheep with Pao2 values of <100 torr (<13.3 kPa) were randomized to continue gas ventilation (control, n=9) or to institute perfluorocarbon-associated gas exchange (n=9) by instilling 1.6 L of unoxygenated perflubron into the trachea and resuming gas ventilation. Blood gas and hemodynamic measurements were obtained throughout the 4-hr study. Both tidal volume and end-inspiratory pressure influenced oxygenation in normal sheep during perfluorocarbon-associated gas exchange. Minute ventilation determined CO2 clearance during perfluorocarbon-associated gas exchange in normal sheep. After acid aspiration lung injury, perfluorocarbon-associated gas exchange increased PaO2 and reduced intrapulmonary shunt fraction. Hypoxia and intrapulmonary shunting were unabated after injury in control animals. Hemodynamics were not influenced by the institution of perfluorocarbon-associated gas exchange. CONCLUSIONS: Tidal volume and end-inspiratory pressure directly influence oxygenation during perfluorocarbon-associated gas exchange in large animals. Minute ventilation influences clearance of CO2. In adult sheep with acid aspiration lung injury, perfluorocarbon-associated gas exchange at an FIO2 of <1.0 supports oxygenation and improves intrapulmonary shunting, without adverse hemodynamic effects, when compared with conventional gas ventilation.

Analysis of Variance↗
PubMed1994

A system for monitoring the delivery of ventilating gas to the oxygenator during cardiopulmonary bypass.

Present methods for monitoring delivery of ventilating gas to the oxygenator during cardiopulmonary bypass have not been critically examined despite the occurrence of catastrophic gas flow disturbances. Currently, a flowmeter regulates the delivery of gas into the proximal portion of the gas circuit, and at these institutions, an oxygen (O2) analyzer positioned downstream of the flowmeter monitors oxygen concentration of the flowing gas. However, these devices are incapable of accurately analyzing the flow of gas into the oxygenator housing. In response to this deficiency, the authors developed and evaluated, in a laboratory model, an alternative system for monitoring ventilating gas flow. The system measured quantity of gas flow by pneumotachography, and oxygen concentration of the ventilating gas with a polarographic oxygen analyzer at the gas inlet port of the oxygenator. Five types of disturbances in gas delivery, which have been documented in the medical literature, were created in a laboratory model: (1) O2 concentration variation, (2 and 3) oxygenator gas line disconnection at each of two locations in the gas circuit, (4) a decrease in gas flow to the oxygenator secondary to a leak in the gas circuit, and (5) excess gas flow to the oxygenator. The capability of currently used monitoring devices (flowmeter and "passive" O2 analyzer) with the proposed monitoring system (pneumotachograph and "aspirating" O2 analyzer) was compared for detecting these abnormalities in gas delivery. The currently used devices were only able to satisfactorily detect a change in oxygen concentration. In contrast, the proposed system was able to rapidly detect all types of gas delivery disturbance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1981

Breath-by-breath measurement of true alveolar gas exchange.

A method has been developed for on-line breath-by-breath calculation of alveolar gas exchange by correcting the gas exchange measured at the mouth for changes in lung gas stores. The corrections are applied to the total lung gas exchange, which is found by directly subtracting expired from inspired volume of each gas. Corrections are made for both breath-to-breath changes in lung volumes and changes in alveolar gas concentrations. The lung volume correction term has the effect of reducing the large error sensitivity of O2 exchange that has, in the past, resulted from direct determination by total lung gas exchange. Error each gas. Corrections are made for both breath-to-breath changes in lung volumes and changes in alveolar gas concentrations. The lung volume correction term has the effect of reducing the large error sensitivity of O2 exchange that has, in the past, resulted from direct determination by total lung gas exchange. Error each gas. Corrections are made for both breath-to-breath changes in lung volumes and changes in alveolar gas concentrations. The lung volume correction term has the effect of reducing the large error sensitivity of O2 exchange that has, in the past, resulted from direct determination by total lung gas exchange. Error sensitivity analysis shows that the effect of inaccuracies due to errors in measuring gas flow or gas concentrations are similar in magnitude to those in the open-circuit method that has traditionally been used. The algorithm for alveolar gas exchange has been implemented in a computer program for on-line respiratory analysis alongside the open-circuit calculation of gas exchange at the mouth that has been used in out laboratory. By use of several experimental studies, it is shown that there are very apparent breath-to-breath differences between the gas exchange measured by the two methods. During metabolic and respiratory transients, these differences often have significant influence on interpretation of the underlying physiology.

