[Gas exchange and ventilation at rest during physical exertion in free and artificially impeded respiration. II. Obstruction of inspiratory respiration].
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Humans↗
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Results for “RESPIRATION, ARTIFICIAL”
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[Automatic artificial pulmonary respiration in external respiration disorders of newborn infants].
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Humans↗
[Artificial tissue respiration with redox system from vital dyes and its application in therapeutics].
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Cell Respiration↗
[Artificial tissue respiration with redox systems from vital dyes and its application in therapeutics].
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Cell Respiration↗
[New artificial lung respiration apparatuses for anesthesia and design of gas flow commutators].
The principles of action of new anesthetic devices and apparatuses for mechanical lung ventilation (MLV) including alternate-flow inhalation generators designed in recent time in VNIIMP-VITA, Ltd. are considered. According to the type of drive, these apparatuses fall into groups of devices with pneumatic drive (Diana) and electric drive (Elan). New technological approaches to design of gas flow commutators for pneumatic drive and respiratory contours of MLV apparatuses are discussed. The design of a new source of stable pneumatic signals providing reliable operation of the control valves of the inhalation and exhalation contours of electrically driven apparatuses. This source allows necessary MLV modes to be implemented during anesthesia.
Anesthesiology↗
[Respiration of artificially ventilated infants: degree of dependence on the respirator according to sleep stage].
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Acute Disease↗
DROWNING: ITS MECHANISM AND TREATMENT.
Pertinent experimental work and literature relative to drowning are reviewed. The different concepts of the mechanism of drowning are dealt with and the view is emphasized that asphyxia is complicated by hemodilution in fresh water and by hemo-concentration in salt water, with resulting electrolyte imbalance. A short description is given of the sequence of events in drowning. Lethal heart failure has occurred as early as two minutes after total submersion. Treatment consists of artificial respiration, cardiac massage, correction of the electrolyte imbalance and continued observation for complications. The danger from hyperventilation in underwater swimming, of cases of so-called "secondary" drowning and the use of diatoms as a proof of drowning are mentioned.
Asphyxia↗
[The ABCD of resuscitation].
Reanimation is divided into two phases. The first phase, primary ABCD, consists of verifying the patient's responsiveness, activating the emergency system, requesting a defibrillator, establishing and maintaining the airway's patency, checking respiration, initiating artificial respiration when necessary, checking the circulation, in the absence of a pulse beginning with chest compressions, and identifying the heart rhythm on the monitor. In particular, one should determine if the rhythm is ventricular fibrillation. Ventricular fibrillation is the most frequent cause of sudden cardiac arrest, estimated to occur in 70 to 80% of cases. The basic measures should not delay the earliest possible use of defibrillation. Only then follows the second phase, secondary ABCD, consisting of intubation, adequate ventilation, intravenous infusion, medications, further defibrillation when appropriate and the determination of treatable causes.
Algorithms↗
Pneumoperitoneum associated with pneumothorax or pneumopericardium: a surgical dilemma in the injured patient.
Three cases of 'idiopathic pneumoperitoneum' following injury are reviewed. Two cases occurred several days after initial injury and were associated with post-traumatic pneumothorax and artificial respiration. It is likely that artificial respiration induced pneumoperitoneum in these cases. The third case of pneumoperitoneum occurred one hour after initial injury and was associated with bilateral pneumothoraces and pneumopericardium. Congenital abnormalities and tension pneumothorax were thought to account for this case of 'idiopathic pneumoperitoneum'.
Adolescent↗
The effect of artificial ventilation on functional residual capacity and arterial oxygenation. II. Comparison of spontaneous respiration and artificial ventilation at similar arterial carbon dioxide tensions, tidal volumes and inspiratory gas flow rates.
We have compared cardiac output, gas exchange and pulmonary mechanics during spontaneous breathing and artificial ventilaton under conditions which kept PaCO2 within the normal range and maintained constant tidal volume and inspired gas flow rate. In dogs anaesthetized with pentobarbitone and ventilated with air, artificial ventilation increased VD/VT but did not reduce Q angstrom, FRC, or CL. PaO2 increased and A-aDO2 decreased during aritificial ventilation, perhaps because of a small increase in Q angstrom and a small decrease in oxygen consumption. It appears that many of the reported deleterious effects of artificial ventilation may be due to the use of other anaesthetic agents and patterns of ventilation, and to changes in PaCO2.
Anesthesia↗
Arterial to end-tidal PCO2 difference varies with different ventilatory conditions during steady state hypercapnia in the rat.
