Gastric mucosal pH and blood flow during weaning from mechanical ventilation in patients with chronic obstructive pulmonary disease.

Abstract:

:To determine if gastric intramucosal pH changes during weaning from mechanical ventilation are related to gastric mucosal blood flow modifications, we studied 16 ventilator-supported patients with chronic obstructive pulmonary disease (COPD) who tolerated a 2-h trial of spontaneous breathing with pressure support ventilation and were successfully extubated and 11 patients with COPD who failed such a trial. Gastric mucosal perfusion was assessed using gastric intramucosal pH (pH(i)) by tonometry and laser-Doppler flowmetry. During the weaning attempt, the failure weaning group developed a rapid, shallow breathing pattern with acute respiratory acidosis. The pH(i) was lower and gastric intramucosal PCO(2) (PCO(2)im) was higher in the failure weaning group than in the successful weaning group (p < 0.05). No change in gastric intramucosal-arterial PCO(2) difference was observed and a linear correlation was found between arterial PCO(2) and PCO(2)im (r(2) = 0.70; p < 0.001). Cardiac index increased in the failure group (p < 0.05) and remained stable in the success group whereas gastric mucosal blood flow decreased in the failure group (H(120) (min): -22 +/- 11% from baseline; p < 0.05) and increased in the success group (H(120) (min): 85 +/- 27% from baseline; p < 0.05). We conclude that gastric intramucosal pH changes during a 2-h weaning trial are mainly due to arterial PCO(2) variations. Nevertheless, gastric mucosal blood flow changes do occur and differ according to the weaning success or failure.

authors

Bocquillon N,Mathieu D,Neviere R,Lefebvre N,Marechal X,Wattel F

doi

10.1164/ajrccm.160.5.9901018

keywords:

subject

Has Abstract

pub_date

1999-11-01 00:00:00

pages

1555-61

issue

5 Pt 1

eissn

1073-449X

issn

1535-4970

journal_volume

160

pub_type

杂志文章
  • Abnormal Glucose Tolerance in Infants and Young Children with Cystic Fibrosis.

    abstract:RATIONALE:In cystic fibrosis, abnormal glucose tolerance is associated with decreased lung function and worsened outcomes. Translational evidence indicates that abnormal glucose tolerance may begin in early life. OBJECTIVES:To determine whether very young children with cystic fibrosis have increased abnormal glucose t...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,多中心研究

    doi:10.1164/rccm.201512-2518OC

    authors: Yi Y,Norris AW,Wang K,Sun X,Uc A,Moran A,Engelhardt JF,Ode KL

    更新日期:2016-10-15 00:00:00

  • Tenascin mRNA expression at the foci of recent injury in usual interstitial pneumonia.

    abstract::To elucidate which cells are synthesizing tenascin in usual interstitial pneumonia (UIP) we have analyzed thoracoscopic or open lung biopsies from 30 patients with UIP by mRNA in situ hybridization, using (35)S-labeled tenascin RNA probes. The phenotype of the cells expressing tenascin mRNA was confirmed by immunohist...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.161.3.9809115

    authors: Pääkkö P,Kaarteenaho-Wiik R,Pöllänen R,Soini Y

    更新日期:2000-03-01 00:00:00

  • Effect of prone and supine positions on functional residual capacity, oxygenation, and respiratory mechanics in ventilated infants and children.

    abstract::Although numerous reports have described the improvement in PAO2 in patients in the prone position, the underlying mechanism has yet to be determined. Some authors have suggested this phenomenon may be related to an increase in functional residual capacity (FRC); however, no previous studies have described positional ...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.156.4.9601042

    authors: Numa AH,Hammer J,Newth CJ

    更新日期:1997-10-01 00:00:00

  • Airway obstruction in boilermakers exposed to fuel oil ash. A prospective investigation.

