Spontaneous breathing improves lung aeration in oleic acid-induced lung injury.

Abstract:

BACKGROUND:Experimental and clinical studies have shown reduction in intrapulmonary shunt with improved oxygenation by spontaneous breathing with airway pressure release ventilation (APRV) in acute lung injury. The mechanisms of these findings are not clear. The authors hypothesized that spontaneous breathing results in better aeration of lung tissue and that improvement in oxygenation can be explained by these changes. This hypothesis was studied in a porcine model of oleic acid-induced lung injury. METHODS:Two hours after induction of lung injury, 24 pigs were randomly assigned to APRV with or without spontaneous breathing at a positive end-expiratory pressure of 5 cm H(2)O. Hemodynamics, spirometry, and end-expiratory lung volume by nitrogen washout were measured at baseline, after 2 h of lung injury, and after 2 and 4 h of mechanical ventilation in the specific mode. Finally, spiral computed tomography of the chest was performed at end-expiratory lung volume in 22 pigs. RESULTS:Arterial carbon dioxide tension and mean and end-inspiratory airway pressures were comparable between settings. Four hours of APRV with spontaneous breathing resulted in improved oxygenation compared with APRV without spontaneous breathing (arterial oxygen tension, 144 +/- 65 vs. 91 +/- 50 mmHg, P < 0.01 for interaction time x mode), higher end-expiratory lung volume (786 +/- 320 vs. 384 +/- 148 ml, P < 0.001), and better aeration. End-expiratory lung volume and venous admixture were both correlated with the amount of lung reaeration (r(2) = 0.62 and r(2) = 0.61, respectively). CONCLUSIONS:The results support the hypothesis that spontaneous breathing during APRV improves oxygenation mainly by recruitment of nonaerated lung and improved aeration of the lungs.

journal_name

Anesthesiology

journal_title

Anesthesiology

authors

Wrigge H,Zinserling J,Neumann P,Defosse J,Magnusson A,Putensen C,Hedenstierna G

doi

10.1097/00000542-200308000-00019

subject

Has Abstract

pub_date

2003-08-01 00:00:00

pages

376-84

issue

2

eissn

0003-3022

issn

1528-1175

pii

00000542-200308000-00019

journal_volume

99

pub_type

杂志文章
  • Electrocardiographic exercise stress testing for cardiac risk assessment in patients undergoing noncardiac surgery.

    abstract:BACKGROUND:The value of exercise electrocardiography in the prediction of perioperative cardiac risk has yet to be defined. This study was performed to determine the predictive value of exercise electrocardiography as compared with clinical parameters and resting electrocardiography. METHODS:A total of 204 patients at...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200101000-00011

    authors: Gauss A,Röhm HJ,Schäuffelen A,Vogel T,Mohl U,Straehle A,Meierhenrich R,Georgieff M,Steinbach G,Schütz W

    更新日期:2001-01-01 00:00:00

  • Can bispectral index monitoring predict recovery of consciousness in patients with severe brain injury?

    abstract:BACKGROUND:The probability of recovering consciousness in acute brain-injured patients depends on central nervous system damage and complications acquired during their stay in the intensive care unit. The objective of this study was to establish a relation between the Bispectral Index (BIS) and other variables derived ...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000542-200407000-00009

    authors: Fàbregas N,Gambús PL,Valero R,Carrero EJ,Salvador L,Zavala E,Ferrer E

    更新日期:2004-07-01 00:00:00

  • Acid-sensing Ion Channel 3 Overexpression in Incisions Regulated by Nerve Growth Factor Participates in Postoperative Nociception in Rats.

    abstract:BACKGROUND:Acid-sensing ion channel 3 (ASIC3) upregulation has been reported in dorsal root ganglion neurons after incision and contributes to postoperative nociception. This study hypothesized that upregulation of ASIC3 in incised tissues is induced by nerve growth factor through the phosphoinositide 3-kinase/protein ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000003576

    authors: Li H,Li H,Cheng J,Liu X,Zhang Z,Wu C

    更新日期:2020-12-01 00:00:00

  • Functional studies of RYR1 mutations in the skeletal muscle ryanodine receptor using human RYR1 complementary DNA.

