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1.
Fisioter. Bras ; 22(3): 412-424, Jul 15, 2021. tab, graf
Article in English | LILACS | ID: biblio-1284564

ABSTRACT

Objective: To compare in neonates with transitory tachypnea if chest rebalancing thoraco-abdominal method (RTA) increased immediate pain. Methods: This was a randomized controlled clinical trial. Forty-nine neonates with transitory tachypnea and aged < 72 hours were included to receive either conventional physiotherapy (CP) or RTA method. Participants received usual care and one 15- minute session of chest physiotherapy. Neonatal Infant Pain Scale (NIPS), peripheral oxygen saturation, heart rate, respiratory rate, axillary temperature before and after chest physiotherapy were recorded. Kruskal-Wallis ANOVA and Mc Nemar test were used to compare differences between measures. The relative risk (RR) for pain after interventions was calculated using a Poisson regression model (robust estimation). A significance level of 5% (p < 0.05) was adopted for all analyses. Results: RTA was not associated to pain. After chest physiotherapy, NIPS reduced (2 versus 3, p < 0.001) and number of neonates with pain reduced (10.2% versus 28.6%, p = 0.02). RR for pain after chest physiotherapy in comparison to before was 0.3 (95% CI 0.15-0.41; p = 0.02); respiratory frequency decreased after chest physiotherapy (58 versus 70, p < 0.001) and peripheral oxygen saturation increased (98% versus 96%, p < 0.001). Conclusion: In neonates with transitory tachypnea, in the first 72 hours of life, RTA did not influence pain evaluation, chest physiotherapy was safe and reduced immediate pain. (AU)


Objetivo: Comparar em recém-nascidos com taquipneia transitória se o método reequilíbrio tóraco-abdominal (RTA) aumentou a dor imediatamente após. Métodos: Estudo de ensaio clínico randomizado. Quarenta e nove recémnascidos com diagnóstico de taquipneia transitória com menos de 72 horas de vida, foram incluídos para receber fisioterapia respiratória. Os participantes receberam os cuidados usuais e uma sessão de fisioterapia convencional ou do método reequilíbrio tóraco-abdominal. Foram registradas a escala NIPS (Neonatal Infant Pain Scale), a saturação periférica de oxigênio, a frequência cardíaca, a frequência respiratória e a temperatura axilar antes e depois da fisioterapia. Para as comparações entre as medidas, foram utilizados o teste de ANOVA de Kruskal-Wallis e o teste de McNemar. O risco relativo de dor após os procedimentos foi calculado usando o modelo de regressão de Poisson (estimação robusta). Foi considerado o nível de significância de 5% para todas as análises (p < 0,05). Resultados: O método RTA não foi associado a dor. Após a fisioterapia respiratória, a escala NIPS reduziu (2 versus 3, p < 0,001) e a proporção de recém-nascidos com dor também reduziu (10,2% versus 28,6%, p = 0,02). O risco relativo de dor após a fisioterapia respiratória em comparação a antes, foi de 0,3 (IC 95% 0,15-0,41; p = 0,02), a frequência respiratória diminuiu (58 versus 70, p < 0,001) e a saturação periférica de oxigênio aumentou (98% versus 96%, p < 0,001). Conclusão: Em recém-nascidos com taquipneia transitória nas primeiras 72 horas de vida, o método RTA não influenciou a avaliação da dor, a fisioterapia respiratória foi segura e reduziu a dor imediatamente após. (AU)


Subject(s)
Humans , Infant, Newborn , Pain Measurement , Infant, Newborn , Physical Therapy Modalities , Pain , Respiration , Thorax , Analysis of Variance , Respiratory Rate
2.
Cambios rev. méd ; 20(1): 117-132, 30 junio 2021. tabs.
Article in Spanish | LILACS | ID: biblio-1292987

ABSTRACT

La principal función del sistema respira-torio es el intercambio de gases durante la inspiración y expiración, una alteración en cualquier parte de este sistema puede generar problemas respiratorios agudos como en el caso de la insuficiencia respiratoria aguda (IRA), que es la incapacidad pulmonar de cumplir con el intercambio gaseoso de oxígeno y dióxido de carbono entre el aire ambiental y la sangre circu-lante1, está acompañada de varios signos y síntomas como taquipnea, cianosis entre otros2, es de inicio súbito, y cons-tituye la causa de ingreso a las unidades de emergencia, por ello la Organización Mundial de la Salud (OMS) indica que "cientos de millones de personas sufren cada día las consecuencias de enferme-dades respiratorias"3. En los indicadores Básicos-Ecuador 2012 del Ministerio de Salud Pública (MSP) del Ecuador a nivel general registró 4 122 muertes por IRA, correspondió a la Provincia de Pichincha 8254, en el Hospital de Especialidades Carlos Andrade Marín (HECAM), la primera causa de ingreso correspondió a neumonía con el 41,29% en el periodo de enero-septiembre 2018 (Coordinación General de Planificación y Estadísticas HECAM).La ruta planteada constituye una herra-mienta que permite al personal de enfer-mería realizar una evaluación efectiva a través de una valoración inicial, primaria y secundaria, con el propósito de evitar complicaciones durante el cuidado de pa-cientes pediátricos con insuficiencia res-piratoria aguda en la Unidad Pediátricos Área de Emergencia (UPAE).