    abstract::We prospectively investigated the lower airway response in boilermakers overhauling an oil-powered boiler. We studied 26 male boilermakers with a mean age (SD) of 43.3 (8.6) yr. Pre-exposure spirometry and methacholine challenge tests were performed before beginning the boiler overhaul; postexposure tests were perform...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.152.5.7582280

    authors: Hauser R,Elreedy S,Hoppin JA,Christiani DC

    更新日期:1995-11-01 00:00:00

  • Intrasubject variability in airway inflammation in biopsies in mild to moderate stable asthma.

    abstract::We have studied intrasubject variability with respect to counts of immunostained inflammatory cells in snap frozen endobronchial biopsies from a group of patients with clinically mild to moderate stable asthma. Fiberoptic bronchoscopy was used to obtain endobronchial biopsies from the upper and lower lobes in 12 volun...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.153.3.8630570

    authors: Richmond I,Booth H,Ward C,Walters EH

    更新日期:1996-03-01 00:00:00

  • Genetic and environmental risk factors for asthma: a cotwin-control study.

    abstract::In complex diseases of genetic etiology such as asthma and atopy, it is difficult to differentiate causes of disease from consequences, and quantitate the importance of such causative factors. We examined possible risk factors for the development of wheezing and bronchial hyperresponsiveness in a cotwin-control study ...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.157.3.9702070

    authors: Duffy DL,Mitchell CA,Martin NG

    更新日期:1998-03-01 00:00:00

  • Effects of glutathione-S-transferase M1, T1, and P1 on childhood lung function growth.

    abstract::The effects of glutathione-S-transferase (GST) M1, GSTT1, and GSTP1 genotypes on lung function growth were investigated in 1,940 children enrolled in the Children's Health Study as fourth graders (aged 8-11 years) in two cohorts during 1993 and 1996 and were followed annually over a 4-year period. Genotypes for GSTM1 ...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.2112065

    authors: Gilliland FD,Gauderman WJ,Vora H,Rappaport E,Dubeau L

    更新日期:2002-09-01 00:00:00

  • Noncommunicable Lung Disease in Sub-Saharan Africa. A Community-based Cross-Sectional Study of Adults in Urban Malawi.

    abstract:RATIONALE:Noncommunicable diseases are major causes of morbidity and mortality in sub-Saharan Africa (sSA). Valid burden of disease estimates are lacking for noncommunicable lung disease in sSA. OBJECTIVES:We performed a community-based survey to determine the prevalence of chronic lung disease among adults 18 years o...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.201509-1807OC

    authors: Meghji J,Nadeau G,Davis KJ,Wang D,Nyirenda MJ,Gordon SB,Mortimer K

    更新日期:2016-07-01 00:00:00

  • Genetic Advances in Chronic Obstructive Pulmonary Disease. Insights from COPDGene.

    abstract::Chronic obstructive pulmonary disease (COPD) is a common and progressive disease that is influenced by both genetic and environmental factors. For many years, knowledge of the genetic basis of COPD was limited to Mendelian syndromes, such as alpha-1 antitrypsin deficiency and cutis laxa, caused by rare genetic variant...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1164/rccm.201808-1455SO

    authors: Ragland MF,Benway CJ,Lutz SM,Bowler RP,Hecker J,Hokanson JE,Crapo JD,Castaldi PJ,DeMeo DL,Hersh CP,Hobbs BD,Lange C,Beaty TH,Cho MH,Silverman EK

    更新日期:2019-09-15 00:00:00

  • Fifty Years of Research in ARDS. Long-Term Follow-up after Acute Respiratory Distress Syndrome. Insights for Managing Medical Complexity after Critical Illness.

    abstract::Critical illness is not a discrete disease state or syndrome. It is the culmination of a multiplicity of heterogeneous disease states and their varied health trajectories leading to extreme illness that requires advanced life support in a distinct geographic location in the hospital. It is a marker of newly acquired o...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1164/rccm.201704-0815ED

    authors: Herridge MS

    更新日期:2017-12-01 00:00:00

  • Operation Everest III (Comex '97): modifications of cardiac function secondary to altitude-induced hypoxia. An echocardiographic and Doppler study.

