Abstract:
:The aim of this study was to assess positive end-expiratory pressure (PEEP)-induced lung overdistension and alveolar recruitment in six patients with acute lung injury (ALI) using a computed tomographic (CT) scan method. Lung overdistension was first determined in six healthy volunteers in whom CT sections were obtained at FRC and at TLC with a positive airway pressure of 30 cm H2O. In patients, lung volumes were quantified by the analysis of the frequency distribution of CT numbers on the entire lung at zero end-expiratory pressure (ZEEP) and PEEP. In healthy volunteers at FRC, the distribution of the density histograms was monophasic with a peak at -791 +/- 12 Hounsfield units (HU). The lowest CT number observed was -912 HU. At TLC, lung volume increased by 79 +/- 35% and the peak CT number decreased to -886 +/- 26 HU. More than 70% of the increase in lung volume was located below -900 HU, suggesting that this value can be considered as the threshold separating normal aeration from overdistension. In patients with ALI, at ZEEP the distribution of density histograms was either monophasic (n = 3) or biphasic (n = 3). The mean CT number was -319 +/- 34 HU. At PEEP 13 +/- 3 cm H2O, lung volume increased by 47 +/- 19% whereas mean CT number decreased to -538 +/- 171 HU. PEEP induced a mean alveolar recruitment of 320 +/- 160 ml and a mean lung overdistension of 238 +/- 320 ml. In conclusion, overdistended lung parenchyma of healthy volunteers is characterized by a CT number below -900 HU. This threshold can be used in patients with ALI for differentiating PEEP-induced alveolar recruitment from lung overdistension.
journal_name
Am J Respir Crit Care Medauthors
Vieira SR,Puybasset L,Richecoeur J,Lu Q,Cluzel P,Gusman PB,Coriat P,Rouby JJdoi
10.1164/ajrccm.158.5.9802101subject
Has Abstractpub_date
1998-11-01 00:00:00pages
1571-7issue
5 Pt 1eissn
1073-449Xissn
1535-4970journal_volume
158pub_type
杂志文章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
更新日期:2011-02-15 00:00:00
abstract:RATIONALE:Extracellular nucleotides have recently been identified as proinflammatory mediators involved in asthma pathogenesis by signaling via purinergic receptors, but the role of the purinergic receptor type 6 (P2Y6R) has not been previously investigated. OBJECTIVES:To investigate the role of P2Y6R in asthma pathog...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201011-1762OC
更新日期:2011-07-15 00:00:00
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pub_type: 杂志文章
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journal_title:American journal of respiratory and critical care medicine
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abstract:RATIONALE:Epithelial-mesenchymal transition (EMT) plays a key role in the development of chronic obstructive pulmonary disease (COPD) and lung cancer. OBJECTIVES:There are five major EMT regulatory genes (Snai1, Slug, Zeb1, Zeb2, and Twist1) involved in EMT. We hypothesized that germline variants in these genes may in...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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更新日期:2016-08-15 00:00:00
abstract:RATIONALE:Immediate graft performance after lung transplantation is associated with short- and long-term clinical outcomes. However, the biologic mechanism that determines outcomes is not fully understood. OBJECTIVES:To investigate the impact of cell death signals at 24 and 48 hours after lung transplantation on short...
journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201510-2115OC
更新日期:2016-07-01 00:00:00
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pub_type: 杂志文章
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更新日期:2002-08-01 00:00:00
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2003-08-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,随机对照试验
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2004-04-15 00:00:00
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更新日期:2004-02-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/rccm.201507-1311OC
更新日期:2016-06-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2002-06-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2010-08-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
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pub_type: 杂志文章
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更新日期:2002-02-15 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
doi:10.1164/ajrccm.156.4.9601042
更新日期:1997-10-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:2020-12-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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更新日期:1999-09-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章,评审
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更新日期:2004-06-15 00:00:00
abstract:RATIONALE:Tumor-infiltrating immune cells affect lung cancer outcome. However, the factors that influence the composition and function of the tumor immune environment remain poorly defined and need investigation, particularly in the era of immunotherapy. OBJECTIVES:To determine whether the tumoral immune environment i...
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pub_type: 杂志文章
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更新日期:2016-12-01 00:00:00
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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journal_title:American journal of respiratory and critical care medicine
pub_type: 杂志文章
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