WorldWideScience

Sample records for barotrauma

  1. Ear barotrauma

    Science.gov (United States)

    Barotitis media; Barotrauma; Ear popping - barotrauma; Pressure-related ear pain; Eustachian tube dysfunction - barotrauma ... The air pressure in the middle ear is most often the same as the air ... body. The Eustachian tube is a connection between the middle ...

  2. Roller coaster-induced barotrauma.

    Science.gov (United States)

    Al-Khudari, Samer; Loochtan, Michael; Yaremchuk, Kathleen

    2011-03-01

    We present the case of a 24-year-old male who presented to the otolaryngology clinic for otalgia and aural fullness after riding a roller coaster. We present his clinical course and outcome and briefly discuss the mechanism of injury and otologic barotrauma. Roller coasters have been reported as the cause of many different types of injuries, but this is the first reported case of otologic barotrauma. As the engineering for roller coasters continues to advance in terms of increasing speed, otolaryngologists need to be aware of a new etiology of otologic barotrauma.

  3. Barotrauma with extreme pressures in sport: from scuba to skydiving.

    Science.gov (United States)

    Lynch, James H; Deaton, Travis G

    2014-01-01

    The human body is well adapted to dealing with small variations in atmospheric pressure. However when our pursuit of sport and recreation takes us to extreme altitudes or ocean depths, the change in surrounding pressure has the potential to cause significant morbidity. Sports with more extreme changes in atmospheric pressure such as skydiving and scuba diving commonly place the athlete at risk for barotrauma injuries, especially in the middle ear and sinuses. Middle ear barotrauma occurs when a pressure differential develops between the middle ear and the pressure outside of the tympanic membrane. Early symptoms include ear pain, dizziness, and muffled hearing. When extreme pressure gradients are not relieved, middle ear effusions and rupture of the tympanic membrane can occur. A similar mechanism and injury pattern occurs in the sinuses as well. With proper training and prevention strategies, athletes in these sports can protect themselves from most barotrauma injuries.

  4. Upper Respiratory Infections and Barotrauma Among Commercial Pilots

    DEFF Research Database (Denmark)

    Boel, Nina Monrad; Klokker, Mads

    2017-01-01

    BACKGROUND: Health incapacitation is a serious threat to flight safety. Therefore, a study conducted 10 yr ago examined the incidents of ear-nose-throat (ENT) barotrauma and upper respiratory infection (URI) among commercial pilots and found that a large number continued to carry out their duties...

  5. Delayed Diagnosis of Pharyngeal Perforation following Exploding Tyre Blast Barotrauma

    Directory of Open Access Journals (Sweden)

    Samantha M. Field

    2014-01-01

    Full Text Available Introduction. Pharyngoesophageal perforation secondary to barotrauma is a rare phenomenon that can have serious complications if identified late. It is challenging to detect due to nonspecific symptoms. We present a case in which detection proved difficult leading to delayed diagnosis. Case Report. A 27-year-old mechanic presented with haemoptysis, dysphonia, and odynophagia after a car tyre exploded in his face. Flexible nasoendoscopy (FNE revealed blood in the pharynx, thought to represent mucosal haemorrhage. Initial treatment consisted of IV dexamethasone and antibiotics. After 3 days, odynophagia persisted prompting a CT scan. This revealed a defect in the posterior hypopharynx and surgical emphysema in the deep neck tissues. Contrast swallow confirmed posterior hypopharyngeal leak. NG feeding was commenced until repeated contrast swallow confirmed resolution of the defect. Discussion. Prompt nonsurgical management of pharyngoesophageal perforation has good outcomes but untreated perforation can have serious complications. FNE should be performed routinely, but only a contrast swallow can diagnose a functional perforation. Clinicians should have a high index of clinical suspicion when patients present with barotrauma and odynophagia. Patients should be kept nil by mouth until perforation has been excluded. Conclusion. When faced with cases of facial barotrauma, clinicians should have a low threshold for further imaging to exclude pharyngoesophageal perforation.

  6. Sphenoid sinus barotrauma with intracranial air in sella turcica after diving.

    Science.gov (United States)

    Tryggvason, G; Briem, B; Guomundsson, O; Einarsdóttir, H

    2006-10-01

    We report the case of a diver who presented with air in the sella turcica after barotrauma to the sphenoid sinus during an ascent from a dive. To our knowledge, this is the first report of intracranial air after a barotrauma to the sphenoid sinus.

  7. Vulnerability of larval and juvenile white sturgeon to barotrauma: can they handle the pressure?

    Science.gov (United States)

    Brown, Richard S; Cook, Katrina V; Pflugrath, Brett D; Rozeboom, Latricia L; Johnson, Rachelle C; McLellan, Jason G; Linley, Timothy J; Gao, Yong; Baumgartner, Lee J; Dowell, Frederick E; Miller, Erin A; White, Timothy A

    2013-01-01

    Techniques were developed to determine which life stages of fish are vulnerable to barotrauma from expansion of internal gases during decompression. Eggs, larvae, and juvenile hatchery-reared white sturgeon (Acipenser transmontanus; up to 91 days post hatch; d.p.h.) were decompressed to assess vulnerability to barotrauma and identify initial swim bladder inflation. Barotrauma-related injury and mortality were first observed 9 d.p.h., on the same day as initial exogenous feeding. However, barotrauma-related injury did not occur again until swim bladder inflation 75 d.p.h. (visible at necropsy and on radiographs). Swim bladder inflation was not consistent among individuals, with only 44% being inflated 91 d.p.h. Additionally, swim bladder inflation did not appear to be size dependent among fish ranging in total length from 61 to 153 mm at 91 d.p.h. The use of a combination of decompression tests and radiography was validated as a method to determine initial swim bladder inflation and vulnerability to barotrauma. Extending these techniques to other species and life-history stages would help to determine the susceptibility of fish to hydro turbine passage and aid in fish conservation.

  8. Vulnerability of larval and juvenile white sturgeon to barotrauma: can they handle the pressure?

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Richard S.; Cook, Katrina V.; Pflugrath, Brett D.; Rozeboom, Latricia L.; Johnson, Rachelle C.; McLellan, Jason; Linley, Timothy J.; Gao, Yong; Baumgartner, Lee J.; Dowell, Frederick E.; Miller, Erin A.; White, Timothy A.

    2013-07-01

    Techniques were developed to determine which life stages of fish are vulnerable to barotrauma from expansion of internal gases during decompression. Eggs, larvae and juvenile hatchery-reared white sturgeon (Acipenser transmontanus; up to 91 days post hatch; dph), were decompressed to assess vulnerability to barotrauma and identify initial swim bladder inflation. Barotrauma related injury and mortality were first observed 9 dph, on the same day as initial exogenous feeding. However, barotrauma related injury did not occur again until swim bladder inflation 75 dph (visible from necropsy and x-ray radiographs). Swim bladder inflation was not consistent among individuals, with only 44% being inflated 91 dph. Additionally, swim bladder inflation did not appear to be size dependent among fish ranging in total length from 61-153 mm at 91 dph. The use of a combination of decompression tests and x-ray radiography was validated as a method to determine initial swim bladder inflation and vulnerability to barotrauma. Extending these techniques to other species and life history stages would help to determine fish susceptibility to hydroturbine passage and aid in fish conservation.

  9. Barodontalgias, dental and orofacial barotraumas: a survey in Swiss divers and caisson workers.

    Science.gov (United States)

    Zanotta, Cristina; Dagassan-Berndt, Dorothea; Nussberger, Peter; Waltimo, Tuomas; Filippi, Andreas

    2014-01-01

    Changing ambient pressure can lead to medical conditions in body cavities filled with air. Intraoral pain elicited by changes in pressure is referred to as barodontalgia. Dental barotraumas are defined as pressure-induced damages of teeth and restorations. The pathophysiologic background so far is not completely clear. The present study deals with dental and orofacial symptoms which can occur as a result of pressure variations. With the aid of cantonal administrations, diving associations, and tunnel construction firms, 520 pressure-exposed individuals (499 scuba/ professional divers, 21 caisson workers operating at excess pressure) were questioned regarding dental problems. A personal interview was conducted with affected individuals. Problems in the dental area were experienced by 15% of all respondents. Toothaches were suffered by 10.2% of the participants. Tooth injuries occurred in 6.3% of all interviewees (26 fractured amalgam restorations, 4 crown fractures, 3 losses of tooth fragments). A proportion of 11.3% among the respondents complained about temporomandibular joint problems or mucosal irritations (for example aphthae) related to the mouthpieces. Barotraumas outside the dental area were incurred by 31.9% of the divers. Of these, 69.9% concerned the ears and 65.6% occurred during the descent. Based on the results obtained from the survey and taking into account the current literature, recommendations for the prevention of barotraumas in divers and caisson workers were prepared. Diagnostic exclusion of dental pathologies and avoidance of retentive reconstruction materials are important factors for the prevention of barodontalgias and dental barotraumas.

  10. Angling-induced barotrauma in snapper Chrysophrys auratus: are there consequences for reproduction?

    Science.gov (United States)

    Peregrin, Laura S; Butcher, Paul A; Broadhurst, Matt K; Millar, Russell B

    2015-01-01

    In response to concerns regarding the potential for sub-lethal impacts of barotrauma on reproductively active Chrysophrys auratus during catch and release, 90 males and 90 females representing five reproductive stages (immature or resting--28%, developing--8%, developed--7%, ripe or spawning--23% and spent--34%) were angled from 8-70 m and macroscopically assessed (on-board and then in a laboratory). Irrespective of sex, all fish exhibited various clinical signs of barotrauma, including a prolapsed cloaca (60% of fish); gastric herniation (46%); ruptured swim bladder (73%); organ displacement (48%); and kidney (3%), liver (73%) and coloemic-cavity haemorrhaging (33%); with the frequency of nearly all positively associated with capture depth. Reproductive stage was also an important barotrauma predictor (reflecting related morphological changes) with a general trend towards spent fish least likely to incur the various clinical signs--especially for a prolapsed cloaca (also common among immature or resting fish and significantly affected by food in the digestive tract) and a ruptured swim bladder (common among ripe or spawning fish). The only macroscopically visible gonad damage was haemorrhaging, which was least common among immature or resting and spent fish and, irrespective of reproductive stage, temporally reduced in frequency, and more quickly among males than females. While further research is required to accurately describe the effects of angling at each stage of the reproductive cycle and the physiological consequences of barotrauma on the gonads of C. auratus, given the observed influences of reproductive stage and depth on barotrauma found in this study, any adverse effects might be partially managed by regulating either temporal or spatial fishing effort.

  11. Angling-induced barotrauma in snapper Chrysophrys auratus: are there consequences for reproduction?

    Directory of Open Access Journals (Sweden)

    Laura S Peregrin

    Full Text Available In response to concerns regarding the potential for sub-lethal impacts of barotrauma on reproductively active Chrysophrys auratus during catch and release, 90 males and 90 females representing five reproductive stages (immature or resting--28%, developing--8%, developed--7%, ripe or spawning--23% and spent--34% were angled from 8-70 m and macroscopically assessed (on-board and then in a laboratory. Irrespective of sex, all fish exhibited various clinical signs of barotrauma, including a prolapsed cloaca (60% of fish; gastric herniation (46%; ruptured swim bladder (73%; organ displacement (48%; and kidney (3%, liver (73% and coloemic-cavity haemorrhaging (33%; with the frequency of nearly all positively associated with capture depth. Reproductive stage was also an important barotrauma predictor (reflecting related morphological changes with a general trend towards spent fish least likely to incur the various clinical signs--especially for a prolapsed cloaca (also common among immature or resting fish and significantly affected by food in the digestive tract and a ruptured swim bladder (common among ripe or spawning fish. The only macroscopically visible gonad damage was haemorrhaging, which was least common among immature or resting and spent fish and, irrespective of reproductive stage, temporally reduced in frequency, and more quickly among males than females. While further research is required to accurately describe the effects of angling at each stage of the reproductive cycle and the physiological consequences of barotrauma on the gonads of C. auratus, given the observed influences of reproductive stage and depth on barotrauma found in this study, any adverse effects might be partially managed by regulating either temporal or spatial fishing effort.

  12. Cardioplegia cristalóide, barotrauma e função endotelial: considerações experimentais Crystalloid cardioplegia, barotrauma and endothelium function: experimental considerations

    Directory of Open Access Journals (Sweden)

    Paulo Roberto B Évora

    1996-06-01

    Full Text Available O presente ensaio experimental estudou o efeito da infusão de solução cardioplégica cristalóide a altas pressões sobre a função endotelial de artérias epicárdicas de cães. Não se encontraram alterações a nível de receptores (curvas dose-respostas à ACH e ADP; da transdução do sinal iniciado nos receptores/sitema de G-proteínas (fluoreto de sódio e nos processos intracelulares da produção de EDRF/ NO (fosfolipase C e ionóforo do cálcio A23187. A função da musculatura lisa vascular não foi afetada quando se analisaram as respostas relaxantes (nitroprussiato de sódio e isoproterenol e contrateis (KCI e prostaglandina 2alfa. Estes achados permitem as seguintes considerrações especulativas: a O barotrauma produzido pela infusão da cardioplegia cristalóide a altas pressões ocorreria apenas em circulações coronarianas previamente doentes? b Uma vez que as infusões duraram de 2 a 3 minutos, seria o barotrauma coronariano um fenômeno dependente do tempo de infusão? c Para que ocorra o barotrauma seriam necessários níveis mais elevados de potássio? d Questionar a existência do fenômeno do barotrauma coronariano produzido pela infusão de soluções cadioplégicas pelo menos nas condições experimentais utilizadas, e A metodologia empregada estuda apenas as reatividades vasculares de artérias coronárias epicárdicas. Estas artérias seriam menos sensíveis aos efeitos da pressão de infusão da cardioplegia do que a microcirculação coronariana? f Seria a circulação coronária do cão menos sensível a altas pressões do que do homem? Estas observações experimentais sugerem que a infusão de cardioplegia cristalóide, moderadamente hipocalêmica, a altas pressõe em um tempo de 2 a 3 minutos, não interfere com a produção de EDRF/NO pelo endotélio de coronárias epicárdicas do cão.Experiments were performed in "organ chambers" to investigate if high pressures infusions of crystalloid cardioplegia

  13. A Preliminary Assessment of Barotrauma Injuries and Acclimation Studies for Three Fish Species

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Richard S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Walker, Ricardo W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Stephenson, John R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-12-15

    Fish that pass hydro structures either through turbine passage, deep spill, or other deep pathways can experience rapid decreases in pressure that can result in barotrauma. In addition to morphology and physiology of the fish’s swim bladder, the severity of barotrauma is directly related to the volume of undissolved gas in fish prior to rapid decompression and the lowest pressure the fish experience as they pass hydro structures (termed the “nadir”). The volume of undissolved gas in fish is influenced by the depth of acclimation (the pressure at which the fish is neutrally buoyant); therefore, determining the depth where fish are neutrally buoyant is a critical precursor to determining the relationship between pressure changes and injury or mortality.

  14. Understanding barotrauma in fish passing hydro structures: a global strategy for sustainable development of water resources

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Richard S.; Colotelo, Alison HA; Pflugrath, Brett D.; Boys, Craig A.; Baumgartner, Lee J.; Deng, Zhiqun; Silva, Luiz G.; Brauner, Colin J.; Mallen-Cooper, Martin; Phonekhampeng, Oudom; Thorncraft, Garry; Singhanouvong, Douangkham

    2014-03-24

    Freshwater fishes are one of the most imperiled groups of vertebrates and species declines have been linked to a number of anthropogenic influences. This is alarming as the diversity and stability of populations are at risk. In addition, freshwater fish serve as important protein sources, particularly in developing countries. One of the focal activities thought to influence freshwater fish population declines is water resource development, which is anticipated to increase over the next several decades. For fish encountering hydro structures, such as passing through hydroturbines, there may be a rapid decrease in pressure which can lead to injuries commonly referred to as barotraumas. The authors summarize the research to date that has examined the effects of rapid pressure changes on fish and outline the most important factors to consider (i.e., swim bladder morphology, depth of acclimation, migration pattern and life stage) when examining the susceptibility of barotraumas for fish of interest.

  15. Otic Barotrauma Resulting from Continuous Positive Airway Pressure: Case Report and Literature Review

    Science.gov (United States)

    McCormick, Justin P.; Hildrew, Douglas M.; Lawlor, Claire M.; Guittard, Jesse A.; Worley, N. Knight

    2016-01-01

    Background: Obstructive sleep apnea (OSA) is a growing problem affecting millions of people in the United States. The prevalence of OSA has risen drastically in the past few decades concurrently with the increasing prevalence of obesity. Subsequently, there has been an ever-increasing rise in the use of continuous positive airway pressure (CPAP) devices. While using CPAP devices may lead to many adverse effects, the majority of these effects are described as relatively benign. Case Report: We describe the detailed clinical course and outcome for a patient with otic barotrauma as a result of excessive self-titration of CPAP therapy in an in-home setting. We also discuss the pathophysiology of otic barotrauma and present a review of current literature on the topic. Conclusion: While the benefits of CPAP are clear, we must take into account the rare but possible effects on ear structure and function. Many studies describe an increase in middle ear pressure with the use of CPAP, but few describe the effects of this increased pressure on the middle ear, such as the otic barotrauma described in this case. Given the increased prevalence of OSA, it is important to understand the risks associated with CPAP therapy. PMID:27303224

  16. [The influence of barometric pressure changes in the oral cavity: dental barotrauma and barodontalgia].

    Science.gov (United States)

    Nakdimon, I; Zehavi, E; Chapnik, L; Zadik, Y

    2014-07-01

    Several oro-facial physiologic and pathologic phenomena affect individuals during flight or self-contained underwater breathing apparatus (SCUBA) diving. Physicians and dentists who treat aircrews and divers are occasionally challenged by those manifestations, though their uncommon appearance. This article reviews the two main barometric-related phenomena in the oral cavity: dental barotrauma and barodontalgia. Dental barotrauma includes all barometric-related dental mechanical phenomena. Tooth fracture or failure of dental restoration usually appears in a tooth with a leaking restoration or secondary caries lesion. In addition, changes in barometric pressure can cause a reduction in the retention of dental restoration and appliance. Barodontalgia is the oral pain which evoked during changes of the atmospheric pressure. This manifestation can be classified as a direct or non-direct pain. In most cases, the direct pain is caused by deterioration of pre-existed oral disease, whereas the source of the nondirect pain is an extra-oral facial barotrauma. These two barometric-related manifestations can cause a decrease in life quality and jeopardize the safety of flight or diving.

  17. Comparative Study of Barotrauma Risk during Fish Passage through Kaplan Turbines

    Energy Technology Data Exchange (ETDEWEB)

    Richmond, Marshall C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Hydrology Group; Romero-Gomez, Pedro [Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Hydrology Group; Serkowski, John A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Hydrology Group; Rakowski, Cynthia L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States). Hydrology Group; Graf, Michael J. [Voith Hydro, York, PA (United States)

    2015-10-01

    Rapid pressure changes in hydroelectric turbine flows can cause barotrauma that can be hazardous to the passage of fish, in particular migratory juvenile salmonids. Although numerous laboratory tests have evaluated the effect of rapid decompression in fish species of relevance, numerical modeling studies offer the advantage of predicting, for new turbine designs, the potential risks of mortality and injury from rapid pressure change during turbine passage. However, rapid pressure change is only one of several hydraulic risks encountered by fish during turbine passage in addition to blade strike, shear, and turbulence. To better understand the role of rapid pressure changes, the present work focuses on the application of a computational fluid dynamics based method for evaluating the risk of pressure-related mortality to fish passing through an early 1960s era original hydroelectric Kaplan turbine at Wanapum Dam (Columbia River, Washington), and a modern advanced Kaplan turbine installed in 2005. The results show that the modeling approach acceptably reproduced the nadir pressure distributions compared to field data previously collected at the site using an autonomous sensor. Our findings show that the new advanced-design unit performs better, in terms of reduced barotrauma risk to fish from exposure to low pressures, than the original turbine unit. The outcomes allow for comparative analyses of turbine designs and operations prior to installation, an advantage that can potentially be integrated in the process of designing new turbine units to achieve superior environmental performance. Overall, the results show that modern turbine designs can achieve the multiple objectives of increasing power generation, lowering cavitation potential, and reducing barotrauma risks to passing fish.

  18. Effects of gill-net trauma, barotrauma, and deep release on postrelease mortality of Lake Trout

    Science.gov (United States)

    Ng, Elizabeth L.; Fredericks, Jim P.; Quist, Michael C.

    2015-01-01

    Unaccounted postrelease mortality violates assumptions of many fisheries studies, thereby biasing parameter estimates and reducing efficiency. We evaluated effects of gill-net trauma, barotrauma, and deep-release treatment on postrelease mortality of lake trout Salvelinus namaycush. Lake trout were captured at depths up to 65 m with gill nets in Priest Lake, Idaho, and held in a large enclosure for 10–12 d. Postrelease mortality was the same for surface-release–and deep-release–treated fish (41%). Mixed-effects logistic regression models were used to evaluate effects of intrinsic and environmental factors on the probability of mortality. Presence of gill-net trauma and degree of barotrauma were associated with increased probability of postrelease mortality. Smaller fish were also more likely to suffer postrelease mortality. On average, deep-release treatment did not reduce postrelease mortality, but effectiveness of treatment increased with fish length. Of the environmental factors evaluated, only elapsed time between lifting the first and last anchors of a gill-net gang (i.e., lift time) was significantly related to postrelease mortality. Longer lift times, which may allow ascending lake trout to acclimate to depressurization, were associated with lower postrelease mortality rates. Our study suggests that postrelease mortality may be higher than previously assumed for lake trout because mortality continues after 48 h. In future studies, postrelease mortality could be reduced by increasing gill-net lift times and increasing mesh size used to increase length of fish captured.

  19. Barotrauma em peixes em usinas hidrelétricas: ferramentas para o estudo

    Energy Technology Data Exchange (ETDEWEB)

    Do Vale Beirao, Bernardo; Castelo Branco Marciano, Natlia; de Souza Dias, Luma; Carvalho Falco, Ricardo; Wander Dias, Edson; Leite Fabrino, Daniela; Barreira Martinez, Carlos; Martins Da Silva, Luiz Gustavo; Walker, Ricardo W.; Brown, Richard S.; Deng, Zhiqun

    2015-09-30

    The main source of electric power generation in Brazil comes from hydropower plants, nevertheless, the installed power is expected to raise 56.8%, reaching a total of 116,000 MW at the year 2020. The increase at the hydroelectric sector will be responsible for a series of fish community impacts. One of the impacts over the fish community is related to fish kills due to downstream passage through turbines or fish entrance at the draft tube from the tailrace. Usually when there is a maneuver and the turbine stops, fish get attracted and enter the draft tube and, just as the downstream passage through a turbine, when the turbine starts, a rapid decompression occurs and can cause barotrauma. When such events happen, according to Boyle’s law (P1V1=P2V2), swim bladder volume expands at the same rate that the pressure decreases, which can lead to the organ’s rupture.

  20. Nasopharyngeal cancer mimicking otitic barotrauma in a resource-challenged center: a case report

    Directory of Open Access Journals (Sweden)

    Daniel Adekunle

    2011-10-01

    Full Text Available Abstract Introduction Nasopharyngeal cancer commonly manifests with cervical lymphadenopathy, recurrent epistaxis and progressive nasal obstruction. Neuro-ophthalmic and otologic manifestations can also occur. Isolated otologic presentations of nasopharyngeal cancer are rare and the diagnosis of nasopharyngeal cancer may not be foremost in the list of differentials. Case presentation We present the case of a 29-year-old Nigerian woman with bilateral conductive hearing loss and tinnitus after air travel. There were no other symptoms. The persistence of the symptoms after adequate treatment for otitic barotrauma necessitated re-evaluation, which led to a diagnosis of nasopharyngeal cancer. Conclusion Isolated otologic manifestations of nasopharyngeal cancer are rare in regions with low incidence of the disease. There is a need for it to be considered as a possible differential in patients presenting with bilateral serous otitis media.

