Lung mechanics in congenital heart disease with increased and decreased pulmonary blood flow

Bancalari, Eduardo; Jesse, Mary Jane; Gelband, Henry; García, Otto L.

doi:10.1016/s0022-3476(77)80628-8

Cited by 111 publications

(53 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[31][32][33] It can be hypothesized that such changes in respiratory epithelial perfusion and pulmonary interstitial fluid homeostasis could alter sputum production. To our knowledge, there are no published reports concerning this topic.…”

Section: Discussionmentioning

confidence: 99%

Recombinant Human Deoxyribonuclease Shortens Ventilation Time in Young, Mechanically Ventilated Children

Riethmueller

Borth-Bruhns

Kumpf

et al. 2005

Pediatric Pulmonology

View full text Add to dashboard Cite

Summary. Recombinant human deoxyribonuclease I (dornase alfa) is currently used as an inhaled mucoactive agent in the treatment of cystic fibrosis. In a randomized, placebo-controlled, double-blind clinical study in 100 infants, we investigated whether the therapeutic use of dornase alfa can be extended to ventilated, fluid-restricted children to reduce reintubation rate, ventilation duration, pediatric intensive care unit (PICU) stay, and ventilation complications. While reintubation rates were similar for dornase alfa 7% vs. placebo 9% (odds ratio, 0.77; confidence interval, 0.11-4.9), the incidence of atelectasis (6 vs. 17, respectively; P-value 0.051), median ventilation time (2.2 vs. 3.4 days, respectively; P-value 0.043), median length of PICU stay (7 vs. 8 days, respectively; P-value 0.051), and mean costs (s4,830 vs. s6,320, respectively) were lower in the dornase alfa group. No adverse effects were observed, even in critically ill patients. We found that dornase alfa was beneficial and safe. Our findings also indicate that dornase alfa is possibly of value from the first day of mechanical ventilation onward, particularly when longer ventilation (>3 days) is expected in fluid-restricted children after cardiac surgery.

show abstract

Section: Discussionmentioning

confidence: 99%

Recombinant Human Deoxyribonuclease Shortens Ventilation Time in Young, Mechanically Ventilated Children

Riethmueller

Borth-Bruhns

Kumpf

et al. 2005

Pediatric Pulmonology

View full text Add to dashboard Cite

show abstract

“…Semuanya ini akan menyebabkan kerusakan mukosa saluran napas, gangguan imunitas dan pada akhirnya meningkatkan risiko infeksi saluran pernapasan. 15,[16][17][18] Infeksi saluran pernapasan sering dialami pada 3 tahun pertama kehidupan, khususnya pada tahun pertama. Hal ini kemungkinan berhubungan dengan status imunitas dan ukuran jalan napas yang kecil pada anak-anak yang lebih muda.…”

Section: (Tabel 7)unclassified

Beberapa Faktor yang Berhubungan dengan Episode Infeksi Saluran Pernapasan Akut pada Anak dengan Penyakit Jantung Bawaan

Wilar

Wantania

2016

View full text Add to dashboard Cite

“…forced oscillations; alveolar wall; elastin; end-expiratory lung volume THE MECHANICAL PROPERTIES of the lungs are significantly influenced by changes in the pulmonary hemodynamic conditions (3,7,9,11,20,21, 27,29,(35)(36)(37)40). Numerous clinical (3,7,9,11,20, 27) and experimental studies (29,36,37) have demonstrated that elevation of the pulmonary blood flow (7,20, 27) and/or pressure (3, 11, 29, 36, 37) leads to a deterioration of the lung function via a decrease in functional residual capacity (FRC) (7) and/or stiffening of the alveolar wall (40). Although the qualitative examinations performed by von Basch (38a) in 1889 suggested that not only congestion, but also pulmonary hypoperfusion, can alter the lung configuration, few data are available concerning the changes in the mechanical conditions of the lungs during hypoperfusion or the complete absence of pulmonary perfusion (21,25,29,35).…”

mentioning

confidence: 99%

Impact of microvascular circulation on peripheral lung stability

Peták

Babik

Hantos

et al. 2004

American Journal of Physiology-Lung Cellular and Molecular Phys

View full text Add to dashboard Cite

volvement of pulmonary circulation in the mechanical properties was studied in isolated rat lungs. Pulmonary input impedance (ZL) was measured at a mean transpulmonary pressure (Ptp mean) of 2 cmH2O before and after physiological perfusion with either blood or albumin. In these lungs and in a group of unperfused lungs, ZL was also measured at Ptp mean values between 1 and 8 cmH2O. Airway resistance (R aw) and parenchymal damping (G) and elastance (H) were estimated from ZL. End-expiratory lung volume (EELV) was measured by immersion before and after blood perfusion. The orientation of the elastin fibers relative to the basal membrane was assessed in additional unperfused and blood-perfused lungs. Pressurization of the pulmonary capillaries significantly decreased H by 31.5 Ϯ 3.7% and 18.7 Ϯ 2.7% for blood and albumin, respectively. Perfusion had no effect on R aw but markedly altered the Ptpmean dependences of G and H Ͻ4 cmH 2O, with significantly lower values than in the unperfused lungs. At a Ptp mean of 2 cmH2O, EELV increased by 31 Ϯ 11% (P ϭ 0.01) following pressurization of the capillaries, and the elastin fibers became more parallel to the basal membrane. Because the organization of elastin fibers results in smaller H values of the individual alveolus, the higher H in the unperfused lungs is probably due to a partial alveolar collapse leading to a loss in lung volume. We conclude that the physiological pressure in the pulmonary capillaries is an important mechanical factor in the maintenance of the stability of the alveolar architecture. forced oscillations; alveolar wall; elastin; end-expiratory lung volume THE MECHANICAL PROPERTIES of the lungs are significantly influenced by changes in the pulmonary hemodynamic conditions (3,7,9,11,20,21, 27,29,(35)(36)(37)40). Numerous clinical (3,7,9,11,20, 27) and experimental studies (29,36,37) have demonstrated that elevation of the pulmonary blood flow (7,20, 27) and/or pressure (3, 11, 29, 36, 37) leads to a deterioration of the lung function via a decrease in functional residual capacity (FRC) (7) and/or stiffening of the alveolar wall (40). Although the qualitative examinations performed by von Basch (38a) in 1889 suggested that not only congestion, but also pulmonary hypoperfusion, can alter the lung configuration, few data are available concerning the changes in the mechanical conditions of the lungs during hypoperfusion or the complete absence of pulmonary perfusion (21,25,29,35). Mitzner et al. (25) observed a transient increase in the respiratory resistance and a decrease in the compliance after occluding a pulmonary artery in mice, but the explanation of this finding remained unclarified. Furthermore, we recently demonstrated that low pulmonary venous pressures cause an impairment in lung mechanics, manifested in increases in the parenchymal resistive and elastic parameters, while the airway properties remain unaffected (29). However, the mechanisms responsible for the compromised lung mechanics at low vascular pressure or when there is no perfusion ...

show abstract

Lung mechanics in congenital heart disease with increased and decreased pulmonary blood flow

Cited by 111 publications

References 8 publications

Recombinant Human Deoxyribonuclease Shortens Ventilation Time in Young, Mechanically Ventilated Children

Recombinant Human Deoxyribonuclease Shortens Ventilation Time in Young, Mechanically Ventilated Children

Beberapa Faktor yang Berhubungan dengan Episode Infeksi Saluran Pernapasan Akut pada Anak dengan Penyakit Jantung Bawaan

Impact of microvascular circulation on peripheral lung stability

Contact Info

Product

Resources

About