    abstract::During Operation Everest III (Comex '97), to assess the consequences of altitude-induced hypoxia, eight volunteers were decompressed in a hypobaric chamber, with a decompression profile simulating the climb of Mount Everest. Cardiac function was assessed using a combination of M-mode and two-dimensional echocardiograp...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.161.1.9902096

    authors: Boussuges A,Molenat F,Burnet H,Cauchy E,Gardette B,Sainty JM,Jammes Y,Richalet JP

    更新日期:2000-01-01 00:00:00

  • Objective predictors of response for staple versus laser emphysematous lung reduction.

    abstract::Recently described surgical approaches to the treatment of emphysema, including buttressed stapled volume reduction and laser coagulation, are associated with variable clinical outcomes. We examined objective preoperative factors as predictors of response to treatment in patients enrolled in a randomized trial of stap...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1164/ajrccm.155.4.9105070

    authors: Brenner M,McKenna R Jr,Gelb A,Osann K,Schein MJ,Panzera J,Wong H,Berns MW,Wilson AF

    更新日期:1997-04-01 00:00:00

  • Analysis of plasma-protein leakage and local secretion in sputum from patients with asthma and chronic obstructive pulmonary disease.

    abstract::In order to assess the usefulness of sputum analysis in studying plasma-protein exudation and local secretion of proteins in the airways, we measured specific proteins in the sputum sol phase (SSP) and sputum gel phase (SGP) from patients with stable asthma or chronic obstructive pulmonary disease (COPD). Protein leve...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.150.6.7952610

    authors: Schoonbrood DF,Lutter R,Habets FJ,Roos CM,Jansen HM,Out TA

    更新日期:1994-12-01 00:00:00

  • A new method for bronchial-provocation testing in asthmatic subjects using a dry powder of mannitol.

    abstract::We developed a bronchial provocation test (BPT) with a dry powder preparation of mannitol. The mannitol was inhaled from gelatin capsules containing 5, 10, 20, or 40 mg to a cumulative dose of 635 mg, and was delivered via an inhalator, Halermatic, or Dinkihaler device. We studied the airway sensitivity to inhaled man...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 临床试验,杂志文章

    doi:10.1164/ajrccm.156.3.9701113

    authors: Anderson SD,Brannan J,Spring J,Spalding N,Rodwell LT,Chan K,Gonda I,Walsh A,Clark AR

    更新日期:1997-09-01 00:00:00

  • Opposing effects of 60% oxygen and neutrophil influx on alveologenesis in the neonatal rat.

    abstract::The lungs of newborn rats exposed to 60% oxygen for 14 days develop an injury that shares morphologic similarities to human bronchopulmonary dysplasia (BPD). Neutrophil influx into the lung, as part of an inflammatory response, may play a pivotal role in the development of BPD. A neutrophil chemokine, cytokine-induced...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200402-215OC

    authors: Yi M,Jankov RP,Belcastro R,Humes D,Copland I,Shek S,Sweezey NB,Post M,Albertine KH,Auten RL,Tanswell AK

    更新日期:2004-12-01 00:00:00

  • Low-dose theophylline reduces eosinophilic inflammation but not exhaled nitric oxide in mild asthma.

    abstract::Theophylline is well-established in the management of asthma, and there is some evidence of an antiinflammatory effect in asthma. It is not known whether theophylline affects inflammatory markers such as sputum eosinophils and exhaled nitric oxide (NO) in patients with mild asthma not receiving inhaled steroid therapy...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1164/ajrccm.164.2.2006043

    authors: Lim S,Tomita K,Caramori G,Jatakanon A,Oliver B,Keller A,Adcock I,Chung KF,Barnes PJ

    更新日期:2001-07-15 00:00:00

  • Effect of the addition of montelukast to inhaled fluticasone propionate on airway inflammation.

    abstract::The aim of the study was to investigate the effect of addition of montelukast to inhaled fluticasone propionate (FP) therapy, compared with FP therapy alone (100 microg twice a day) on airway immunopathology in individuals with mild asthma. Twenty-eight subjects received FP (100 microg twice a day) or FP (100 microg t...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1164/rccm.200208-783OC

    authors: O'Sullivan S,Akveld M,Burke CM,Poulter LW

    更新日期:2003-03-01 00:00:00

  • Clinical course and prediction of survival in idiopathic pulmonary fibrosis.