  1. The assessment and management of inner ear barotrauma in divers and recommendations for returning to diving.

    Science.gov (United States)

    Elliott, Elizabeth J; Smart, David R

    2014-12-01

    Inner ear barotrauma (IEBt) constitutes a spectrum of pressure-related pathology in the inner ear, with antecedent middle ear barotrauma (MEBt) common. IEBt includes perilymph fistula, intralabyrinthine membrane tear, inner ear haemorrhage and other rarer pathologies. Following a literature search, the pathophysiology, diagnosis, and treatment of IEBt in divers and best-practice recommendations for returning to diving were reviewed. Sixty-nine papers/texts were identified and 54 accessed. Twenty-five case series (majority surgical) provided guidance on diagnostic pathways; nine solely reported divers. IEBt in divers may be difficult to distinguish from inner ear decompression sickness (IEDCS), and requires dive-risk stratification and careful interrogation regarding diving-related ear events, clinical assessment, pure tone audiometry, a fistula test and electronystagmography (ENG). Once diagnosed, conservative management is the recommended first line therapy for IEBt. Recompression does not appear to cause harm if the diagnosis (IEBt vs IEDCS) is doubtful (limited case data). Exploratory surgery is indicated for severe or persisting vestibular symptoms or hearing loss, deterioration of symptoms, or lack of improvement over 10 days indicating significant pathology. Steroids are used, but without high-level evidence. It may be possible for divers to return to subaquatic activity after stakeholder risk acceptance and informed consent, provided: (1) sensorineural hearing loss is stable and not severe; (2) there is no vestibular involvement (via ENG); (3) high-resolution computed tomography has excluded anatomical predilection to IEBt and (4) education on equalising techniques is provided. There is a need for a prospective data registry and controlled trials to better evaluate diagnostic and treatment algorithms.

  2. Ruptura gástrica por barotrauma Barogenic rupture of the stomach

    Directory of Open Access Journals (Sweden)

    Rodrigo Severo de Camargo Pereira

    2008-09-01

    Full Text Available INTRODUÇÃO: A ruptura gástrica por barotrauma é uma causa rara de abdome agudo perfurativo, sendo geralmente tratada por laparotomia e rafia primária da lesão. Nas reanimações cardiopulmonares pode ocorrer 9 a 12% de lesões de mucosa gástrica. RELATO DO CASO: Mulher no 5º dia de puerpério necessitou intubação orotraqueal devido à pneumonia hospitalar. Após procedimento evoluiu com distensão abdominal importante, associada a sinais de choque séptico. Após radiografia simples de abdome foi constado pneumoperitôneo. Submetida à laparotomia exploradora evidenciou-se ruptura de pequena curvatura gástrica de 7 cm. O tratamento da lesão foi com sutura primária. Recebeu alta no 14º do pós operatório após término do tratamento para pneumonia. CONCLUSÃO: Apesar de rara, a ruptura gástrica por barotrauma deve ser sempre aventada quando após reanimação cardiopulmonar houver distensão abdominal refratária à sondagem naso-gástrica.BACKGROUND: Barogenic rupture of the stomach is a rare cause of acute perforated abdomen generally treated by laparotomy and primary wound suture. The lesion of gastric mucosa may occur during cardiopulmonary resuscitation in 9 to 12% of cases. CASE REPORT: Woman was intubated in the fifth day of delivery due to nosocomial pneumonia. She underwent to abdominal distension associated to septic shock signs after the procedure. The abdominal X-ray showed pneumoperitoneum. She was submitted to laparotomy and a 7 cm rupture in the gastric small curvature was found. The lesion was treated by primary suture. The patient was discharged 14 days after the surgery, in the ending of pneumonia treatment. CONCLUSION: Besides rare, barogenic gastric rupture must be inquired when after cardiopulmonary resuscitation the patient presents abdominal distension ovenproof to nasogastric tube.

  3. Assessment of Barotrauma Resulting from Rapid Decompression of Depth Acclimated Juvenile Chinook Salmon Bearing Radio Telemetry Transmitters

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Richard S.; Carlson, Thomas J.; Welch, Abigail E.; Stephenson, John R.; Abernethy, Cary S.; McKinstry, Craig A.; Theriault, Marie-Helene

    2007-09-06

    A multifactor study was conducted by Battelle for the US Army Corps of Engineers to assess the significance of the presence of a radio telemetry transmitter on the effects of rapid decompression from simulated hydro turbine passage on depth acclimated juvenile run-of-the-river Chinook salmon. Study factors were: (1) juvenile chinook salmon age;, subyearling or yearling, (2) radio transmitter present or absent, (3) three transmitter implantation factors: gastric, surgical, and no transmitter, and (4) four acclimation depth factors: 1, 10, 20, and 40 foot submergence equivalent absolute pressure, for a total of 48 unique treatments. Exposed fish were examined for changes in behavior, presence or absence of barotrauma injuries, and immediate or delayed mortality. Logistic models were used to test hypotheses that addressed study objectives. The presence of a radio transmitter was found to significantly increase the risk of barotrauma injury and mortality at exposure to rapid decompression. Gastric implantation was found to present a higher risk than surgical implantation. Fish were exposed within 48 hours of transmitter implantation so surgical incisions were not completely healed. The difference in results obtained for gastric and surgical implantation methods may be the result of study design and the results may have been different if tested fish had completely healed surgical wounds. However, the test did simulate the typical surgical-release time frame for in-river telemetry studies of fish survival so the results are probably representative for fish passing through a turbine shortly following release into the river. The finding of a significant difference in response to rapid decompression between fish bearing radio transmitters and those not implies a bias may exist in estimates of turbine passage survival obtained using radio telemetry. However, the rapid decompression (simulated turbine passage) conditions used for the study represented near worst case exposure

  4. 鼻窦气压伤的研究进展%Research progress of sinus barotrauma

    Institute of Scientific and Technical Information of China (English)

    汪斌如; 徐先荣; 张扬; 林建洪; 何萍

    2013-01-01

    目的 回顾国内外有关鼻窦气压伤(sinuses barotrauma,SB)的研究进展,提出进一步的研究建议. 资料来源与选择 国内外公开发表的相关专著、研究论文、综述和标准. 资料引用 引用标准1项,公开发表文献57篇. 资料综合 阐述有关SB的历史演变和流行病学,比较了SB的发病率及各鼻窦SB的构成比;探讨SB病理损伤分级,结合临床航空医学,将SB分为轻、重两度,并依据原发性和继发性病变进行了分型;分析SB病因及病理生理学,概述SB临床表现、影响因素及并发症;总结SB的鉴别手段与诊断方法,如内窥镜广泛应用于SB的诊断及治疗,SB临床路径的提出及《职业性航空病诊断标准》的颁布,使SB诊治更加规范化;综述SB防治措施和航空医学鉴定方面的文献,对低压舱检查的注意事项和飞行人员SB航空医学鉴定原则进行了概括. 结论 SB的诊疗水平有了较大提高,航空医学鉴定趋于规范化,飞行人员停飞率明显降低,但有关不同升降高度和速率所致SB的发病特点有待进一步研究.%Objective To summarize the research progress of sinus barotrauma (SB) and give the advices for further research.Literature resource and selection Monographs,research papers,reviews and standard in this field published at home and abroad.Literature quotation One standard and fifty seven published papers were cited.Literature synthesis The viewpoints of historical evolution and epidemiology of SB were illustrated.While,the incidences of SB in aviation and maritime medicine as well as in civil and military flights were compared between China and foreign countries.The composition ratio of SB was analyzed in different sinuses.The different viewpoints of pathological damage classification were sort out.According to clinical aviation medicine,SB was rated as mild and severe.Then,it was classified according to the primary and secondary pathology.Pathogenesis and pathophysiology

  5. Barodontalgia and barotrauma in the human teeth: findings in navy divers, frogmen, and submariners of the Federal Republic of Germany.

    Science.gov (United States)

    Goethe, W H; Bäter, H; Laban, C

    1989-10-01

    From 2,580 submariners, divers, and frogmen, 13,618 individual findings were evaluated from a total of about 50,000 dental findings of the Nautical Medical Institute of the German Navy, Kiel, West Germany. Trend analysis and statistical significance tests showed that the teeth of navy divers and frogmen had deteriorated very much more within a period of 9 years after their first dental examination than those of submariners. This negative tendency was verified through additional direct comparison between 37 navy divers and 37 submariners whose dental states were observed during a period of 10 years. Here as well, navy divers had significantly worse teeth. The cause of this distinctive dental deterioration among navy divers is probably due to the additional barometric stress they were subjected to for many years during their diving career. Delayed damages as a result of barotrauma may be assumed, a logical suspicion which should be verified by further scientific research.

  6. Barotrauma: Tooth Under Pressure.

    Science.gov (United States)

    Kumar, Satheesh; Kumar, Preeti Satheesh; John, Jins; Patel, Ruchi

    2015-11-01

    With the growing number of air passengers, flight attendants, leisure pilots, as well as military and airline pilots, dentists may encounter physiological and pathological phenomena precipitated by high altitude. With the introduction of the self-contained breathing apparatus (SCUBA), many of these manifestations caused by changes in atmospheric pressure were reported in association with diving as well. Limited literature exists on this subject. Hence, this article aims to review literature concerning the classification, etiology and manifestations of barodontalgia, as well as important clinical considerations for its management.

  7. Barotrauma pulmonar no intra-operatório de procedimento cirúrgico oftalmológico: relato de caso Barotrauma pulmonar en el intraoperatorio de procedimiento quirúrgico oftalmológico: relato de caso Intraoperative pulmonary barotrauma during ophthalmologic surgery: case report

    Directory of Open Access Journals (Sweden)

    Affonso Henrique Zugliani

    2008-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Acidentes anestésicos graves por mau funcionamento de ventiladores mecânicos tornaram-se raros nos tempos atuais. Porém, detalhes técnicos, mesmo em aparelhos de fabricação recente, podem resultar em armadilhas para o anestesiologista e ameaçar a segurança do paciente. O objetivo deste relato de caso foi enfatizar a necessidade de análise criteriosa do material em uso, assim como de detectar e tratar o pneumotórax hipertensivo intra-operatório. RELATO DO CASO: Paciente do sexo feminino, 16 anos, estado físico ASA I, submetida a recobrimento conjuntival de córnea sob anestesia geral. A manutenção foi feita com isoflurano e ventilação controlada mecânica. A anestesia transcorreu sem anormalidades. Na fase final do procedimento cirúrgico, após mobilização do aparelho de anestesia para o início do procedimento de despertar, observou-se quadro de hipóxia, hipotensão arterial e dificuldade ventilatória. Retirados os campos cirúrgicos, evidenciou-se importante enfisema subcutâneo, envolvendo a face, o pescoço e o membro superior. Procedeu-se à troca da cânula traqueal, observando-se a presença de sangue em seu interior. A radiografia de tórax confirmou o diagnóstico de pneumotórax, que foi prontamente drenado. A inspeção no equipamento revelou acotovelamento da mangueira que liga a região inferior do canister ao corpo do aparelho, em função da mobilização do braço articulado, bloqueando o fluxo normal de gases e levando a barotrauma pulmonar. CONCLUSÕES: O pneumotórax hipertensivo durante anestesia geral com ventilação com pressão positiva deve ser sempre um acidente a ser considerado. Múltiplos fatores podem precipitá-lo, o que exige alto grau de suspeição sempre que estiverem envolvidos no ato anestésico-cirúrgico. O equipamento de anestesia deve ser cuidadosamente examinado para que sejam detectadas potenciais causas de acidentes anestésicos.JUSTIFICATIVA Y OBJETIVOS

  8. AFSC/ABL: Rockfish Barotrauma

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Because rockfish (Sebastes spp.) are physoclystic, i.e. their gas bladders are closed off from the gut, they often suffer internal injuries from rapid, internal air...

  9. Pneumomediastinum Secondary to Barotrauma after Recreational Nitrous Oxide Inhalation

    Directory of Open Access Journals (Sweden)

    H. Jeddy

    2016-01-01

    Full Text Available We present a case of a seventeen-year-old patient, admitted in the care of the surgical team following inhalation of nitrous oxide at high pressure, leading to extensive pneumomediastinum and surgical emphysema. We discuss the subsequent investigations and management for this patient. In the absence of history of airway injury and respiratory problems including asthma and with no oesophageal perforation on investigations, the diagnostic and management challenges encountered have been discussed which will help in future management of similar cases.

  10. Evidence of injury caused by gas bubbles in a live marine mammal: barotrauma in a California sea lion Zalophus californianus.

    Science.gov (United States)

    Van Bonn, W; Montie, E; Dennison, S; Pussini, N; Cook, P; Greig, D; Barakos, J; Colegrove, K; Gulland, F

    2011-09-01

    A yearling male California sea lion Zalophus californianus with hypermetric ataxia and bilateral negative menace reflexes was brought to The Marine Mammal Center, Sausalito, California, U.S.A., in late 2009 for medical assessment and treatment. The clinical signs were due to multiple gas bubbles within the cerebellum. These lesions were intraparenchymal, multifocal to coalescing, spherical to ovoid, and varied from 0.5 to 2.4 cm diameter. The gas composed 21.3% of the total cerebellum volume. Three rib fractures were also noted during diagnostic evaluation and were presumed to be associated with the gas bubbles in the brain. The progression of clinical signs and lesion appearance were monitored with magnetic resonance imaging, cognitive function testing and computed tomography. Gas filled voids in the cerebellum were filled with fluid on follow up images. Clinical signs resolved and the sea lion was released with a satellite tag attached. Post release the animal travelled approximately 75 km north and 80 km south of the release site and the tag recorded dives of over 150 m depth. The animal re-stranded 25 d following release and died of a subacute bronchopneumonia and pleuritis. This is the first instance of clinical injury due to gas bubble formation described in a living pinniped and the first sea lion with quantifiable cerebellar damage to take part in spatial learning and memory testing.

  11. Travelers' Health: Scuba Diving

    Science.gov (United States)

    ... 2 - Environmental Hazards Chapter 2 - Medical Tourism Scuba Diving Daniel A. Nord Published estimates report anywhere from ... may include an electrocardiogram and exercise treadmill test. DIVING DISORDERS Barotrauma Ear and sinus Ear barotrauma is ...

  12. 高性能战斗机飞行员耳气压性损伤1例%A case of high performance fighter pilot with otitic barotrauma

    Institute of Scientific and Technical Information of China (English)

    王俊涛; 李宏喜

    2010-01-01

    @@ 1 临床资料 患者,男性,32岁,高性能战斗机飞行员.单独转场回本部机场.起飞前患感冒,自觉不严重,因无航医伴随,坚持起飞.到达本场小航线快速着陆过程中出现压耳感觉,耳痛明显.着陆后做捏鼻鼓气、活动下颌及吞咽动作,效果不佳.

  13. Ear Tubes

    Science.gov (United States)

    ... of the ear drum or eustachian tube, Down Syndrome, cleft palate, and barotrauma (injury to the middle ear caused by a reduction of air pressure, ... specialist) may be warranted if you or your child has experienced repeated ... fluid in the middle ear, barotrauma, or have an anatomic abnormality that ...

  14. [Otorhinolaryngologic aspects of diving sports].

    Science.gov (United States)

    Strutz, J

    1993-08-01

    ENT disorders are the most common of all medical problems of diving. This review summarizes the specific conditions and ENT diseases in Scuba diving. During compression failure to equalize the pressure of air-filled cavities surrounded by bone deprives the middle ear or sinuses of aeration. Middle ear barotrauma is the most common barotrauma encountered in divers while sinus barotrauma and especially inner ear barotrauma (with rupture of the round or oval window) are less common. Decompression sickness in primarily the result of inert gas bubbles; deafness and vertigo may result if the inner ear is involved. The ENT examination necessary for assessment of diving fitness focuses on the middle and inner ear as well as the nose, sinuses and larynx. A list of ENT contra-indications is presented that mandate temporary or permanent disqualification from diving.

  15. Shallow Water Diving - The NASA Experience

    Science.gov (United States)

    Fitzpatrick, Daniel; Kelsey-Seybold

    2010-01-01

    This slide presentation reviews some of the problems and solutions that personnel have experienced during sessions in the Neutral Bu0yancy Lab (NBL). It reviews the standard dive that occurs at the NBL, Boyles and Henry's laws as they relate to the effects of diving. It then reviews in depth some of the major adverse physiologic events that happen during a diving session: Ear and Sinus Barotrauma, Decompression Sickness, (DCS), Pulmonary Barotrauma (i.e., Arterial Gas Embolism (AGE). Mediastinal Emphysema, Subcutaneous Emphysema, and Pneumothorax) Oxygen Toxicity and Hypothermia. It includes information about the pulmonary function in NBL divers. Also included is recommendations about flying after diving.

  16. Effects of Impulsive Pile-Driving Exposure on Fishes.

    Science.gov (United States)

    Casper, Brandon M; Carlson, Thomas J; Halvorsen, Michele B; Popper, Arthur N

    2016-01-01

    Six species of fishes were tested under aquatic far-field, plane-wave acoustic conditions to answer several key questions regarding the effects of exposure to impulsive pile driving. The issues addressed included which sound levels lead to the onset of barotrauma injuries, how these levels differ between fishes with different types of swim bladders, the recovery from barotrauma injuries, and the potential effects exposure might have on the auditory system. The results demonstrate that the current interim criteria for pile-driving sound exposures are 20 dB or more below the actual sound levels that result in the onset of physiological effects on fishes.

  17. Relationship between Radiological Stages and Prognoses of Pneumocystis Pneumonia in Non-AIDS Immunocompromised Patients

    Directory of Open Access Journals (Sweden)

    Xiang-Dong Mu

    2016-01-01

    Conclusions: Based on the radiological manifestations, the course of PCP in non-AIDS immunocompromised patients can be divided into three stages: early stage, mid stage, and late stage. The prognoses of patients treated at early stage are good, and those at late stage are poor. Furthermore, the CFR of patients with barotrauma is high.

  18. Decompressieziekte

    NARCIS (Netherlands)

    Gho, J. M.; Kramer, I.F.; van Hulst, R. A.; Kramer, W. L.

    2012-01-01

    Nowadays, diving is being performed ever more frequently; it is thus important to take diving injuries into consideration in patients presenting with even minor complaints after diving. Every dive is risky and could result in decompression illness, barotrauma and/or death. We report on two cases of

  19. Electroporation ablation: A new energy modality for ablation of arrhythmogenic cardiac substrate

    NARCIS (Netherlands)

    van Driel, VJHM

    2016-01-01

    At the very end of the Direct Current (DC) era, low-energy DC ablation was demonstrated to cause myocardial lesions by non-thermal irreversible electroporation (IRE) (permanent formation of pores in the cell membrane, leading to cell death), without arcing and/or barotrauma. To eliminate rather smal

  20. Barodontalgia.

    Science.gov (United States)

    Zadik, Yehuda

    2009-04-01

    Although considered rare, dentists may encounter oral pain evoked by a change in barometric pressure, a condition known as barodontalgia (aerodontalgia). The article reviews the epidemiology, clinical presentation, pathogenesis, diagnostic process and differential diagnosis (including facial and dental barotrauma) of this phenomenon. Preventive measures are described as well.

  1. [Aerosinusitis: part 1: Fundamentals, pathophysiology and prophylaxis].

    Science.gov (United States)

    Weber, R; Kühnel, T; Graf, J; Hosemann, W

    2014-01-01

    The relevance of aerosinusitis stems from the high number of flight passengers and the impaired fitness for work of the flight personnel. The frontal sinus is more frequently affected than the maxillary sinus and the condition generally occurs during descent. Sinonasal diseases and anatomic variations leading to obstruction of paranasal sinus ventilation favor the development of aerosinusitis. This Continuing Medical Education (CME) article is based on selective literature searches of the PubMed database (search terms: "aerosinusitis", "barosinusitis", "barotrauma" AND "sinus", "barotrauma" AND "sinusitis", "sinusitis" AND "flying" OR "aviator"). Additionally, currently available monographs and further articles that could be identified based on the publication reviews were also included. Part 1 presents the pathophysiology, symptoms, risk factors, epidemiology and prophylaxis of aerosinusitis. In part 2, diagnosis, conservative and surgical treatment will be discussed.

  2. Neurological complications of underwater diving.

    Science.gov (United States)

    Rosińska, Justyna; Łukasik, Maria; Kozubski, Wojciech

    2015-01-01

    The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. They occur in both commercial and recreational diving and are connected with increasing interest in the sport of diving. Hence it is very important to know the possible complications associated with this kind of sport. Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers.

  3. Neumotórax hipertensivo por inhalación de cocaína

    Directory of Open Access Journals (Sweden)

    William José González Cogollo

    2002-03-01

    Full Text Available El uso de la cocaína causa complicaciones pulmonares, cardiacas, músculo esqueléticas, obstétricas y gastrointestinales. Se describe el caso de un varón joven quien presento barotrauma (neumotórax hipertensivo posterior a la inhalación de cocaína. Basados en este caso y en una revisión de la literatura medica se recomienda interrogar exhaustivamente acerca del uso de drogas en todo paciente adulto o adolescente con neumotórax "espontáneo".The use of cocaine causes pulmonary, cardiac, obstetric, muskuloskeletal and gastrointestinal complications. The case of a young man who sustained barotrauma (hipertensive pneumotorax associated with the use of cocaine is presentes here. Based on this case and a review of the literature it is recommended that a careful drug abuse history be obtained when "spontaneous" pneumotorax is encountered in an adult or adolescent patient.

  4. Liquid nitrogen ingestion followed by gastric perforation.

    Science.gov (United States)

    Berrizbeitia, Luis D; Calello, Diane P; Dhir, Nisha; O'Reilly, Colin; Marcus, Steven

    2010-01-01

    Ingestion of liquid nitrogen is rare but carries catastrophic complications related to barotrauma to the gastrointestinal tract. We describe a case of ingestion of liquid nitrogen followed by gastric perforation and respiratory insufficiency and discuss the mechanism of injury and management of this condition. Liquid nitrogen is widely available and is frequently used in classroom settings, in gastronomy, and for recreational purposes. Given the potentially lethal complications of ingestion, regulation of its use, acquisition, and storage may be appropriate.

  5. Medical Aspects of Harsh Environments. Volume 2

    Science.gov (United States)

    2002-01-01

    Unilateral high-altitude pulmonary edema in a subject with right pulmonary artery hypoplasia . Respiration. 1994;61:51–54. 91. Torrington KG. Recurrent...enough to cause rupture of the round window with cochlear and vestibular damage (see Inner Ear Barotrauma, below). The Frenzel maneuver consists of...probably due to cochlear membrane rupture or hemorrhage. If deafness is instantaneous and present in all frequencies, it is probably due to se- vere round

  6. A Biomedical Review of the U.S. Navy Submarine Escape System: 1996.

    Science.gov (United States)

    2007-11-02

    in the es- cape system: hypothermia, nitrogen narcosis , hypercarbia, barotrauma, and decompression sickness. He attributed these shortcomings to... Nitrogen narcosis is experienced at 600 fsw (183 msw) following a 20-second rapid ZPreST f t3Tu°nd b0tt0m ^ ™e Phys^al effects of nitrogen at...effect of nitrogen narcosis during this rapid cycle (8). How long tiie subject wouWremamun^pafredbeyondSseimerbysubje^ known, but continued use of

  7. Moving in extreme environments: inert gas narcosis and underwater activities

    OpenAIRE

    Clark, James E

    2015-01-01

    Exposure to the underwater environment for pleasure or work poses many challenges on the human body including thermal stress, barotraumas, decompression sickness as well as the acute effects of breathing gases under pressure. With the popularity of recreational self-contained underwater breathing apparatus (SCUBA) diving on the increase and deep inland dive sites becoming more accessible, it is important that we understand the effects of breathing pressurised gas at depth can have on the body...

  8. Decompression from He-N2-O2 (TRIMIX) Bounce Dives Is Not More Efficient Than From He-O2 (HELIOX) Bounce Dives

    Science.gov (United States)

    2015-05-28

    bubbles grow if the animal breathes air. Qualitatively similar results are observed in adipose tissue, where nitrogen permeability might exceed that of...or in Skeletal Muscle in Sheep," Journal of Applied Physiology, Vol. 118 (2015), pp. 586-594. 41. R. H. Strauss and T. D. Kunkle, "Isobaric Bubble...typical and common for this diver Vague abdominal or chest pain, not related to trauma or barotrauma Vague symptoms of any kind not responding to

  9. A piecewise regression approach for determining biologically relevant hydraulic thresholds for the protection of fish at river infrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Boys, Craig A.; Robinson, Wayne; Miller, Brett; Pflugrath, Brett D.; Baumgartner, Lee J.; Navarro, Anna; Brown, Richard S.; Deng, Zhiqun

    2016-05-13

    Barotrauma injury can occur when fish are exposed to rapid decompression during downstream passage through river infrastructure. A piecewise regression approach was used to objectively quantify barotrauma injury thresholds in two physoclistous species (Murray cod Maccullochella peelii and silver perch Bidyanus bidyanus) following simulated infrastructure passage in barometric chambers. The probability of injuries such as swim bladder rupture; exophthalmia; and haemorrhage and emphysema in various organs increased as the ratio between the lowest exposure pressure and the acclimation pressure (ratio of pressure change RPCE/A) fell. The relationship was typically non-linear and piecewise regression was able to quantify thresholds in RPCE/A that once exceeded resulted in a substantial increase in barotrauma injury. Thresholds differed among injury types and between species but by applying a multi-species precautionary principle, the maintenance of exposure pressures at river infrastructure above 70% of acclimation pressure (RPCE/A of 0.7) should sufficiently protect downstream migrating juveniles of these two physoclistous species. These findings have important implications for determining the risk posed by current infrastructures and informing the design and operation of new ones.

