Effectiveness of a novel semi-closed barrier device with a personalized exhaust in cough aerosol simulation according to particle counts and visualization of particles.

Oxygen therapy is an essential treatment for patients with coronavirus disease 2019, although there is a risk of aerosolization of additional viral droplets occurring during this treatment that poses a danger to healthcare professionals. High-flow oxygen through nasal cannula (HFNC) is a vital treatment bridging low-flow oxygen therapy with tracheal intubation. Although many barrier devices (including devices without negative pressure in the barrier) have been reported in the literature, few barrier devices are suitable for HFNC and aerosol infection control procedures during HFNC have not yet been established.

Variations in respiratory excretion of carbon dioxide can be used to calculate pulmonary blood flow.

Background: A non-invasive means of measuring pulmonary blood flow (PBF) would have numerous benefits in medicine. Traditionally, respiratory-based methods require breathing maneuvers, partial rebreathing, or foreign gas mixing because exhaled CO2 volume on a per-breath basis does not accurately represent alveolar exchange of CO2. We hypothesized that if the dilutional effect of the functional residual capacity was accounted for, the relationship between the calculated volume of CO2 removed per breath and the alveolar partial pressure of CO2 would be reversely linear.

A short period of fasting before surgery conserves basal metabolism and suppresses catabolism according to indirect calorimetry performed under general anesthesia.

It is recommended that the period of fasting before elective surgery should be shortened to facilitate a rapid recovery by preventing catabolism. We examined the effects of a short period of fasting on metabolism by performing indirect calorimetry (IC) under general anesthesia. A prospective observational study involving 26 consecutive patients who underwent elective surgery and whose metabolism was evaluated using IC during anesthesia was conducted.

Spinal cord stimulation for a woman with complex regional pain syndrome who wished to get pregnant.

A woman with complex regional pain syndrome (CRPS) in the right lower extremity who wished to discontinue medications to get pregnant underwent implantation of a spinal cord stimulation system (SCS). An electrode lead was placed at Th(10-11) in the epidural space, accessed via the L(2-3) interspace with a paramedian approach, and a pulse generator was implanted in the left buttock. She kept the SCS on 24 h a day.

A new enteral diet, MHN-02, which contains abundant antioxidants and whey peptide, protects against carbon tetrachloride-induced hepatitis.

Background: Inflammatory or oxidative stress is related to various diseases, including not only inflammatory diseases, but also diabetes, cancer, and atherosclerosis. The aim of this study was to evaluate the anti-inflammatory effects of a new enteral diet, MHN-02, which contains abundant antioxidants and whey peptide. The study also investigated the ability of MHN-02 to attenuate lethality, liver injury, the production of inflammatory cytokines, and the production of oxidized products using a carbon tetrachloride-induced rat model of severe fulminant hepatitis.

Severe hyponatremia occurring after surgical stress in a patient with mitochondrial disease.

A 53-year-old man with mitochondrial disease underwent gastrectomy because of gastric cancer. Three days after the surgery, he developed severe hyponatremia (Na, 106 mmol l(-1)) together with hypovolemic shock and lactic acidosis. Despite the hyponatremia, his urine sodium concentration was high, suggesting renal salt wasting.

A novel skin-traction method is effective for real-time ultrasound-guided internal jugular vein catheterization in infants and neonates weighing less than 5 kilograms.

Background: Internal jugular vein (IJV) catheterization in pediatric patients is sometimes difficult because of the small sizes of veins and their collapse during catheterization. To facilitate IJV catheterization, we developed a novel skin-traction method (STM), in which the point of puncture of the skin over the IJV is stretched upward with tape during catheterization. In this study, we examined whether the STM increases the cross-sectional area of the vein and thus facilitates catheterization.

A simple, lightweight CPAP-delivery device, composed of a three-way stopcock, for the nondependent lung.

Purpose: We aimed to introduce a simple, lightweight continuous positive airway pressure (CPAP)-delivery device for the nondependent lung during one-lung ventilation, to investigate how the type of three-way stopcocks, and the compliance and resistance of a test lung affect the relationship between the oxygen flow rate and CPAP level produced, and to examine how the device works in a clinical setting.

Methods: In the test lung study, the bronchial blocker of a Univent tube was connected to a test lung. The effects of oxygen-flow rate, types of three-way stopcocks, and compliance and resistance of the test lung on the CPAP levels were studied.