    abstract:BACKGROUND:Malignant hyperthermia is associated with mutations within the gene encoding the skeletal muscle ryanodine receptor, the calcium channel that releases Ca from sarcoplasmic reticulum stores triggering muscle contraction, and other metabolic activities. More than 200 variants have been identified in the ryanod...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181d69283

    authors: Sato K,Pollock N,Stowell KM

    更新日期:2010-06-01 00:00:00

  • Comparison of enflurane, halothane, and isoflurane for diagnostic and therapeutic procedures in children with malignancies.

    abstract::The authors performed a randomized, prospective trial comparing enflurane, halothane, and isoflurane (each administered with nitrous oxide) to establish which inhaled anesthetic produced the fewest complications and the most rapid induction of anesthesia for children undergoing general anesthesia for diagnostic proced...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-198512000-00015

    authors: Fisher DM,Robinson S,Brett CM,Perin G,Gregory GA

    更新日期:1985-12-01 00:00:00

  • Basal forebrain histaminergic transmission modulates electroencephalographic activity and emergence from isoflurane anesthesia.

    abstract:BACKGROUND:The tuberomammillary histaminergic neurons are involved in the sedative component of anesthetic action. The nucleus basalis magnocellularis (NBM) in the basal forebrain receives dense excitatory innervation from the tuberomammillary nucleus and is recognized as an important site of sleep-wake regulation. Thi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181b061a0

    authors: Luo T,Leung LS

    更新日期:2009-10-01 00:00:00

  • Pancuronium and vecuronium pharmacokinetics and pharmacodynamics in younger and elderly adults.

    abstract::To evaluate the effect of aging on the distribution, metabolism, and neuromuscular junction sensitivity to pancuronium and vecuronium, the authors determined the pharmacokinetics and pharmacodynamics of these drugs in 12 healthy elderly subjects (70-84 yr) and 12 young adults (30-57 yr) during halothane-nitrous oxide ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198707000-00008

    authors: Rupp SM,Castagnoli KP,Fisher DM,Miller RD

    更新日期:1987-07-01 00:00:00

  • Intravenous lidocaine and bupivacaine dose-dependently attenuate bronchial hyperreactivity in awake volunteers.

    abstract:BACKGROUND:In standard textbooks, intravenous lidocaine is recommended for intubation of patients with bronchial hyperreactivity. However, whether and to what extent intravenous local anesthetics attenuate bronchial hyperreactivity in humans is unknown. Accordingly, nine awake volunteers with known bronchial hyperreact...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199603000-00007

    authors: Groeben H,Schwalen A,Irsfeld S,Stieglitz S,Lipfert P,Hopf HB

    更新日期:1996-03-01 00:00:00

  • Effect of parecoxib, a novel intravenous cyclooxygenase type-2 inhibitor, on the postoperative opioid requirement and quality of pain control.

    abstract:BACKGROUND:The analgesic efficacy and side effect profile of intravenous parecoxib, a novel cyclooxygenase type-2 (COX-2) inhibitor, was assessed in a double-blinded, placebo-controlled study involving patients undergoing major gynecologic surgical procedures. METHODS:After Institutional Review Board approval, 60 cons...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-200206000-00007

    authors: Tang J,Li S,White PF,Chen X,Wender RH,Quon R,Sloninsky A,Naruse R,Kariger R,Webb T,Norel E

    更新日期:2002-06-01 00:00:00

  • Halothane, enflurane, and isoflurane decrease calcium sensitivity and maximal force in detergent-treated rat cardiac fibers.

    abstract::This study was designed to test the hypothesis that the volatile anesthetics directly affect cardiac contractile proteins. For this purpose, the effects of various anesthetic doses of halothane, enflurane, and isoflurane on myocardial calcium sensitivity and maximal calcium-activated force were examined in rat cardiac...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198812000-00015

    authors: Murat I,Ventura-Clapier R,Vassort G

    更新日期:1988-12-01 00:00:00

  • Treatment of iron deficiency anemia in orthopedic surgery with intravenous iron: efficacy and limits: a prospective study.