Breath Tests↗
PubMed1996

Evaluation of gas exchange, pulmonary compliance, and lung injury during total and partial liquid ventilation in the acute respiratory distress syndrome.

OBJECTIVE: To investigate whether pulmonary compliance and gas exchange will be sustained during "total" perfluorocarbon liquid ventilation followed by "partial" perfluorocarbon liquid ventilation when compared with gas ventilation in the setting of the acute respiratory distress syndrome (ARDS). STUDY DESIGN: A prospective, controlled, laboratory study. SETTING: A university research laboratory. SUBJECTS: Ten sheep, weighing 12.7 to 25.0 kg. INTERVENTIONS: Lung injury was induced in ten young sheep, utilizing a right atrial injection of 0.07 mL/kg of oleic acid followed by saline pulmonary lavage. Bijugular venovenous extracorporeal life support access, a pulmonary artery catheter, and a carotid artery catheter were placed. When the alveolar-arterial O2 gradient was >/= 600 torr and PaO2 </= 50 torr (</= 6.7 kPa) with an FIO2 of 1.0, extracorporeal life support was instituted. For the first 30 mins on extracorporeal life support, all animals were ventilated with gas. Animals were then ventilated with equal tidal volumes of 15 mL/kg during gas ventilation (n=5) over the ensuing 2.5 hrs, or with total liquid ventilation for 1 hr, followed by partial liquid ventilation for 1.5 hrs (total/partial liquid ventilation, n=5). MEASUREMENTS AND MAIN RESULTS: An increase in physiologic shunt (gas ventilation = 69 +/- 11%, total/partial liquid ventilation = 71 +/- 3%) and a decrease in static total pulmonary compliance measured at 20 mL/kg inflation volume (gas ventilation = O.48 +/- 0.03 mL/cm H2O/kg, total/partial liquid ventilation = 0.50 +/- 0.17 mL/cm H2O/kg) were observed in both groups with induction of lung injury. Physiologic shunt was significantly reduced during total and partial liquid ventilation when compared with physiologic shunt observed in the gas ventilation animals (gas ventilation = 93 +/- 8%, total liquid ventilation = 45 +/- 11%, p<.001; gas ventilation = 95 +/- 3%, partial liquid ventilation = 61 +/- 12%, p<.001), while static compliance was significantly increased in the total, but not the partial liquid ventilated animals when compared with the gas ventilated group (gas ventilation = 0.43 +/- 0.03 mL/cm H2O/kg, total liquid ventilation = 1.13 +/- 18 mL/cm H2O/kg, p <.001; gas ventilation = 0.41 +/- 0.02 mL/cm H2O/kg, partial liquid ventilation = 0.47 +/- 0.08, p = .151). In addition, the extracorporeal life support flow rate required to maintain adequate oxygenation was significantly lower in the total/partial liquid ventilation group when compared with that of the gas ventilation group (gas ventilation = 89 +/- 7 mL/kg/min, total liquid ventilation = 22 +/- 10 mL/kg/min, p <.001; gas ventilation = 91 +/- 12 mL/kg/min, partial liquid ventilation = 41 +/- 11 mL/kg/min, p < .001). Lung biopsy light microscopy demonstrated a marked reduction in alveolar hemorrhage, lung fluid accumulation, and inflammatory infiltration in the total/partial liquid ventilation animals when compared with the gas ventilation animals. CONCLUSIONS: In a model of severe ARDS, pulmonary gas exchange is improved during total followed by partial liquid ventilation. Pulmonary compliance is improved during total, but not during partial liquid ventilation. Total followed by partial liquid ventilation was associated with a reduction in alveolar hemorrhage, pulmonary edema, and lung inflammatory infiltration.

Animals↗