  10. How low can they go when going with the flow? Tolerance of egg and larval fishes to rapid decompression

    Energy Technology Data Exchange (ETDEWEB)

    Boys, Craig A.; Robinson, Wayne; Miller, Brett; Pflugrath, Brett; Baumgartner, Lee J.; Navarro, Anna; Brown, Richard; Deng, Zhiqun

    2016-05-26

    Egg and larval fish that drift downstream are likely to encounter river infrastructure and consequently rapid decompression, which may result in significant injury. In juvenile fish, pressure-related injury (or barotrauma) occurs when pressures fall sufficiently below the pressure at which the fish has acclimated. Because eggs and larvae are less-developed and more fragile than juveniles, there is a presumption that they may be at least as, if not more, susceptible to barotrauma injury, but studies to date report inconsistent results and none have considered the relationship between pressure change and barotrauma over a sufficiently broad range of pressure changes to enable detrimental levels to be properly determined. To address this, we exposed eggs and larvae of three physoclistic species to rapid decompression in a barometric chamber over a broad range of discrete pressure changes. Eggs, but not larvae, were unaffected by all levels of decompression tested. At exposure pressures below ~40 kPa, or ~40% of atmospheric pressure, swim bladder deflation occurred in all species and internal haemorrhage was observed in one species. None of these injuries killed the fish within 24 hours, but subsequent mortality cannot be excluded. Consequently, if larval drift is expected, it seems prudent to maintain exposure pressures at river infrastructure at 40% or more of the pressure to which a drifting larvae has acclimated.

  11. Diving dentistry: a review of the dental implications of scuba diving.

    Science.gov (United States)

    Zadik, Y; Drucker, S

    2011-09-01

    In light of the overwhelming popularity of self-contained underwater breathing apparatus (SCUBA) diving, general dental practitioners should be prepared to address complications arising as a result of diving and to provide patients with accurate information. The aim of this article was to introduce the concepts of diving medicine and dentistry to the dentist, and to supply the dental practitioner with some diagnostic tools as well as treatment guidelines. The literature was reviewed to address diving barotrauma (pressure-induced injury related to an air space) to the head, face and oral regions, as well as scuba mouthpiece-related oral conditions. The relevant conditions for dentists who treat divers include diving-associated headache (migraine, tension-type headache), barosinusitis and barotitis-media (sinus and middle ear barotrauma, respectively), neuropathy, trigeminal (CN V) or facial (CN VII) nerve baroparesis (pressure-induced palsy), dental barotrauma (barometric-related tooth injury), barodontalgia (barometric-related dental pain), mouthpiece-associated herpes infection, pharyngeal gag reflex and temporomandibular joint disorder (dysfunction). For each condition, a theoretical description is followed by practical recommendations for the dental practitioner for the prevention and management of the condition.

  12. Neumotórax hipertensivo por inhalación de cocaína

    Directory of Open Access Journals (Sweden)

    William José González Cogollo

    2002-03-01

    Full Text Available El uso de la cocaína causa complicaciones pulmonares, cardiacas, músculo esqueléticas, obstétricas y gastrointestinales. Se describe el caso de un varón joven quien presento barotrauma (neumotórax hipertensivo posterior a la inhalación de cocaína. Basados en este caso y en una revisión de la literatura medica se recomienda interrogar exhaustivamente acerca del uso de drogas en todo paciente adulto o adolescente con neumotórax "espontáneo".

  13. Sinusoplastía con balón en seno frontal: Experiencia en 8 pacientes

    OpenAIRE

    2010-01-01

    Introducción: La sinusoplastia con balón es una técnica cada vez más usada en patología sinusal, ya que previene el trauma, conserva la anatomía, evita la instrumentación del seno frontal, preserva la mucosa del receso frontal, con un alto grado de seguridad. Dentro de sus principales indicaciones se encuentra la patología de seno frontal, como es el caso de sinusitis aislada, osteítis focalizada, sinusitis posoperatoria y barotrauma. Las controversias se relacionan con sus indicaciones limit...

  14. [Lungs et diving].

    Science.gov (United States)

    Héritier, F; Avanzi, P; Nicod, L

    2014-11-19

    Whilst underwater, the body is submitted to significant variations of the surrounding pressure according to the depth. These conditions modify the hemodynamic and the ventilatory mechanics considerably. Some repercussions, like pulmonary barotrauma, are related to simple physical phenomena. Others, like decompression sickness, are due to more com- plex processes. Breath-hold diving disrupts haematosis and can be complicated by alveolar haemorrhage and loss of consciousness. Acute pulmonary oedema during scuba-diving, breath-hold diving and swimming has been reported more recently. In case of pulmonary disorders scuba-diving is contraindicated most of the time. It is therefore highly recommended to seek medical advice to prevent problems.

  15. Reducing Bat Fatalities From Interactions with Operating Wind Turbines (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    Lawson, M.

    2013-11-01

    One of the biggest advantages of wind energy is that, overall, it has fewer negative impacts on the environment than fossil fuel-generated energy. Most professionals in the wind industry would like to reduce the impact of energy generation on plants, animals, and their habitats. This is why the industry is highly motivated to find out why migrating bats have unexpectedly high fatality rates near operating wind farms. New research has provided quantitative data that indicates barotrauma is not a major cause of bat deaths around operating turbines.

  16. Neurological oxygen toxicity.

    Science.gov (United States)

    Farmery, Scott; Sykes, Oliver

    2012-10-01

    SCUBA diving has several risks associated with it from breathing air under pressure--nitrogen narcosis, barotrauma and decompression sickness (the bends). Trimix SCUBA diving involves regulating mixtures of nitrogen, oxygen and helium in an attempt to overcome the risks of narcosis and decompression sickness during deep dives, but introduces other potential hazards such as hypoxia and oxygen toxicity convulsions. This study reports on a seizure during the ascent phase, its potential causes and management and discusses the hazards posed to the diver and his rescuer by an emergency ascent to the surface.

  17. Neumotórax hipertensivo por inhalación de cocaína

    OpenAIRE

    2002-01-01

    El uso de la cocaína causa complicaciones pulmonares, cardiacas, músculo esqueléticas, obstétricas y gastrointestinales. Se describe el caso de un varón joven quien presento barotrauma (neumotórax hipertensivo) posterior a la inhalación de cocaína. Basados en este caso y en una revisión de la literatura medica se recomienda interrogar exhaustivamente acerca del uso de drogas en todo paciente adulto o adolescente con neumotórax "espontáneo".The use of cocaine causes pulmonary, cardiac, obstetr...

  18. Barotite média em tripulantes da aviação civil

    Directory of Open Access Journals (Sweden)

    Bastos Adriana Geórgia Davim

    2004-01-01

    Full Text Available O barotrauma da orelha média ou barotite média (BM é definido, segundo Armstrong & Hein, como uma inflamação traumática aguda ou crônica causada por alterações da pressão atmosférica. OBJETIVO: O objetivo deste estudo é analisar os aspectos clínicos relacionados ao barotrauma da orelha média em tripulantes da aviação civil. DESENHO DO ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Foram avaliados 17 casos de BM no período de dezembro de 2002 a setembro de 2003, entre tripulantes atendidos no ambulatório de ORL do serviço médico da Fundação Ruben Berta/RJ (FRB/RJ. Em revisão dos prontuários foram colhidos e analisados dados relacionados ao sexo, idade, quadro clínico, evolução e tratamento. RESULTADOS: No total dos casos, 11 eram homens e 6 mulheres; idade média de 37,3 anos. Todos apresentaram otalgia durante a descida do avião. Catorze pacientes (82,4% apresentavam queixa de plenitude aural. Zumbidos ocorreram em 2 pacientes. No momento do vôo, onze pacientes (64,7% apresentavam quadro sugestivo de infecção de vias aéreas superiores associada. O barotrauma foi de grau 1 de Teed em 17,6% dos casos, grau 2 em 58,8% dos casos e 23,6% grau 3. Nenhum paciente apresentou BM grau 4. O tratamento foi conservador em todos os casos, sendo preferida à utilização de antibióticos, corticosteróides e descongestionantes, por via oral. CONCLUSÃO: A BM é uma doença peculiar à medicina aeroespacial e a otorrinolaringologia. A compreensão da fisiopatologia e mecanismos de prevenção do barotrauma da orelha média é fundamental para manejo adequado destes pacientes.

  19. Marine and other aquatic dermatoses

    Directory of Open Access Journals (Sweden)

    Jandhyala Sridhar

    2017-01-01

    Full Text Available Occupational and recreational aquatic activity predisposes our population to a wide variety of dermatoses. Sunburn, urticaria, jellyfish stings, and contact dermatitis to rubber equipment are common allergies that are encountered in the aquatic environment. Among the infections, tinea versicolor, intertrigo, and verruca vulgaris are widespread. Swimmer's itch may occur due to skin penetration by schistosome cercariae, while free-floating nematocysts of marine coelenterates may precipitate seabather's eruption. “Suit squeeze” due to cutaneous barotrauma and lymphoedematous peau d'orange due to decompression are rare, described entities. This review serves as a ready reckoner for Indian dermatologists and medical practitioners to identify and manage these conditions.

  20. Barodontalgia: what have we learned in the past decade?

    Science.gov (United States)

    Zadik, Yehuda

    2010-04-01

    This article reviews the current knowledge regarding barodontalgia, a barometric pressure-related oral (dental and other) pain. Contemporary classification, prevalence, and incidence, features, etiology, and diagnosis of this entity are presented regarding flight and diving conditions. Summarizing the past decade data, three-fourths of episodes were described as severe, sharp, and localized pain. Barodontalgia affects 11.9% of divers and 11.0% of military aircrews with a rate of 5 episodes/1,000 flight-years. Upper and lower dentitions were affected equally in flight, but more upper than lower dentition were affected in diving. The most prevalent etiologic pathologies for in-flight dental pain were faulty dental restorations (including dental barotrauma) and dental caries without pulp involvement (29.2%), necrotic pulp/periapical inflammation (27.8%), vital pulp pathology (13.9%), recent dental treatment (11.1%), and barosinusitis (9.7%). This review refutes 3 generally accepted conventions: According to the results, the current in-flight barodontalgia incidence is similar to the incidence in the first half of the 20th century, the weighted incidence of barodontalgia among aircrews are similar to the weighted incidence among divers, and the role of facial barotrauma in the etiology of in-flight barodontalgia is minor.

  1. 招收飞行学员和飞行人员耳气压机能不良的比较研究%A comparative study about Eustachian tube dysfunction between pilot candidates and the active pilots

    Institute of Scientific and Technical Information of China (English)

    徐先荣; 汪运坤; 汪斌儒; 叶晓军

    2012-01-01

    Objective To study the otological diagnosis in the primary physical examination of pilot candidates in order to reduce the prevalence rate of aural barotrauma in pilots and the dysfunction dependent flying disqualification rate.Methods ① The prevalence rate of Eustachian tube dysfunction,that diagnosed by performing Valsalva maneuver or improved Valsalva maneuver,was statistically analyzed upon 12 812 physical examination records of pilot candidates and was compared with the questionnaire collected prevalence rate of aural barotrauma in 120 qualified fighter pilots.②The percentage of aural barotrauma case against the inpatients of Otorhinolaryngological Department was calculated based on 273 fighter pilot cases.Upon 50 otorhinolaryngology caused grounding cases of the flying personnel the percentages of aural barotraumas reason was picked out and was compared with the percentage of otorhinolaryngological reasons eliminated candidates in the otorhinolaryngology eliminations of recruitment examination.Results ① The detection rate of Eustachian tube dysfunction in the candidates was 0.12% (16/12 812),much lower than the prevalence rate of aural barotrauma in active pilots(63.33 %,76/120)(x2 =6724.52,P<0.01).②The eliminating rate of the candidates with Eustachian tube dysfunction was 0.84% (16/1914) in otorhinolaryngological examinations,much lower than the percentage of aural barotraumas cases in hospitalized fighter pilots in the otorhinolaryngological Department (23.08 %,63/273) (x2 =339.44,P<0.01) ; much lower than the aural barotrauma caused grounding rate (20.00%,10/50) (x2 =136.99,P<0.01).Conclusion The method and criterion for diagnosing Eustachian tube dysfunction in the physical examination of pilot candidates should be improved to raise the detection rate and then to reduce its prevalence rate and the grounding rate of flying personnel.%目的 探讨从招飞体检源头降低飞行人员耳气压伤发

  2. Diving injuries to the inner ear.

    Science.gov (United States)

    Farmer, J C

    1977-01-01

    Most of the previous literature concerning otologic problems in compressed gas environments has emphasized middle ear barotrauma. With recent increases in commercial, military, and sport diving to deeper depths, inner ear disturbances during these exposures have been noted more frequently. Studies of inner ear physiology and pathology during diving indicate that the causes and treatment of these problems differ depending upon the phase and type of diving. Humans exposed to simulated depths of up to 305 meters without barotrauma or decompression sickness develop transient, conductive hearing losses with no audiometric evidence of cochlear dysfunction. Transient vertigo and nystagmus during diving have been noted with caloric stimulation, resulting from the unequal entry of cold water into the external auditory canals, and with asymmetric middle ear pressure equilibration during ascent and descent (alternobaric vertigo). Equilibrium disturbances noted with nitrogen narcosis, oxygen toxicity, hypercarbia, or hypoxia appear primarily related to the effects of these conditions upon the central nervous system and not to specific vestibular end-organ dysfunction. Compression of humans in helium-oxygen at depths greater than 152.4 meters results in transient symptoms of tremor, dizziness, and nausea plus decrements in postural equilibrium and psychomotor performance, the high pressure nervous syndrome. Vestibular function studies during these conditions indicate that these problems are due to central dysfunction and not to vestibular end-organ dysfunction. Persistent inner ear injuries have been noted during several phases of diving: 1) Such injuries during compression (inner ear barotrauma) have been related to round window ruptures occurring with straining, or a Valsalva's maneuver during inadequate middle ear pressure equilibration. Divers who develop cochlear and/or vestibular symptoms during shallow diving in which decompression sickness is unlikely or during

  3. Biocorrodible metals for coronary revascularization: Lessons from PROGRESS-AMS, BIOSOLVE-I, and BIOSOLVE-II.

    Science.gov (United States)

    Bouchi, Yasir H; Gogas, Bill D

    2015-01-01

    The impetus for developing drug-eluting bioresorbable scaffolds (BRS) has been driven by the need for elastic and transient platforms instead of stiff and permanent metallic implants in diseased coronary anatomies. This endeavor would prevent acute recoil or occlusion, allow sealing of post-procedural dissections following acute barotrauma, provide inhibition of in-segment restenosis through efficient drug-elution and would further prepare the vessel to enter a reparative phase following scaffold resorption. Biocorrodible metallic platforms have been introduced as alternatives to bioresorbable polymeric scaffolds for the treatment of significant atherosclerosis and in view of the body of evidence derived from recent clinical trials we elaborate on the clinical safety and efficacy of these devices in interventional cardiology.

  4. A phase I study of low-pressure hyperbaric oxygen therapy for blast-induced post-concussion syndrome and post-traumatic stress disorder.

    Science.gov (United States)

    Harch, Paul G; Andrews, Susan R; Fogarty, Edward F; Amen, Daniel; Pezzullo, John C; Lucarini, Juliette; Aubrey, Claire; Taylor, Derek V; Staab, Paul K; Van Meter, Keith W

    2012-01-01

    This is a preliminary report on the safety and efficacy of 1.5 ATA hyperbaric oxygen therapy (HBOT) in military subjects with chronic blast-induced mild to moderate traumatic brain injury (TBI)/post-concussion syndrome (PCS) and post-traumatic stress disorder (PTSD). Sixteen military subjects received 40 1.5 ATA/60 min HBOT sessions in 30 days. Symptoms, physical and neurological exams, SPECT brain imaging, and neuropsychological and psychological testing were completed before and within 1 week after treatment. Subjects experienced reversible middle ear barotrauma (5), transient deterioration in symptoms (4), and reversible bronchospasm (1); one subject withdrew. Post-treatment testing demonstrated significant improvement in: symptoms, neurological exam, full-scale IQ (+14.8 points; pPTSD symptoms (PCL-M: pself-report of percent of normal (pPTSD. Significant improvements occurred in symptoms, abnormal physical exam findings, cognitive testing, and quality-of-life measurements, with concomitant significant improvements in SPECT.

  5. [One-lung ventilation using dexmedetomidine in an emphysema patient with pneumothorax due to metastatic lung cancer].

    Science.gov (United States)

    Ono, Naomi; Komasawa, Nobuyasu; Nakano, Shoko; Tatsumi, Shinichi; Nakao, Kenta; Minami, Toshiaki

    2014-05-01

    We report a case of double-lumen tube intubation and intraoperative one-lung ventilation under spontaneous breathing with continuous dexmedetomidine administration. A 61-year-old man developed pneumothorax due to multiple metastatic cancer, had multiple bilateral bullae, and underwent bullae resection under general anesthesia. An epidural catheter was placed at T8-9. Under dexmedetomidine sedation and regional anesthesia with lidocaine, a double-lumen tube was inserted with a Macintosh laryngoscope. The patient was under one-lung ventilation with spontaneous breathing during the operation. There were no complications from one-lung ventilation and the patient was extubated in the operating room. One-lung ventilation, which preserves spontaneous breathing, under dexmedetomidine sedation is considered effective for preventing barotrauma in patients with multiple metastatic cancer.

  6. A case of pneumothorax due to non-invasive mechanical ventilation

    Directory of Open Access Journals (Sweden)

    İbrahim Koç

    2014-09-01

    Full Text Available Emphysema is enlargement of alveolus, alveolary ducts and destruction of alveolary wall. One of complications of non-invasive mechanical ventilation (NIMV is barotrauma of damaged lung. Here we present a 75 years old male who had Chronic Obstructive Pulmonary Disease (COPD, emphysema for 5 years and suffered from pneumothorax after NIMV. During treatment with NIMV his general condition deteriorated and oxygen saturation decreased immediately. Chest X-ray and tomography revealed pneumothorax. Chest tube inserted under local anesthesia. Although NIMV might seem like innocent, in patients whose general condition immediately worsens, oxygen saturation decreases, has emphysema and bullous lesions pneumothorax must be excluded. J Clin Exp Invest 2014; 5 (3: 469-471

  7. Cerebral Arterial Air Embolism Associated with Mechanical Ventilation and Deep Tracheal Aspiration

    Directory of Open Access Journals (Sweden)

    S. Gursoy

    2012-01-01

    Full Text Available Arterial air embolism associated with pulmonary barotrauma has been considered a rare but a well-known complication of mechanical ventilation. A 65-year-old man, who had subarachnoid hemorrhage with Glasgow coma scale of 8, was admitted to intensive care unit and ventilated with the help of mechanical ventilator. Due to the excessive secretions, deep tracheal aspirations were made frequently. GCS decreased from 8–10 to 4-5, and the patient was reevaluated with cranial CT scan. In CT scan, air embolism was detected in the cerebral arteries. The patient deteriorated and spontaneous respiratory activity lost just after the CT investigation. Thirty minutes later cardiac arrest appeared. Despite the resuscitation, the patient died. We suggest that pneumonia and frequent tracheal aspirations are predisposing factors for cerebral vascular air embolism.

  8. Non-heparinized ECMO serves a rescue method in a multitrauma patient combining pulmonary contusion and nonoperative internal bleeding: a case report and literature review.

    Science.gov (United States)

    Wen, Pei-Hung; Chan, Wai Hung; Chen, Ying-Cheng; Chen, Yao-Li; Chan, Chien-Pin; Lin, Ping-Yi

    2015-01-01

    Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patients are still unable to maintain their oxygenation. The role of extracorporeal membrane oxygenation (ECMO) has been more clarified when the lung is extensively damaged and when conventional modality failed. ECMO provides the lung an opportunity to rest by permitting reduced ventilator settings and limiting further barotraumas. However, ECMO is still considered contraindicated in polytramatic patients combining pulmonary contusion and other organ hemorrhage because of systemic anticoagulation during the treatment. We herein report a patient who successfully survive a multitrauma combining pulmonary contusion and grade IV liver laceration using non-heparinized venovenous extracorporeal membrane oxygenation (vv-ECMO). The associated literature were reviewed.

  9. Effect of cannabis smoking on lung function and respiratory symptoms: a structured literature review

    Science.gov (United States)

    Ribeiro, Luis IG; Ind, Philip W

    2016-01-01

    As cannabis use increases, physicians need to be familiar with the effects of both cannabis and tobacco on the lungs. However, there have been very few long-term studies of cannabis smoking, mostly due to legality issues and the confounding effects of tobacco. It was previously thought that cannabis and tobacco had similar long-term effects as both cause chronic bronchitis. However, recent large studies have shown that, instead of reducing forced expiratory volume in 1 s and forced vital capacity (FVC), marijuana smoking is associated with increased FVC. The cause of this is unclear, but acute bronchodilator and anti-inflammatory effects of cannabis may be relevant. Bullous lung disease, barotrauma and cannabis smoking have been recognised in case reports and small series. More work is needed to address the effects of cannabis on lung function, imaging and histological changes. PMID:27763599

  10. "Bong lung" in cystic fibrosis: a case report

    Directory of Open Access Journals (Sweden)

    Hauser Jenny

    2010-11-01

    Full Text Available Abstract Introduction Marijuana or "bong" lung has been recently described. Subjects typically develop large peripheral paraseptal lung bullae and are predisposed to spontaneous pneumothoraces. The underlying mechanism for bullae formation is uncertain, but probably relates to direct lung toxicity and repeated barotrauma as the smoker performs frequent valsalva manoeuvres in an attempt to derive a greater drug effect. Case presentation We describe a case of probable "bong lung" occurring in a 23-year-old Caucasian man with cystic fibrosis who had a history of recurrent pneumothoraces and unusual findings on sputum cytology. Conclusion Our case highlights the importance of questioning young adult cystic fibrosis patients about illicit drug use and the utility of sputum cytology and computed tomography scanning when patients present with pneumothoraces and deteriorations in clinical status.

  11. Oral and maxillofacial aspects of diving medicine.

    Science.gov (United States)

    Brandt, Matthew T

    2004-02-01

    Sport diving has witnessed explosive growth in the past decade, as 8.5 million people are certified in the United States alone. Even though scuba diving is a relatively safe sport, there are serious risks that all divers must consider. Beyond the better-known sequelae such as decompression sickness, middle ear dysfunction, and potential central nervous system effects, scuba diving also carries inherent risk to the maxillofacial region. Atypical facial pain, temporomandibular joint dysfunction, sinus barotraumas, and barodontalgia have all been reported by dentists and physicians treating military, commercial, and sport divers. Additionally, clinicians must address anatomic concerns for would-be divers, including cleft lip and palate, edentulism, or patients with pre-existing temporomandibular dysfunction, midfacial trauma, or craniomaxillofacial surgery. Health care professionals should have a thorough understanding of the implications of scuba diving for consultation and recommendation regarding diving fitness and the treatment of adverse effects of scuba diving to the maxillofacial region.

  12. [Oral problems in divers].

    Science.gov (United States)

    Scheper, W A; Lobbezoo, F; Eijkman, M A J

    2005-05-01

    Divers can have several oral problems. Firstly, problems caused by pressure changes. These are barodontalgia and odontocrexis. Barodontalgia is toothache by barotrauma. Odontocrexis is restorations coming lose or breaking or tooth fractures by expansion of air beneath restorations. Other problems can occur by cements used to fix casted restorations, by inflammations in the orofacial region, and by not yet fully healed oral wounds. Secondly, there are problems related to the diver's mouthpiece. To keep the mouthpiece in place, the mandible has to be forced in a forward position. Holding this position often and for long periods of time, may develop or aggravate temporomandibular dysfunction. Insufficient fit of the mouthpiece may induce oral mucosal lesions. Therefore, it is recommended to produce individual diver mouthpieces. It is also recommended to produce individual diver mouthpieces for complete dentures wearing divers and for divers with fixed orthodontic appliances.

