American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 1994
Comparative StudyComparative evaluation of diaphragmatic activity during pressure support ventilation and intermittent mandatory ventilation in animal model.
The aim of the present study is a comparative evaluation of the effects of pressure support ventilation (PSV) and intermittent mandatory ventilation (IMV) on diaphragmatic activity in rabbit model of neonate. The animals were divided into a PSV group and an IMV group. In the IMV group, spontaneous breathing and four kinds of IMV rate (5, 10, 15, and 20/min) were applied (Ventilator: Bear BP200, peak inspiratory pressure [PIP]: 12 cm H2O, inspiratory time: 0.6 s). ⋯ Diaphragmatic activity disappeared at IMV20/min. In contrast, PSV reduced Edi and Pes linearly according to support level. In conclusion, diaphragmatic activity could be reduced more gradually with PSV than IMV by altering ventilatory support level.
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Am. J. Respir. Crit. Care Med. · Dec 1994
Comparative StudyCardiopulmonary resuscitation by precordial compression but without mechanical ventilation.
It is widely held that mechanical ventilation is essential for cardiopulmonary resuscitation (CPR). However, cardiac output and therefore pulmonary blood flow is reduced to less than one-third of normal during CPR. We therefore reasoned that ventilatory requirements are correspondingly reduced and postulated that gas exchange may be maintained during precordial compression with oxygen passively delivered to the airway in the absence of mechanical ventilation. ⋯ Postresuscitation myocardial contractility, reflected in the maximally generated dP/dt40, was also not adversely affected. In the unventilated group, only resuscitated animals developed spontaneous gaspings at an average frequency of 17 +/- 2/min-1. The current emphasis on mechanical ventilation as the highest priority for cardiopulmonary resuscitation is therefore not fully supported under the experimental conditions of this study.
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Am. J. Respir. Crit. Care Med. · Dec 1994
ReviewStructure of the azurocidin, proteinase 3, and neutrophil elastase genes. Implications for inflammation and vasculitis.
The granule-associated elastase homologues neutrophil elastase (NE), proteinase 3 (PR3), and azurocidin (AZU) are involved in immune defense reactions of neutrophils and monocytes. Proteinase 3 and NE contribute to the destruction and elimination of microorganisms, cleave elastin and other proteins of connective tissues, and generate chemotactic activities by forming alpha 1-proteinase inhibitor (alpha 1-PI) complexes. Azurocidin is cytotoxic to certain microorganisms and chemotactic to monocytes. ⋯ Autoantibodies against PR3 are an obligate feature in the pathogenesis of Wegener's granulomatosis, a systemic autoimmune vasculitis. In addition, PR3 appears to regulate growth and terminal differentiation of the myelomonocyte lineage. Future investigations will clarify whether allelic variations in the AZU-PR3-NE locus predispose patients to increased degradation of elastic fibers, as in pulmonary emphysema, and to the formation of autoantibodies against PR3 in patients with Wegener's granulomatosis.
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Am. J. Respir. Crit. Care Med. · Dec 1994
Multicenter StudyVolume spirometers need automated internal temperature sensors.
Spirometer temperature was measured automatically during all years of the Lung Health Study. Short- and long-term changes in temperature were analyzed for the 23 dry-rolling-seal volume spirometers used at the 10 clinical centers involved in the study. Within-test-session spirometer temperature increased a mean of 0.3 degrees C, and as much as 3.0 degrees C during methacholine challenge testing. ⋯ Month-to-month changes of more than 15 degrees C were not uncommon. If ambient temperature had been assumed to apply to all maneuvers and used for BTPS corrections, FEV1, and FVC measurement errors of up to 6% would have occurred. When using volume spirometers, the temperature of air inside the spirometer should be measured accurately during each breathing maneuver.