1. INTRODUCTION The main function of the respiratory system is the exchange of gases during inharing and exhaling processes. An al-teration in any part of this system can generate acute respiratory problems as in the case of acute respiratory failure (ARF), which is the inability of the lung to comply with the gaseous exchange of oxygen and carbon dioxide between the external air and circulating blood1. It is accompanied by various signs and symp-toms such as tachypnea, cyanosis, among others2, is of sudden start, and is the cause of admission to emergency units. This is why the World Health Organization (WHO) indicates that "hundreds of millions of people suffer the consequences of respiratory diseases every day"3. In the Basic Indicators-Ecuador 2012 of the Mi-nistry of Public Health of Ecuador at the general level recorded 4 122 deaths due to ARI, corresponding to the Province of Pichincha 8254, in the Carlos Andrade Marín Specialties Hospital (HECAM). The first cause of admission corresponded to pneumonia with 41,29% in the period January-September 2018 (General Coordination of Planning and Statistics HECAM).The proposed route constitutes a tool that allows the nursing staff to perform an effective evaluation through an initial, primary, and secondary assessment, with the purpose of avoiding complications during the care of pediatric patients with acute respiratory failure in the Pediatric Emergency Area Unit (UPAE).


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Pediatric Nursing , Respiratory Insufficiency/nursing , Emergency Nursing , Critical Care Nursing , Nursing Care , Pediatrics , Respiration , Respiration, Artificial , Hypoxia
3.
Rev. colomb. anestesiol ; 49(2): e500, Apr.-June 2021. graf
Article in English | LILACS, COLNAL | ID: biblio-1251502

ABSTRACT

Abstract Introduction Foreign body aspiration (FBA) is a potentially fatal paediatric emergency. Our objective was to highlight the importance of a multidisciplinary approach to difficult/doubtful diagnosis. Case report 34-month-old girl referred for urgent rigid bronchoscopy after suspected metallic blade ingestion (found chewing on it). She had a previous recurrent history of wheezing. The physical examination revealed face/lip wounds, traces of powder on her teeth but no breathing difficulty. The plain X-Ray revealed radiopaque images of the upper pulmonary field and gastric chamber. In the absence of FBA clinical signs but considering a previous history of bronchial hyperresponsiveness, a direct digital radiographic study was performed. There were no images compatible with foreign bodies: the results were interpreted as artefacts and no bronchoscopy was performed. Conclusions A careful pre-anaesthetic evaluation, a high level of suspicion and excellent multidisciplinary communication led to the recognition of false radiologic findings. A conservative approach was followed and invasive procedures in a remote location, with high anaesthetic risk for the paediatric population were avoided.


Resumen Introducción La aspiración de cuerpo extraño (ACE) es una emergencia pediátrica potencialmente fatal. La intención del presente artículo es resaltar la importancia de un abordaje multidisciplinario en caso de un diagnóstico difícil/dudoso. Reporte de caso Se trata de una paciente de 4 meses de edad remitida para broncoscopia rígida de urgencia, luego de la sospecha de ingestión de una hojilla metálica (se encontró a la bebé mordiéndola). La paciente tenía antecedentes de sibilancia. Al examen físico se encontraron heridas en la cara y los labios, rastros de polvo en los dientes, pero no había dificultad respiratoria. El examen de rayos-x mostraba imágenes radio opacas en el cuadrante superior derecho del pulmón y en la cámara gástrica. En virtud de la ausencia de signos clínicos de ACE en una paciente con antecedentes de hiperresponsividad bronquial, se realizó un estudio radiográfico digital. No hubo imágenes compatibles con cuerpos extraños: los resultados se interpretaron como artefactos y no se realizó la broncoscopia. Conclusiones Un cuidadoso examen pre-anestesia, el alto grado de sospecha y una excelente comunicación multidisciplinaria, permitieron el reconocimiento de hallazgos radiológicos falsos. Se siguió un abordaje conservador, evitando así procedimientos invasivos en lugares remotos con alto grado de riesgo para la población pediátrica.


Subject(s)
Humans , Male , Infant , Respiration , Respiratory Sounds , Eating , Emergencies , Foreign Bodies , Wounds and Injuries , X-Rays , Bronchoscopy , Risk , Artifacts , Absenteeism , Lung , Mastication
4.
Belo Horizonte; UFMG; 2021. 16 p.
Monography in Portuguese | LILACS, BDENF, ColecionaSUS | ID: biblio-1180000

ABSTRACT

Produto do projeto: Impacto da coordenação e acompanhamento do cuidado por telemonitoramento na qualidade da assistência prestada aos usuários do SUS portadores de doenças crônicas, egressos de internação hospitalar em Belo Horizonte, MG, Brasil.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Physical Endurance , Quality of Life , Respiration , Self Care , Teaching Materials , Unified Health System , Physical Fitness , Health Education , Pulmonary Disease, Chronic Obstructive/prevention & control , Nasal Lavage/methods
5.
Chinese Medical Journal ; (24): 281-291, 2021.
Article in English | WPRIM | ID: wpr-878037