  13. Global surgery in a postconflict setting - 5-year results of implementation in the Russian North Caucasus

    Directory of Open Access Journals (Sweden)

    Fatima I. Lunze

    2015-10-01

    Full Text Available Background: Collaborations for global surgery face many challenges to achieve fair and safe patient care and to build sustainable capacity. The 2004 terrorist attack on a school in Beslan in North Ossetia in the Russian North Caucasus left many victims with complex otologic barotrauma. In response, we implemented a global surgery partnership between the Vladikavkaz Children's Hospital, international surgical teams, the North Ossetian Health Ministry, and civil society organizations. This study's aim was to describe the implementation and 5-year results of capacity building for complex surgery in a postconflict, mid-income setting. Design: We conducted an observational study at the Children's Hospital in Vladikavkaz in the autonomous Republic of North Ossetia-Alania, part of the Russian Federation. We assessed the outcomes of 15 initial patients who received otologic surgeries for complex barotrauma resulting from the Beslan terrorism attack and for other indications, and report the incidence of intra- and postoperative complications. Results: Patients were treated for trauma related to terrorism (53% and for indications not related to violence (47%. None of the patients developed peri- or postoperative complications. Three patients (two victims of terrorism who underwent repair of tympanic perforations presented with re-perforations. Four junior and senior surgeons were trained on-site and in Germany to perform and teach similar procedures autonomously. Conclusions: In mid-income, postconflict settings, complex surgery can be safely implemented and achieve patient outcomes comparable to global standards. Capacity building can build on existing resources, such as operation room management, nursing, and anesthesia services. In postconflict environments, substantial surgical burden is not directly attributable to conflict-related injury and disease, but to health systems weakened by conflicts. Extending training and safe surgical care to include

  14. Global surgery in a postconflict setting - 5-year results of implementation in the Russian North Caucasus.

    Science.gov (United States)

    Lunze, Fatima I; Lunze, Karsten; Tsorieva, Zemfira M; Esenov, Constantin T; Reutov, Alexandr; Eichhorn, Thomas; Offergeld, Christian

    2015-01-01

    Background Collaborations for global surgery face many challenges to achieve fair and safe patient care and to build sustainable capacity. The 2004 terrorist attack on a school in Beslan in North Ossetia in the Russian North Caucasus left many victims with complex otologic barotrauma. In response, we implemented a global surgery partnership between the Vladikavkaz Children's Hospital, international surgical teams, the North Ossetian Health Ministry, and civil society organizations. This study's aim was to describe the implementation and 5-year results of capacity building for complex surgery in a postconflict, mid-income setting. Design We conducted an observational study at the Children's Hospital in Vladikavkaz in the autonomous Republic of North Ossetia-Alania, part of the Russian Federation. We assessed the outcomes of 15 initial patients who received otologic surgeries for complex barotrauma resulting from the Beslan terrorism attack and for other indications, and report the incidence of intra- and postoperative complications. Results Patients were treated for trauma related to terrorism (53%) and for indications not related to violence (47%). None of the patients developed peri- or postoperative complications. Three patients (two victims of terrorism) who underwent repair of tympanic perforations presented with re-perforations. Four junior and senior surgeons were trained on-site and in Germany to perform and teach similar procedures autonomously. Conclusions In mid-income, postconflict settings, complex surgery can be safely implemented and achieve patient outcomes comparable to global standards. Capacity building can build on existing resources, such as operation room management, nursing, and anesthesia services. In postconflict environments, substantial surgical burden is not directly attributable to conflict-related injury and disease, but to health systems weakened by conflicts. Extending training and safe surgical care to include specialized

  15. Is high-frequency oscillatory ventilation more effective and safer than conventional protective ventilation in adult acute respiratory distress syndrome patients? A meta-analysis of randomized controlled trials

    Science.gov (United States)

    2014-01-01

    Introduction Comprehensively evaluating the efficacy and safety of high-frequency oscillatory ventilation (HFOV) is important to allow clinicians who are using or considering this intervention to make appropriate decisions. Methods To find randomized controlled trials (RCTs) comparing HFOV with conventional mechanical ventilation (CMV) as an initial treatment for adult ARDS patients, we searched electronic databases (including PubMed, MedLine, Springer Link, Elsevier Science Direct, ISI web of knowledge, and EMBASE) with the following terms: “acute respiratory distress syndrome”, “acute lung injury”, and “high frequency oscillation ventilation”. Additional sources included reference lists from the identified primary studies and relevant meta-analyses. Two investigators independently screened articles and extracted data. Meta-analysis was conducted using random-effects models. Results We included 6 RCTs with a total of 1,608 patients in this meta-analysis. Compared with CMV, HFOV did not significantly reduce the mortality at 30 or 28 days. The pooled relative risk (RR) was 1.051 (95% confidence interval (CI) 0.813 to 1.358). ICU mortality was also not significantly reduced in HFOV group, with a pooled RR of 1.218 (95% CI 0.925 to 1.604). The pooled effect sizes of HFOV for oxygenation failure, ventilation failure and duration of mechanical ventilation were 0.557 (95% CI 0.351 to 0.884), 0.892 (95% CI 0.435 to 1.829) and 0.079 (95% CI −0.045 to 0.203), respectively. The risk of barotrauma and hypotension were similar between the CMV group and HFOV group, with a RR of 1.205 (95% CI 0.834 to 1.742) and a RR of 1.326 (95% CI 0.271 to 6.476), respectively. Conclusions Although HFOV seems not to increase the risk of barotrauma or hypotension, and reduces the risk of oxygenation failure, it does not improve survival in adult acute respiratory distress syndrome patients. PMID:24887179

  16. Relationship between Radiological Stages and Prognoses of Pneumocystis Pneumonia in Non-AIDS Immunocompromised Patients

    Institute of Scientific and Technical Information of China (English)

    Xiang-Dong Mu; Peng Jia; Li Gao; Li Su; Cheng Zhang; Ren-Gui Wang; Guang-Fa Wang

    2016-01-01

    Background:Although radiological features ofpneumocystis pneumonia (PCP) in non-Acquired Immune Deficiency Syndrome (AIDS) immunocompromised patients have been reported by other authors,there were no studies on the radiological stages of PCP previously.This study aimed to elucidate the radiological stages and prognoses of PCP in non-AIDS immunocompromised patients.Methods:Retrospective analysis ofradiological manifestations and prognoses of 105 non-AIDS PCP immunocompromised patients from August 2009 to April 2016 was conducted.Chest radiograph was divided into three stages:early stage (normal or nearly normal chest radiograph),mid stage (bilateral pulmonary infiltrates),and late stage (bilateral pulmonary consolidations);chest high-resolution computed tomography (HRCT) was also divided into three stages:early stage (bilateral diffuse ground-glass opacity [GGO]),mid stage (bilateral diffuse GGO and patchy consolidations),and late stage (bilateral diffuse consolidations).Results:The case fatality rate (CFR) of all patients was 34.3% (36/105),all of them took routine chest X-ray (CXR),and 84 underwent chest CT examinations.According to the CXR most near the beginning of anti-PCP therapy,18 cases were at early stage and CFR was 0 (0/18,P < 0.0 1),50 cases were at mid stage and CFR was 28.0% (14/50,P > 0.05),and 37 cases were at late stage and CFR was 59.5% (22/37,P < 0.01).According to the chest HRCT most near the beginning ofanti-PCP therapy,40 cases were at early stage and CFR was 20.0% (8/40,P > 0.05),34 cases were at mid stage and CFR was 47.1% (16/34,P > 0.05),and 10 cases were at late stage and CFR was 80.0% (8/10,P < 0.05);barotrauma,including pneumothorax,pneumomediastinum,and pneumohypoderma,was found in 18 cases and the C FR was 77.8% (14/18,P < 0.01).Conclusions:Based on the radiological manifestations,the course of PCP in non-AIDS immunocompromised patients can be divided into three stages:early stage,mid stage,and late stage

  17. Threshold for onset of injury in Chinook salmon from exposure to impulsive pile driving sounds.

    Science.gov (United States)

    Halvorsen, Michele B; Casper, Brandon M; Woodley, Christa M; Carlson, Thomas J; Popper, Arthur N

    2012-01-01

    The risk of effects to fishes and other aquatic life from impulsive sound produced by activities such as pile driving and seismic exploration is increasing throughout the world, particularly with the increased exploitation of oceans for energy production. At the same time, there are few data that provide insight into the effects of these sounds on fishes. The goal of this study was to provide quantitative data to define the levels of impulsive sound that could result in the onset of barotrauma to fish. A High Intensity Controlled Impedance Fluid filled wave Tube was developed that enabled laboratory simulation of high-energy impulsive sound that were characteristic of aquatic far-field, plane-wave acoustic conditions. The sounds used were based upon the impulsive sounds generated by an impact hammer striking a steel shell pile. Neutrally buoyant juvenile Chinook salmon (Oncorhynchus tshawytscha) were exposed to impulsive sounds and subsequently evaluated for barotrauma injuries. Observed injuries ranged from mild hematomas at the lowest sound exposure levels to organ hemorrhage at the highest sound exposure levels. Frequency of observed injuries were used to compute a biological response weighted index (RWI) to evaluate the physiological impact of injuries at the different exposure levels. As single strike and cumulative sound exposure levels (SEL(ss), SEL(cum) respectively) increased, RWI values increased. Based on the results, tissue damage associated with adverse physiological costs occurred when the RWI was greater than 2. In terms of sound exposure levels a RWI of 2 was achieved for 1920 strikes by 177 dB re 1 µPa(2)⋅s SEL(ss) yielding a SEL(cum) of 210 dB re 1 µPa(2)⋅s, and for 960 strikes by 180 dB re 1 µPa(2)⋅s SEL(ss) yielding a SEL(cum) of 210 dB re 1 µPa(2)⋅s. These metrics define thresholds for onset of injury in juvenile Chinook salmon.

  18. Threshold for onset of injury in Chinook salmon from exposure to impulsive pile driving sounds.

    Directory of Open Access Journals (Sweden)

    Michele B Halvorsen

    Full Text Available The risk of effects to fishes and other aquatic life from impulsive sound produced by activities such as pile driving and seismic exploration is increasing throughout the world, particularly with the increased exploitation of oceans for energy production. At the same time, there are few data that provide insight into the effects of these sounds on fishes. The goal of this study was to provide quantitative data to define the levels of impulsive sound that could result in the onset of barotrauma to fish. A High Intensity Controlled Impedance Fluid filled wave Tube was developed that enabled laboratory simulation of high-energy impulsive sound that were characteristic of aquatic far-field, plane-wave acoustic conditions. The sounds used were based upon the impulsive sounds generated by an impact hammer striking a steel shell pile. Neutrally buoyant juvenile Chinook salmon (Oncorhynchus tshawytscha were exposed to impulsive sounds and subsequently evaluated for barotrauma injuries. Observed injuries ranged from mild hematomas at the lowest sound exposure levels to organ hemorrhage at the highest sound exposure levels. Frequency of observed injuries were used to compute a biological response weighted index (RWI to evaluate the physiological impact of injuries at the different exposure levels. As single strike and cumulative sound exposure levels (SEL(ss, SEL(cum respectively increased, RWI values increased. Based on the results, tissue damage associated with adverse physiological costs occurred when the RWI was greater than 2. In terms of sound exposure levels a RWI of 2 was achieved for 1920 strikes by 177 dB re 1 µPa(2⋅s SEL(ss yielding a SEL(cum of 210 dB re 1 µPa(2⋅s, and for 960 strikes by 180 dB re 1 µPa(2⋅s SEL(ss yielding a SEL(cum of 210 dB re 1 µPa(2⋅s. These metrics define thresholds for onset of injury in juvenile Chinook salmon.

  19. Delayed pneumothorax after laparoscopic sigmoid colectomy in a patient without underlying lung disease

    Directory of Open Access Journals (Sweden)

    Richie K Huynh

    2014-10-01

    Full Text Available We present an unusual case of a delayed pneumothorax occurring approximately 72 h post-operatively in a patient without any underlying lung disease who had undergone laparoscopic sigmoid colon resection. The patient was in her mid-40s with a body mass index of 28.0 and had no history of smoking. Her spontaneous pneumothorax manifested without any precipitating events or complications during recovery. There was no evidence of any infectious process. There were no central line attempts and all ports were placed intra-peritoneally, and there was no evidence of any subcutaneous emphysema. One possible mechanism of injury that we propose is barotrauma from an extended period of time in Trendelenburg position. Notably, the only abnormal finding throughout the entire post-operative period preceding the delayed pneumothorax was a PO2 desaturation the day before. This case highlights the necessity to examine and investigate any desaturation post-operatively and deliberate its possible significance. Furthermore, it demonstrates that, even during a normal recovery period for a patient without any underlying lung disease or risk factors, spontaneous pneumothorax could still develop in a delayed fashion multiple days post-operatively from a laparoscopic procedure.

  20. Cocaine-induced pulmonary changes: HRCT findings

    Energy Technology Data Exchange (ETDEWEB)

    Almeida, Renata Rocha de; Zanetti, Glaucia; Marchiori, Edson, E-mail: edmarchiori@gmail.com [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil). Programa de Pos-Graduacao em Radiologia; Souza Junior, Arthur Soares [Faculdade de Medicina de Petropolis, Petropolis, RJ (Brazil); Souza, Luciana Soares de [Ultra-X, Sao Jose do Rio Preto, SP (Brazil); Silva, Jorge Luiz Pereira e [Universidade Federal da Bahia (UFBA), Salvador (Brazil). Dep. de Medicina e Apoio Diagnostico; Escuissato, Dante Luiz [Universidade Federal do Parana (UFPR), Curitiba (Brazil). Dept. de Clinica Medica; Irion, Klaus Loureiro [Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool (United Kingdom); Mancano, Alexandre Dias [Hospital Anchieta, Taguatinga, DF (Brazil); Nobre, Luiz Felipe [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil); Hochhegger, Bruno [Universidade Federal de Ciencias da Saude de Porto Alegre, Porto Alegre, RS (Brazil); Marchiori, Edson [Universidade Federal Fluminense (UFF), Niteroi, RJ (Brazil)

    2015-07-15

    Objective: To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease. Methods: We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors. Results: In 8 patients (36.4%), the clinical and tomographic findings were consistent with 'crack lung', those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%), barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each. Conclusions: Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings. (author)

  1. Pleural controversy: optimal chest tube size for drainage.

    Science.gov (United States)

    Light, Richard W

    2011-02-01

    In recent years, a higher and higher percentage of patients with pleural effusions or pneumothorax are being treated with small-bore (10-14 F) chest tubes rather than large-bore (>20 F). However, there are very few randomized controlled studies comparing the efficacy and complication rates with the small- and large-bore catheters. Moreover, the randomized trials that are available have flaws in their design. The advantages of the small-bore catheters are that they are easier to insert and there is less pain with their insertion while they are in place. The placement of the small-bore catheters is probably more optimal when placement is done with ultrasound guidance. Small-bore chest tubes are recommended when pleurodesis is performed. The success of the small-bore indwelling tunnelled catheters that are left in place for weeks documents that the small-bore tubes do not commonly become obstructed with fibrin. Patients with complicated parapneumonic effusions are probably best managed with small-bore catheters even when the pleural fluid is purulent. Patients with haemothorax are best managed with large-bore catheters because of blood clots and the high volume of pleural fluid. Most patients with pneumothorax can be managed with aspiration or small-bore chest tubes. If these fail, a large-bore chest tube may be necessary. Patients on mechanical ventilation with barotrauma induced pneumothoraces are best managed with large-bore chest tubes.

  2. The significance of recurrent lung opacities in neonates on surfactant treatment for respiratory distress syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Odita, J.C. [Dept. of Radiology, Louisiana State Univ. Health Sciences Center, Shreveport (United States)

    2001-02-01

    Purpose. To determine the significance of recurrent opacities in chest radiographs of neonates on surfactant therapy for respiratory distress syndrome (RDS) after an initial period of improvement. Materials and methods. Serial pre- and post-surfactant chest radiographs on 94 preterm infants with RDS were analyzed and the pattern of chest radiographic response was classified as (a) clear, (b) recurrent opacities, and (c) no response. Their clinical characteristics were also recorded. Results. In 34 infants the RDS changes cleared within 3 days. 31 infants developed lung opacities within 10 days after an initial period of improvement. Twenty-nine infants failed to respond to the surfactant. The corresponding mean birth weights for the three groups were 1.74, 1.19, and 0.76 kg and the mean gestation ages 32.6, 27.7, and 25.4 weeks. The incidence of bronchopulmonary dysplasia (BPD) was highest among the slumping infants (72. % vs 50 % in no responders, P < 0.001) Conclusions. The pattern of chest radiographic response is primarily affected by gestation age and birth weight. Recurrent lung opacity after an initial positive response to surfactant therapy may be caused by such factors as edema from barotrauma and patent ductus arteriosus. Infants with intraventricular hemorrhage may demonstrate neurogenic edema. Other contributory factors include pneumonia and abnormal consumption of surfactant. Recurrent lung opacities after surfactant may be a predictor of chronic lung disease in the preterm infant. (orig.)

  3. Chest computed tomography in children undergoing extra-corporeal membrane oxygenation: a 9-year single-centre experience

    Energy Technology Data Exchange (ETDEWEB)

    Goodwin, Susie J.; Calder, Alistair D. [Great Ormond Street Hospital for Children NHS Foundation Trust, Radiology Department, London (United Kingdom); Randle, Elise; Iguchi, Akane; Brown, Katherine; Hoskote, Aparna [Great Ormond Street Hospital for Children NHS Foundation Trust, Cardiac Intensive Care and ECMO, London (United Kingdom)

    2014-06-15

    We retrospectively reviewed the imaging findings, indications, technique and clinical impact in children who had undergone chest CT while undergoing extra-corporeal membrane oxygenation (ECMO). Radiology and ECMO databases were searched to identify all 19 children who had undergone chest CT (20 scans in total) while on ECMO at our institution between May 2003 and May 2012. We reviewed all CT scans for imaging findings. Chest CT is performed in a minority of children on ECMO (4.5% in our series). Timing of chest CT following commencement of ECMO varied among patient groups but generally it was performed earlier in the neonatal group. Clinically significant imaging findings were found in the majority of chest CT scans. Many scans contained several findings, with most cases demonstrating parenchymal or pleural abnormalities. Case examples illustrate the spectrum of imaging findings, including underlying pathology such as necrotising pneumonia and severe barotrauma, and ECMO-related complications such as tension haemothoraces and cannula migration. The results of chest CT led to a change in patient management in 16 of 19 children (84%). There were no adverse events related to patient transfer. An understanding of scan technique and awareness of potential findings is important for the radiologist to provide prompt and optimal image acquisition and interpretation in appropriate patients. (orig.)

  4. Use of dynamic CT in acute respiratory distress syndrome (ARDS) with comparison of positive and negative pressure ventilation

    Energy Technology Data Exchange (ETDEWEB)

    Helm, Emma; Babyn, Paul [Hospital for Sick Children, Department of Diagnostic Imaging, Toronto (Canada); Talakoub, Omid; Alirezaie, Javad [Ryerson University, Department of Electrical and Computer Engineering, Toronto, ON (Canada); Grasso, Francesco; Engelberts, Doreen; Kavanagh, Brian P. [Hospital for Sick Children and the University of Toronto, Departments of Anesthesia and Critical Care Medicine and the Program in Pulmonary and Experimental Medicine, Toronto (Canada)

    2009-01-15

    Negative pressure ventilation via an external device ('iron lung') has the potential to provide better oxygenation with reduced barotrauma in patients with ARDS. This study was designed to see if oxygenation differences between positive and negative ventilation could be explained by CT. Six anaesthetized rabbits had ARDS induced by repeated saline lavage. Rabbits were ventilated with positive pressure ventilation (PPV) and negative pressure ventilation (NPV) in turn. Dynamic CT images were acquired over the respiratory cycle. A computer-aided method was used to segment the lung and calculate the range of CT densities within each slice. Volumes of ventilated lung and atelectatic lung were measured over the respiratory cycle. NPV was associated with an increased percentage of ventilated lung and decreased percentage of atelectatic lung. The most significant differences in ventilation and atelectasis were seen at mid-inspiration and mid-expiration (ventilated lung NPV=61%, ventilated lung PPV=47%, p<0.001; atelectatic lung NPV=10%, atelectatic lung PPV 19%, p<0.001). Aeration differences were not significant at end-inspiration. Dynamic CT can show differences in lung aeration between positive and negative ventilation in ARDS. These differences would not be appreciated if only static breath-hold CT was used. (orig.)

  5. Diagnosis and management of headache attributed to airplane travel.

    Science.gov (United States)

    Mainardi, Federico; Maggioni, Ferdinando; Lisotto, Carlo; Zanchin, Giorgio

    2013-03-01

    The headache attributed to airplane travel, also named "airplane headache", is characterized by the sudden onset of a severe head pain exclusively in relation to airplane flights, mainly during the landing phase. Secondary causes, such as upper respiratory tract infections or acute sinusitis, must be ruled out. Although its cause is not thoroughly understood, sinus barotrauma should be reasonably involved in the pathophysiological mechanisms. Furthermore, in the current International Classification of Headache Disorders, rapid descent from high altitude is not considered as a possible cause of headache, although the onset of such pain in airplane travellers or aviators has been well known since the beginning of the aviation era. On the basis of a survey we conducted with the courteous cooperation of people who had experienced this type of headache, we proposed diagnostic criteria to be added to the forthcoming revision of the International Classification of Headache Disorders. Their formal validation would favour further studies aimed at improving knowledge of the pathophysiological mechanisms involved and at implementing preventative measures.

  6. Differential effects of superoxide and hydrogen peroxide on myogenic signaling, membrane potential, and contractions of mouse renal afferent arterioles.

    Science.gov (United States)

    Li, Lingli; Lai, En Yin; Wellstein, Anton; Welch, William J; Wilcox, Christopher S

    2016-06-01

    Myogenic contraction is the principal component of renal autoregulation that protects the kidney from hypertensive barotrauma. Contractions are initiated by a rise in perfusion pressure that signals a reduction in membrane potential (Em) of vascular smooth muscle cells to activate voltage-operated Ca(2+) channels. Since ROS have variable effects on myogenic tone, we investigated the hypothesis that superoxide (O2 (·-)) and H2O2 differentially impact myogenic contractions. The myogenic contractions of mouse isolated and perfused single afferent arterioles were assessed from changes in luminal diameter with increasing perfusion pressure (40-80 mmHg). O2 (·-), H2O2, and Em were assessed by fluorescence microscopy during incubation with paraquat to increase O2 (·-) or with H2O2 Paraquat enhanced O2 (·-) generation and myogenic contractions (-42 ± 4% vs. -19 ± 4%, P contractions (-10 ± 1% vs. -19 ± 2%, P contractions with paraquat without preventing the reduction in Em Myogenic contractions were independent of the endothelium and largely independent of nitric oxide. We conclude that O2 (·-) and H2O2 activate different signaling pathways in vascular smooth muscle cells linked to discreet membrane channels with opposite effects on Em and voltage-operated Ca(2+) channels and therefore have opposite effects on myogenic contractions.

  7. Contemporary treatment of children with critical and near-fatal asthma

    Science.gov (United States)

    Shein, Steven L.; Speicher, Richard H.; Filho, José Oliva Proença; Gaston, Benjamin; Rotta, Alexandre T.