    abstract::Idiopathic pulmonary fibrosis (IPF) is a progressive, life-threatening, interstitial lung disease of unknown etiology. The median survival of patients with IPF is only 2 to 3 years, yet some patients live much longer. Respiratory failure resulting from disease progression is the most frequent cause of death. To date w...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,评审

    doi:10.1164/rccm.201006-0894CI

    authors: Ley B,Collard HR,King TE Jr

    更新日期:2011-02-15 00:00:00

  • Patient-centric blood pressure-targeted cardiopulmonary resuscitation improves survival from cardiac arrest.

    abstract:RATIONALE:Although current resuscitation guidelines are rescuer focused, the opportunity exists to develop patient-centered resuscitation strategies that optimize the hemodynamic response of the individual in the hopes to improve survival. OBJECTIVES:To determine if titrating cardiopulmonary resuscitation (CPR) to blo...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.201407-1343OC

    authors: Sutton RM,Friess SH,Naim MY,Lampe JW,Bratinov G,Weiland TR 3rd,Garuccio M,Nadkarni VM,Becker LB,Berg RA

    更新日期:2014-12-01 00:00:00

  • Once-weekly rifapentine-containing regimens for treatment of tuberculosis in mice.

    abstract::The bactericidal activities of several once-weekly rifapentine (P)-containing combination regimens against Mycobacterium tuberculosis, and their ability to prevent the selection of rifampin (R)-resistant mutants, were compared with those of the standard six-times-weekly regimen consisting of R, isoniazid (H), and pyra...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.157.5.9709072

    authors: Grosset J,Lounis N,Truffot-Pernot C,O'Brien RJ,Raviglione MC,Ji B

    更新日期:1998-05-01 00:00:00

  • Children's urinary phthalate metabolites and fractional exhaled nitric oxide in an urban cohort.

    abstract:RATIONALE:Phthalates are used widely in consumer products. Exposure to several phthalates has been associated with respiratory symptoms and decreased lung function. Associations between children's phthalate exposures and fractional exhaled nitric oxide (Fe(NO)), a biomarker of airway inflammation, have not been examine...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.201203-0398OC

    authors: Just AC,Whyatt RM,Miller RL,Rundle AG,Chen Q,Calafat AM,Divjan A,Rosa MJ,Zhang H,Perera FP,Goldstein IF,Perzanowski MS

    更新日期:2012-11-01 00:00:00

  • Fibrotic idiopathic interstitial pneumonia: the prognostic value of longitudinal functional trends.

    abstract::Survival is linked to the histopathologic distinction between usual interstitial pneumonia (UIP) and nonspecific interstitial pneumonia (NSIP), the most commonly encountered fibrotic idiopathic interstitial pneumonia. We retrospectively compared the prognostic significance of histopathologic diagnoses, baseline pulmon...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.200210-1245OC

    authors: Latsi PI,du Bois RM,Nicholson AG,Colby TV,Bisirtzoglou D,Nikolakopoulou A,Veeraraghavan S,Hansell DM,Wells AU

    更新日期:2003-09-01 00:00:00

  • Longitudinal evaluation of the association between pulmonary function and total serum IgE.

    abstract::The role of immunoglobulin E (IgE) in the development and course of impaired ventilatory function and chronic obstructive pulmonary disease (COPD) required further study. This role has been examined in the longitudinal Tucson Epidemiological Study of Airways Obstructive Disease, which started in 1972. The association ...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.152.1.7599870

    authors: Sherrill DL,Lebowitz MD,Halonen M,Barbee RA,Burrows B

    更新日期:1995-07-01 00:00:00

  • Evidence of a critical period of airway instability during central apneas in preterm infants.