ABSTRACT

BACKGROUND@#Conventional pressure support ventilation (PSP) is triggered and cycled off by pneumatic signals such as flow. Patient-ventilator asynchrony is common during pressure support ventilation, thereby contributing to an increased inspiratory effort. Using diaphragm electrical activity, neurally controlled pressure support (PSN) could hypothetically eliminate the asynchrony and reduce inspiratory effort. The purpose of this study was to compare the differences between PSN and PSP in terms of patient-ventilator synchrony, inspiratory effort, and breathing pattern.@*METHODS@#Eight post-operative patients without respiratory system comorbidity, eight patients with acute respiratory distress syndrome (ARDS) and obvious restrictive acute respiratory failure (ARF), and eight patients with chronic obstructive pulmonary disease (COPD) and mixed restrictive and obstructive ARF were enrolled. Patient-ventilator interactions were analyzed with macro asynchronies (ineffective, double, and auto triggering), micro asynchronies (inspiratory trigger delay, premature, and late cycling), and the total asynchrony index (AI). Inspiratory efforts for triggering and total inspiration were analyzed.@*RESULTS@#Total AI of PSN was consistently lower than that of PSP in COPD (3% vs. 93%, P = 0.012 for 100% support level; 8% vs. 104%, P = 0.012 for 150% support level), ARDS (8% vs. 29%, P = 0.012 for 100% support level; 16% vs. 41%, P = 0.017 for 150% support level), and post-operative patients (21% vs. 35%, P = 0.012 for 100% support level; 15% vs. 50%, P = 0.017 for 150% support level). Improved support levels from 100% to 150% statistically increased total AI during PSP but not during PSN in patients with COPD or ARDS. Patients' inspiratory efforts for triggering and total inspiration were significantly lower during PSN than during PSP in patients with COPD or ARDS under both support levels (P < 0.05). There was no difference in breathing patterns between PSN and PSP.@*CONCLUSIONS@#PSN improves patient-ventilator synchrony and generates a respiratory pattern similar to PSP independently of any level of support in patients with different respiratory system mechanical properties. PSN, which reduces the trigger and total patient's inspiratory effort in patients with COPD or ARDS, might be an alternative mode for PSP.@*TRIAL REGISTRATION@#ClinicalTrials.gov, NCT01979627; https://clinicaltrials.gov/ct2/show/record/NCT01979627.


Subject(s)
Cross-Over Studies , Humans , Prospective Studies , Respiration , Respiration, Artificial , Respiratory System , Ventilators, Mechanical
6.
Braz. j. med. biol. res ; 54(11): e10974, 2021. tab, graf
Article in English | LILACS | ID: biblio-1285663

ABSTRACT

Continuous positive airway pressure (CPAP) has been used to improve gas exchange and diaphragmatic function, among others benefits. Moreover, it can be used to increase exercise tolerance and positively influence ventilatory function and breathing pattern (BP) during exercise. However, there is no information about the long-term effects of CPAP, as an adjunct to an inpatient cardiac rehabilitation (CR) program, on BP and heart rate variability (HRV) of patients after coronary artery bypass grafting surgery (CABG). Twenty patients were allocated to receive, after randomization, standard inpatient CR without CPAP (control group - CG) or CR with CPAP between 10 to 12 cmH2O (CPAP group - CPG) associated with the exercises. Participants were assessed preoperatively and on the discharge day, in the sitting rest position. Outcome measurements included BP variables, collected by respiratory inductive plethysmography, and HRV, collected by polar precision performance. The CPG presented lower values of percent rib cage inspiratory and expiratory contributions to tidal volume (%RCi and %RCe) at discharge time, compared to CG. No statistical differences between groups were observed for HRV variables and both groups presented lower values of these indices, compared to preoperative ones. In this context, the patients who received CPAP throughout the whole rehabilitation program were discharged with a better BP, which could indicate more synchronized breathing. CPAP did not influence cardiac autonomic modulation in the long term.


Subject(s)
Exercise , Continuous Positive Airway Pressure , Respiration , Coronary Artery Bypass , Heart Rate
7.
Electron. j. biotechnol ; 48: 36-45, nov. 2020. ilus, tab
Article in English | LILACS | ID: biblio-1254948

ABSTRACT

Azotobacter vinelandii is a gram-negative soil bacterium that produces two biopolymers of biotechnological interest, alginate and poly(3-hydroxybutyrate), and it has been widely studied because of its capability to fix nitrogen even in the presence of oxygen. This bacterium is characterized by its high respiration rates, which are almost 10-fold higher than those of Escherichia coli and are a disadvantage for fermentation processes. On the other hand, several works have demonstrated that adequate control of the oxygen supply in A. vinelandii cultivations determines the yields and physicochemical characteristics of alginate and poly(3-hydroxybutyrate). Here, we summarize a review of the characteristics of A. vinelandii related to its respiration systems, as well as some of the most important findings on the oxygen consumption rates as a function of the cultivation parameters and biopolymer production.