    2016-01-01

    Asthma is the most common chronic illness in childhood. Although the vast majority of children with acute asthma exacerbations do not require critical care, some fail to respond to standard treatment and require escalation of support. Children with critical or near-fatal asthma require close monitoring for deterioration and may require aggressive treatment strategies. This review examines the available evidence supporting therapies for critical and near-fatal asthma and summarizes the contemporary clinical care of these children. Typical treatment includes parenteral corticosteroids and inhaled or intravenous beta-agonist drugs. For children with an inadequate response to standard therapy, inhaled ipratropium bromide, intravenous magnesium sulfate, methylxanthines, helium-oxygen mixtures, and non-invasive mechanical support can be used. Patients with progressive respiratory failure benefit from mechanical ventilation with a strategy that employs large tidal volumes and low ventilator rates to minimize dynamic hyperinflation, barotrauma, and hypotension. Sedatives, analgesics and a neuromuscular blocker are often necessary in the early phase of treatment to facilitate a state of controlled hypoventilation and permissive hypercapnia. Patients who fail to improve with mechanical ventilation may be considered for less common approaches, such as inhaled anesthetics, bronchoscopy, and extracorporeal life support. This contemporary approach has resulted in extremely low mortality rates, even in children requiring mechanical support. PMID:27305039

  8. Ear problems in swimmers.

    Science.gov (United States)

    Wang, Mao-Che; Liu, Chia-Yu; Shiao, An-Suey; Wang, Tyrone

    2005-08-01

    Acute diffuse otitis externa (swimmer's ear), otomycosis, exostoses, traumatic eardrum perforation, middle ear infection, and barotraumas of the inner ear are common problems in swimmers and people engaged in aqua activities. The most common ear problem in swimmers is acute diffuse otitis externa, with Pseudomonas aeruginosa being the most common pathogen. The symptoms are itching, otalgia, otorrhea, and conductive hearing loss. The treatment includes frequent cleansing of the ear canal, pain control, oral or topical medications, acidification of the ear canal, and control of predisposing factors. Swimming in polluted waters and ear-canal cleaning with cotton-tip applicators should be avoided. Exostoses are usually seen in people who swim in cold water and present with symptoms of accumulated debris, otorrhea and conductive hearing loss. The treatment for exostoses is transmeatal surgical removal of the tumors. Traumatic eardrum perforations may occur during water skiing or scuba diving and present with symptoms of hearing loss, otalgia, otorrhea, tinnitus and vertigo. Tympanoplasty might be needed if the perforations do not heal spontaneously. Patients with chronic otitis media with active drainage should avoid swimming, while patients who have undergone mastoidectomy and who have no cavity problems may swim. For children with ventilation tubes, surface swimming is safe in a clean, chlorinated swimming pool. Sudden sensorineural hearing loss and some degree of vertigo may occur after diving because of rupture of the round or oval window membrane.

  9. Aerosinusitis: pathophysiology, prophylaxis, and management in passengers and aircrew.

    Science.gov (United States)

    Weitzel, Erik K; McMains, K Christopher; Rajapaksa, Suresh; Wormald, Peter-John

    2008-01-01

    Patients presenting before flight with an upper respiratory infection are at risk for aerosinusitis. Prophylaxis of this condition consists of an oral decongestant before flight and nasal decongestant spray during the flight just prior to descent. Evaluation of the patient presenting with aerosinusitis consists of a careful physical exam with emphasis on diagnosing treatable nasal and sinus pathology. Categorization of the patient into the Weissman classification is important for determining prognostic factors for recovery. Management of this condition is based on the Weissman stage. Stage I or II lesions are generally treated conservatively with a 1-wk course of topical sprays, analgesics, a tapering course of steroids, and oral decongestants. Use of antibiotics is reserved for those cases initiated by bacterial sinusitis. Additionally, antihistamines are reserved for cases where allergies were the inciting cause. Stage III lesions are rarely seen in civilian air travelers due to the relatively low fluctuations in ambient air pressure. Aircrew that suffer Stage III aerosinusitis are at risk for recurrent sinus barotrauma that may require an expertly performed functional endoscopic sinus surgery to successfully manage it.

  10. Diet, ageing and genetic factors in the pathogenesis of diverticular disease

    Institute of Scientific and Technical Information of China (English)

    Daniel Martin Commane; Ramesh Pulendran Arasaradnam; Sarah Mills; John Cummings Mathers; Mike Bradburn

    2009-01-01

    Diverticular disease (DD) is an age-related disorder of the large bowel which may affect half of the population over the age of 65 in the UK. This high prevalence ranks it as one of the most common bowel disorders in western nations. The majority of patients remain asymptomatic but there are sociated life-threatening co-morbidities, which, given the large numbers of people with DD, translates into a considerable number of deaths per annum. Despite this public health burden, relatively little seems to be known about either the mechanisms of development or causality.In the 1970s, a model of DD formulated the concept that diverticula occur as a onsequence of pressureinduced damage to the colon wall amongst those with a low intake of dietary fiber. In this review, we have examined the evidence regarding the influence of ageing, diet,inflammation and genetics on DD development. We argue that the evidence supporting the barotrauma hypothesis is largely anecdotal. We have also identified several gaps in the knowledge base which need to be filled before we can complete a model for the etiology of diverticular disease.

  11. Neurology and diving.

    Science.gov (United States)

    Massey, E Wayne; Moon, Richard E

    2014-01-01

    Diving exposes a person to the combined effects of increased ambient pressure and immersion. The reduction in pressure when surfacing can precipitate decompression sickness (DCS), caused by bubble formation within tissues due to inert gas supersaturation. Arterial gas embolism (AGE) can also occur due to pulmonary barotrauma as a result of breath holding during ascent or gas trapping due to disease, causing lung hyperexpansion, rupture and direct entry of alveolar gas into the blood. Bubble disease due to either DCS or AGE is collectively known as decompression illness. Tissue and intravascular bubbles can induce a cascade of events resulting in CNS injury. Manifestations of decompression illness can vary in severity, from mild (paresthesias, joint pains, fatigue) to severe (vertigo, hearing loss, paraplegia, quadriplegia). Particularly as these conditions are uncommon, early recognition is essential to provide appropriate management, consisting of first aid oxygen, targeted fluid resuscitation and hyperbaric oxygen, which is the definitive treatment. Less common neurologic conditions that do not require hyperbaric oxygen include rupture of a labyrinthine window due to inadequate equalization of middle ear pressure during descent, which can precipitate vertigo and hearing loss. Sinus and middle ear overpressurization during ascent can compress the trigeminal and facial nerves respectively, causing temporary facial hypesthesia and lower motor neuron facial weakness. Some conditions preclude safe diving, such as seizure disorders, since a convulsion underwater is likely to be fatal. Preventive measures to reduce neurologic complications of diving include exclusion of individuals with specific medical conditions and safe diving procedures, particularly related to descent and ascent.

  12. Diving medicine.

    Science.gov (United States)

    Bove, Alfred A

    2014-06-15

    Exposure to the undersea environment has unique effects on normal physiology and can result in unique disorders that require an understanding of the effects of pressure and inert gas supersaturation on organ function and knowledge of the appropriate therapies, which can include recompression in a hyperbaric chamber. The effects of Boyle's law result in changes in volume of gas-containing spaces when exposed to the increased pressure underwater. These effects can cause middle ear and sinus injury and lung barotrauma due to lung overexpansion during ascent from depth. Disorders related to diving have unique presentations, and an understanding of the high-pressure environment is needed to properly diagnose and manage these disorders. Breathing compressed air underwater results in increased dissolved inert gas in tissues and organs. On ascent after a diving exposure, the dissolved gas can achieve a supersaturated state and can form gas bubbles in blood and tissues, with resulting tissue and organ damage. Decompression sickness can involve the musculoskeletal system, skin, inner ear, brain, and spinal cord, with characteristic signs and symptoms. Usual therapy is recompression in a hyperbaric chamber following well-established protocols. Many recreational diving candidates seek medical clearance for diving, and healthcare providers must be knowledgeable of the environmental exposure and its effects on physiologic function to properly assess individuals for fitness to dive. This review provides a basis for understanding the diving environment and its accompanying disorders and provides a basis for assessment of fitness for diving.

  13. Fatal diving accidents in western Norway 1983-2007.

    Science.gov (United States)

    Ramnefjell, M P; Morild, I; Mørk, S J; Lilleng, P K

    2012-11-30

    Despite efforts to reduce their number, fatal diving accidents still occur. The circumstances and post-mortem findings in 40 fatal diving accidents in western Norway from 1983 through 2007 were investigated. Diving experience, medical history and toxicology reports were retrieved. The material consisted of recreational divers, professional saturation divers and professional divers without experience with saturation. In 33 cases the diving equipment was examined as part of the forensic investigation. In 27 cases defects in the diving equipment were found. For six divers such defects were responsible for the fatal accidents. Eighteen divers died on the surface or less than 10 m below surface. Five divers reached below 100 msw, and two of them died at this depth. The fatalities were not season-dependent. However, wave-height and strength of currents were influential factors in some cases. Twelve divers were diving alone. Twenty divers had one buddy, 9 of these divers were alone at the time of death. The cause of death was drowning in 31 out of 40 divers; one of them had a high blood-ethanol concentration, in two other divers ethanol was found in the urine, indicating previous ethanol consumption. Nine divers died from sudden decompression, pulmonary barotraumas, underwater trauma and natural causes. The study shows that most of the fatal diving accidents could be avoided if adequate diving safety procedures had been followed.

  14. Activation of thiazide-sensitive co-transport by angiotensin II in the cyp1a1-Ren2 hypertensive rat.

    Directory of Open Access Journals (Sweden)

    Ali Ashek

    Full Text Available Transgenic rats with inducible expression of the mouse Ren2 gene were used to elucidate mechanisms leading to the development of hypertension and renal injury. Ren2 transgene activation was induced by administration of a naturally occurring aryl hydrocarbon, indole-3-carbinol (100 mg/kg/day by gastric gavage. Blood pressure and renal parameters were recorded in both conscious and anesthetized (butabarbital sodium; 120 mg/kg IP rats at selected time-points during the development of hypertension. Hypertension was evident by the second day of treatment, being preceded by reduced renal sodium excretion due to activation of the thiazide-sensitive sodium-chloride co-transporter. Renal injury was evident after the first day of transgene induction, being initially limited to the pre-glomerular vasculature. Mircoalbuminuria and tubuloinsterstitial injury developed once hypertension was established. Chronic treatment with either hydrochlorothiazide or an AT1 receptor antagonist normalized sodium reabsorption, significantly blunted hypertension and prevented renal injury. Urinary aldosterone excretion was increased ≈ 20 fold, but chronic mineralocorticoid receptor antagonism with spironolactone neither restored natriuretic capacity nor prevented hypertension. Spironolactone nevertheless ameliorated vascular damage and prevented albuminuria. This study finds activation of sodium-chloride co-transport to be a key mechanism in angiotensin II-dependent hypertension. Furthermore, renal vascular injury in this setting reflects both barotrauma and pressure-independent pathways associated with direct detrimental effects of angiotensin II and aldosterone.

  15. Pulmonary overinflation syndrome in an underwater logger.

    Science.gov (United States)

    Rozali, A; Sulaiman, A; Zin, B Mohd; Khairuddin, H; Abd-Halim, M; Sherina, M S

    2006-10-01

    Pulmonary overinflation syndrome (POIS) is a group of barotrauma-related diseases caused by the expansion of gas trapped in the lung, or over-pressurization of the lung with subsequent over-expansion and rupture of the alveolar air sacs. This group of disorders includes arterial gas embolism, tension pneumothorax, mediastinal emphysema, subcutaneous emphysema and rarely pneumopericardium. In the case of diving activities, POIS is rarely reported and is frequently related to unsafe diving techniques. We report a classical case of POIS in an underwater logger while cutting trees for logs in Tasik Kenyir, Terengganu. The patient, a 24-year-old worker, made a rapid free ascent to the surface after his breathing equipment malfunctioned while he was working underwater. He suffered from bilateral tension pneumothoraces, arterial gas embolism giving rise to multiple cerebral and cerebellar infarcts, mediastinal and subcutaneous emphysema as well as pneumopericardium. He was treated in a recompression chamber with hyperbaric oxygen therapy and discharged with residual weakness in his right leg.

  16. Development of underwater and hyperbaric medicine in Malaysia.

    Science.gov (United States)

    Rozali, A; Rampal, K G; Zin, B Mohd; Sherina, M S; Khairuddin, H; Abd Halim, M; Sulaiman, A

    2006-12-01

    Underwater and Hyperbaric Medicine is a treatment modality gaining recognition in Malaysia. It uses the hyperbaric oxygen therapy (HBOT) approach where patients are placed in recompression chambers and subjected to oxygen therapy under pressure. In Malaysia it was introduced as early as the 1960's by the Royal Malaysian Navy to treat their divers for decompression illness (DCI), arterial gas embolism (AGE) and barotraumas. Other sectors in the armed forces, universities and private health centres began developing this approach too in the late 1990's, for similar purposes. In 1996, Underwater and Hyperbaric Medicine began gaining its popularity when the Institute of Underwater and Hyperbaric Medicine at the Armed Forces Hospital in Lumut started treating specific clinical diseases such as diabetic foot ulcers, osteomyelitis, and carbon monoxide poisoning and other diseases using HBOT. This paper discusses the development of this interesting treatment modality, giving a brief historical overview to its current development, as well as provides some thought for its future development in Malaysia.

  17. Case report: respiratory inductance plethysmography as a monitor of ventilation during laser ablation and balloon dilatation of subglottic tracheal stenosis.

    Science.gov (United States)

    Atkins, Joshua H; Mirza, Natasha; Mandel, Jeff E

    2009-01-01

    We describe a 61-year-old female who underwent KTP laser ablation and CRE balloon dilatation of symptomatic idiopathic subglottic stenosis (50% obstruction). The procedure was conducted, using our standard approach for such cases, under total intravenous general anesthesia with subglottic high-frequency jet ventilation (HFJV) via Lindholm laryngoscope. The patient was enrolled in an ongoing investigational protocol in which respiratory inductance plethysmography (RIP; Ambulatory Monitoring Inc., Ardsley, N.Y., USA) bands were used to monitor ventilation in addition to pulse oximetry and visual inspection. HFJV instituted with an Acutronic Monsoon jet ventilator (Acutronic Medical, Hirzel, Switzerland) resulted in a rapid increase in RIP signal amplitude consistent with breath stacking and inadequate expiratory flow around the tight stenosis. High pressure alarms sounded and automatic cessation of jet ventilation ensued. After successful tracheal dilation under intermittent apnea, subsequent jet ventilation produced only modest RIP amplitude changes. RIP may be an important safety monitor during jet ventilation for patients with obstructive tracheal lesions to lessen the risk of both barotrauma and hypoventilation. RIP remains under active study by our group for this purpose.

  18. Moving in extreme environments: inert gas narcosis and underwater activities.

    Science.gov (United States)

    Clark, James E

    2015-01-01

    Exposure to the underwater environment for pleasure or work poses many challenges on the human body including thermal stress, barotraumas, decompression sickness as well as the acute effects of breathing gases under pressure. With the popularity of recreational self-contained underwater breathing apparatus (SCUBA) diving on the increase and deep inland dive sites becoming more accessible, it is important that we understand the effects of breathing pressurised gas at depth can have on the body. One of the common consequences of hyperbaric gas is the narcotic effect of inert gas. Nitrogen (a major component of air) under pressure can impede mental function and physical performance at depths of as little as 10 m underwater. With increased depth, symptoms can worsen to include confusion, disturbed coordination, lack of concentration, hallucinations and unconsciousness. Narcosis has been shown to contribute directly to up to 6% of deaths in divers and is likely to be indirectly associated with other diving incidents at depth. This article explores inert gas narcosis, the effect on divers' movement and function underwater and the proposed physiological mechanisms. Also discussed are some of the factors that affect the susceptibility of divers to the condition. In conclusion, understanding the cause of this potentially debilitating problem is important to ensure that safe diving practices continue.

  19. Spontaneous pneumomediastinum in a healthy young female: A case report and literature review

    Directory of Open Access Journals (Sweden)

    Ahmed Dirweesh

    2017-01-01

    Full Text Available Spontaneous pneumomediastinum (SPM is an uncommon finding in young adults presenting usually without any comorbidities or an underlying pathology. It is most commonly due to alveolar rupture in the setting of an inciting event such an underlying asthma, barotrauma, valsalva maneuver, or esophageal rupture. Individuals can have varying presentations, from chest pain, dyspnea and dysphagia, to anxiety, weakness, or facial and neck swelling. The majority of patients have subcutaneous emphysema on examination and can have abnormal laboratory findings such as an elevated C-reactive proteins and leukocytosis. Diagnostic modalities used include chest x-ray, CT scan, ultrasound and barium swallow or esophagram. Majority of individuals and treated conservatively with rest, analgesia and oxygen administration. The prognosis of SPM is usually good with resolution within several days in most cases and the recurrence rate is very low. We report the case of a 22-year-old female presented with SPM diagnosed by chest x-ray and chest CT scan who was treated conservatively with subsequent spontaneous resolution.

  20. The role of endocrine mechanisms in ventilator-associated lung injury in critically ill patients.

    Science.gov (United States)

    Penesova, A; Galusova, A; Vigas, M; Vlcek, M; Imrich, R; Majek, M

    2012-07-01

    The critically ill subjects are represented by a heterogeneous group of patients suffering from a life-threatening event of different origin, e.g. trauma, cardiopulmonary failure, surgery or sepsis. The majority of these patients are dependent on the artificial lung ventilation, which means a life-saving chance for them. However, the artificial lung ventilation may trigger ventilation-associated lung injury (VALI). The mechanical ventilation at higher volumes (volutrauma) and pressure (barotrauma) can cause histological changes in the lungs including impairments in the gap and adherens junctions and desmosomes. The injured lung epithelium may lead to an impairment of the surfactant production and function, and this may not only contribute to the pathophysiology of VALI but also to acute respiratory distress syndrome. Other components of VALI are atelectrauma and toxic effects of the oxygen. Collectively, all these effects may result in a lung inflammation associated with a subsequent profibrotic changes, endothelial dysfunction, and activation of the local and systemic endocrine responses such as the renin-angiotensin system (RAS). The present review is aimed to describe some of the pathophysiologic aspects of VALI providing a basis for novel therapeutic strategies in the critically ill patients.

  1. CESAR: conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure

    Directory of Open Access Journals (Sweden)

    Mugford Miranda

    2006-12-01

    Full Text Available Abstract Background An estimated 350 adults develop severe, but potentially reversible respiratory failure in the UK annually. Current management uses intermittent positive pressure ventilation, but barotrauma, volutrauma and oxygen toxicity can prevent lung recovery. An alternative treatment, extracorporeal membrane oxygenation, uses cardio-pulmonary bypass technology to temporarily provide gas exchange, allowing ventilator settings to be reduced. While extracorporeal membrane oxygenation is proven to result in improved outcome when compared to conventional ventilation in neonates with severe respiratory failure, there is currently no good evidence from randomised controlled trials to compare these managements for important clinical outcomes in adults, although evidence from case series is promising. Methods/Design The aim of the randomised controlled trial of Conventional ventilatory support vs extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR is to assess whether, for patients with severe, but potentially reversible, respiratory failure, extracorporeal membrane oxygenation will increase the rate of survival without severe disability ('confined to bed' and 'unable to wash or dress' by six months post-randomisation, and be cost effective from the viewpoints of the NHS and society, compared to conventional ventilatory support. Following assent from a relative, adults (18–65 years with severe, but potentially reversible, respiratory failure (Murray score ≥ 3.0 or hypercapnea with pH Discussion Analysis will be based on intention to treat. A concurrent economic evaluation will also be performed to compare the costs and outcomes of both treatments.

  2. Noise exposure under hyperbaric conditions

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-03-01

    Objective evidence exists that divers demonstrate a hearing deficit greater than would be expected from ageing effects alone. Deafness in divers may be caused by a number of factors other than exposure to excessive noise levels, eg barotrauma, ear infection etc. This review concentrates on the concern that exposure of commercial divers to noise while at work may cause a hearing deficit. Sound pressure levels recorded both underwater and in diving chambers often exceed those allowable to workers onshore. However, the sound perceived by the diver is modified both in amplitude and in frequency when he is either underwater or in pressurised chambers. Broadly the effect of this modification is to attenuate the sound and thus offer some protection from high noise levels. The degree of attentuation varies with the frequency of the sound, however it is also possible under specific conditions associated with gas density for the sensitivity to particular frequencies to be amplified above that for normal atmospheric air. The levels of sound observed from some underwater tools are of concern even after allowing for a significant de-sensitisation of the divers` hearing. Reports of tinnitus and temporary hearing loss following a dive are sure signs that the noise levels have been harmful. It is not possible at present to describe risk criteria for hearing damage due to noise exposure associated with diving. (author)

  3. Effects of Tidal Turbine Noise on Fish Task 2.1.3.2: Effects on Aquatic Organisms: Acoustics/Noise - Fiscal Year 2011 - Progress Report - Environmental Effects of Marine and Hydrokinetic Energy

    Energy Technology Data Exchange (ETDEWEB)

    Halvorsen, Michele B.; Carlson, Thomas J.; Copping, Andrea E.

    2011-09-30

    Naturally spawning stocks of Chinook salmon (Oncorhynchus tshawytscha) that utilize Puget Sound are listed as threatened (http://www.nwr.noaa.gov/ESA-Salmon-Listings/Salmon-Populations/ Chinook/CKPUG.cfm). Plans exist for prototype tidal turbines to be deployed into their habitat. Noise is known to affect fish in many ways, such as causing a threshold shift in auditory sensitivity or tissue damage. The characteristics of noise, its spectra and level, are important factors that influence the potential for the noise to injure fish. For example, the frequency range of the tidal turbine noise includes the audiogram (frequency range of hearing) of most fish. This study (Effects on Aquatic Organisms, Subtask 2.1.3.2: Acoustics) was performed during FY 2011 to determine if noise generated by a 6-m-diameter open-hydro turbine might affect juvenile Chinook salmon hearing or cause barotrauma. After they were exposed to simulated tidal turbine noise, the hearing of juvenile Chinook salmon was measured and necropsies performed to check for tissue damage. Experimental groups were (1) noise exposed, (2) control (the same handling as treatment fish but without exposure to tidal turbine noise), and (3) baseline (never handled). Preliminary results indicate that low levels of tissue damage may have occurred but that there were no effects of noise exposure on the auditory systems of the test fish.

  4. Acute management of vascular air embolism

    Directory of Open Access Journals (Sweden)

    Shaikh Nissar

    2009-01-01

    Full Text Available Vascular air embolism (VAE is known since early nineteenth century. It is the entrainment of air or gas from operative field or other communications into the venous or arterial vasculature. Exact incidence of VAE is difficult to estimate. High risk surgeries for VAE are sitting position and posterior fossa neurosurgeries, cesarean section, laparoscopic, orthopedic, surgeries invasive procedures, pulmonary overpressure syndrome, and decompression syndrome. Risk factors for VAE are operative site 5 cm  above the heart, creation of pressure gradient which will facilitate entry of air into the circulation, orogenital sex during pregnancy, rapid ascent in scuba (self contained underwater breathing apparatus divers and barotrauma or chest trauma. Large bolus of air can lead to right ventricular air lock and immediate fatality. In up to 35% patient, the foramen ovale is patent which can cause paradoxical arterial air embolism. VAE affects cardiovascular, pulmonary and central nervous system. High index of clinical suspicion is must to diagnose VAE. The transesophgeal echocardiography is the most sensitive device which will detect smallest amount of air in the circulation. Treatment of VAE is to prevent further entrainment of air, reduce the volume of air entrained and haemodynamic support. Mortality of VAE ranges from 48 to 80%. VAE can be prevented significantly by proper positioning during surgery, optimal hydration, avoiding use of nitrous oxide, meticulous care during insertion, removal of central venous catheter, proper guidance, and training of scuba divers.

  5. Sublethal effects of catch-and-release fishing: measuring capture stress, fish impairment, and predation risk using a condition index

    Science.gov (United States)

    Campbell, Matthew D.; Patino, Reynaldo; Tolan, J.M.; Strauss, R.E.; Diamond, S.

    2009-01-01

    The sublethal effects of simulated capture of red snapper (Lutjanus campechanus) were analysed using physiological responses, condition indexing, and performance variables. Simulated catch-and-release fishing included combinations of depth of capture and thermocline exposure reflective of environmental conditions experienced in the Gulf of Mexico. Frequency of occurrence of barotrauma and lack of reflex response exhibited considerable individual variation. When combined into a single condition or impairment index, individual variation was reduced, and impairment showed significant increases as depth increased and with the addition of thermocline exposure. Performance variables, such as burst swimming speed (BSS) and simulated predator approach distance (AD), were also significantly different by depth. BSSs and predator ADs decreased with increasing depth, were lowest immediately after release, and were affected for up to 15 min, with longer recovery times required as depth increased. The impairment score developed was positively correlated with cortisol concentration and negatively correlated with both BSS and simulated predator AD. The impairment index proved to be an efficient method to estimate the overall impairment of red snapper in the laboratory simulations of capture and shows promise for use in field conditions, to estimate release mortality and vulnerability to predation.

