This study is a critical evaluation of the concept of Milic-Emili et al. (J. Appl. Physiol 1966, 21: 749-759) that lung density has an overwhelming influence on the regional distribution of alveolar expansions and transpulmonary pressures, at least in healthy subjects in quasi-static conditions. Our measurements showed, indeed, that these distributions have a vertical, gravitational gradient, and that almost mirror images of these were obtained after 180 degrees body inversion. These inversions of distributions were not accompanied by interfering changes in shape of chest or lung. This implies that the lung, although being a structured network and thus essentially subjected to stress-strain interactions, behaves mechanically as a liquid in a gravitational field, at least within the conditions of our investigations.
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Zhonghua Er Ke Za Zhi
January 2025
Heart Center, Women and Children's Hospital, Qingdao University, Qingdao266034, China.
To evaluate the clinical efficacy of percutaneous balloon pulmonary valvuloplasty (PBPV) via antegrade venous-arterial loop in neonates with critical pulmonary stenosis with intact ventricular septum (CPS-IVS). A retrospective case review was conducted. Fifteen neonates with CPS-IVS who underwent PBPV via antegrade venous-arterial loop at the Women and Children's Hospital, Qingdao University between September 2020 and September 2023 were included.
View Article and Find Full Text PDFFront Med (Lausanne)
January 2025
Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
Introduction: Positive end-expiratory pressure (PEEP) and prone positioning can improve gas exchange by promoting uniform lung aeration. However, elevated ventilation pressures may increase intracranial pressure (ICP) and disrupt cerebral autoregulation. This study investigated the effects of PEEP on ICP and cerebral autoregulation in a porcine model with healthy lungs and normal ICP, comparing prone and supine positions.
View Article and Find Full Text PDFCurr Opin Crit Care
January 2025
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, University of Milan, Milan, Italy.
Purpose Of Review: The increasing use of prone position, in intubated patients with acute respiratory distress syndrome as well as in patients with acute hypoxemic respiratory failure receiving noninvasive respiratory support, mandates a better definition and monitoring of the response to the manoeuvre. This review will first discuss the definition of the response to prone positioning, which is still largely based on its effect on oxygenation. We will then address monitoring respiratory and hemodynamic responses to prone positioning in intubated patients.
View Article and Find Full Text PDFJ Clin Med
November 2024
Department of Cardiology, AORN dei Colli Monaldi Hospital, 80131 Naples, Italy.
: Pulmonary arterial elastance (Ea) is a helpful parameter to predict the risk of acute postoperative right ventricular failure (RVF) after left ventricular assist device (LVAD) implantation. A new method for calculating Ea, obtained by the ratio between transpulmonary gradient and stroke volume (Ea), has been proposed as a more accurate measure than the Ea obtained as the ratio between pulmonary artery systolic pressure and stroke volume (Ea). However, the role of Ea in predicting acute RVF post-LVAD implantation remains unclear.
View Article and Find Full Text PDFEur Respir J
December 2024
Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
Background: Exercise pulmonary hypertension (PH) was defined by a mean pulmonary arterial pressure (mPAP)/cardiac output (CO) slope >3 mmHg·min·L between rest and exercise in the 2022 European Society of Cardiology/European Respiratory Society PH guidelines. However, large, multicentre studies on the prognostic relevance of exercise haemodynamics and its added value to resting haemodynamics are missing.
Patients And Methods: The PEX-NET (Pulmonary Haemodynamics during Exercise Network) registry enrolled patients who underwent clinically indicated right heart catheterisations both at rest and ergometer exercise from 23 PH centres worldwide.
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