Subject(s)
Respiration , Biopolymers/biosynthesis , Azotobacter vinelandii/physiology , Polyesters , Alginates , Gram-Negative Bacteria/physiology , Hydroxybutyrates , Nitrogen Fixation
8.
Electron. j. biotechnol ; 47: 1-9, sept. 2020. graf, tab
Article in English | LILACS | ID: biblio-1224606

ABSTRACT

BACKGROUND: γ-Aminobutyric acid (GABA) bypasses the TCA cycle via GABA shunt, suggesting a relationship with respiration. However, little is known about its role in seed germination under salt conditions. RESULTS: In this study, exogenous GABA was shown to have almost no influence on mungbean seed germination, except 0.1 mM at 10 h, while it completely alleviated the inhibition of germination by salt treatment. Seed respiration was significantly inhibited by 0.1 and 0.5 mM GABA, but was evidently enhanced under salt treatment, whereas both were promoted by 1 mM GABA alone or with salt treatment. Mitochondrial respiration also showed a similar trend at 0.1 mM GABA. Moreover, proteomic analysis further showed that 43 annotated proteins were affected by exogenous GABA, even 0.1 mM under salt treatment, including complexes of the mitochondrial respiratory chain. CONCLUSIONS: Our study provides new evidence that GABA may act as a signal molecule in regulating respiration of mungbean seed germination in response to salt stress.


Subject(s)
Seeds/growth & development , Vigna , gamma-Aminobutyric Acid , Respiration , Stress, Physiological , Proteins , Germination , Proteomics , Salt Tolerance , Salt Stress
9.
Rev. Pesqui. Fisioter ; 10(1): 127-134, Fev. 2020. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1223477

ABSTRACT

A Doença de Parkinson (DP) é uma patologia neurodegenerativa, lentamente progressiva. As alterações posturais típicas da DP, associado à rigidez dos músculos intercostais, comprometem a mobilidade da caixa torácica, repercutindo na diminuição da expansibilidade pulmonar na inspiração e da depressão torácica na expiração. A dinâmica respiratória é afetada pela diminuição da força dos músculos respiratórios, a qual leva a atelectasia, hipoxemia e insuficiência ventilatória. OBJETIVO: Identificar através de revisão sistemática quais as disfunções respiratórias na doença de Parkinson. MATERIAS e MÉTODOS: trata-se de um estudo de Revisão Sistemática, sobre as disfunções respiratórias na doença de Parkinson. Foram realizadas buscas nas bases de dados, Medline, PubMED, Lilacs, SciELO, Scopus não foi imposta restrição de idiomas para pesquisa. Para critério de inclusão foram selecionados estudos que relataram as disfunções respiratórias na DP, desenvolvidos nos últimos 10 anos. A qualidade metodológica dos estudos foi analisada utilizando a escala de PEDro. RESULTADOS: Na buscar iniciada no período de 2009 a outubro de 2019, foram incluídos 10 artigos nesta revisão sistemática que demostraram as disfunções respiratórias na doença de Parkinson. CONCLUSÃO: Os estudos demostraram que a doença de Parkinson apresenta diminuição do volume expiratório forçado no primeiro segundo, diminuição da capacidade vital forçada, aumento do volume residual e resistências das vias aéreas.


Parkinson's disease (PD) is a slowly progressive neurodegenerative disorder, being the characteristic neurological sign of the loss of dopaminergic neurons in the compact part of substantia nigra, causing and unknown and affecting elderly people over 65 years. The clinical features published in PD are used for signs and symptoms such as tremor at rest, bradykinesia, hypokinesia, postural alteration, loss of postural reflexes and freezing phenomenon. Because typical postural changes in PD, associated with intercostal muscle stiffness, compromise rib cage mobility, decrease the impact on pulmonary expansion on inspiration, and thoracic changes in respiration, respiratory respiration is affected by respiratory muscle strength, occasionally respiratory muscle strength intercostal muscles stiffness and bradykinesia leading to atelectasis, hypoxemia and ventilatory insufficiency. OBJECTIVE: Identify, through systematic review, what are the respiratory dysfunctions in Parkinson's disease. MATERIALS AND METHODS: This is a systematic review study on respiratory dysfunction in Parkinson's disease. Searches were performed in the databases Medline, Pubmed, Lilacs, Scielo, and no language restrictions were imposed for research. For inclusion criteria, studies related to respiratory dysfunction in PD lasting 10 years were selected. The methodological quality of the studies was analyzed using a PEDro scale. RESULT: In the research initiated between 2009 and October 2019, 10 articles were included in this systematic review that demonstrated respiratory dysfunction in Parkinson's disease. CONCLUSION: Studies of Parkinson's disease showed decreased forced expiratory volume in one second, decreased forced vital capacity, increased residual volume and airway resistance.