  6. Venovenous Extracorporeal Membrane Oxygenation in Pediatric Respiratory Failure.

    Science.gov (United States)

    Ham, P Benson; Hwang, Brice; Wise, Linda J; Walters, K Christian; Pipkin, Walter L; Howell, Charles G; Bhatia, Jatinder; Hatley, Robyn

    2016-09-01

    Conventional treatment of respiratory failure involves positive pressure ventilation that can worsen lung damage. Extracorporeal membrane oxygenation (ECMO) is typically used when conventional therapy fails. In this study, we evaluated the use of venovenous (VV)-ECMO for the treatment of severe pediatric respiratory failure at our institution. A retrospective analysis of pediatric patients (age 1-18) placed on ECMO in the last 15 years (1999-2014) by the pediatric surgery team for respiratory failure was performed. Five pediatric patients underwent ECMO (mean age 10 years; range, 2-16). All underwent VV-ECMO. Diagnoses were status asthmaticus (2), acute respiratory distress syndrome due to septic shock (1), aspergillus pneumonia (1), and respiratory failure due to parainfluenza (1). Two patients had severe barotrauma prior to ECMO initiation. Average oxygenation index (OI) prior to cannulation was 74 (range 23-122). No patients required conversion to VA-ECMO. The average ECMO run time was 4.4 days (range 2-6). The average number of days on the ventilator was 15 (range 4-27). There were no major complications due to the procedure. Survival to discharge was 100%. Average follow up is 4.4 years (range 1-15). A short run of VV-ECMO can be lifesaving for pediatric patients in respiratory failure. Survival is excellent despite severely elevated oxygen indices. VV-ECMO may be well tolerated and can be considered for severe pediatric respiratory failure.

  7. An evaluation of the safety and efficacy of an anti-inflammatory, pulmonary enteral formula in the treatment of pediatric burn patients with respiratory failure.

    Science.gov (United States)

    Mayes, Theresa; Gottschlich, Michele M; Kagan, Richard J

    2008-01-01

    Respiratory failure is associated with a high mortality rate in burned children. Recently, a specialized pulmonary enteral formula (SPEF) was commercially introduced as an adjunct intervention in acute lung injury management. SPEF contains condition-specific nutrients to modulate the inflammatory response. The study examined SPEF impact in critically ill, pediatric burn patients with respiratory failure. Medical records of acute burn patients admitted December 1997 to October 2006 were reviewed for SPEF treatment. Respiratory and renal indices were compared on the first and final days of SPEF use. Nineteen patients with respiratory failure received SPEF for a mean of 10.8 +/- 0.9 days during their acute burn course. Mean age was 5.3 +/- 1.5 years. Mean total body surface area burn was 44.3 +/- 5.4% with 32.5 +/- 6.4% full thickness. Patients were admitted 2.3 +/- 0.9 days postburn. Significant improvements in peak pressure, PEEP, FiO2, P:F ratio, Pco2, Po2, and ETco2 were noted. Seventeen of the 19 patients survived despite the fact that 9 of the 19 patients developed severe barotrauma requiring multiple tube thoracotomies, and all 19 had extremely poor prognoses at SPEF initiation. Adult SPEF formula for critically ill, pediatric burn patients with respiratory failure is safe and well tolerated. SPEF seems to facilitate recovery from acute lung injury as evidenced by improvements in oxygenation and pulmonary compliance.

  8. 超低出生体重儿呼吸管理的研究进展%Advance in the respiratory management of extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    黄文娣

    2014-01-01

    随着辅助生育技术及新生儿重症监护室的发展,超低出生体重儿存活率逐渐增加.由于超低出生体重儿肺发育不成熟,一些产前干预、复苏策略及产后的呼吸管理对于该类患儿长期存活及远期预后具有重要意义.无创性呼吸支持策略可以减少机械通气产生的气压伤、容量伤及氧化应激损伤.吸入性NO、体外膜肺等呼吸支持策略还有待深入研究.%With the improvement of assisted reproductive technology and neonatal intensive care unit,the extremely low birth weight infants have increasingly survived.Since the immature pulmonary,antenatal interventions,resuscitation techniques and postnatal respiratory management attribute to their survival and long term outcomes.Non-invasive ventilation minimize barotrauma,volutrauma and oxygen toxicity induced by mechanical ventilation.Other new strategy such asinhaled NO,extracorporeal membrane oxygenation will be explored.

  9. Passive flooding of paranasal sinuses and middle ears as a method of equalisation in extreme breath-hold diving.

    Science.gov (United States)

    Germonpré, Peter; Balestra, Costantino; Musimu, Patrick

    2011-06-01

    Breath-hold diving is both a recreational activity, performed by thousands of enthusiasts in Europe, and a high-performance competitive sport. Several 'disciplines' exist, of which the 'no-limits' category is the most spectacular: using a specially designed heavy 'sled,' divers descend to extreme depths on a cable, and then reascend using an inflatable balloon, on a single breath. The current world record for un-assisted descent stands at more than 200 m of depth. Equalising air pressure in the paranasal sinuses and middle-ear cavities is a necessity during descent to avoid barotraumas. However, this requires active insufflations of precious air, which is thus unavailable in the pulmonary system. The authors describe a diver who, by training, is capable of allowing passive flooding of the sinuses and middle ear with (sea) water during descent, by suppressing protective (parasympathetic) reflexes during this process. Using this technique, he performed a series of extreme-depth breath-hold dives in June 2005, descending to 209 m of sea water on one breath of air.

  10. Sports-related lung injury during breath-hold diving

    Directory of Open Access Journals (Sweden)

    Tanja Mijacika

    2016-12-01

    Full Text Available The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise. In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition. According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage.

  11. Sports-related lung injury during breath-hold diving.

    Science.gov (United States)

    Mijacika, Tanja; Dujic, Zeljko

    2016-12-01

    The number of people practising recreational breath-hold diving is constantly growing, thereby increasing the need for knowledge of the acute and chronic effects such a sport could have on the health of participants. Breath-hold diving is potentially dangerous, mainly because of associated extreme environmental factors such as increased hydrostatic pressure, hypoxia, hypercapnia, hypothermia and strenuous exercise.In this article we focus on the effects of breath-hold diving on pulmonary function. Respiratory symptoms have been reported in almost 25% of breath-hold divers after repetitive diving sessions. Acutely, repetitive breath-hold diving may result in increased transpulmonary capillary pressure, leading to noncardiogenic oedema and/or alveolar haemorrhage. Furthermore, during a breath-hold dive, the chest and lungs are compressed by the increasing pressure of water. Rapid changes in lung air volume during descent or ascent can result in a lung injury known as pulmonary barotrauma. Factors that may influence individual susceptibility to breath-hold diving-induced lung injury range from underlying pulmonary or cardiac dysfunction to genetic predisposition.According to the available data, breath-holding does not result in chronic lung injury. However, studies of large populations of breath-hold divers are necessary to firmly exclude long-term lung damage.

  12. Pulmonary alterations in cocaine users

    Directory of Open Access Journals (Sweden)

    Mário Terra Filho

    Full Text Available CONTEXT: Brazilian researchers have recently recognized a marked increase in the number of people using abusable drugs and the consequences of this habit. It has become a major public health problem in a potentially productive segment of the general population. In the last few years, several medical articles have given special emphasis to pulmonary complications related to cocaine use. This review is based on this information and experience acquired with groups of cocaine users. OBJECTIVE: To present to physicians the pulmonary aspects of cocaine use and warn about the various effects this drug has on the respiratory system, stressing those related to long-term use. DESIGN: Narrative review. METHOD: Pulmonary complications are described. These may include infections (Staphylococcus aureus, pulmonary tuberculosis, acquired immunodeficiency syndrome/aids, etc., aspiration pneumonia, lung abscess, empyema, septic embolism, non-cardiogenic pulmonary edema, barotrauma, pulmonary granulomatosis, bronchiolitis obliterans and organizing pneumonia, pneumonitis and interstitial fibrosis, pneumonitis hypersensitivity, lung infiltrates and eosinophilia in individuals with bronchial hyperreactivity, diffuse alveolar hemorrhage, vasculitis, pulmonary infarction, pulmonary hypertension and alterations in gas exchange. It is concluded that physicians should give special attention to the various pulmonary and clinical manifestations related to cocaine use, particularly in young patients.

  13. Cocaine-induced pulmonary changes: HRCT findings

    Directory of Open Access Journals (Sweden)

    Renata Rocha de Almeida

    2015-08-01

    Full Text Available AbstractObjective: To evaluate HRCT scans of the chest in 22 patients with cocaine-induced pulmonary disease.Methods: We included patients between 19 and 52 years of age. The HRCT scans were evaluated by two radiologists independently, discordant results being resolved by consensus. The inclusion criterion was an HRCT scan showing abnormalities that were temporally related to cocaine use, with no other apparent causal factors.Results:In 8 patients (36.4%, the clinical and tomographic findings were consistent with "crack lung", those cases being studied separately. The major HRCT findings in that subgroup of patients included ground-glass opacities, in 100% of the cases; consolidations, in 50%; and the halo sign, in 25%. In 12.5% of the cases, smooth septal thickening, paraseptal emphysema, centrilobular nodules, and the tree-in-bud pattern were identified. Among the remaining 14 patients (63.6%, barotrauma was identified in 3 cases, presenting as pneumomediastinum, pneumothorax, and hemopneumothorax, respectively. Talcosis, characterized as perihilar conglomerate masses, architectural distortion, and emphysema, was diagnosed in 3 patients. Other patterns were found less frequently: organizing pneumonia and bullous emphysema, in 2 patients each; and pulmonary infarction, septic embolism, eosinophilic pneumonia, and cardiogenic pulmonary edema, in 1 patient each.Conclusions: Pulmonary changes induced by cocaine use are varied and nonspecific. The diagnostic suspicion of cocaine-induced pulmonary disease depends, in most of the cases, on a careful drawing of correlations between clinical and radiological findings.

  14. Safety and efficacy of hyperbaric oxygen therapy in chronic wound management: current evidence

    Directory of Open Access Journals (Sweden)

    Eggleton P

    2015-04-01

    Full Text Available Paul Eggleton,1 Alexandra J Bishop,2 Gary R Smerdon21Institute of Biomedical & Clinical Science, University of Exeter Medical School, Exeter, 2DDRC Healthcare, Plymouth, UKAbstract: The breathing of pure oxygen under pressure to treat tissue damage has been employed for almost 45 years and has been investigated in prospective, retrospective, and randomized controlled trials. The physiological effects of oxygen treatment on wound tissue are profound, and include activation of immune cells, changes in cytokine production, and modulation of inflammatory and bactericidal mediators. Hyperbaric oxygen influences the biochemistry of whole cells, altering cell proliferation, angiogenesis, clotting, and tissue regeneration. The precise effects of hyperbaric oxygen on individual cell types and tissues are only beginning to be revealed in both animal and human studies. Many independent studies using hyperbaric oxygen adjunctively with standard wound care have observed improved healing, in particular for diabetic foot ulcers, and can result in a significant reduction in major amputations. Side effects occur infrequently, but myopia, ear barotrauma, and rarely oxygen toxicity have been reported. As antibiotics become less available, and clinician time and complex dressings become more expensive, use of hyperbaric oxygen as a means of treating a variety of wound types may become an increasingly appropriate option for treatment.Keywords: clinical trials, foot ulceration, non-healing wounds, oxygen

  15. Blast Injuries: From Improvised Explosive Device Blasts to the Boston Marathon Bombing.

    Science.gov (United States)

    Singh, Ajay K; Ditkofsky, Noah G; York, John D; Abujudeh, Hani H; Avery, Laura A; Brunner, John F; Sodickson, Aaron D; Lev, Michael H

    2016-01-01

    Although most trauma centers have experience with the imaging and management of gunshot wounds, in most regions blast wounds such as the ones encountered in terrorist attacks with the use of improvised explosive devices (IEDs) are infrequently encountered outside the battlefield. As global terrorism becomes a greater concern, it is important that radiologists, particularly those working in urban trauma centers, be aware of the mechanisms of injury and the spectrum of primary, secondary, tertiary, and quaternary blast injury patterns. Primary blast injuries are caused by barotrauma from the initial increased pressure of the explosive detonation and the rarefaction of the atmosphere immediately afterward. Secondary blast injuries are caused by debris carried by the blast wind and most often result in penetrating trauma from small shrapnel. Tertiary blast injuries are caused by the physical displacement of the victim and the wide variety of blunt or penetrating trauma sustained as a result of the patient impacting immovable objects such as surrounding cars, walls, or fences. Quaternary blast injuries include all other injuries, such as burns, crush injuries, and inhalational injuries. Radiography is considered the initial imaging modality for assessment of shrapnel and fractures. Computed tomography is the optimal test to assess penetrating chest, abdominal, and head trauma. The mechanism of blast injuries and the imaging experience of the victims of the Boston Marathon bombing are detailed, as well as musculoskeletal, neurologic, gastrointestinal, and pulmonary injury patterns from blast injuries.

  16. Síndrome do aqueduto vestibular alargado: relato de 3 casos e revisão bibliográfica Enlarged vestibular aqueduct syndrome: report of 3 cases and literature review

    Directory of Open Access Journals (Sweden)

    José A. Pinto

    2005-06-01

    Full Text Available A Síndrome do Aqueduto Vestibular Alargado (SAVA é caracterizada por um alargamento do aqueduto vestibular associado a uma perda auditiva neurossensorial, algumas vezes mista, que pode ser congênita ou adquirida na infância. A disacusia pode ser dividida em leve, moderada ou profunda, associada com períodos de melhora ou de piora súbita. O alargamento do aqueduto vestibular é a anomalia da orelha interna mais comum. A SAVA é admitida como resultado de uma anormalidade genética no desenvolvimento do aqueduto vestibular anterior à quinta semana de gestação. A incidência de SAVA está entre 1% e 1,3%, podendo chegar a 7% dependendo da população examinada. O objetivo deste estudo é relatar 3 casos de SAVA atendidos no Núcleo de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço de São Paulo e no serviço de Radiologia do Hospital São Camilo - São Paulo, sendo que dois pacientes são irmãos somente por parte materna. Dois pacientes eram do sexo feminino, um do sexo masculino e a idade variou de 9 a 30 anos. O método diagnóstico de eleição é a TC de osso temporais. A conduta para os casos foi o tratamento conservador com ressalva a cuidados como traumatismos cranianos, barotraumas e, quando necessário, uso de próteses auditivas.Enlarged Vestibular Aqueduct Syndrome is characterized by a widening of the vestibular aqueduct, associated with sensorineural hearing loss, or sometimes with mixed hearing loss, which may be congenital or acquired during childhood. The sensorineural hearing loss may be classified into mild, moderate and severe, associated with sudden periods of improvement or aggravation. The enlargement of the vestibular aqueduct is the most common inner ear anomaly. This syndrome is admitted as a result of a genetic abnormality of the vestibular aqueduct development, previous to the fifth week of gestation. The incidence of this syndrome ranges from 1% to 1.3%, with the possibility of getting up to 7

  17. A reanimação do prematuro extremo em sala de parto: controvérsias Controversies about the resuscitation of extremely preterm infants in the delivery room

    Directory of Open Access Journals (Sweden)

    Maria Fernanda Branco de Almeida

    2005-03-01

    Full Text Available OBJETIVO: Relatar as principais controvérsias quanto aos procedimentos atualmente realizados na reanimação de recém-nascidos de extremo baixo peso na sala de parto. FONTES DOS DADOS: Revisão sistemática dos artigos incluídos em MEDLINE, SciELO e Cochrane Library e dos temas livres publicados em congressos internacionais e nacionais, utilizando-se as palavras-chave reanimação, asfixia e recém-nascido. SÍNTESE DOS DADOS: As principais controvérsias incluem aspectos relacionados à oxigenação e à ventilação do prematuro de extremo baixo peso ao nascimento. Os efeitos da administração de oxigênio em concentrações entre 21% e 100% precisam ser investigados. Os parâmetros adequados de pressão inspiratória, volume pulmonar e pressão expiratória final positiva necessitam ser estabelecidos com a finalidade de minimizar o barotrauma e o volutrauma. Os benefícios da aplicação da pressão positiva contínua de vias aéreas por via nasal também precisam ser bem determinados através de ensaios clínicos randomizados. Além disso, reanimadores manuais devem ser desenvolvidos para otimizar a administração desses parâmetros e minimizar a lesão pulmonar no início da vida extra-uterina. Estudos clínicos sobre a administração ao nascimento de adrenalina, expansores de volume e bicarbonato de sódio são inexistentes em prematuros de muito baixo peso. Adicionalmente, o principal dilema ético envolve a decisão conjunta entre os profissionais e os pais de não iniciar a reanimação na dependência da idade gestacional. CONCLUSÕES: A conduta atualmente vigente poderá ser modificada a partir dos resultados de ensaios clínicos randomizados e controlados, em conjunto com a avaliação do desenvolvimento, realizados em recém-nascidos de extremo baixo peso submetidos à reanimação na sala de parto.OBJECTIVE: To describe the main controversies about resuscitation procedures performed in extremely low birth weight infants in

  18. Causes of bat fatalities at wind turbines: Hypotheses and predictions

    Science.gov (United States)

    Cryan, P.M.; Barclay, R.M.R.

    2009-01-01

    Thousands of industrial-scale wind turbines are being built across the world each year to meet the growing demand for sustainable energy. Bats of certain species are dying at wind turbines in unprecedented numbers. Species of bats consistently affected by turbines tend to be those that rely on trees as roosts and most migrate long distances. Although considerable progress has been made in recent years toward better understanding the problem, the causes of bat fatalities at turbines remain unclear. In this synthesis, we review hypothesized causes of bat fatalities at turbines. Hypotheses of cause fall into 2 general categoriesproximate and ultimate. Proximate causes explain the direct means by which bats die at turbines and include collision with towers and rotating blades, and barotrauma. Ultimate causes explain why bats come close to turbines and include 3 general types: random collisions, coincidental collisions, and collisions that result from attraction of bats to turbines. The random collision hypothesis posits that interactions between bats and turbines are random events and that fatalities are representative of the bats present at a site. Coincidental hypotheses posit that certain aspects of bat distribution or behavior put them at risk of collision and include aggregation during migration and seasonal increases in flight activity associated with feeding or mating. A surprising number of attraction hypotheses suggest that bats might be attracted to turbines out of curiosity, misperception, or as potential feeding, roosting, flocking, and mating opportunities. Identifying, prioritizing, and testing hypothesized causes of bat collisions with wind turbines are vital steps toward developing practical solutions to the problem. ?? 2009 American Society of Mammalogists.

  19. The physiology and pathophysiology of human breath-hold diving.

    Science.gov (United States)

    Lindholm, Peter; Lundgren, Claes E G

    2009-01-01

    This is a brief overview of physiological reactions, limitations, and pathophysiological mechanisms associated with human breath-hold diving. Breath-hold duration and ability to withstand compression at depth are the two main challenges that have been overcome to an amazing degree as evidenced by the current world records in breath-hold duration at 10:12 min and depth of 214 m. The quest for even further performance enhancements continues among competitive breath-hold divers, even if absolute physiological limits are being approached as indicated by findings of pulmonary edema and alveolar hemorrhage postdive. However, a remarkable, and so far poorly understood, variation in individual disposition for such problems exists. Mortality connected with breath-hold diving is primarily concentrated to less well-trained recreational divers and competitive spearfishermen who fall victim to hypoxia. Particularly vulnerable are probably also individuals with preexisting cardiac problems and possibly, essentially healthy divers who may have suffered severe alternobaric vertigo as a complication to inadequate pressure equilibration of the middle ears. The specific topics discussed include the diving response and its expression by the cardiovascular system, which exhibits hypertension, bradycardia, oxygen conservation, arrhythmias, and contraction of the spleen. The respiratory system is challenged by compression of the lungs with barotrauma of descent, intrapulmonary hemorrhage, edema, and the effects of glossopharyngeal insufflation and exsufflation. Various mechanisms associated with hypoxia and loss of consciousness are discussed, including hyperventilation, ascent blackout, fasting, and excessive postexercise O(2) consumption. The potential for high nitrogen pressure in the lungs to cause decompression sickness and N(2) narcosis is also illuminated.

  20. 护理干预在突发性耳聋患者高压氧治疗中的作用%Effect of nursing intervention on hyperbaric oxygen therapy of patients with sudden deafness

    Institute of Scientific and Technical Information of China (English)

    宋月梅

    2016-01-01

    目的:探讨护理干预在突发性耳聋患者高压氧治疗中的应用及效果。方法:180例突发性耳聋患者给予药物联合高压氧治疗,并给予护理干预,观察其疗效。结果:痊愈53例,显效47例,有效66例,无效14例,有效率92.2%;无中耳气压伤等高压氧并发症发生。结论:有效的护理干预可提高突发性耳聋患者高压氧治疗依从性及临床疗效,减少并发症发生,改善患者预后。%Objective:To explore the application and effect of nursing intervention on hyperbaric oxygen therapy of patients with sudden deafness.Methods:180 patients with sudden deafness were given drug combined with hyperbaric oxygen therapy and nursing intervention.The effect was observed.Results:53 cases were cured;47 cases were markedly effective;66 cases were effective;14 cases were ineffective;the effective rate was 92.2%.There was no hyperbaric oxygen complications such as middle ear barotrauma.Conclusion:Effective nursing intervention can improve the treatment compliance and clinical curative effect of hyperbaric oxygen therapy in patients with sudden deafness,reduce the incidence of complications,and improve the prognosis of patients.

  1. Pressure- and flow-controlled media perfusion differently modify vascular mechanics in lung decellularization.

    Science.gov (United States)

    da Palma, Renata K; Campillo, Noelia; Uriarte, Juan J; Oliveira, Luis V F; Navajas, Daniel; Farré, Ramon

    2015-09-01

    Organ biofabrication is a potential future alternative for obtaining viable organs for transplantation. Achieving intact scaffolds to be recellularized is a key step in lung bioengineering. Perfusion of decellularizing media through the pulmonary artery has shown to be effective. How vascular perfusion pressure and flow vary throughout lung decellularization, which is not well known, is important for optimizing the process (minimizing time) while ensuring scaffold integrity (no barotrauma). This work was aimed at characterizing the pressure/flow relationship at the pulmonary vasculature and at how effective vascular resistance depends on pressure- and flow-controlled variables when applying different methods of media perfusion for lung decellularization. Lungs from 43 healthy mice (C57BL/6; 7-8 weeks old) were investigated. After excision and tracheal cannulation, lungs were inflated at 10 cmH2O airway pressure and subjected to conventional decellularization with a solution of 1% sodium dodecyl sulfate (SDS). Pressure (PPA) and flow (V'PA) at the pulmonary artery were continuously measured. Decellularization media was perfused through the pulmonary artery: (a) at constant PPA=20 cmH2O or (b) at constant V'PA=0.5 and 0.2 ml/min. Effective vascular resistance was computed as Rv=PPA/V'PA. Rv (in cmH2O/(ml/min)); mean±SE) considerably varied throughout lung decellularization, particularly for pressure-controlled perfusion (from 29.1±3.0 in baseline to a maximum of 664.1±164.3 (pperfusion (from 49.9±3.3 and 79.5±5.1 in baseline to a maximum of 114.4±13.9 and 211.7±70.5 (pperfusion mechanics throughout decellularization provides information relevant for optimizing the process time while ensuring that vascular pressure is kept within a safety range to preserve the organ scaffold integrity.

