Respiratory physiology & neurobiology
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Every year thousands of ski, trekking or climbing fans travel to the mountains where they stay at the altitude of more than 2500-3000m above sea level or climb mountain peaks, often exceeding 7000-8000m. High mountain climbers are at a serious risk from the effects of adverse environmental conditions prevailing at higher elevations. They may experience health problems resulting from hypotension, hypoxia or exposure to low temperatures; the severity of those conditions is largely dependent on elevation, time of exposure as well as the rate of ascent and descent. ⋯ HAPE incidence ranges from an estimated 0.01% to 15.5%. Climbers with a previous history of HAPE, who ascent rapidly above 4500m have a 60% chance of illness recurrence. The aim of this article was to present the relevant details concerning epidemiology, pathophysiology, clinical symptoms, prevention, and treatment of high altitude pulmonary edema among climbers in the mountain environment.
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Acute respiratory distress syndrome (ARDS) and its milder form acute lung injury (ALI) may result from various diseases and situations including sepsis, pneumonia, trauma, acute pancreatitis, aspiration of gastric contents, near-drowning etc. ALI/ARDS is characterized by diffuse alveolar injury, lung edema formation, neutrophil-derived inflammation, and surfactant dysfunction. ⋯ Changed concentrations of individual markers may suggest injury or activation of the specific types of lung cells-epithelial or endothelial cells, neutrophils, macrophages, etc.), and thereby help in diagnostics and in evaluation of the patient's clinical status and the treatment efficacy. This chapter reviews various biomarkers of acute lung injury and evaluates their usefulness in diagnostics and prognostication of ALI/ARDS.
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Respir Physiol Neurobiol · Jan 2015
Pleural liquid and kinetic friction coefficient of mesothelium after mechanical ventilation.
Volume and protein concentration of pleural liquid in anesthetized rabbits after 1 or 3h of mechanical ventilation, with alveolar pressure equal to atmospheric at end expiration, were compared to those occurring after spontaneous breathing. Moreover, coefficient of kinetic friction between samples of visceral and parietal pleura, obtained after spontaneous or mechanical ventilation, sliding in vitro at physiological velocity under physiological load, was determined. ⋯ Protein concentration of pleural liquid after mechanical ventilation was also similar to that occurring after spontaneous ventilation. Coefficient of kinetic friction after mechanical ventilation was 0.023±0.001, similar to that obtained after spontaneous breathing.
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Respir Physiol Neurobiol · Jan 2015
Electrical activity of the diaphragm during progressive cycling exercise in endurance-trained men.
The study aimed to investigate diaphragm respiratory drive modulation through electrical activity of the diaphragm (EADi) during progressive cycling in endurance-trained men (N=7) and to test day-to-day measurement reliability. Normalized EADi increased at exercise intensities from 40% workload (WL) to 70% and 85%WL but plateaued from 70% to 85% (p<0.05). ⋯ Within-day variability appeared constant indicating that measurements within a trial are reliable. Results suggest that diaphragm respiratory drive increases at moderate exercise intensities, but plateaus at high intensities where other respiratory muscles might contribute significantly to the breathing effort, perhaps to "protect" against diaphragm fatigue.
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Respir Physiol Neurobiol · Jan 2015
Derivation of recruitment function from the pressure-volume curve in an acute lung injury model.
Lung volume changes involve the recruitment of collapsed alveoli and the expansion of already opened alveoli. This study aimed to determine the alveolar recruitment function by using a mathematical model from a pressure-volume curve (P-V curve). ⋯ We obtained the P-R curve from the P-V curve, and two curves were differently shaped after lung injury. We concluded that the recruitment function was obtained from the P-V curve and that the P-R curve estimated the recruitment and derecruitment status.