Respiratory care
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The gas mask is used to protect military and non-military personnel exposed to respiratory hazards (chemical, biologic, radiologic, and nuclear agents). The objective was to evaluate the impact of the gas mask on indexes of respiratory effort and breathing patterns in a human model because no data exist. ⋯ This study demonstrated a substantial increase in the indicies of respiratory effort both at rest and during exercise with a gas mask. Our measurements and findings may be referred in future research and development studies in this field. (ClinicalTrials.gov registration NCT02782936.).
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Quantification of patient effort during spontaneous breathing is important to tailor ventilatory assistance. Because a correlation between inspiratory muscle pressure (Pmus) and electrical activity of the diaphragm (EAdi) has been described, we aimed to assess the reliability of surface electromyography (EMG) of the respiratory muscles for monitoring diaphragm electrical activity and subject effort during assisted ventilation. ⋯ During assisted mechanical ventilation, EAdi can be reliably monitored by both EAdi and surface EMG. The measurement of Pmus based on the calibration of EAdi was also feasible by the use of surface EMG.
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Patients who develop ARDS from medical or traumatic causes typically present after the inciting event has already occurred. Postoperative ARDS is unique in that the inciting insult potentially responsible for ARDS is known ahead of time, which provides an opportunity to study the early pathophysiology of ARDS. The objective of this study was to better understand the early pathophysiology of postoperative ARDS through a temporal analysis of key biomarkers of interest. ⋯ Our study supported the hypothesis that dysregulated coagulation, inflammation, and epithelial injury are pathophysiologic features of early postoperative ARDS. Interleukin-8, plasminogen activator-1, and surfactant protein-D may help predict development of postoperative ARDS.
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Editorial Comment
Why Not Prevent ARDS? The Possible Role of Plasma Biomarkers in Surgery.