To estimate the influence of ventilatory conditions on the CO2 equilibration between the alveolar gas and arterial blood during steady state hypercapnia, we measured arterial and end-tidal PCO2 (PaCO2, PETCO2) of the anesthetized rat under the following three conditions: spontaneously breathing with CO2 inhalation, artificial respiration with gas mixture containing CO2, and artificial respiration with reduced ventilatory volume (hypoventilation). In each ventilatory condition, PaCO2 correlated linearly with PETCO2. However, in spontaneously breathing animals, the PaCO2-PETCO2 difference which was positive in a control condition (without CO2 inhalation) became negative during CO2 inhalation. The mean (+/- S.D.) difference was -3.6 +/- 1.5 mmHg (n = 9, p less than 0.001) at the PETCO2 range from 72 to 77 mmHg. During artificial respiration with constant ventilatory volume, initial positive PaCO2-PETCO2 difference approached zero when CO2 was administered into inspiratory gas. In both ventilatory conditions the slope of the PETCO2-PaCO2 relation line was less than 1.0, whereas the PaCO2-PETCO2 difference remained positive when PCO2 level was increased with reducing the ventilatory volume (accumulation of endogenous CO2). These observations suggest that for a given increase in PCO2 by administration of exogenous CO2, the extent to which PaCO2 increases is smaller than that of PETCO2. This peculiar relationship together with changes in breathing pattern during CO2 inhalation likely results in "negative" PaCO2-PETCO2 difference in the spontaneously breathing animal. We conclude that the PaCO2-PETCO2 difference, either as positive or negative values, depends upon both the level of PCO2 and the ventilatory condition to increase PCO2.
Animals↗
[Indications for use of artificial ventilation and its complications in pediatric surgery].
Artificial respiration is often indicated in the child surgical patient preoperatively, as well as postoperatively because of the specific features of this age group. The characteristics of the respiratory function which are various in different ages, as well as the preoperative condition of the child and the nature of the surgical procedure and anaesthesia are factors which influence the indications for artificial respiration. Of particular importance is the neonatal period of the child where beside the immaturity of vital functions, and a high metabolism level with small calorie reserves, as well as a large consumption of oxygen, there is the addition of stress due to the surgical procedure and anaesthesia which can seriously endanger respiration. The paper analyzes indications for applying artificial respiration at the Clinic for Child Surgery in Novi Sad during a five-year period. Ways of applying artificial respiration, its parameters, as well as the complications during its use are followed. Artificial respiration was applied in 82 children, 46.34% were newborns operated on because of ileus conditions and 43.90% were larger children treated due to polytrauma. The most frequent complications were in the group of newborns: pneumonia, atelectasis, ductus arteriosus opening, lung bleeding and pneumothorax.
Child, Preschool↗
[Can ventilation based on the principle of the iron lung act today as a substitute for or an alternative method to conventional forms of ventilation?].
A plastic lung working on the same principles as an iron lung has been developed at the Medical School in Hannover. Functional and practical tests were performed in a representative group of patients. Respirators support following the principles of an iron lung may be provided as a supplement or an alternative to existing artificial respirator therapy. The modern artificial respirators are superior to the plastic lung, which however, has advantages for particular indications: Respiratory therapy performed in a plastic lung is well tolerated by the patients. It requires specific skills which can easily be learned by the medical staff. Routine use certainly cannot be instituted before further technical improvement has been achieved; in particular the noise level should be reduced. The plastic lung is suitable for short-term ventilation (2-10 h); in view of the restricted nursing procedures possible, prolonged artificial respiration cannot be recommended. In conclusion, immediate postoperative ventilation is the area of application for the plastic lung. Several advantages are known: the endotracheal tube can be removed, there is no indication for sedative drugs, cardiac function and organ blood flow are positively influenced, mucolysis and lung expansion are adequate. A patient whose spontaneous respiratory activity is borderline benefits from short-term therapy, which can be repeated as necessary. Protracted artificial ventilation can be avoided. The gradual process of weaning from the ventilator following prolonged artificial respiration is facilitated by the use of a plastic lung. Plastic lung therapy is superior to other common methods of treating persistent atelectasis, because its mucolytic effects lead to expansion of the atelectatic lobe or segment.(ABSTRACT TRUNCATED AT 250 WORDS)
Equipment Design↗
Physiological studies of thoracic spinocerebellar tract neurons in relation to respiratory movement.
The differential roles of thoracic spinocerebellar tract (SCT) neurons with axons ascending in ipsi- (uncrossed) and contralaterally (crossed) spinal cord and their activities during respiratory movement were examined by extracellular recordings in the T9-T12 spinal segments of the anaesthetized cat. A total of 36 uncrossed and 7 crossed SCT neurons showed rhythmic discharges in relation to either spontaneous or artificial respiration. Uncrossed neurons were located in and around Clarke's column and thus are cells of origin of the dorsal spinocerebellar tract (DSCT). Crossed neurons were located in laminae VII and VIII. Almost all DSCT neurons were modulated during artificial respiration. Nineteen DSCT neurons showed high-frequency discharges during chest expansion and 15 DSCT neurons showed high-frequency discharges during the chest retraction phase of artificial respiration. Their respiration-related activity maintained the same phase relation and firing patterns after vagotomy. The phase relationship of neural rhythmicity to chest movement during artificial respiration and spontaneous breathing was the same in 14 neurons examined. Artificially induced pneumothorax caused a marked decrease of respiration-related modulation, and severing of a single nerve to the appropriate muscle caused a marked decrease of modulation, suggesting that respiration-related rhythmic activity of DSCT neurons is induced by the extension of respiratory muscles in the chest wall during both spontaneous and artificial respiration. Crossed SCT neurons showed rhythmic activity in phase with the central respiratory rhythm as indexed by phrenic nerve activity. Two neurons received an excitatory influence and five an inhibitory influence in the inspiratory phase from the centre. Four neurons in the latter group also received excitatory inputs from the periphery during chest expansion. Since inspiration brings chest expansion during spontaneous breathing, the central and peripheral inputs seem antagonistic in function. These neurons seemed to signal a discrepancy between the chest wall movement and the central respiratory rhythm. Functional differences between uncrossed and crossed SCTs in the lower thoracic segments in regard to the central and peripheral inputs as observed here are similar to those observed in the lumbar SCTs during locomotion.