  2. How to mitigate impacts of wind farms on bats? A review of potential conservation measures in the European context

    Energy Technology Data Exchange (ETDEWEB)

    Peste, Filipa, E-mail: filipapeste@gmail.com [Centre for Environmental and Marine Studies (CESAM) (Portugal); Department of Biology, University of Aveiro (Portugal); Paula, Anabela [Bioinsight - Ambiente e Biodiversidade, Lda. Lisboa (Portugal); Silva, Luís P. da [Centre for Environmental and Marine Studies (CESAM) (Portugal); Department of Biology, University of Aveiro (Portugal); MARE and CEF, Department of Life Sciences, University of Coimbra (Portugal); Bernardino, Joana; Pereira, Pedro [Bio3 - Estudos e Projectos em Biologia e Recursos Naturais, Lda. Almada (Portugal); Mascarenhas, Miguel [Bioinsight - Ambiente e Biodiversidade, Lda. Lisboa (Portugal); Costa, Hugo [Bio3 - Estudos e Projectos em Biologia e Recursos Naturais, Lda. Almada (Portugal); Vieira, José; Bastos, Carlos [Department of Electronics, Telecommunications and Informatics / IEETA, University of Aveiro (Portugal); Fonseca, Carlos [Centre for Environmental and Marine Studies (CESAM) (Portugal); Department of Biology, University of Aveiro (Portugal); Pereira, Maria João Ramos [Centre for Environmental and Marine Studies (CESAM) (Portugal); PPGBAN, Department of Zoology, Institute of Biosciences, Federal University of Rio Grande do Sul (Brazil); PPGEC, Federal University of Mato Grosso do Sul (Brazil)

    2015-02-15

    Wind energy is growing worldwide as a source of power generation. Bat assemblages may be negatively affected by wind farms due to the fatality of a significant number of individuals after colliding with the moving turbines or experiencing barotrauma. The implementation of wind farms should follow standard procedures to prevent such negative impacts: avoid, reduce and offset, in what is known as the mitigation hierarchy. According to this approach avoiding impacts is the priority, followed by the minimisation of the identified impacts, and finally, when residual negative impacts still remain, those must be offset or at least compensated. This paper presents a review on conservation measures for bats and presents some guidelines within the compensation scenario, focusing on negative impacts that remain after avoidance and minimisation measures. The conservation strategies presented aim at the improvement of the ecological conditions for the bat assemblage as a whole. While developed under the European context, the proposed measures are potentially applicable elsewhere, taking into consideration the specificity of each region in terms of bat assemblages present, landscape features and policy context regarding nature and biodiversity conservation and management. An analysis of potential opportunities and constraints arising from the implementation of offset/compensation programmes and gaps in the current knowledge is also considered. - Highlights: • Wind energy impacts bat populations in ways not yet fully understood. • As the use of windfarms is growing worldwide greater impacts on bat populations are also expected. • Mitigation hierarchy provides a way to reduce impacts from new wind farm facilities. • Compensation measures may be used to reduce the residual effects on bat populations. • Identify bats ecological needs and compensate according to the existing surroundings.

  3. Complicaciones de la Ventilación Mecánica. Unidad de Cuidados Intensivos Pediátricos Holguín

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Córdova-Vega

    2013-01-01

    Full Text Available Se realizó un estudio prospectivo, descriptivo en pacientes ingresados en la Unidad de Cuidados Intensivos del Hospital Pediátrico de Holguín y que necesitaron ventilación mecánica por un tiempo mayor a las 24 horas, durante el año 2010, con el objetivo de conocer las complicaciones relacionadas con este proceder. Dentro de los resultados encontramos que las afecciones neurológicas (35,29%, las respiratorias y las malformaciones congénitas (17,64% fueron las principales causas que llevaron a la ventilación de estos niños. Las complicaciones infecciosas y pulmonares fueron las más frecuentes (58,94% y dentro de ellas sobresalieron la neumonía asociada a la ventilación (63,63%, el síndrome de disfunción de múltiples órganos (36,36%, el barotrauma (44,44% y las atelectasias (44,44%. Desde el punto de vista estadístico fue significativo que los pacientes con más de siete días de ventilación mecánica presentaron mayores complicaciones. El 66,66% de los fallecidos presentó algún tipo de complicación relacionada con la ventilación mecánica, destacándose dentro de ellas las de causas infecciosas: Neumonía asociada a la ventilación (71,42% y el síndrome de disfunción de múltiples órganos (75%.

  4. Lesão brônquica e pneumotórax após reintubação usando um cateter para troca da via aérea Lesión brónquica y neumotórax posterior a la reintubación usando un catéter para el cambio de la vía aérea Bronchial injury and pneumothorax after reintubation using an airway exchange catheter

    Directory of Open Access Journals (Sweden)

    Juliano P. de Almeida

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Relatamos um caso de pneumotórax causado por perfuração brônquica durante uma reintubação usando um cateter para troca da via aérea (CTVA em um paciente com câncer de cabeça e pescoço. RELATO DE CASO: Paciente do sexo masculino, 53 anos, com carcinoma de orofaringe, foi internado na UTI com pneumonia grave e síndrome da angústia respiratória aguda (SARA. O paciente foi identificado como sendo de difícil intubação e uma sonda endotraqueal (SET foi inserida através de um broncoscópio. Após uma semana de tratamento, observou-se ruptura do manguito endotraqueal. A troca da sonda endotraqueal foi necessária para obter uma ventilação pulmonar satisfatória. Um cateter para troca da via aérea (Cook, tamanho 14 foi usado para realizar a reintubação. Depois da reintubação, o paciente apresentou piora na saturação de oxigênio e uma radiografia revelou um grande pneumotórax. Um dreno torácico foi inserido e uma melhora imediata na saturação de oxigênio foi observada. A repetição da radiografia confirmou o posicionamento correto do dreno torácico e a reexpansão do pulmão direito. A broncoscopia realizada mostrou uma laceração posterior do brônquio principal direito. O paciente foi extubado no dia seguinte. Depois de quatro dias, o dreno torácico foi removido. A radiografia realizada um dia depois da retirada do dreno revelou um pequeno pneumotórax no lobo superior direito, mas o paciente permaneceu assintomático. CONCLUSÕES: O cateter para troca da via aérea é uma ferramenta valiosa para lidar com pacientes difíceis de intubar. Embora os médicos geralmente concentrem sua atenção em evitar um barotrauma causado pelo suplemento de oxigênio ou ventilação a jato através do CTVA, a preocupação com a técnica de inserção pode minimizar as complicações que ameaçam a vida e aumentar a segurança do CTVA.JUSTIFICATIVA Y OBJETIVOS: Relatamos aquí un caso de neumotórax causado

  5. High-inflation pressure and positive end-expiratory pressure. Injurious to the lung? No.

    Science.gov (United States)

    Nelson, L D

    1996-07-01

    Survival rates in ARDS with conventional ventilation using high oxygen fractions and low PEEP levels have been reported to be less than 10%. In three prospective evaluations of ARDS in the 1980s, mortality rates remained greater than 60%. Early studies using high-level PEEP therapy in severe ARDS by Douglas, Downs, Kirby, and Civetta showed improved survival rates with ranges between 60% and 80%. In 1979 Gallagher reviewed 59 patients with ARDS who were treated with PEEP greater than 15 cm H2O titrated to improve FRC by achieving an intrapulmonary shunt fraction of 15%. The overall survival was 65%, with only 5% of the patients dying secondary to respiratory failure. In the more recent study by Miller in trauma patients and later by DiRusso in a variety of surgical patients, the overall mortality rate for those patients receiving PEEP greater than 15 cm H2O was 20% to 30%. Of the 14 patients who died, only seven (10% of the total) succumbed to respiratory failure. The remaining patients died from the primary underlying disease with normal oxygenation or after significant weaning from high PEEP levels. By using a goal-oriented approach to the management of patients with severe ARDS, we have found that high-level PEEP therapy was effective in lowering the intrapulmonary shunt and improving the SaO2 at acceptable levels of inspired oxygen. All of these patients were ventilated with traditional high tidal volumes (10 to 15 mL/kg) and therefore exhibited high peak inspiratory airway pressures. This support method did not seem to cause lung injury or an excessive amount of barotrauma in these patients, but in fact, was associated with a lower mortality rate (30%) than reported in other studies of patients with lesser degrees of lung oxygenation dysfunction and extrapulmonary organ system dysfunction. Currently available information indicates that increases in mean airway pressure (induced with PEEP or other modes of ventilatory support to restore losses in FRC that occur

  6. Effect of safety management on mental states of patients with carbon monoxide poisoning treated by hyperbaric oxygen%安全管理对采用高压氧治疗一氧化碳中毒患者心理状态的影响

    Institute of Scientific and Technical Information of China (English)

    刘瑾; 林少虹; 廖惠璇; 陆琼妹; 黄秀婷

    2012-01-01

    Objective To study the effect of safety management on mental states of patients with carbon monoxide poisoning treated by hyperbaric oxygen.Methods Safety management was performed for 56 patients with carbon monoxide poisoning treated by hyperbaric oxygen by means of regulating and implementing safety management system,preventing barotraumas and conducting psychological nursing.The mental states before and after safety management were assessed by self-rating anxiety scale (SAS) and self- rating depression scale (SDS).Result The rates of depression and anxiety were significantly decreased after safety management (P < 0.05).Conclusion Safety management can decrease the negativity of mental states so that the patients can be active in curative cooperation and completing the course of treatment.%目的 探讨安全管理对采用高压氧治疗一氧化碳中毒患者心理状态的影响.方法 对56例采用高压氧治疗的一氧化碳中毒患者实施安全管理,包括制订和实施安全管理制度、气压伤预防管理和心理疏导.采用Zung焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(Self-rating Depression Scale,SDS)测评安全管理前后患者心理状态的差异.结果 安全管理后患者抑郁和焦虑情绪发生率均较安全管理前降低,管理前后比较,均P<0.05,差异具有统计学意义.结论 一氧化碳中毒患者在高压氧治疗过程中实施安全管理,可有效降低患者的负性心理,使其主动和积极配合治疗,从而保证治疗顺利完成.

  7. Effects of pressure-controlled and volume-controlled ventilation on respiratory mechanics and systemic stress response during laparoscopic cholecystectomy.

    Science.gov (United States)

    Sen, Oznur; Umutoglu, Tarik; Aydın, Nurdan; Toptas, Mehmet; Tutuncu, Ayse Cigdem; Bakan, Mefkur

    2016-01-01

    Pressure-controlled ventilation (PCV) is less frequently employed in general anesthesia. With its high and decelerating inspiratory flow, PCV has faster tidal volume delivery and different gas distribution. The same tidal volume setting, delivered by PCV versus volume-controlled ventilation (VCV), will result in a lower peak airway pressure and reduced risk of barotrauma. We hypothesized that PCV instead of VCV during laparoscopic surgery could achieve lower airway pressures and reduce the systemic stress response. Forty ASA I-II patients were randomly selected to receive either the PCV (Group PC, n = 20) or VCV (Group VC, n = 20) during laparoscopic cholecystectomy. Blood sampling was made for baseline arterial blood gases (ABG), cortisol, insulin, and glucose levels. General anesthesia with sevoflurane and fentanyl was employed to all patients. After anesthesia induction and endotracheal intubation, patients in Group PC were given pressure support to form 8 mL/kg tidal volume and patients in Group VC was maintained at 8 mL/kg tidal volume calculated using predicted body weight. All patients were maintained with 5 cmH2O positive-end expiratory pressure (PEEP). Respiratory parameters were recorded before and 30 min after pneumoperitonium. Assessment of ABG and sampling for cortisol, insulin and glucose levels were repeated 30 min after pneumoperitonium and 60 min after extubation. The P-peak levels observed before (18.9 ± 3.8 versus 15 ± 2.2 cmH2O) and during (23.3 ± 3.8 versus 20.1 ± 2.9 cmH2O) pneumoperitoneum in Group VC were significantly higher. Postoperative partial arterial oxygen pressure (PaO2) values are higher (98 ± 12 versus 86 ± 11 mmHg) in Group PC. Arterial carbon dioxide pressure (PaCO2) values (41.8 ± 5.4 versus 36.7 ± 3.5 mmHg) during pneumoperitonium and post-operative mean cortisol and insulin levels were higher in Group VC. When compared to VCV mode, PCV mode may improve compliance during pneumoperitoneum

  8. Development of carbon-fiber gas cylinder of 18 liters%18L碳纤维缠绕气瓶的研制

    Institute of Scientific and Technical Information of China (English)

    刘平小; 马新; 王建华; 于峰涛; 史惠星; 苑玲

    2014-01-01

    Objective To design and develop a carbon-fiber gas cylinder of 18 liters, which could provide breathing gas to a portable medical chamber in the first aid and transfer of casualties with diving diseases and pulmonary barotrauma .Methods The di-mension, weight and layers of winding were determined , through the design of the winding method and the interior of the gas cylinder . Then a series of tests , such as water pressure test , fatigue test and demolition test were conducted to demonstrate that all the technical specifications were met .Results The capacity of the cylinder was 18.1 L, weight 9.86 kg, overall length 782 mm and outside diameter 201 mm.The pressure of water test was 30 MPa, which was maintained for 60 s.Residue distortion was <5%and the pressure for fa-tigue test for a succession of 1 500 times was 20 MPa, and actual demolition test pressure was 88.4 MPa.Conclusion Related cylinder tests were conducted in accordance with corresponding criteria , and test results indicated that all the criteria specified in《the Safety Su-pervision Procedures of Gas Cylinders》were met.%目的:设计一种18 L碳纤维缠绕气瓶,专门用于在急救、转运潜水疾病、肺气压伤病员过程中,为便携式医疗加压舱提供呼吸气体。方法通过气瓶内胆和缠绕设计,确定相应的尺寸、质量和缠绕层数,再通过水压试验、疲劳试验和爆破试验验证其技术指标。结果气瓶容积18.1 L,质量9.86 kg,长度782 mm,外径201 mm。水压试验压力30 MPa、保压60 s,残余变形<5%;疲劳试验压力20 MPa,1500次;实际爆破压力88.4 MPa。结论根据相关标准进行气瓶试验,试验情况满足《气瓶安全监察规程》的要求。

  9. Effects of Tidal Turbine Noise on Fish Hearing and Tissues - Draft Final Report - Environmental Effects of Marine and Hydrokinetic Energy

    Energy Technology Data Exchange (ETDEWEB)

    Halvorsen, Michele B.; Carlson, Thomas J.; Copping, Andrea E.

    2011-09-30

    Snohomish Public Utility District No.1 plans to deploy two 6 meter OpenHydro tidal turbines in Admiralty Inlet in Puget Sound, under a FERC pilot permitting process. Regulators and stakeholders have raised questions about the potential effect of noise from the turbines on marine life. Noise in the aquatic environment is known to be a stressor to many types of aquatic life, including marine mammals, fish and birds. Marine mammals and birds are exceptionally difficult to work with for technical and regulatory reasons. Fish have been used as surrogates for other aquatic organisms as they have similar auditory structures. This project was funded under the FY09 Funding Opportunity Announcement (FOA) to Snohomish PUD, in partnership with the University of Washington - Northwest National Marine Renewable Energy Center, the Sea Mammal Research Unit, and Pacific Northwest National Laboratory. The results of this study will inform the larger research project outcomes. Proposed tidal turbine deployments in coastal waters are likely to propagate noise into nearby waters, potentially causing stress to native organisms. For this set of experiments, juvenile Chinook salmon (Oncorhynchus tshawytscha) were used as the experimental model. Plans exist for prototype tidal turbines to be deployed into their habitat. Noise is known to affect fish in many ways, such as causing a threshold shift in auditory sensitivity or tissue damage. The characteristics of noise, its spectra and level, are important factors that influence the potential for the noise to injure fish. For example, the frequency range of the tidal turbine noise includes the audiogram (frequency range of hearing) of most fish. This study was performed during FY 2011 to determine if noise generated by a 6-m diameter OpenHydro turbine might affect juvenile Chinook salmon hearing or cause barotrauma. Naturally spawning stocks of Chinook salmon that utilize Puget Sound are listed as threatened (http://www.nwr.noaa

  10. Lesão brônquica e pneumotórax após reintubação usando um cateter para troca da via aérea

    Directory of Open Access Journals (Sweden)

    Juliano P. de Almeida

    2013-02-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Relatamos um caso de pneumotórax causado por perfuração brônquica durante uma reintubação usando um cateter para troca da via aérea (CTVA em um paciente com câncer de cabeça e pescoço. RELATO DE CASO: Paciente do sexo masculino, 53 anos, com carcinoma de orofaringe, foi internado na UTI com pneumonia grave e síndrome da angústia respiratória aguda (SARA. O paciente foi identificado como sendo de difícil intubação e uma sonda endotraqueal (SET foi inserida através de um broncoscópio. Após uma semana de tratamento, observou-se ruptura do manguito endotraqueal. A troca da sonda endotraqueal foi necessária para obter uma ventilação pulmonar satisfatória. Um cateter para troca da via aérea (Cook, tamanho 14 foi usado para realizar a reintubação. Depois da reintubação, o paciente apresentou piora na saturação de oxigênio e uma radiografia revelou um grande pneumotórax. Um dreno torácico foi inserido e uma melhora imediata na saturação de oxigênio foi observada. A repetição da radiografia confirmou o posicionamento correto do dreno torácico e a reexpansão do pulmão direito. A broncoscopia realizada mostrou uma laceração posterior do brônquio principal direito. O paciente foi extubado no dia seguinte. Depois de quatro dias, o dreno torácico foi removido. A radiografia realizada um dia depois da retirada do dreno revelou um pequeno pneumotórax no lobo superior direito, mas o paciente permaneceu assintomático. CONCLUSÕES: O cateter para troca da via aérea é uma ferramenta valiosa para lidar com pacientes difíceis de intubar. Embora os médicos geralmente concentrem sua atenção em evitar um barotrauma causado pelo suplemento de oxigênio ou ventilação a jato através do CTVA, a preocupação com a técnica de inserção pode minimizar as complicações que ameaçam a vida e aumentar a segurança do CTVA.

  11. Avaliação de alterações timpanométricas em pacientes submetidos à anestesia geral com óxido nitroso Evaluation of tympanometric alterations in patients subject to general anesthesia with nitrous oxide

    Directory of Open Access Journals (Sweden)

    Fernanda Mossumez Fernandes Teixeira

    2005-06-01

    Full Text Available O óxido nitroso é um gás inalatório que pode aumentar a pressão intratimpânica durante o ato anestésico, bem como causar pressão negativa após sua suspensão, principalmente em pacientes com disfunção da tuba auditiva. Estas variações pressóricas podem trazer implicações clínicas, como ruptura de membrana timpânica, desarticulação da cadeia ossicular, hemotímpano, barotrauma, deslocamento de prótese de estapedotomia e lateralização do enxerto nas timpanoplastias, além da entrada de fluido seroso na orelha média durante a fase de pressão negativa. OBJETIVO: Avaliar a influência do óxido nitroso na pressão da orelha média em uma população sem disfunção tubária, realizando timpanometria no pré e pós-operatório. FORMA DE ESTUDO: Coorte transversal. MATERIAL E MÉTODO: Foi realizado um estudo prospectivo com pacientes internados no Hospital Universitário Clementino Fraga Filho - UFRJ, submetidos à anestesia geral com o uso do óxido nitroso a 50%, durante o período de abril a julho de 2003. Avaliou-se ainda se a duração da cirurgia, anestésicos associados, presença de rinite alérgica e desvio de septo nasal poderiam influenciar no aparecimento das alterações da pressão intratimpânica. RESULTADOS: A amostra constituiu-se de 50 pacientes, encontrando-se em quase metade (48% alterações timpanométricas no pós-operatório (curva tipo C, quando comparado às de controle do pré-operatório (curva tipo A. Sexo e idade não interferiram no aparecimento das alterações timpanométricas no pós-operatório, bem como a duração da cirurgia. O tipo de anestésico volátil associado, desvio de septo nasal e rinite alérgica não exerceram influência na pressão da orelha média no pós-operatório. CONCLUSÃO: O óxido nitroso altera a pressão na orelha média tanto na fase de indução quanto na fase de resolução anestésica.Nitrous oxide is an inhaling gas that can increase intratympanic pressure

  12. Clinical study on adaptive support ventilation in treatment of severe asthma%适应性支持通气治疗危重哮喘的临床研究

    Institute of Scientific and Technical Information of China (English)

    王金生; 杨轶敏; 唐容辉; 周永江; 唐倩仪

    2013-01-01

    目的 探讨适应性支持通气(ASV)治疗危重哮喘的效果.方法 将49例危重哮喘患者按随机数字表法分为ASV组(25例)和对照组(传统机械通气,24例).比较两组患者机械通气前后的动脉血气分析、呼吸力学、机械通气时间、住院时间及胸部气压伤发生情况.结果 两组机械通气后动脉血气分析和呼吸力学指标均较机械通气前明显改善,差异有统计学意义(P< 0.05或<0.01),但ASV组机械通气后2、12、24h气道峰压、肺动态顺应性、平台压均较同期对照组明显改善[机械通气后2 h:(33±12) cm H2O(1 cm H2O =0.098 kPa)比(37±11) cm H2O、(16±9)ml/ cm H2O 比(17±10) ml/cm H2O、(27±6)cm H2O比(30±12) cm H2O;机械通气后12 h:(23±12) cmH2O比(25±11) cmH2O、(28±6)ml/cm H2O比(23±10) ml/cm H2O、(20±6)cm H2O比(25±4)cm H2O;机械通气后24 h:(18±12) cm H2O比(20±11)cm H2O、(32±9)ml/cm H2O比(28±10) ml/cm H2O、(12±7)cm H2O比(16±7)cm H2O],差异有统计学意义(P< 0.05或<0.01).ASV组机械通气时间、住院时间明显短于对照组[(46±8)h比(56±6)h、(7±2)d比(10±3)d],差异有统计学意义(P<0.01).ASV组无胸部气压伤发生,对照组发生3例皮下气肿、2例气胸.结论 ASV在治疗危重哮喘患者时,能够保持较低的气道峰压和平台压,改善动脉血气分析和肺动态顺应性,缩短机械通气时间以及住院时间,是一种安全而有效的机械通气模式.%Objective To study the effect of adaptive support ventilation (ASV) in treatment of severe asthma.Methods Forty-nine cases of severe asthma were divided into ASV group (25 cases) and control group (24 cases,tradition mechanical ventilation).The arterial blood gas,respiratory dynamics,mechanical ventilation time,hospital stay and thorax barotrauma was compared between two groups.Results The arterial blood gas and respiratory dynamics was improved after mechanical ventilation compared with that before mechanical ventilation in two

  13. 不同通气模式治疗危重型哮喘患者临床疗效对比%Comparison analysis of different support ventilations in treatment of severe asthma

    Institute of Scientific and Technical Information of China (English)

    孙志强

    2015-01-01

    Objective To investigate two different support ventilation modes for treating severe asthma so as to provide certain theoretical basis for clinical disease diagnosis and treatment.Methods 94 severe asthma patients admitted to our hos-pital between February 2012 and February 2015 were divided into two groups,each with 47 cases.Group A were treated by tra-ditional support ventilation,and group B by adaptive support ventilation.PO2 ,PCO2 ,PH,average hospitalization,average venti-lation time and thorax barotrauma of the two groups were observed.Results There were no obvious differences between the two groups in terms of the initial statistical analysis(P>0.05).After mechanical ventilation,PCO2,PO2 and PH indicators were obviously improved(P0.05).Time of traditional me-chanical ventilation and hospital stay was significantly longer than that of adaptive ventilation in the treatment group ( P <0.05).5 cases of chest barotrauma(2 cases of pneumothorax and 3 cases of subcutaneous emphysema)occurred in group A compared with only 1 case of subcutaneous emphysema in group B.The difference was statistically significant(P<0.05). Conclusion Adaptive support ventilation in treatment of severe asthma can significantly improve arterial blood gas, reduce complications,and shorten the time of mechanical ventilation and hospitalization.Mechanical ventilation is a safe and effective way.%目的:探讨分析2种不同通气模式治疗危重型哮喘患者的安全性和临床疗效,为临床疾病诊治提供理论依据。方法2012年2月-2015年2月我院收治的重症哮喘患者共94例,按入院时间先后随机分为A组、B组,每组各47例。所有患者均行常规哮喘及对症治疗,其中A组行传统机械通气治疗,B组行适应性支持通气( ASV)治疗,观察比较2组患者机械通气前后动脉血氧浓度、动脉二氧化碳浓度及pH值等血气分析指标、机械通气时间、住院时间、胸部气压损伤及

  14. 高频震荡通气治疗先天性心脏病术后重症ARDS32例效果观察%Observations on high-frequency oscillatory ventilation effects in pediatric patients with acute respiratory distress syndrome after congenital heart surgery

    Institute of Scientific and Technical Information of China (English)

    王旭; 张燕搏; 曾敏; 段雷雷; 李胜利; 王珊

    2012-01-01

    Objective To evaluate the effectiveness of high-frequency oscillatory ventilation (HFOV) in pediatric pa-tients with acute respiratory distress syndrome (ARDS) after congenital heart surgery. Methods Thirty-two pediatric pa-tients were treated with HFOV for failing conventional mechanical ventilation (CMV) , ventilation and oxygen parameters were adjusted, and lung recruitment maneuvers was applied after tracheal suction. Changes of blood gas indexes, HFOV treating time, changes of cycle indexes during re-ex-pansion of the lung, complications and survival rate were observed. Results After 12 to 48 hs of HFOV, PaO2, PaCO2, FiO2 and PaO2/FiO2 were all improved significantly and remained within the target range thereafter. The mean duration of HFOV was 43-238 ( 128. 5 ±67. 49) hs. Barotrauma necessitating the insertion of the chest tube were appeared in 9 children. Twenty-one children (65. 6% ) were successfully weaned and survived to discharge, 11 children died . Conclusion In pediatric patients with acute respiratory distress syndrome failing conventional ventilation, HFOV can improve ventilation and gas exchange in a rapid fashion, and can be used as rescue treatment for some pediatric ARDS patients after congenital heart surgery.%目的 探讨高频震荡通气( HFOV)对小儿心脏手术后重症ARDS的治疗效果.方法 对32例心脏手术后常频通气(CMV)治疗无效的重症ARDS患儿行HFOV治疗,设置相应的参数并行氧合、通气管理,每次吸痰后行肺复张.观察治疗前后血气指标变化、HFOV治疗时间、肺复张期间循环指标变化、整体治疗期间并发症发生情况及患儿存活情况.结果 HFOV治疗后通气及气体交换在较短的时间内改善,12~48 h血气相关指标PaO2、PaCO2、吸人氧浓度(FiO2)、氧合指数(PaO2/FiO2)均明显改善且稳定.HFOV治疗时间43 ~238(128.5±67.49)h,肺复张期间循环指标未出现异常变化,末梢血氧饱和度快速恢复至吸痰前水平,呼吸机

  15. SPATIALLY-EXPLICIT BAT IMPACT SCREENING TOOL FOR WIND TURBINE SITING

    Energy Technology Data Exchange (ETDEWEB)

    Versar, Inc.; Exponent, Inc.