    abstract::The timing and magnitude of airway narrowing in central apneas is unknown. We have developed a method of apnea classification that relies on the transmission of cardiac airflow oscillation to indicate airway patency. Using a theoretical model, we showed that the amplitude of the cardiac airflow oscillation is proporti...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.157.2.9612125

    authors: Lemke RP,Idiong N,Al-Saedi S,Kwiatkowski K,Cates DB,Rigatto H

    更新日期:1998-02-01 00:00:00

  • Idiopathic pulmonary fibrosis: predicting response to therapy and survival.

    abstract::Idiopathic pulmonary fibrosis (IPF) is associated with significant morbidity and mortality despite aggressive therapy. Thirty-eight patients with biopsy-proven IPF were studied to identify pretreatment features that could be used to predict short-term improvement in pulmonary function and improved longer term survival...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.157.4.9703022

    authors: Gay SE,Kazerooni EA,Toews GB,Lynch JP 3rd,Gross BH,Cascade PN,Spizarny DL,Flint A,Schork MA,Whyte RI,Popovich J,Hyzy R,Martinez FJ

    更新日期:1998-04-01 00:00:00

  • Calcium channel blocker reduces airway remodeling in severe asthma. A proof-of-concept study.

    abstract:RATIONALE:Severe asthma is a major public health issue throughout the world. Increased bronchial smooth muscle (BSM) mass, a characteristic feature of airway remodeling in severe asthma, is associated with resistance to high-intensity treatment and poor prognosis. In vitro, the Ca(2+)-channel blocker gallopamil decreas...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章,随机对照试验

    doi:10.1164/rccm.201410-1874OC

    authors: Girodet PO,Dournes G,Thumerel M,Begueret H,Dos Santos P,Ozier A,Dupin I,Trian T,Montaudon M,Laurent F,Marthan R,Berger P

    更新日期:2015-04-15 00:00:00

  • Use of flow-volume curves in detecting secretions in ventilator-dependent patients.

    abstract::A noninvasive means of detecting airway secretions in ventilator-dependent patients is desirable because endotracheal suctioning can result in life-threatening complications. In a patient who had copious secretions, we observed a sawtooth pattern on his flow-volume curve that disappeared after suctioning. Accordingly,...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.150.3.8087350

    authors: Jubran A,Tobin MJ

    更新日期:1994-09-01 00:00:00

  • Standardized Intensive Care. Protocol Misalignment and Impact Misattribution.

    abstract::Guidelines, protocols, and checklists (together called "protocols") can be immensely helpful in the clinical arena. However, clinicians and health care systems relying on protocols must assess whether benefits are being accrued, whether such "benefits" are real, and whether harm can be detected. These concerns are imp...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/rccm.201502-0314CP

    authors: Kavanagh BP,Nurok M

    更新日期:2016-01-01 00:00:00

  • Application of tracheal gas insufflation to acute unilateral lung injury in an experimental model.

    abstract::In unilateral lung injury, application of global positive end-expiratory pressure (PEEP) may cause overdistension of normal alveoli and redistribution of blood flow to diseased lung areas, thereby worsening oxygenation. We hypothesized that selective application of tracheal gas insufflation (TGI) will recruit the inju...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.164.4.2005127

    authors: Blanch L,Van der Kloot TE,Youngblood AM,Murias G,Naveira A,Adams AB,Romero PV,Nahum A

    更新日期:2001-08-15 00:00:00

  • DNA and actin bind and inhibit interleukin-8 function in cystic fibrosis sputa: in vitro effects of mucolytics.

    abstract::Infection of the cystic fibrosis (CF) airways elicits an exaggerated, interleukin-8 (IL-8) mediated, neutrophil inflammatory response. Necrosing neutrophils release DNA and actin into the airways, increasing the viscoelasticity of airway secretions. Mucolytics aim to improve airway clearance by reducing this viscoelas...

    journal_title:American journal of respiratory and critical care medicine

    pub_type: 杂志文章

    doi:10.1164/ajrccm.162.5.9908107

    authors: Perks B,Shute JK

    更新日期:2000-11-01 00:00:00