Subject(s)
Parkinson Disease , Respiration
10.
Rev. Pesqui. Fisioter ; 10(1): 43-49, Fev. 2020. tab, ilus
Article in English, Portuguese | LILACS | ID: biblio-1223362

ABSTRACT

A sarcopenia é uma síndrome caracterizada por perda progressiva e generalizada de massa e força do músculo esquelética, bem como possivelmente da musculatura respiratória com risco de desfechos adversos, como declínio da funcionalidade, má qualidade de vida e morte. O risco de complicações respiratórias e infecções na população idosa é elevado, o que pode ser devido, em parte, as alterações da força do diafragma. OBJETIVO: Avaliar a associação entre força muscular periférica e força muscular respiratória em idosos hospitalizados. MÉTODOS: Trata-se de um estudo realizado em um hospital público na cidade de Salvador, Bahia. As variáveis primárias mensuradas foram medidas antropométricas, força de preensão palmar, força muscular respiratória através da aferição da pressão inspiratória máxima (PImáx), velocidade de marcha e presença de tabagismo. As variáveis secundárias extraídas a partir de dados de prontuário foram idade, gênero, diagnóstico médico admissional, perfil clínico admissional (clínico ou cirúrgico), tempo de internação no momento da coleta e índice de comorbidades de Charlson. Para avaliação entre as variáveis da FPP e força muscular respiratória foi utilizado a análise da correlação de Pearson. RESULTADOS: Dos 95 idosos avaliados, 73,7% era do sexo masculino, 89,5% tinham internação por motivo cirúrgico (40,2% cirurgias abdominais; 30,4% cirurgias urológicas; 16,3% amputações; 13,1% outras cirurgias), IMC 24,5 ± 4,1Kg/m2. A média de idade foi 68,1±6,1 anos, força de preensão palmar 31,3 ± 9,1Kgf e PImáx -77,5±33,2 cm H2O. O tempo para avaliação inicial foi de 4,3 ± 3,1 dias após internação hospitalar. O índice de comorbidades de Charlson foi de 3,6 ± 1,89 e a pontuação do mini-exame do estado mental foi 22,9±7,22. A correlação entre a força de preensão palmar e a força muscular respiratória foi moderada (R=-0,439 e valor de p= 0,001). CONCLUSÃO: Existe relação entre FMR e FMP, bem como a FMR pode predizer dinapenia. Apesar disso, recomenda-se que a avaliação da FMR e FMP sejam feitas de forma individualizada para um posterior direcionamento do plano terapêutico, já que esta relação foi apenas moderada.


Sarcopenia is a syndrome characterized by the progressive and widespread loss of skeletal muscle mass and strength, which can be used as a life-threatening respiratory massage, such as decline in function, poor quality of life, and death. The risk of respiratory and control complications in the elderly population is one that may be due to a change in the strength of the diaphragm. OBJECTIVE: To assess the association between peripheral muscle strength and respiratory muscle strength in hospitalized elderly. METHODS: this is a study carried out in a public hospital in Salvador, Bahia. The primary variables measured were anthropometric measurements, palmar grip strength, respiratory muscle strength through maximal inspiratory pressure (MIP), gait velocity and presence of smoking. The secondary variables extracted from medical records were age, gender, admission medical diagnosis, admission clinical profile (clinical or surgical), length of hospital stay at time of collection and Charlson comorbidities index. The Pearson correlation analysis was used to evaluate the PPF variables and respiratory muscle strength. RESULTS: Of the 95 elderly patients evaluated, 73.7% were male, 89.5% were hospitalized for surgical reasons (40.2% were abdominal surgeries, 30.4% were urological surgeries, 16.3% were amputations, 13.1% were other surgeries ), BMI 24.5 ± 4.1 kg / m2. The mean age was 68.1 ± 6.1 years, palmar grip strength 31.3 ± 9.1 Kgf and PImax -77.5 ± 33.2 cm H2O. The time for initial evaluation was 4.3 ± 3.1 days after hospital admission. The Charlson comorbidities index was 3.6 ± 1.89 and the mini-mental status score was 22.9 ± 7.22. The correlation between palmar grip strength and respiratory muscle strength was moderate (R = -0.439 and p = 0.001). CONCLUSION: There is a relationship between FMR and FMP, and FMR can predict dynapenia. Despite this, it is recommended that the evaluation of FMR and FMP be made in an individualized way for a subsequent direction of the therapeutic plan, since this relationship was only moderate.


Subject(s)
Respiration , Aged , Muscle Strength
12.
Article in Chinese | WPRIM | ID: wpr-828657

ABSTRACT

OBJECTIVE@#To study the characteristics of pulmonary function in children with pertussis-like coughing caused by different pathogen infections.@*METHODS@#The data on etiology and tidal breathing pulmonary function were collected from 95 hospitalized infants and young children with pertussis-like coughing. The tidal breathing pulmonary function was compared between these children and 67 healthy children. According to the type of pathogen, the children with pertussis-like coughing were classified to 6 groups: pertussis (n=17), viral infection (n=23), tuberculosis infection (n=6), Mycoplasma infection (n=9), other bacterial infection (n=8), and unknown pathogen (n=32).@*RESULTS@#Among the 95 children with pertussis-like coughing, 15 (16%) had mild obstructive ventilatory dysfunction, 30 (32%) had moderate obstructive ventilatory dysfunction, and 22 (23%) had severe obstructive ventilatory dysfunction. Compared with the normal control group, the children with pertussis-like coughing had significant reductions in inspiratory-to-expiratory time ratio, ratio of time to peak tidal expiratory flow to total expiratory time (tPF%tE), and ratio of volume to peak tidal expiratory flow to total expiratory volume (vPF%vE) (P<0.05). The tuberculosis infection and Mycoplasma infection groups had a significantly lower tidal volume than the normal control group (P<0.05). All pathogen infection groups except the tuberculosis infection group had significantly lower tPF%tE and vPF%vE than the normal control group (P<0.05). The pertussis group had significantly lower tPF%tE and vPF%vE than the other infection groups (P<0.05).@*CONCLUSIONS@#Most of children with pertussis-like coughing have abnormal pulmonary functions. The children with Bordetella pertussis infection have the most severe pulmonary function impairment. Tidal breathing pulmonary function test may provide a reference for pathogen analysis of children with pertussis-like coughing.


