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Respiratory plasticity induced by chronic hyperoxia in juvenile and adult rats.
Respir Physiol Neurobiol
December 2024
Department of Biology, Bates College, Lewiston, ME 04240, USA.
Chronic hyperoxia during early postnatal development depresses breathing when neonatal rats are returned to room air and causes long-lasting attenuation of the hypoxic ventilatory response (HVR). In contrast, little is known about the control of breathing of juvenile or adult mammals after chronic exposure to moderate hyperoxia later in life. Therefore, Sprague-Dawley rats were exposed to 60 % O for 7 days (juveniles) or for 4 and 14 days (adults) and ventilation was measured by whole-body plethysmography immediately after the exposure or following a longer period of recovery in room air.
View Article and Find Full Text PDFCorticosteroids in Pediatric Septic Shock: A Narrative Review.
J Pers Med
December 2024
Neonatal and Pediatric Intensive Care Unit, University Hospital of Messina, 98124 Messina, Italy.
A controversial aspect of pediatric septic shock management is corticosteroid therapy. Current guidelines do not recommend its use in forms responsive to fluids and inotropes but leave the decision to physicians in forms refractory to the first steps of therapy. Review of literature from January 2013 to December 2023 from online libraries Pubmed, Medline, Cochrane Library, and Scopus.
View Article and Find Full Text PDFOpioid-induced respiratory depression: clinical aspects and pathophysiology of the respiratory network effects.
Am J Physiol Lung Cell Mol Physiol
December 2024
The author is retired. The positions and affiliations are those prior to his retirement.
Important insights and consensus remain lacking for risk prediction of opioid-induced respiratory depression (OIRD), reversal of respiratory depression (RD), the pathophysiology of OIRD, and which sites make the most significant contribution to its induction. The ventilatory response to inhaled carbon dioxide is the most sensitive biomarker of OIRD. To accurately predict respiratory depression (RD), a multivariant RD prospective trial using continuous capnograph and oximetry examining 5 independent variables: age ≥60, sex, opioid naivety, sleep disorders, and chronic heart failure (PRODIGY trial), was undertaken.
View Article and Find Full Text PDFExercise testing in clinical context: Reference ranges for interpreting anaerobic threshold as an outcome for congenital heart disease patients.
Int J Cardiol Congenit Heart Dis
December 2024
Department of Cardiology, Boston Children's Hospital, Boston, MA, USA.
Background: Change in the oxygen consumption (VO) at the ventilatory anaerobic threshold (VAT) is an important outcome in research studies of children with congenital heart disease (CHD). The range of values reported by different raters for any given VAT is needed to contextualize a change in VAT in intervention studies.
Methods: Sixty maximal cardiopulmonary exercise tests (CPET) for CHD patients 8-21 years old were independently reviewed by six exercise physiologists and four pediatric cardiologists.
Acute hypoxic ventilatory response is an important reflex that helps maintain breathing during low oxygen levels, but it is attenuated by most general anaesthetics. Analgesic doses of ketamine and esketamine are known to have respiratory stimulant effects. In their recent study in the British Journal of Anaesthesia, Jansen and colleagues show that low-dose esketamine preserved the acute hypoxic ventilatory response, while increasing breathing rate, systolic blood pressure, and heart rate.
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