    2013-10-28

    As the U.S. seeks to increase energy production from renewable energy sources, development of wind power resources continues to grow. One of the most important ecological issues restricting wind energy development, especially the siting of wind turbines, is the potential adverse effect on bats. High levels of bat fatality have been recorded at a number of wind energy facilities, especially in the eastern United States. The U.S. Department of Energy contracted with Versar, Inc., and Exponent to develop a spatially-explicit site screening tool to evaluate the mortality of bats resulting from interactions (collisions or barotrauma) with wind turbines. The resulting Bat Vulnerability Assessment Tool (BVAT) presented in this report integrates spatial information about turbine locations, bat habitat features, and bat behavior as it relates to possible interactions with turbines. A model demonstration was conducted that focuses on two bat species, the eastern red bat (Lasiurus borealis) and the Indiana bat (Myotis sodalis). The eastern red bat is a relatively common tree-roosting species that ranges broadly during migration in the Eastern U.S., whereas the Indiana bat is regional species that migrates between a summer range and cave hibernacula. Moreover, Indiana bats are listed as endangered, and so the impacts to this species are of particular interest. The model demonstration used conditions at the Mountaineer Wind Energy Center (MWEC), which consists of 44 wind turbines arranged in a linear array near Thomas, West Virginia (Tucker County), to illustrate model functions and not to represent actual or potential impacts of the facility. The turbines at MWEC are erected on the ridge of Backbone Mountain with a nacelle height of 70 meters and a collision area of 72 meters (blade height) or 4,071 meters square. The habitat surrounding the turbines is an Appalachian mixed mesophytic forest. Model sensitivity runs showed that bat mortality in the model was most sensitive to

  16. Ileocecal valve dysfunction in small intestinal bacterial overgrowth: A pilot study

    Institute of Scientific and Technical Information of China (English)

    Larry S Miller; Anil K Vegesna; Aiswerya Madanam Sampath; Shital Prabhu; Sesha Krishna Kotapati; Kian Makipour

    2012-01-01

    AIM:To explore whether patients with a defective ileocecal valve (ICV)/cecal distension reflex have small intestinal bacterial overgrowth.METHODS:Using a colonoscope,under conscious sedation,the ICV was intubated and the colonoscope was placed within the terminal ileum (TI).A manometry catheter with 4 pressure channels,spaced 1 cm apart,was passed through the biopsy channel of the colonoscope into the TI.The colonoscope was slowly withdrawn from the TI while the manometry catheter was advanced.The catheter was placed across the ICV so that at least one pressure port was within the TI,ICV and the cecum respectively.Pressures were continuously measured during air insufflation into the cecum,under direct endoscopic visualization,in 19 volunteers.Air was insufflated to a maximum of 40 mmHg to prevent barotrauma.All subjects underwent lactulose breath testing one month after the colonoscopy.The results of the breath tests were compared with the results of the pressures within the ICV during air insufflation.RESULTS:Nineteen subjects underwent colonoscopy with measurements of the ICV pressures after intubation of the ICV with a colonoscope.Initial baseline readings showed no statistical difference in the pressures of the TI and ICV,between subjects with positive lactulose breath tests and normal lactulose breath tests.The average peak ICV pressure during air insufflation into the cecum in subjects with normal lactulose breath tests was significantly higher than cecal pressures during air insufflation (49.33 ± 7.99 mmHg vs 16.40 ± 2.14 mmHg,P =0.0011).The average percentage difference of the area under the pressure curve of the ICV from the cecum during air insufflations in subjects with normal lactulose breath tests was significantly higher (280.72% ± 43.29% vs 100% ± 0%,P =0.0006).The average peak ICV pressure during air insufflation into the cecum in subjects with positive lactulose breath tests was not significantly different than cecal pressures during

  17. Penguin lungs and air sacs: implications for baroprotection, oxygen stores and buoyancy.

    Science.gov (United States)

    Ponganis, P J; St Leger, J; Scadeng, M

    2015-03-01

    The anatomy and volume of the penguin respiratory system contribute significantly to pulmonary baroprotection, the body O2 store, buoyancy and hence the overall diving physiology of penguins. Therefore, three-dimensional reconstructions from computerized tomographic (CT) scans of live penguins were utilized to measure lung volumes, air sac volumes, tracheobronchial volumes and total body volumes at different inflation pressures in three species with different dive capacities [Adélie (Pygoscelis adeliae), king (Aptenodytes patagonicus) and emperor (A. forsteri) penguins]. Lung volumes scaled to body mass according to published avian allometrics. Air sac volumes at 30 cm H2O (2.94 kPa) inflation pressure, the assumed maximum volume possible prior to deep dives, were two to three times allometric air sac predictions and also two to three times previously determined end-of-dive total air volumes. Although it is unknown whether penguins inhale to such high volumes prior to dives, these values were supported by (a) body density/buoyancy calculations, (b) prior air volume measurements in free-diving ducks and (c) previous suggestions that penguins may exhale air prior to the final portions of deep dives. Based upon air capillary volumes, parabronchial volumes and tracheobronchial volumes estimated from the measured lung/airway volumes and the only available morphometry study of a penguin lung, the presumed maximum air sac volumes resulted in air sac volume to air capillary/parabronchial/tracheobronchial volume ratios that were not large enough to prevent barotrauma to the non-collapsing, rigid air capillaries during the deepest dives of all three species, and during many routine dives of king and emperor penguins. We conclude that volume reduction of airways and lung air spaces, via compression, constriction or blood engorgement, must occur to provide pulmonary baroprotection at depth. It is also possible that relative air capillary and parabronchial volumes are

  18. 胸科手术的单肺通气策略%Strategy of one-lung ventilation for thoracic surgery

    Institute of Scientific and Technical Information of China (English)

    闫丽娟; 李文志

    2016-01-01

    Background One-lung ventilation(OLV) can provide optimum surgical operating conditions and isolate the lungs to protect them during anesthesia for thoracic surgery.Unfortunately,OLV is a way of ventilation under the non-physiological condition.During the OLV,it often leads to ventilator-induced lung injury(VILI) as a result of barotraumas,oxygen toxicity,and so on.Objective Investigate the preferable strategy of one-lung ventilation for thoracic surgery.Content An alveolar recruitment strategy(ARS) and the lung protective ventilation strategy using low-tidal volumes and the appropriate positive end-expiratory pressure (PEEP) would limit plateau and peak inspiratory pressures (Pplat and Ppeak) to 25 cmH2O (1 cmH2O=0.098 kPa) and 35 cmH2O,respectively.FiO2 should be limited,too.According to the arterial blood gas analysis,respiration rate can be adjusted properly.Trend For the non-operated lung,it can avoid alveolar over-inflation and cyclic recruitment-derecruitment during the OLV.High FiO2 would aggravate oxidative stress,so it is wise to limit FiO2 during OLV.Also,hypercapnia is well tolerated in the short term.Individualized management of patients would create fewer admissions to the intensive care unit and a shorter hospital stay,and improve survival rates and quality of life of them.%背景 在胸科手术的麻醉中进行单肺通气(one-lung ventilation,OLV),不但可以为手术提供良好的术野,而且可以隔离并保护肺脏.但是,这是一种非生理状态下的通气方式,OLV期间的气压伤和氧毒性等因素常导致机械通气相关性肺损伤(ventilator-induced lung injury,VILI). 目的 探讨适合胸科手术的OLV策略. 内容 在OLV期间,采用肺泡复苏策略(alveolar recruitment strategy,ARS)和“小潮气量+呼气末正压通气(positive end-expiratory pressure,PEEP)”的保护性通气策略,使吸气平台压(plateau pressure,Pplat)<25 cmH2O(1 cmH2O=0.098 kPa)和气道峰压(peak inspiratory pressure,Ppeak)<35 cmH2

  19. Influence by lidocaine by intravenous injection on airway pressure during intubation anesthesia by double-lumen tube%利多卡因静脉注射对双腔气管导管插管麻醉期间气道压力的影响

    Institute of Scientific and Technical Information of China (English)

    胡秀才; 齐英凯; 韩倩; 王雷; 单士强

    2016-01-01

    Objective To investigate influence by lidocaine by intravenous injection on airway pressure during intubation anesthesia by double-lumen tube. Methods A total of 80 peripheral lung cancer patients, who received thoracoscopic lobectomy, were randomly divided into group Ⅰ and group Ⅱ, with 40 cases in each group. Group Ⅰ received lidocaine by intravenous injection before anesthesia, and continuous intravenous pumping of lidocaine after anesthesia intubation. Group Ⅱ received normal saline by intravenous injection at corresponding time point before anesthesia, and continuous intravenous pumping of normal saline after anesthesia intubation. Observation was made on plateau pressure and peak airway pressure at the time of lateral two-lung ventilation (T1), one-lung ventilation (T2), intraoperative broken bronchus (T3), and intraoperative two-lung ventilation (T4). Results Group Ⅰ had all lower plateau pressure as (15±3), (24±3), (23±3) and (21±4) cm H2O (1 cm H2O=0.098 kPa) and peak airway pressure as (18±4), (25±5), (25±3) and (23±3) cm H2O at T1, T2, T3 and T4 than group Ⅱ (P<0.05). Conclusion Preventive implement of lidocaine by intravenous injection before anesthesia induction can effectively reduce ventilation pressure and barotraumas during one-lung ventilation in thoracoscopic lobectomy patients, as well as improve one-lung ventilation effect.%目的:探讨利多卡因静脉注射对双腔气管导管插管麻醉期间气道压力的影响。方法80例周围型肺癌行胸腔镜肺叶切除术患者,随机分为组Ⅰ和组Ⅱ,各40例。组Ⅰ患者在麻醉前静脉注射利多卡因,麻醉插管后持续静脉泵注利多卡因。组Ⅱ患者在麻醉前相应时间点静脉注射生理盐水,麻醉插管后持续静脉泵注生理盐水。观察侧卧位双肺通气(T1)、单肺通气(T2)、术中离断支气管(T3)、术后双肺通气(T4)时的平台压和气道峰压。结果组Ⅰ患者 T1、T2、T3、T4时平台压(15±3)、(24±3)

  20. Analysis of disease spectrum resulting in fighter pilots disqualified from 2003 to 2008%2003-2008年歼击机飞行员飞行不合格疾病谱分析

    Institute of Scientific and Technical Information of China (English)

    刘红巾; 熊巍; 徐先荣; 程军; 郑军; 徐蜀宣; 付兆君; 张扬; 崔丽; 刘晶

    2009-01-01

    , orthopedics, otorhinolaryngology and cardiovasology. ④ Most disqualified pilots were at the age from 35~39 years old. ⑤ By comparing with the case history data, the proportion of acceleration intolerance, flight illusion and ear barotraumas decreased while the proportion of hypertension increased. Conclusions The most common diseases of disqualified fighter pilots' were the acceleration intolerance, cervical and lumbar disorder, headache, neurosis, functional disturbances of gastrointestinal tract and ground syncope. The flying disqualification rates of hypertension and diabetes mellitus show increased tendency while the aviation diseases decreased.

  1. 双侧肺同期手术中不同体位和单肺通气对病人呼吸力学的影响%Effects of different positions and one-lung ventilation modes on respiratory mechanics of patients during bilateral pulmonary surgery

    Institute of Scientific and Technical Information of China (English)

    马宏伟; 耿恩江; 李凤茹; 杨永斌; 丁丽景; 马辉

    2012-01-01

    Objective To investigate the effects of different positions and one-lung ventilation modes on respiratory mechanics of patients during bilateral pulmonary surgery. Methods Analysis on 142 cases who underwent bilateral pulmonary surgery from June, 2007 to December, 2010. PIP,Pplat,Raw and Cdyn measures were continuous monitored by side stream spirometry while SpO2 and PETCO2 were observed on the Patient Monitor. After dual cavity bronchus vessel was fixed and different ventilation modes were applied, blood gas analyses were made after 10 min with patients in lateral positions. Results When patient was changed to a lateral position under double-lung ventilation and when one-lung ventilation mode was applied, PIP、PplatRaw increased while Cdyn decreased, and PH decreased while PETCO2 and PaCO2 increased with SpO2 and PaO2 decreasing( P < 0. 05 ). When a different ventilation mode was applied under double-lung ventilation, PIP, Pplat and Raw decreased while Cdyn increased, PH decreased while PaO2 、SpO2 、PaCO2、PETCO2 increased ( P <0. 05 );when 38 cases were applied with a different ventilation mode under one-lung ventilation, PIP, Pplat and Raw decreased significantly while Cdyn increased, PH,PaO2 and SpO2 increased while PaCO2 and PETCO2 decreased( P <0. 05 ). Conclusion Different positions and ventilation modes have great effect on respiratory mechanics of patients during bilateral pulmonary surgery, and appropriate ventilation modes can improve respiratory mechanics and prevent hypoxemia, hypercarbia and barotraumas to protect lungs.%目的 观察双侧肺同期手术中体位改变和单肺通气时对病人呼吸力学的影响.方法 选取我院2007年6月至2010年12月双侧肺同期手术病人142例,经气道旁路采用旁气流通气连续监测病人PIP、Pplat、Raw、Cdyn等呼吸力学指标,监测SpO2、PETCO2指标,分别在双腔支气管导管定位后,平卧改侧卧,单肺通气及改换通气方式后10 min抽取动

  2. Procedures for restoring vestibular disorders

    Directory of Open Access Journals (Sweden)

    Walther, Leif Erik

    2005-09-01

    round window membrane can, for example, also be caused by an implosive inner ear barotrauma during the decompression phase of diving. Dehiscence of the anterior semicircular canal, a relatively rare disorder, can be treated conservatively (avoiding stimuli which cause dizziness, by non-ablative „resurfacing" or by „plugging" the semicircular canal. A perilymph fistula can cause a Tullio-phenomenon resulting from a traumatic dislocation or hypermobility of the stapes, which can be surgically corrected. Vestibular disorders can also result from otosurgical therapy. When balance disorders persist following stapedectomy it is necessary to carry out a revision operation in order to either exclude a perilymph fistula or shorten the piston. Surgically reducing the size of open mastoid cavities (using for example porous hydroxylapatite or cartilage can result in a reduction of vertiginous symptoms while nursing or during exposure to ambient air. Vestibular disturbances can occur both before and after vestibular nerve surgery (acoustic neuroma. Initially, good vestibular compensation can be expected after surgically removing the acoustic neuroma. An aberrant regeneration of nerve fibers of the vestibulocochlear nerve has been suggested as a cause for secondary worsening. Episodes of vertigo can be caused by an irritation of the vestibular nerve (vascular loop. Neurovascular decompression is generally regarded as the best surgical therapy. In the elderly, vestibular disturbances can severely limit quality of life and are often aggravated by multiple comorbidities. Antivertiginous drugs (e.g. dimenhydrinate in combination with movement training can significantly reduce symptoms. Administering antivertiginous drugs over varying periods of time (e.g. transdermal scopolamine application via patches as well as kinetosis training can be used as both prophylactically and as a therapy for kinetosis. Exposure training should be used as a prophylactic for height vertigo.

  3. Influência do manuseio do balão autoinflável neonatal sobre o pico de pressão e o volume corrente Peak pressure and tidal volume are affected by how the neonatal self-inflating bag is handled

    Directory of Open Access Journals (Sweden)

    Mariana A. Bassani

    2009-06-01

    88 mL (mean = 39.56 mL; 95%CI 36.86-42.25 for tidal volume. There was no significant influence of the profession on any of the variables (p > 0.05. However, bag handling significantly influenced both peak pressure and tidal volume (p < 0.0001, which were higher when the operator used both hands. CONCLUSION: The results indicate that most professionals delivered excessively high peak pressures and tidal volumes, which could increase the risk of barotrauma and volutrauma, especially when both hands were used to ventilate. On the other hand, a small number of professionals delivered insufficient pressure and volume for adequate lung expansion and ventilation. The delivery of inadequate ventilation was not dependent on profession.

  4. Clinical efficacy and safety of recruitment maneuver in patients with acute respiratory distress syndrome using low tidal volume ventilation: a multicenter randomized controlled clinical trial

    Institute of Scientific and Technical Information of China (English)

    XI Xiu-ming; JIANG Li; ZHU Bo; the RM group

    2010-01-01

    , 120 minutes after RM. There was no incidence of barotraumas.Conclusions RM was safe and useful for improving oxygenation in patients with ARDS who were ventilated with a low tidal volume, with a beneficial impact on their clinical outcome.

  5. 慢性阻塞性肺疾病合并呼吸衰竭患者机械通气撤机时机的分析%Chronic Obstructive Pulmonary Dsease Patients with Respiratory Failure with Mechanical Ventilation Weaning Timing

    Institute of Scientific and Technical Information of China (English)

    张祥标; 叶晓东; 王丽萍

    2016-01-01

    Objective To explore under the guidance of the respiratory system function score mechanical ventilation in COPD with respiratory failure in patients weaning feasibility. Methods June 2013 to February 2015, hospital receiving mechanical ventila-tion in the treatment of COPD and respiratory failure in 90 patients were randomly divided into 3 groups using traditional of weaning ( n=45), respiratory function score of 3 to 4 minutes (n = 30 )and 5 to 6 minutes (n = 15 ). Extubation respiratory function score u-sing respiratory function score guidance weaning. Dynamic observed and compared three groups of patients with mechanical ventilation and oxygenation before ventilation, respiratory function score, while receiving mechanical ventilation longer directly weaning success rate, total weaning success rate, the rate of re-intubation, ventilator-associated pneumonia (VAP) The incidence of pulmonary baro-trauma incidence. Results Compared to 3 to 4 minutes ,direct weaning success rate, the total withdrawal rate of no significant differ-ence (P>0. 05) machine success;traditional mechanical ventilation weaning unit significantly reduced (P﹤0. 05), VAP incidence was lower (P0. 05). Conclusion COPD with respiratory failure patients using mechanical ventilation weaning respiratory function score guidance weaning measures have the safety, feasibility;without affecting the success rate of weaning premise when respiratory system score 3-4 timeshare weaning can reduce the incidence of mechanical ventilation and lung complications.%目的:探讨在呼吸系统功能评分指导下,机械通气治疗慢性阻塞性肺疾病合并呼吸衰竭患者撤机的可行性。方法2013年6月至2015年2月接受机械通气治疗的慢性阻塞性肺疾病呼吸衰竭患者90例,随机分成传统撤机组( n=45人),3~4分撤机组( n=30人),5~6分撤机组( n=15人),撤机组采用呼吸系统功能评分指导撤机。动态观察并比较三组患者撤机成功率、重新插管

  6. 呼吸支持在新生儿先天性膈疝围手术期的应用%Application of respiratory support in perioperative period of congenital diaphragmatic hernia in neonates

    Institute of Scientific and Technical Information of China (English)

    姚岭松; 徐延波

    2015-01-01

    Objective To explore the ventilation strategies and treatment outcomes in the neonates with congenital diaphragmatic hernia(CDH) during perioperative period. Methods We conducted a retro-spective study of 13 infants with CDH in our NICU. Infants with prenatal diagnosis of CDH should be intuba-ted immediately after delivery,then they were transferred to NICU and gave ventilator support. During pre-operation period,high-frequency oscillatory ventilation(HFOV) mode was used as initial therapy. Neonates with CDH-associated pulmonary hypertension received inhaled nitric oxide( iNO) therapy. The surgical repair of CDH was usually delayed until physiologic stabilization and improvement of pulmonary hypertension. After surgical repair,we still used HFOV mode. According to the pre-operation parameter,the parameters of postop-erative ventilation were regulated. The ventilator mode was changed to conventional ventilation( synchronized intermittent mandatory ventilation+pressure support ventilation) when FiO2≤40%,mean airway pressure≤10 cmH2O(1 cmH2O=0. 098 kPa),blood gas analysis resulted within normal range,the target preductal satu-ration range was 85% to 95%. When the babies′ spontaneous respiration maintained stronger,FiO2≤30%, mean airway pressure≤8 cmH2 O, SaO2 , blood gas analysis resulted within normal range, thoracic X-ray showed the lung border on the contralateral side between the 8th and the 9th rib,then we weaned ventilator support. Results This gentle ventilation strategies were routinely used in our center,and made a good thera-peutic effect in infants with CDH. Eleven of 13 CDH cases smoothly passed the ventilator support,no one de-veloped into bronchopulmonary dysplasia. Conclusion Infants with CDH should be intubated immediately after birth and give ventilator support in perioperative period. This gentle ventilation strategy to avoid baro-trauma until vital organs functions are stabilized. In order to improve the survival rate of infants with CDH

  7. Anti-inflammtory effects of erythropoietin on hyperoxia-induced bronchopulmonary dysplasia in newborn rats%促红细胞生成素对高氧肺损伤炎症反应病理过程的影响

    Institute of Scientific and Technical Information of China (English)

    王晓蕾; 薛辛东

    2009-01-01

    Objective Bronchopulmonary dysplasia (BPD) is a multifactorial disease resulting from the impact of injury (including oxygen toxicity, barotrauma, volutrauma, and infection) on the immature lung. Oxygen toxicity is thought to be a major contributing factor in the pathogenesis in BPD. Previous animal studies have shown that exposure to hyperoxia in the neonatal period causes lung structural changes that are similar to the histology seen in human infants with BPD. Erythropeietin (EPO) has pleiotropic actions including antioxidant, anti-apeptotic, anti-inflammatory and angiogenic effects. Animal experiments reveal that EPO may have protective effects on hyperoxic lung injury, but the mechanisms remain unknown. The aim of the study was to evaluate the anti-inflammatory effects and understand mechanism of action of EPO on the hyperexia-induced BPD in newborn rats. Method Several litters of Wistar pups were pooled together within 12 hours after birth and randomly divided into four groups: Ⅰ. air-exposed control group, Ⅱ. air-exposed human recombinant erythropeietin (rhEPO)-treated group, Ⅲ. hyperoxia-expesed placebo group and Ⅳ. hyperoxia-expesed rhEPO-treated group. Group Ⅲ and Ⅳ rats were exposed to 85% oxygen. Group Ⅱ and Ⅳ rats received rhEPO (1200 IU/kg) subcutaneously on postnatal days 0 and 2. Group Ⅰ and Ⅲ received 0.9% saline in the same way. Pups from each group were sacrificed on days 3, 7, and 14. Blood hemoglobin concentration, hematocrit and platelet count were determined by blood cell analyzer. Total protein content in bronchoaiveolar lavage fluid (BALF) and myelopsroxidase (MPO) were measured by biochemical assay. Changes of monocyte chemoattractant protein-1 (MCP-1) and cytokine-induced neutrophil cbemoattraclant-1 (CINC-1) mRNA expressions were measured by BT-PCR. Result In group Ⅲ, there were a few inflammatory cells infiltrations in interstitium on day 3 and inflammatory response worsened on day 7. Alveolar and capillary