Effects of temperature on lung and blood gases in the South American rattlesnake Crotalus durissus terrificus

The effects of temperature on lung and blood gases were measured in the South American rattlesnake (Crotalus durissus terrificus). Arterial blood and lung gas samples were obtained from chronically cannulated animals at 15, 25, and 35 degrees C. As expected for reptiles, arterial pH fell with increased temperature (0.018 U degrees C-1 between 15 and 25 degrees C and 0.011 U degrees C-1 between 25 and 35 degrees C) while lung gas PCO2 rose from 5.8 mmHg at 15 degrees C to 13.2 mmHg at 35 degrees C. Concurrently, lung gas PO2 declined from 132 mmHg at 15 degrees C to 120 mmHg at 35 degrees C, and arterial PO2 increased from 33 to 76 mmHg in that temperature range. Arterial haemoglobin O-2 saturation rose from 0.53 at 15 degrees C to 0.83 at 25 degrees C but became slightly reduced (0.77) with a further elevation of temperature to 35 degrees C. Arterial haemoglobin concentration increased from 1.96 to 2.53 mM between 15 and 35 degrees C, consistent with higher demands on oxygen delivery to tissues at elevated temperatures. Moreover, the substantial increase of haemoglobin O-2 saturation between 15 and 25 degrees C conforms to the idea that reduction of the central vascular right-to-left shunt (pulmonary bypass of systemic venous return) is associated with high metabolic demands. (C) 1998 Elsevier B.V. All rights reserved.

Effects of Tityus serrulatus scorpion venom on lung mechanics and inflammation in mice

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Determinação de eletrólitos, gases sanguíneos, osmolalidade, hematócrito, hemoglobina, base titulável e anion gap no sangue venoso de equinos destreinados submetidos a exercício máximo e submáximo em esteira rolante

Estudaram-se as alterações nos eletrólitos, nos gases sanguíneos, na osmolalidade, no hematócrito, na hemoglobina, nas bases tituláveis e no anion gap no sangue venoso de 11 equinos da raça Puro Sangue Árabe, destreinados, submetidos a exercício máximo e submáximo em esteira rolante. Esses animais passaram por período de três dias de adaptação à esteira rolante e posteriormente realizaram dois exercícios testes, um de curta e outro de longa duração. Foram coletadas amostras de sangue venoso antes, imediatamente após e 30 minutos após o término dos exercícios. Após a realização do exercício máximo, observou-se diminuição significativa no pHv, na PvCO2, no HCO3, na cBase além de elevação no AG. Detectou-se também aumento do K+, do Ht e da Hb. Ao final do exercício submáximo, constatou-se somente aumento significativo no pHv, na cBase, na SatvO2 e na PvO2. Conclui-se que os equinos submetidos a exercício máximo desenvolveram acidose metabólica e alcalose respiratória compensatória, hipercalemia e aumento nos valores de hematócrito e hemoglobina. No exercício submáximo, os animais apresentaram alcalose metabólica hipoclorêmica e não ocorreram alterações no equilíbrio hidroeletrolítico.

Cinética da fermentação e taxas de degradação de forrageiras tropicais em diferentes idades de corte estimadas pela técnica de produção de gases in vitro

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

The influence of physical activity in the progression of experimental lung cancer in mice

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Avaliação do efeito de gases poluentes na corrosão metálica: um experimento para o ensino da corrosão

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Positive end-expiratory pressure in acute respiratory distress syndrome: should the 'open lung strategy' be replaced by a 'protective lung strategy'?

In patients with acute respiratory distress syndrome, positive end-expiratory pressure is associated with alveolar recruitment and lung hyperinflation despite the administration of a low tidal volume. The best positive end-expiratory pressure should correspond to the best compromise between recruitment and distension, a condition that coincides with the best respiratory elastance.

Umidificação e aquecimento do gás inalado durante ventilação artificial com baixo fluxo e fluxo mínimo de gases frescos