Subject(s)
Child , Child, Preschool , Humans , Infant , Lung , Respiration , Respiratory Function Tests , Tidal Volume , Whooping Cough
13.
Chinese Medical Journal ; (24): 2721-2730, 2020.
Article in English | WPRIM | ID: wpr-877868

ABSTRACT

Treatment-emergent central sleep apnea (TECSA) is a specific form of sleep-disordered breathing, characterized by the emergence or persistence of central apneas during treatment for obstructive sleep apnea. The purpose of this review was to summarize the definition, epidemiology, potential mechanisms, clinical characteristics, and treatment of TECSA. We searched for relevant articles up to January 31, 2020, in the PubMed database. The prevalence of TECSA varied widely in different studies. The potential mechanisms leading to TECSA included ventilatory control instability, low arousal threshold, activation of lung stretch receptors, and prolonged circulation time. TECSA may be a self-limited disorder in some patients and could be resolved spontaneously over time with ongoing treatment of continuous positive airway pressure (CPAP). However, central apneas persist even with the regular CPAP therapy in some patients, and new treatment approaches such as adaptive servo-ventilation may be necessary. We concluded that several questions regarding TECSA remain, despite the findings of many studies, and it is necessary to carry out large surveys with basic scientific design and clinical trials for TECSA to clarify these irregularities. Further, it will be vital to evaluate the baseline demographic and polysomnographic data of TECSA patients more carefully and comprehensively.


Subject(s)
Continuous Positive Airway Pressure , Humans , Lung , Respiration , Sleep Apnea, Central/therapy , Sleep Apnea, Obstructive
14.
Article in Korean | WPRIM | ID: wpr-811246

ABSTRACT

This paper reviews the updated findings, including the current clinical guidelines and recent research trends, on the pathophysiology, diagnosis, and treatment of obstructive sleep apnea (OSA), a common sleep disorder associated with medical and mental disorders. The pathophysiology of OSA is believed to be related not only to the anatomical causes of the upper airway but also to the comparative anatomical mechanisms, such as the upper airway muscle function, arousal threshold, and loop gain. When OSA is suspected of being a clinical symptom or sign, a sleep study should be used for a diagnosis of OSA. Traditionally, continuous positive airway pressure has been the most effective first-line treatment for OSA. On the other hand, there could be a limitation of long-term compliance and new therapies that are suitable for the diverse mechanisms of OSA have been proposed or studied. In the future, the treatment of enhancing the effect through a more individualized consideration should be applied for OSA.


Subject(s)
Arousal , Compliance , Continuous Positive Airway Pressure , Diagnosis , Hand , Mental Disorders , Respiration , Sleep Apnea, Obstructive , Sleep Wake Disorders
15.
Article in English | WPRIM | ID: wpr-811136

ABSTRACT

Longitudinal imaging of murine pancreas is technically challenging due to the mechanical softness of the tissue influenced by peristalsis. Here, we report a novel pancreatic imaging window for long-term stabilized cellular-level observation of the islets in the pancreas in vivo. By spatially separating the pancreas from the bowel movement and physiologic respiration with a metal plate integrated in the imaging window, we successfully tracked the pancreatic islets up to three weeks and visualized the dumbbell-shape transformation from the single islet. This window can be a useful tool for long-term cellular-level visualization of the microstructure in the pancreas.


Subject(s)
Animals , Intravital Microscopy , Islets of Langerhans , Mice , Pancreas , Peristalsis , Respiration
16.
Rev. cuba. pediatr ; 92(supl.1): e1195, 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1156611

ABSTRACT

Cada paciente requiere una evaluación particular considerando criterios individuales de tipo clínicos y laboratoriales, así como epidemiológicos y sociales. Los protocolos chinos así lo expresaban: ¨el paciente ha tenido una respiración no alterada, conciencia clara, habla no afectada, dieta normal y temperatura corporal normal durante más de 3 días; las imágenes de pulmón muestran una mejora significativa;y dos pruebas consecutivas de ácido nucleico han sido negativas¨ (4). El seguimiento es mandatorio pues los pacientes que se han recuperado de COVID-19 pueden quedar con un daño permanente en sus pulmones, en específico con fibrosis pulmonar(AU)


Subject(s)
Humans , Pulmonary Fibrosis , Respiration , Unified Health System , Coronavirus Infections , Aftercare , Conscience
17.
Fisioter. Mov. (Online) ; 33: e003337, 2020. tab
Article in English | LILACS | ID: biblio-1133910