Animals↗
[H.R.P.-System 2000: a new universally applicable ventilation system for single or limited multiple use with high bacteriologic-hygienical safety (author's transl)].
A new bacteriologically safe system for artificial respiration, H.R.P.-System 2000, is presented. Only two different SETS for artificial respiration of prematures, newborns and infants (P.N.J.) and adults, children and todlers (A.T.) are necessary. They can be adapted very easily on different types of respirators. Besides the tubing and expiratory valve the H.R.P.-SETS include a highly efficient electronically controlled humidifier working on the principle of gas bubbling through a heated water bath, a special tracheal tube adapter with an automatic water exhaust and flexible gas-reservoir for manual ventilation as well as C.P.A.P. or I.M.V. therapy. The H.R.P.-SETS are available as steril disposables. Resterilisation with gas on several occasions is possible. In a control study on thirty children, mainly premature infants and newborns a conventional SET, similar to the Bennett respiration system with disposable tubing and the H.R.P.-SETS are compared under the conditions of our intensive care unit. Using the criteria of serial bacteriological examinations of the tracheo-bronchial secretions and clinical criteria, H.R.P.-SETS proved superior. Artificial respiration without bacterial contamination by hospital strains for more than 10--14 days seems to be possible as a routine in newborns and children.
Adult↗
Subglottic stenosis in newborns after mechanical ventilation.
UNLABELLED: Mechanical ventilation in the neonatal period is sometimes followed by difficulty in removal of the endotracheal tube although the patient does not need further respiratory support. This problem results from subglottic stenosis consequent on prolonged use of endotracheal tubes. We found this complication in 5 patients among 854 newborns who required artificial respiration. A further patient was admitted from another hospital because of extubation problems. Our clinical diagnosis was confirmed by endoscopy. Drug therapy with steroids and anti-inflammatory agents was tried in all six patients and was successful in two. In four patients conservative management failed and laser surgery was performed; three of these infants required tracheostomy. In two decannulation has already been performed at the age of 2 1/2 years. IN CONCLUSION: five of six patients were treated successfully, and one 3-year-old patient is still being treated. In the light of reports from other authors, this approach can be recommended for the management of acquired subglottic stenosis.
Anti-Inflammatory Agents↗
Facilitation of the Bezold-Jarisch reflex by central stimulation of alpha 2 adrenoceptors in dogs.
The Bezold-Jarisch reflex characterized by hypotension and bradycardia was elicited in anaesthetized artificially respired dogs (pretreated with a beta-adrenoceptor antagonist ) using capsaicin 10 micrograms/kg (i.v.). Intracisternal administration of the highly selective "clonidine-like" alpha 2 adrenoceptor agonists B-HT 920 (10 micrograms/kg) or B-HT 933 (30 micrograms/kg) significantly facilitated this reflex bradycardia. The involvement of central alpha 2-adrenoceptors is suggested as intracisternal administration of the alpha 2 adrenoceptor blocking drugs yohimbine (50 micrograms/kg) and piperoxan (50 micrograms/kg) antagonized this facilitation. B-HT 920 also facilitated the vagally mediated baroreceptor reflex to the hypertensive effect of intravenous noradrenaline (3 micrograms/kg). Although the Bezold-Jarisch reflex and the baroreceptor reflex have different afferent pathways, both reflexes may either converge into a common pathway or have separate neuronal chains within the medulla; however, this study indicates that both have a similar central modulatory system stimulated by alpha 2 adrenoceptors.
Adrenergic alpha-Agonists↗
Ethylene imine poisoning. A case report.
A case is described of accidental inhalation of ethylene imine vapour in a chemical worker. This resulted in glottic oedema which required tracheostomy. Artificial respiration was needed because of failure to maintain adequate arterial oxygen levels. The patient developed profuse salivation and sputum production. Endoscopy showed that the mucosal surfaces of the pharynx, trachea and major bronchi were destroyed. The patient was treated with steroids and antibiotics for pulmonary infection. Recovery was slow but he was eventually able to leave hospital. He was later readmitted with recurrent infection and developed acute airway obstruction from which he died. Post-mortem examination shoed extensive destruction of the mucosal lining with erosion and collapse of the cartilages. This was the cause of death. Previous reports of ethylene imine poisoning are reviewed. This appears to be the third fatal case.
Accidents, Occupational↗