JUSTIFICATIVA E OBJETIVOS: em pacientes sob intubação traqueal ou traqueostomia, a umidificação e o aquecimento do gás inalado são necessários para a prevenção de lesões no sistema respiratório, conseqüentes ao contato do gás frio e seco com as vias aéreas. O objetivo da pesquisa foi avaliar o efeito do sistema respiratório circular com absorvedor de dióxido de carbono do aparelho de anestesia Cícero da Dräger, quanto à capacidade de aquecimento e umidificação dos gases inalados, utilizando-se fluxo baixo (1 L.min-1) ou mínimo (0,5 L.min-1) de gases frescos. MÉTODO: O estudo aleatório foi realizado em 24 pacientes, estado físico ASA I, com idades entre 18 e 65 anos, submetidos à anestesia geral, utilizando-se a Estação de Trabalho Cícero da Dräger (Alemanha), para realização de cirurgias abdominais, os quais foram distribuídos aleatoriamente em dois grupos: grupo de Baixo Fluxo (BF), no qual foi administrado 0,5 L.min-1 de oxigênio e 0,5 L.min-1 de óxido nitroso e fluxo mínimo (FM), administrando-se somente oxigênio a 0,5 L.min-1. Os atributos estudados foram temperatura, umidade relativa e absoluta da sala de operação e do gás no sistema inspiratório. RESULTADOS: Os valores da temperatura, umidade relativa e umidade absoluta no sistema inspiratório na saída do aparelho de anestesia e junto ao tubo traqueal não apresentaram diferença significante entre os grupos, mas aumentaram ao longo do tempo nos dois grupos (BF e FM), havendo influência da temperatura da sala de operação sobre a temperatura do gás inalado, nos dois grupos estudados. Níveis de umidade e temperatura próximos dos ideais foram alcançados, nos dois grupos, a partir de 90 minutos. CONCLUSÕES: Não há diferença significante da umidade e temperatura do gás inalado utilizando-se baixo fluxo e fluxo mínimo de gases frescos.

Comparison of lung tissue concentrations of nebulized ceftazidime in ventilated piglets: ultrasonic versus vibrating plate nebulizers

Objective: To compare the efficiency of an Aeroneb Pro vibrating plate and an Atomisor MegaHertz ultrasonic nebulizer for providing ceftazidime distal lung deposition.Design: In vitro experiments. One gram of cetazidime was nebulized in respiratory circuits and mass median aerodynamic diameter of particles generated by ultrasonic and vibrating plate nebulizers was compared using a laser velocimeter. In vivo experiments. Lung tissue concentrations and extrapulmonary depositions were measured in ten anesthetized ventilated piglets with healthy lungs that received 1 g of ceftazidime by nebulization with either an ultrasonic (n = 5), or a vibrating plate (n = 5) nebulizer.Setting: A two-bed Experimental Intensive Care Unit of a University School of Medicine.Intervention: Following sacrifice, 5 subpleural specimens were sampled in dependent and nondependent lung regions for measuring ceftazidime lung tissue concentrations by high-performance liquid chromatography.Measurements and results: Mass median aerodynamic diameters generated by both nebulizers were similar with more than 95% of the particles between 0.5 and 5 mu m. Lung tissue concentrations were 553 +/- 123 [95% confidence interval: 514-638] mu g g(-1) using ultrasonic nebulizer, and 452 +/- 172 [95% confidence interval: 376-528] mu g g(-1) using vibrating plate nebulizers (NS). Extrapulmonary depositions were, respectively, of 38 +/- 5% (ultrasonic) and 34 +/- 4% (vibrating plate) (NS).Conclusions: Vibrating plate nebulizer is comparable to ultrasonic nebulizers for ceftazidime nebulization. It may represent a new attractive technology for inhaled antibiotic therapy.

Lung ultrasound in acute respiratory distress syndrome and acute lung injury

Purpose of reviewLung ultrasound at the bedside can provide accurate information on lung status in critically ill patients with acute respiratory distress syndrome.Recent findingsLung ultrasound can replace bedside chest radiography and lung computed tomography for assessment of pleural effusion, pneumothorax, alveolar- interstitial syndrome, lung consolidation, pulmonary abscess and lung recruitment/de-recruitment. It can also accurately determine the type of lung morphology at the bedside (focal or diffuse aeration loss), and therefore it is useful for optimizing positive end-expiratory pressure. The learning curve is brief, so most intensive care physicians will be able to use it after a few weeks of training.SummaryLung ultrasound is noninvasive, easily repeatable and allows assessment of changes in lung aeration induced by the various therapies. It is among the most promising bedside techniques for monitoring patients with acute respiratory distress syndrome.

Compensatory lung growth in autologous lobar implant: Experimental study in dogs

Background. The best way to study compensatory lung growth (CLG) is in a transplant without rejection. Since immunosuppressive drugs may influence CLG, it is better to not use them. Therefore we studied CLG in a reimplant of only one lobe after its removal. The objective was to compare lobar transplant CLG with CLG after lobectomy.Methods. Forty eight dogs were distributed in three groups: G1 = control, G2 = left cranial lobectomy, and G3 = left pneumonectomy with reimplantation of the caudal lobe. Five months after surgery the animals underwent lung scintigraphy and were sacrificed for morphometric study.Results. There was no correlation between scintigraphy and lung mass or lung volume. There was both mass and residual volume CLG in the operated groups, both contralateral and ipsilateral to surgery. There was no compensation for total lung capacity or compliance in the remaining caudal lobe (G2) or the reimplanted caudal lobe (G3) at 5 months after surgery. There was more damage in the reimplanted lobe. As previous studies have shown that CLG starts with increased mass and residual volume and compliance is compensated later. This study seemed to document the beginning of CLG, with lung compliance being the limiting factor of CLG at 5 months.Conclusion. There was CLG in both the reimplanted lobe and the contralateral lung, but compliance was still reduced. CLG was similar in both groups, but in the implanted lobe compliance was more prejudiced.