    abstract:BACKGROUND:Preoperative anemia is frequent in patients undergoing orthopedic surgery. The purpose of this study was to assess the preoperative increase of hemoglobin in iron deficiency anemia patients treated with intravenous iron. METHODS:After obtaining written informed consent, 20 patients with iron deficiency anem...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/01.anes.0000291441.10704.82

    authors: Theusinger OM,Leyvraz PF,Schanz U,Seifert B,Spahn DR

    更新日期:2007-12-01 00:00:00

  • Influence of methylenetetrahydrofolate reductase gene polymorphisms on homocysteine concentrations after nitrous oxide anesthesia.

    abstract:BACKGROUND:Mutations in the methylenetetrahydrofolate reductase (MTHFR) gene (677C>T, 1298A>C) cause elevated plasma homocysteine concentrations and have been linked to fatal outcomes after nitrous oxide anesthesia. This study tested the hypothesis that patients with common MTHFR 677C>T or 1298A>C mutations develop hig...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e318178820b

    authors: Nagele P,Zeugswetter B,Wiener C,Burger H,Hüpfl M,Mittlböck M,Födinger M

    更新日期:2008-07-01 00:00:00

  • Pharmacodynamic Interaction of Remifentanil and Dexmedetomidine on Depth of Sedation and Tolerance of Laryngoscopy.

    abstract:BACKGROUND:Dexmedetomidine is a sedative with modest analgesic efficacy, whereas remifentanil is an opioid analgesic with modest sedative potency. Synergy is often observed when sedative-hypnotics are combined with opioid analgesics in anesthetic practice. A three-phase crossover trial was conducted to study the pharma...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章

    doi:10.1097/ALN.0000000000002882

    authors: Weerink MAS,Barends CRM,Muskiet ERR,Reyntjens KMEM,Knotnerus FH,Oostra M,van Bocxlaer JFP,Struys MMRF,Colin PJ

    更新日期:2019-11-01 00:00:00

  • Cognitive Functioning after Surgery in Middle-aged and Elderly Danish Twins.

    abstract:BACKGROUND:Postoperative cognitive dysfunction is common, but it remains unclear whether there are long-term adverse cognitive effects of surgery combined with anesthesia. The authors examined the association between exposure to surgery and level of cognitive functioning in a sample of 8,503 middle-aged and elderly twi...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0000000000000957

    authors: Dokkedal U,Hansen TG,Rasmussen LS,Mengel-From J,Christensen K

    更新日期:2016-02-01 00:00:00

  • Response to mivacurium in a patient compound heterozygous for a novel and a known silent mutation in the butyrylcholinesterase gene: genotyping by sequencing.

    abstract:BACKGROUND:Patients who are homozygous for the atypical mutation, compound heterozygous for atypical and silent mutations, or homozygous for silent mutations (SS) respond to mivacurium with extensively prolonged neuromuscular block. Although important, exact phenotyping of these patients is difficult. This article pres...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200109000-00010

    authors: Gätke MR,Ostergaard D,Bundgaard JR,Varin F,Viby-Mogensen J

    更新日期:2001-09-01 00:00:00

  • Effects of the nonimmobilizer hexafluroethane on the model membrane dimyristoylphosphatidylcholine.

    abstract:BACKGROUND:Nonimmobilizers are agents that lack anesthetic properties, although their chemical structure is very similar to known anesthetics. The primary action site of both agents, whether at the membrane or target protein level, is still a matter of debate. However, increasing evidence points to the distinct modific...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200210000-00016

    authors: Koubi L,Tarek M,Bandyopadhyay S,Klein ML,Scharf D

    更新日期:2002-10-01 00:00:00

  • Antinociception by spinal and systemic oxycodone: why does the route make a difference? In vitro and in vivo studies in rats.