ABSTRACT

Abstract Introduction: The voice is heavily influenced by breathing and abdominal muscles. Objective: To verify the immediate effects of cervical stimulation and diaphragmatic release on the respiratory and phonatory function of adult women with no vocal complaints. Method: Relaxation maneuvers and eccentric work of the diaphragm were performed together with articulatory maneuver of the third cervical vertebra. Twenty-four women without vocal complaints, aged between 18 and 35 years were part of the intervention. All volunteers were submitted to an evaluation of respiratory muscle strength, maximum phonation time of the vowel /a/, sound pressure level and acoustic vocal analysis, before and after physiotherapeutic intervention. Statistical analysis consisted of the Student's t-test for independent samples and Spearman's correlation. Significance level was set at 5%. Results: There was a significant increase in the maximum phonation time of the vowel /a/ and in the modal sound pressure level. Regarding the acoustic analysis, there was a reduction in the standard deviation values of the fundamental frequency; in the smoothed pitch disturbance quotient; and in the fundamental frequency and amplitude variations. Conclusion: Cervical stimulation and diaphragmatic release improved vocal quality regarding duration of emission, sound pressure, and stability and noise of the glottic signal.


Resumo Introdução: A voz é muito influenciada pela respiração e pela musculatura abdominal. Objetivo: Verificar os efeitos imediatos da estimulação cervical e liberação diafragmática na função respiratória e fonatória de mulheres adultas sem queixas vocais. Método: Realizaram-se manobras de relaxamento e trabalho excêntrico do diafragma junto a uma manobra articulatória da terceira vertebra cervical. Fizerem parte da intervenção 24 mulheres sem queixas vocais, com idades entre 18 e 35 anos. Todas as voluntárias foram submetidas a uma avaliação de força da musculatura respiratória, do tempo máximo de fonação da vogal /a/, do nível de pressão sonora e análise vocal acústica, pré e pós-intervenção fisioterapêutica. Foram realizados os testes t-student para amostras independentes e correlação de Spearman com nível de significância de 5%. Resultados: Verificou-se aumento significativo no tempo máximo de fonação da vogal de /a/ e do nível de pressão sonora modal. Na análise acústica, houve redução dos valores do desvio-padrão da frequência fundamental; do quociente de perturbação do pitch suavizado; da variação da frequência fundamental e da variação da amplitude. Conclusão: As manobras fisioterapêuticas de estimulação cervical e liberação diafragmática melhoraram a qualidade vocal em relação ao tempo de sustentação da emissão, à pressão sonora, à estabilidade e ao ruído do sinal glótico.


Subject(s)
Humans , Female , Adolescent , Adult , Voice Quality , Acoustics , Diaphragm , Respiration , Abdominal Muscles
18.
Rev. Col. Bras. Cir ; 47: e20202430, 2020. tab, graf
Article in English | LILACS | ID: biblio-1136583

ABSTRACT

ABSTRACT Objective: To verify the effect of longitudinal abdominal incisional herniorrhaphy on respiratory muscle pressure. Method: The technique of incisional herniorrhaphy used was proposed by Lázaro da Silva. To measure the pressure, we used a water manometer in 20 patients, median age 48.5 years (range 24 70). We analyzed the maximum inspiratory pressure at the level of residual volume (IP-RV) and functional residual capacity (IP-FRC) and the maximum expiratory pressure of functional residual capacity (EP-FRC) and total lung capacity (EP-TLC) in the preoperative and late postoperative (40 90 days) periods, in 13 patients with large incisional hernias and in 7 patients with medium incisional hernias. Results: There was a significant increase in IP-FRC (p = 0.027), IP-RV (p = 0.011) and EP-TLC (p = 0.003) in patients with large incisional hernias. EP-FRC increased, but not significantly. In patients with medium incisional hernias, the changes were not significant. Conclusion: Surgical correction of large incisional hernias improves the function of the breathing muscles; however, surgery for medium incisional hernias does not alter this function.


RESUMO Objetivo: verificar o efeito da herniorrafia incisional abdominal longitudinal na pressão dos músculos da respiração. Método: a técnica de herniorrafia incisional utilizada foi a proposta por Lázaro da Silva. Para aferir a pressão foi utilizado manômetro de água, em 20 pacientes, idade mediana 48,5 anos (mínimo 24, máximo 70). Foram analisadas a pressão máxima inspiratória no nível do volume residual (PIVR) e da capacidade residual funcional (PICRF) e a pressão máxima expiratória da capacidade residual funcional (PECRF) e da capacidade pulmonar total (PECPT), no pré-operatório e pós-operatório tardio (entre 40 e 90 dias), em 13 pacientes com hérnias incisionais grandes e em 7 pacientes com hérnias incisionais médias. Resultados: houve aumento significante da PICRF (p=0.027), da PIVR (p=0.011), da PECPT (p=0.003) nos pacientes com hérnias incisionais grandes. A PECRF aumentou, porém de forma não significante. Nos pacientes com hérnias incisionais médias as alterações não foram significantes. Conclusão: a correção cirúrgica da hérnia incisional grande melhora a função dos músculos da respiração, porém a cirurgia da hérnia incisional média não altera a referida função.