Systemic response induced by Scorpaena plumieri fish venom initiates acute lung injury in mice

Scorpaena plumieri venomous fish inflicted severe injuries in humans characterized by systemic effects and cardiovascular abnormalities. Although cardiotoxic and hypotensive effects induced in rats by this venom have been studied, little is known about their effect on bronchial epithelial permeability and airway inflammation in mice. The primary goal of this study was to determine whether the intraplantar or intraperitoneal injection of S. plumieri venom results in systemic response, and whether this event initiates acute lung injure. We found that BALB/c mice developed neutrophilic infiltrates, areas of lung hemorrhage and alveolar macrophage activation within 24 h after injection with S. plumieri venom. These histopathological changes were associated with an early increase in BAL fluid protein and early induction of cytokines, chemokines and matrix metaloproteinases, followed by a later increase in BAL fluid neutrophils. These findings provide clear evidence that the injection of S. plumieri venom in footpad or peritoneal cavity of mice results in venom deposition in the airway and initiates a sustained inflammatory response in the lungs. (C) 2007 Elsevier Ltd. All rights reserved.

Predictors of first-year survival in patients with advanced COPD treated using long-term oxygen therapy

Little evidence-based guidance is available to aid clinicians in determining short-term prognoses in very severe COPD patients. Therefore, the present study was designed to provide a prospective assessment (1) of the mortality rates and (2) whether the baseline measurements may be determinants of 1-year mortality in hypoxemic COPD patients receiving long-term oxygen therapy (LTOT).Seventy-eight clinically stable patients with advanced COPD treated using LTOT were enrolled in a prospective cohort study. Outcome variable: first-year mortality. Baseline measurements: categorical variables: age (<60 or >= 60 years); gender; body mass index (<20 or >= 20 kg/m(2)); fat-free mass (FFM) index (<16 [men] and <15kg/m(2) [women]; baseline dyspnea index (BDI) (<= 3 or >3); and corticosteroid use. Continuous variables: smoking history; lung function; FFM; fat mass; hemoglobin; hematocrit; arterial blood gases; forearm muscle strength; St. George's Respiratory Questionnaire (SGRQ); and comorbidity score. By the end of 1-year of follow-up, 12 patients (15.4%) had died. Kaplan-Meier curves showed that BDI <= 3 was the only variable associated with higher mortality. Cox proportional hazards analysis revealed that tower PaO2 and SPO2, higher PaCO2 and SGRQ scores were associated with reduced survival. In the multivariate analysis, BDI remained predictive of mortality (hazard ratio [HR], 0.50; 95% confidence interval [CI], 0.31-0.81), as did PaO2 (HR, 0.49; 95% CI, 0.26-0.95). These data suggest that readily available parameters as dyspnea intensity and hypoxemia severity may be useful in predicting first-year survival rates in advanced COPD patients receiving LTOT (C) 2007 Elsevier Ltd. All rights reserved.

Influence of glycemic control on fetal lung maturity in gestations affected by diabetes or mild hyperglycemia

Objective. To evaluate the influence of glycemic control on fetal lung maturity in pregnancies affected by diabetes or mild hyperglycemia. Design. Cross-sectional study. Setting. Level III maternity center. Population. A total of 187 pregnant women were submitted to routine amniocentesis for the assessment of fetal lung maturity up to 72 hours before delivery. Methods. Fetal lung maturity thresholds were: Clements-positive at a dilution of 0.5; OD(650) nm >= 0.15; and lamellar body count (LBC) >= 32,000/mu l. The relation of test results with adequate (<= 6.7 mmol/l) or poor (> 6.7 mmol/l) glycemic mean (GM) at term and at preterm was evaluated. Main outcome measure. Delay in fetal lung maturity when glycemic control was poor. Results. Glycemic control was adequate in 146 (78.1%) women. Clements maturity rates were higher at term (91.9%) than at preterm (64.7%) when GM <= 6.7 mmol/l (p < 0.001), but not when control was inadequate. LBC median was higher at term (99.0; 62.0-154.0) than at preterm (66.5; 40.5-108.25) (p = 0.009) when GM <= 6.7 mmol/l, while GM > 6.7 mmol/l did not lead to any difference between these rates at term or preterm. When glycemic control was adequate, OD(650) nm medians at term and at preterm were similar. However, when GM > 6.7 mmol/l, OD(650) nm median at term (0.29; 0.22-0.40) was higher than that observed at preterm (0.15; 0.12-0.18) (p < 0.001). Conclusions. Our results suggest that in term pregnancies routine amniocentesis for the assessment of fetal lung maturity should be abandoned. In preterm pregnancies, or when glycemic control is inadequate it is recommended.