Lung volume reduction surgery (LVRS) results in functional improvements in most patients. The mechanisms behind the improvements are not clear. We hypothesized that reduced inequalities in ventilation to perfusion ratio (V/Q) may be a contributing explanation. Nine patients who underwent LVRS were investigated by ventilation and perfusion scintigrams before and after surgery. In addition, 8 healthy subjects were investigated once. The relative ventilation, perfusion and V/Q were calculated in 1 x 1 cm lung elements. Normal range of the element count-rate was determined by the corresponding results in the normal subjects. Results of this small study show a significant effect of LVRS on V/Q, with reduction of shunt-like elements. We conclude that the functional improvement after LVRS to some extent may be explained by decreased V/Q inequality.
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http://dx.doi.org/10.1111/j.1475-097X.2005.00606.x | DOI Listing |
Med Intensiva (Engl Ed)
January 2025
Servicio ECMO, Fundación Cardiovascular de Colombia, Bucaramanga, Colombia.
Objective: To document the experience with ECMO therapy in healthcare institutions across Latin America between 2016 and 2020.
Design: Cross-sectional study.
Setting: Private and public health institutions from 7 countries.
Surgery
January 2025
Senior Department of Burns & Plastic Surgery, Institute of Burn in the Fourth Medical Centre, Chinese PLA General Hospital, Beijing, China. Electronic address:
Background: Primary blast lung injury is a common and severe consequence of explosion events, characterized by immediate and delayed effects such as apnea and rapid shallow breathing. The overpressure generated by blasts leads to alveolar and capillary damage, resulting in ventilation-perfusion mismatch and increased intrapulmonary shunting. This reduces the effective gas exchange area, causing hypoxemia and hypercapnia.
View Article and Find Full Text PDFJ Physiol
January 2025
Heart Research, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Although the corticosteroid betamethasone is routinely administered to accelerate lung and cardiovascular maturation in the preterm fetus prior to birth, and use of delayed cord clamping (DCC) is recommended at birth by professional bodies, it is unknown whether antenatal betamethasone alters perinatal pulmonary or systemic arterial blood flow accompaniments of DCC. To address this issue, preterm fetal lambs [gestation 127 (1) days, term = 147 days] with (n = 10) or without (n = 10) antenatal betamethasone treatment were acutely instrumented under general anaesthesia with flow probes to obtain left (LV) and right ventricular (RV) outputs, major central arterial blood flows and shunt flow across both the ductus arteriosus and foramen ovale (FO). After delivery, lambs underwent initial ventilation for 2 min prior to DCC.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
December 2024
Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, Birmingham, AL. Electronic address:
Objective: The clinical importance of individualized blood pressure management in optimizing cerebral perfusion during cardiac surgery has been well established. However, consensus on blood pressure goals is lacking. The authors studied the associations between cerebral autoregulation metrics, hemodynamic parameters, and postoperative outcomes, and hypothesized that increased time of mean arterial pressure (MAP) below the lower limit of autoregulation (LLA) is associated with major morbidity and mortality (MMOM) incidence.
View Article and Find Full Text PDFPhysiol Meas
January 2025
Department of Critical Care Medicine, Peking Union Medical College Hospital, No.1 Shuaifuyuan, Dongcheng District, Dongcheng-qu, 100730, CHINA.
Prone positioning is a therapeutic strategy for severe Acute Respiratory Distress Syndrome (ARDS). In COVID-19-associated ARDS (CARDS), the application of prone position has shown varying responses, influenced by factors such as lung recruitability and SARS-CoV-2-induced pulmonary endothelial dysfunction. This study aimed to compare the early impact of pronation on lung ventilation-perfusion matching (VQmatch) in CARDS and non-COVID-19 ARDS patients (non-CARDS).
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