    abstract:BACKGROUND:The pharmacology of oxycodone is poorly understood despite its growing clinical use. The discrepancy between its good clinical effectiveness after systemic administration and the loss of potency after spinal administration led the authors to study the pharmacodynamic effects of oxycodone and its metabolites ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200610000-00027

    authors: Lemberg KK,Kontinen VK,Siiskonen AO,Viljakka KM,Yli-Kauhaluoma JT,Korpi ER,Kalso EA

    更新日期:2006-10-01 00:00:00

  • Hemodynamic predictors of myocardial ischemia during halothane anesthesia for coronary-artery revascularization.

    abstract::The authors undertook a prospective study of 30 patients undergoing halothane anesthesia for coronary-artery revascularization to ascertain which clinically monitored hemodynamic variables--or combination of variables--associated with myocardial oxygen supply and demand best predict myocardial ischemia. Simultaneous r...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198307000-00007

    authors: Lieberman RW,Orkin FK,Jobes DR,Schwartz AJ

    更新日期:1983-07-01 00:00:00

  • Dual exposure to sevoflurane improves anesthetic preconditioning in intact hearts.

    abstract:BACKGROUND:Anesthetic preconditioning (APC) with sevoflurane reduces myocardial ischemia-reperfusion injury. The authors tested whether two brief exposures to sevoflurane would lead to a better preconditioning state than would a single longer exposure and whether dual exposure to a lower (L) concentration of sevofluran...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200403000-00016

    authors: Riess ML,Kevin LG,Camara AK,Heisner JS,Stowe DF

    更新日期:2004-03-01 00:00:00

  • Pharyngeal mucosal pressures, airway sealing pressures, and fiberoptic position with the intubating versus the standard laryngeal mask airway.

    abstract:BACKGROUND:The tube of the intubating laryngeal mask (ILM) is more rigid than the standard laryngeal mask airway (LMA), and the authors have tested the hypothesis that pharyngeal mucosal pressures, airway sealing pressures, and fiberoptic position are different when the two devices are compared. METHODS:Twenty anesthe...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199904000-00012

    authors: Keller C,Brimacombe J

    更新日期:1999-04-01 00:00:00

  • Drug actions at mammalian motor nerve endings: the suppression of neostigmine-induced fasciculations by vecuronium and isoflurane.

    abstract::The occurrence of fasciculations following administration of agents is a well-known pharmacologic phenomenon. Using the cat soleus nerve-muscle preparation, intravenous neostigmine doses between 20-200 micrograms/kg evoked fasciculations in a dose-related manner. The data demonstrate that the fasciculations were the r...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198712000-00011

    authors: Baker T,Stanec A

    更新日期:1987-12-01 00:00:00

  • Halothane reversibly inhibits human neutrophil bacterial killing.

    abstract::The effect of halothane, at clinically relevant concentrations on the ability of human polymorphonuclear leukocytes (PMNL) to kill the most frequently isolated gram-negative organisms responsible for human bacteremias, Escherichia coli and Klebsiella pneumoniae, was studied. Exposure of PMNL to 0.75 per cent halothane...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-198155060-00009

    authors: Welch WD

    更新日期:1981-12-01 00:00:00

  • Involvement of adenosine in the antiinflammatory action of ketamine.

    abstract:BACKGROUND:Ketamine is an anesthetic drug. Subanesthetic doses of ketamine have been shown to reduce interleukin-6 concentrations after surgery and to reduce mortality and the production of tumor necrosis factor alpha and interleukin 6 in septic animals. Similarly, adenosine was shown to reduce tumor necrosis factor al...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200506000-00017

    authors: Mazar J,Rogachev B,Shaked G,Ziv NY,Czeiger D,Chaimovitz C,Zlotnik M,Mukmenev I,Byk G,Douvdevani A

    更新日期:2005-06-01 00:00:00

  • Metabolic changes during recovery in normothermic versus hypothermic patients undergoing surgery and receiving general anesthesia and epidural local anesthetic agents.

