Magnetic (eddy-current) stimulation of the inspiratory motor nerves in the neck of the anesthetized dog was achieved. Using a 10-turn coil wound around the base of the neck and a train of pulses (25/s), inspiration was produced by tetanic contraction of the inspiratory muscles. The volume of air inspired increased with an increase in the voltage applied to the capacitor that was discharged repetitively into the coil. In this 10-dog study, the maximum inspired volume was in excess of the spontaneous tidal volume. In a second study, breathing was captured by repeating the stimulus trains at a rate in excess of the spontaneous breathing rate. Oxygen consumption was measured during spontaneous breathing and with captured breathing. The oxygen uptake with magnetic electroventilation was, on the average, 75% higher than with spontaneous breathing. However body temperature did not increase. Although the neck coil was not critical in placement, its field of stimulation was larger than needed to stimulate the phrenic and accessory motor nerves.
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http://dx.doi.org/10.1007/BF02368176 | DOI Listing |
Semin Liver Dis
January 2025
Hepatology, University of Pennsylvania, Philadelphia, United States.
Critically ill patients with cirrhosis and liver failure not uncommonly have hypotension due to multifactorial reasons, that include hyperdynamic state with increased cardiac index, low systemic vascular resistance due to portal hypertension, following the use of beta blocker or diuretic therapy, and severe sepsis. These changes are mediated by microvascular alterations in the liver, systemic inflammation, activation of renin angiotensin aldosterone system, and vasodilatation due to endothelial dysfunction. Hemodynamic assessment includes measuring inferior vena cava indices, cardiac output and systemic vascular resistance using point-of-care ultrasound (POCUS), in addition to arterial waveform analysis, or pulmonary artery pressures, and lactate clearance to guide fluid resuscitation.
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 PDFRadiol Case Rep
March 2025
Faculty of Medicine, Arab American University of Palestine, Jenin, Palestine.
Spontaneous cervical swelling syndrome is an uncommon clinical syndrome characterized by the sudden onset of swelling in the cervical region with no identifiable cause. A 47-year-old woman with a history of Iron Deficiency Anemia presented to the emergency department (ED) complaining of an acute left neck and upper chest swelling and pressure sensation in her neck. The swelling started suddenly and was growing rapidly over several hours.
View Article and Find Full Text PDFJ Cardiothorac Surg
January 2025
Thoracic Surgery Unit, Careggi University Hospital, Largo Brambilla, 1, 50134, Florence, Italy.
Background: Lung cancer is the first cause of cancer-related death. Awake lung resection is a new frontier of the concept of minimally invasive surgery. Our purpose is to demonstrate the feasibility of this technique for lobar and sublobar lung resection in NSCLC patients.
View Article and Find Full Text PDFChest
January 2025
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. Electronic address:
Background: Ventilator-associated pneumonia (VAP) rates are higher in low- and middle-income countries (LMICs) than in high-income countries (HICs).
Research Question: Could differences in ventilator bundle adherence, ventilation practices, and critical care staffing be driving variations in VAP risk between LMICs and HICs?
Study Design And Methods: This secondary analysis of the multicenter, international CERTAIN study included mechanically ventilated patients at risk for VAP from eleven LMICs and five HICs. We included oral care, head-of-bed elevation, spontaneous breathing assessments, and sedation breaks in the ventilator bundle.
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