Respiratory physiology & neurobiology
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Respir Physiol Neurobiol · Nov 2020
Randomized Controlled TrialInspiratory neural drive and dyspnea in interstitial lung disease: Effect of inhaled fentanyl.
Exertional dyspnea in interstitial lung disease (ILD) remains difficult to manage despite advances in disease-targeted therapies. Pulmonary opioid receptors present a potential therapeutic target for nebulized fentanyl to provide dyspnea relief. ⋯ IND rose sharply during constant work rate exercise in association with dyspnea intensity in mild to moderate ILD but was not different after nebulized fentanyl compared with placebo.
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Respir Physiol Neurobiol · Jun 2020
Randomized Controlled TrialNasal high flow improves ventilation during propofol sedation: A randomized cross-over study in healthy volunteers.
Hypoventilation and carbon dioxide (CO2) retention are common during sedation. The current study investigated the ventilation responses to nasal high flow (NHF) during sedation with propofol. ⋯ During sedation with propofol, NHF without supplemental oxygen attenuated CO2 retention and reduced the respiratory rate. The findings show that NHF can improve ventilation during sedation, which may reduce the risk of complications related to hypoventilation.
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Respir Physiol Neurobiol · Sep 2018
Randomized Controlled Trial Multicenter Study Comparative Study Observational StudyPressure support ventilation vs Continuous positive airway pressure for treating of acute cardiogenic pulmonary edema: A pilot study.
Non-invasive ventilation is usually adopted as a support to medical therapy in patients with acute pulmonary edema, but which modality between Pressure Support Ventilation (PSV) and Continuous Positive Airway Pressure (CPAP) has better favourable effects is not been yet well known. Aim of this observational study was to provide data on these different non-invasive ventilation modalities in the management of acute cardiogenic pulmonary edema. ⋯ Furthermore, there were no significant differences regarding mortality in the two groups, but patients treated with PSV had a significant lower rate of endotracheal intubation and a higher improvement of blood gas analyses parameters. In conclusion, our data support only a slight advantage in favour to PSV versus CPAP.
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Respir Physiol Neurobiol · Jun 2018
Randomized Controlled TrialAcute bronchodilator therapy does not reduce wasted ventilation during exercise in COPD.
This randomized, double-blind, crossover study aimed to determine if acute treatment with inhaled bronchodilators, by improving regional lung hyperinflation and ventilation distribution, would reduce dead space-to-tidal volume ratio (VD/VT); thus contributing to improved exertional dyspnea in COPD. Twenty COPD patients (FEV1 = 50 ± 15% predicted; mean ± SD) performed pulmonary function tests and symptom-limited constant-work rate exercise at 75% peak-work rate (with arterialized capillary blood gases) after nebulized bronchodilator (BD; ipratropium 0.5mg + salbutamol 2.5 mg) or placebo (PL; normal saline). After BD versus PL: Functional residual capacity decreased by 0.4L (p = .0001). ⋯ There was no significant difference in arterial CO2 tension or VD/VT, but alveolar ventilation increased by 3.8 ± 5.5 L/min (p = .02). Post-BD improvements in respiratory mechanics explained 51% of dyspnea reduction at a standardized exercise time. Bronchodilator-induced improvements in respiratory mechanics were not associated with reduced wasted ventilation - a residual contributory factor to exertional dyspnea during exercise in COPD.
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Respir Physiol Neurobiol · Oct 2014
Randomized Controlled TrialFlow Controlled Expiration is perceived as less uncomfortable than positive end expiratory pressure.
Recently, we presented Flow Controlled Expiration (FLEX) as a new option for lung-protective ventilation. FLEX delays the expiratory volume decrease in the lungs without prolonging the duration of expiration. Most ventilated patients nowadays receive spontaneous breathing support. ⋯ Only in forced choice comparison a stronger FLEX condition was perceived as less comfortable (p<0.01) than a weaker one. We conclude that FLEX decreases the breathing comfort in healthy subjects to a lesser extent than PEEP. Therefore, FLEX might be used to support ventilation therapy in spontaneously breathing patients.