Subject(s)
Humans , Male , Female , Adult , Aged , Young Adult , Respiration , Respiratory Muscles , Herniorrhaphy/methods , Incisional Hernia/surgery , Hernia, Ventral/surgery , Postoperative Period , Respiratory Function Tests , Preoperative Care , Inspiratory Capacity , Maximal Expiratory Flow Rate , Abdomen , Manometry , Middle Aged
19.
Frontiers of Medicine ; (4): 232-248, 2020.
Article in English | WPRIM | ID: wpr-827858

ABSTRACT

Coronavirus disease 2019 (COVID-19) is a highly contagious disease and a serious threat to human health. COVID-19 can cause multiple organ dysfunction, such as respiratory and circulatory failure, liver and kidney injury, disseminated intravascular coagulation, and thromboembolism, and even death. The World Health Organization reports that the mortality rate of severe-type COVID-19 is over 50%. Currently, the number of severe cases worldwide has increased rapidly, but the experience in the treatment of infected patients is still limited. Given the lack of specific antiviral drugs, multi-organ function support treatment is important for patients with COVID-19. To improve the cure rate and reduce the mortality of patients with severe- and critical-type COVID-19, this paper summarizes the experience of organ function support in patients with severe- and critical-type COVID-19 in Optical Valley Branch of Tongji Hospital, Wuhan, China. This paper systematically summarizes the procedures of functional support therapies for multiple organs and systems, including respiratory, circulatory, renal, hepatic, and hematological systems, among patients with severe- and critical-type COVID-19. This paper provides a clinical reference and a new strategy for the optimal treatment of COVID-19 worldwide.


Subject(s)
Antiviral Agents , Therapeutic Uses , Betacoronavirus , Coronavirus Infections , Drug Therapy , Therapeutics , Humans , Oxygen Inhalation Therapy , Pandemics , Pneumonia, Viral , Therapeutics , Respiration
20.
Arq. ciências saúde UNIPAR ; 23(3)set-dez. 2019.
Article in Portuguese | LILACS | ID: biblio-1046203

ABSTRACT

A mobilidade diafragmática é essencial para a ventilação pulmonar. Pela ultrassonografia sua mensuração é direta, porém o processamento das medidas encontra-se em divergência na literatura. Indica-se pelo valor médio das três incursões respiratórias máximas ou o maior valor dentre elas restringindo à variações de 10%. Dessa forma, não existe um consenso em relação ao processamento da medida de mobilidade diafragmática máxima. Objetivo: Comparar dois diferentes processamentos das medidas pela ultrassonografia para o maior valor de mobilidade diafragmática. Materiais e métodos: Estudo observacional transversal. Avaliou-se a mobilidade diafragmática pela ultrassonografia, com um transdutor convexo (3 MHz) posicionado anteriormente na região subcostal e leve inclinação cranial, em decúbito dorsal. Visualizou-se o hemidiafragma direito pelo ponto médio entre a linha médio clavicular e axilar anterior. Para visualizar a janela do diafragma e mensurar sua mobilidade foi utilizado o modo B, seguido do modo M. Os participantes realizaram inspirações máximas e os maiores valores com diferença máxima de 10% entre eles mensurados e registrados. Para análise, o maior valor e o valor médio obtido das três medidas foram considerados. Para normalidade dos dados foi realizado o teste de Shapiro Wilk. Para diferenças entre os registros, o teste de t student. Resultados: 30 indivíduos (30,33 ± 9,7 anos), 16 mulheres e 14 homens. A medida da mobilidade diafragmática pelo maior valor em comparação ao valor médio apresentou diferença estatisticamente significante (8,11 ± 1,43 cm versus 7,79 ± 1,43 cm; p<0,001). Conclusão: O valor máximo da mobilidade diafragmática foi obtido por meio da análise do maior valor. Ao escolher a média, a mobilidade diafragmática pode ser subestimada. 


Diaphragmatic mobility is essential to pulmonary ventilation. It can be directly measured by using ultrasonography, but the processing of the measurements can be found described differently in the literature. It can be measured as the average of at least three different cycles or from the greatest value among them resticting it to a 10% variation. Thus, there is no consensus about the processing of the maximum measurement of diaphragmatic mobility. Objective: Comparisson of two differents ultrasound measurement processings aiming at the diaphragmatic mobility maximum value. Methodology: Cross-sectional observational study. The diaphragmatic mobility was assessed by ultrasonography with convex transducer (3MHz) placed on the subcostal region between the midclavicular and anterior axillary. In order to explore the right diaphragmatic window and mobility, the B mode was used, followed by the M mode. The participants made maximum inspiration, and the highest value with a maximum difference of 10% was recorded. For statistical analysis, the mean and the highest value of three measurements were considered. The data distribution was analyzed with a Shapiro Wilk test and differences among records by the t student test. Results: 30 participants (30.33 ± 9.7 years) - 16 women and 14 men. The measurement of the diaphragmatic mobility obtained by the highest value compared against the mean value presented a statistically significant difference (8.11 ± 1.43 cm vs 7.79 ± 1.43 cm; p<0.001). Conclusions: The maximum value of diaphragmatic mobility was obtained by the analysis of the highest value. By choosing to use the mean value, diaphragmatic mobility may be underestimated.


Subject(s)
Humans , Male , Female , Adult , Young Adult , Diaphragm/physiology , Respiration , Diaphragm , Cross-Sectional Studies , Ultrasonography , Pulmonary Ventilation , Organ Motion
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