    abstract:BACKGROUND:Mild hypothermia is accompanied by metabolic changes. Epidural local anesthetic agents attenuate the surgical stress response, but it is not known whether they modulate thermal stress. METHODS:Thirty patients undergoing colorectal surgery, performed by one surgical team, received epidural 0.5% bupivacaine t...

    journal_title:Anesthesiology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00000542-199805000-00011

    authors: Motamed S,Klubien K,Edwardes M,Mazza L,Carli F

    更新日期:1998-05-01 00:00:00

  • Serious complications related to regional anesthesia: results of a prospective survey in France.

    abstract:BACKGROUND:Serious complications related to regional anesthesia have previously been described primarily in case reports and retrospective surveys. The authors prospectively evaluated a multicenter series of regional anesthetics, using preplanned criteria to measure the incidence and characteristics of associated serio...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199709000-00005

    authors: Auroy Y,Narchi P,Messiah A,Litt L,Rouvier B,Samii K

    更新日期:1997-09-01 00:00:00

  • Factor XIII substitution in surgical cancer patients at high risk for intraoperative bleeding.

    abstract:BACKGROUND:Excessive intraoperative bleeding is associated with significant morbidity and mortality. The authors and others have shown that fibrin monomer allows preoperative risk stratification for intraoperative blood loss, likely due to an imbalance between available factor XIII and prothrombin conversion. The autho...

    journal_title:Anesthesiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/ALN.0b013e318194b21e

    authors: Korte WC,Szadkowski C,Gähler A,Gabi K,Kownacki E,Eder M,Degiacomi P,Zoller N,Devay J,Lange J,Schnider T

    更新日期:2009-02-01 00:00:00

  • Volume kinetic analysis of the distribution of 0.9% saline in conscious versus isoflurane-anesthetized sheep.

    abstract:BACKGROUND:The distribution and elimination of 0.9% saline given by intravenous infusion has not been compared between the conscious state and during inhalational anesthesia. METHODS:Six adult sheep received an intravenous infusion of 25 ml/kg of 0.9% saline over 20 min in the conscious state and also during isofluran...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-200202000-00033

    authors: Brauer KI,Svensén C,Hahn RG,Traber LD,Prough DS

    更新日期:2002-02-01 00:00:00

  • Increasing isoflurane from 0.9 to 1.1 minimum alveolar concentration minimally affects dorsal horn cell responses to noxious stimulation.

    abstract:BACKGROUND:The spinal cord appears to be the site at which isoflurane suppresses movement that occurs in response to a noxious stimulus. In an attempt to localize its site of suppressant action, the authors determined the effect of isoflurane on dorsal horn neuronal responses to supramaximal noxious stimulation at end-...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-199901000-00027

    authors: Antognini JF,Carstens E

    更新日期:1999-01-01 00:00:00

  • Comparison between bispectral index and patient state index as measures of the electroencephalographic effects of sevoflurane.

    abstract:BACKGROUND:The Bispectral Index (BIS) and the Patient State Index (PSI) quantify depth of anesthesia by analyzing the electroencephalogram. The authors examined the response of BIS and PSI to sevoflurane anesthesia. METHODS:In 22 patients, sevoflurane anesthesia was induced by inhalation with a tight-fitting facemask ...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/ALN.0b013e3181895fd0

    authors: Soehle M,Ellerkmann RK,Grube M,Kuech M,Wirz S,Hoeft A,Bruhn J

    更新日期:2008-11-01 00:00:00

  • Evaluation of acupuncture anesthesia: a psychophysical study.

    abstract::Four volunteers judged eight levels of thermal stimuli induced by a Hardy dolorimeter, varying in intensity from extremely painful to a low level seldom even perceived. Half of the 406 stimuli were applied during acupuncture and half either before insertion or after removal of the needles. The experimental design mini...

    journal_title:Anesthesiology

    pub_type: 杂志文章

    doi:10.1097/00000542-197511000-00005

    authors: Day RL,Kitahata LM,Kao FF,Motoyama EK,Hardy JD

    更新日期:1975-11-01 00:00:00