Skin-traction method prevents the collapse of the internal jugular vein caused by an ultrasound probe in real-time ultrasound-assisted guidance.

Purpose: Real-time ultrasound-assisted guidance for catheterization of the internal jugular vein (IJV) is known to be useful, especially for a small-sized vein, which is difficult to catheterize. However, one of the problems with real-time ultrasound-assisted guidance is that the ultrasound probe itself can collapse the vein. We have developed a novel "skintraction method (STM)", in which the puncture point of the skin over the IJV is stretched upwards with several pieces of surgical tape in the cephalad and caudal directions with the aim being to facilitate catheterization of the IJV.

The skin-traction method increases the cross-sectional area of the internal jugular vein by increasing its anteroposterior diameter.

Purpose: We developed a novel "skin-traction method" in which the puncture point of the skin over the internal jugular vein (IJV) is stretched upward with several pieces of surgical tape in the cephalad and caudad directions to facilitate cannulation of the IJV. We investigated whether this method increases the cross-sectional area of the IJV.

Methods: In 11 healthy volunteers, the cross-sectional area, anteroposterior diameter, and transverse diameter of the right IJV (RIJV) were recorded by ultrasound echo at head tilts of +10 degrees , +5 degrees , 0 degrees , -5 degrees , and -10 degrees with and without the skin-traction method.

Modified oxygen mask to induce target levels of hyperoxia and hypercarbia during radiotherapy: a more effective alternative to carbogen.

Purpose: Carbogen has long been under investigation as an adjuvant to radiotherapy of tumors. A major factor confounding its evaluation is its inconsistency in raising blood partial pressure of CO(2) (pCO(2)). We investigated whether a new partial rebreathing method would provide better control of pCO(2) than carbogen.

Cardiac output increases the rate of carbon monoxide elimination in hyperpneic but not normally ventilated dogs.

Purpose: The very high solubility of carbon monoxide (CO) in blood suggests that its elimination depends predominantly on ventilation and not perfusion. Nevertheless, hyperventilation is not used for CO elimination because of the adverse effects of hypocapnia. With isocapnic hyperpnea (IH), ventilation can be increased considerably without hypocapnia.

Modified N95 mask delivers high inspired oxygen concentrations while effectively filtering aerosolized microparticles.

Study Objective: In a pandemic, hypoxic patients will require an effective oxygen (O2) delivery mask that protects them from inhaling aerosolized particles produced by others, as well as protecting the health care provider from exposure from the patient. We modified an existing N95 mask to optimize O2 supplementation while maintaining respiratory isolation.

Methods: An N95 mask was modified to deliver O2 by inserting a plastic manifold consisting of a 1-way inspiratory valve, an O2 inlet and a gas reservoir.

The changes in pulmonary capillary blood flow and anatomical dead space during pulmonary resection under one-lung ventilation.

Pulmonary capillary blood flow (PCBF), anatomical dead space (VDaw) and SpO2 were measured and recorded continuously using NICO (Novametrix Medical Systems Inc, USA) in 2 cases during pulmonary resection under one-lung ventilation (OLV). A pulmonary artery catheter was inserted and continuous CO (CCO) was also measured in case 2. In both cases PCBF decreased by half when one lung was blocked.

Calculation of O2 consumption during low-flow anesthesia from tidal gas concentrations, flowmeter, and minute ventilation.

We present the principles of a new method to calculate O2 consumption (V*O2) during low-flow anesthesia with a circle circuit when the source gas flows, end-tidal O2 concentrations and patient inspired minute ventilation are known. This method was tested in a model with simulated O2 uptake and CO2 production. The difference between calculated V*O2 and simulated V*O2 was 0.

Dispersal of respiratory droplets with open vs closed oxygen delivery masks: implications for the transmission of severe acute respiratory syndrome.

Nosocomial transmission of droplet-borne respiratory infections such as severe acute respiratory syndrome (SARS) may be influenced by the choice of oxygen face mask. A subject inhaled saline mist and exhaled through three oxygen masks to illustrate the pattern of dispersal of pulmonary gas. In two commonly used masks, exhaled gas formed a plume emanating from the side vents, while a third mask with a valved manifold, which was modified by adding a respiratory filter, retained the droplets.