Respiratory Physiological Phenomena

呼吸生理现象
  • 文章类型: English Abstract
    UNASSIGNED: The quality of the spirometry is estimated with criteria of acceptability and repeatability. The repeatability criteria accepted by consensus is < 0.150 L.
    UNASSIGNED: To know the repeatability in quality A spirometry.
    UNASSIGNED: Analytical cross-sectional design. The demographic variables and the 3 best spirometry curves with normal, suggestive of restriction and bronchial obstruction profiles were obtained from consecutive subjects of both genders from 18 to 80 years of age. The repeatability was analyzed with the mean difference (bias) and the intraclass correlation coefficient.
    UNASSIGNED: 630 curves from 210 subjects were accepted. Group age 60 ± 15 years. Female predominance 113 (53.8%), occupation: domestic services 61 (29%), and diagnosed with chronic obstructive pulmonary disease: 70 (33.4%). The differences in the curves were < 0.150 L. The mean difference (bias) and the intraclass correlation coefficient (95% confidence interval, 95% CI) of the forced expiratory volume in the first second were 1 vs. 2 maneuver: -0.01 (0.13, -0.14), 0.997 (95% CI 0.996, 0.998); 2 vs. 3 maneuver: 0.00 (0.13, -0.13), 0.997 (95% CI 0.996, 0.998), and maneuver 1 vs. 3: -0.00 (0.16, -0.17), 0.995 (95% CI 0.994, 0.996). Forced vital capacity: 1 vs. 2 maneuver: -0.01 (0.17, -0.18), 0.996 (95% CI 0.995, 0.997); 2 vs. 3 maneuver: 0.01 (0.17, -0.16), 0.997 (95% CI 0.0.996, 0.998), and maneuver 1 vs. 3: -0.00 (0.18, -0.19), 0.996 (95% CI 0.995, 0.997).
    UNASSIGNED: The repeatability obtained in spirometry with quality A validates the use of the repeatability criterion of 0.150 L.
    UNASSIGNED: la calidad de la espirometría se estima con criterios de aceptabilidad y repetitividad. La repetitividad aceptada por consenso es < 0.150 L.
    UNASSIGNED: conocer la repetitividad en espirometrías de calidad A.
    UNASSIGNED: diseño transversal analítico. Se obtuvieron las variables demográficas y las 3 mejores curvas de espirometría con perfil normal, que sugiriera restricción y obstrucción bronquial de sujetos consecutivos de ambos géneros de 18 a 80 años. La repetitividad se analizó con la diferencia de medias (sesgo) y el coeficiente de correlación intraclase.
    UNASSIGNED: se aceptaron 630 curvas de 210 sujetos. Edad grupal 60 ± 15 años. Predominio femenino 113 (53.8%), ocupación: servicios domésticos 61 (29%) y con enfermedad pulmonar obstructiva crónica 70 (33.4%). Las diferencias en las curvas fueron < 0.150 L. Las diferencias medias (sesgo) y el coeficiente de correlación intraclase (intervalo de confianza al 95%, IC 95%) del volumen espiratorio forzado en el primer segundo fueron: maniobra 1 frente a 2: −0.01 (0.13, −0.14), 0.997 (IC 95% 0.996, 0.998); maniobra 2 frente a 3: 0.00 (0.13, −0.13), 0.997 (IC 95% 0.996, 0.998), y maniobra 1 frente a 3: −0.00 (0.16, −0.17), 0.995 (IC 95% 0.994, 0.996). La capacidad vital forzada: maniobra 1 frente a 2: −0.01 (0.17, −0.18), 0.996 (IC 95% 0.995, 0.997); maniobra 2 frente a 3: 0.01 (0.17, −0.16), 0.997 (IC 95% 0.0.996, 0.998), y maniobra 1 frente a 3: −0.00 (0.18, −0.19), 0.996 (IC 95% 0.995, 0.997).
    UNASSIGNED: la repetitividad obtenida en espirometrías con calidad A valida el uso del criterio de repetitividad de 0.150 L.
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  • 文章类型: Journal Article
    方法:关于呼吸功能的自我诱发认知恍惚(SICT)知之甚少。这个未来的目标,单中心,非随机化,健康志愿者的开放标签研究,是为了表征SICT期间的肺活量变化,确认这项技术的安全性,并研究SICT的潜在临床益处。
    结果:有9人参加。FEV1FVC或FEF25-75前无显著差异,during,在割伤之后。SICT期间握力有显著改善(+2.2kg/5.7%,p<0.05),并且在恍惚结束时与身体活动有关的自我效能评分。在最近的上呼吸道感染的背景下,一名参与者在SICT期间FEV1显著恶化。
    结论:SICT不会显著改变健康志愿者的肺活量测定数据,并且可以改善与体力活动相关的自我效能。上呼吸道感染期间应谨慎进行SICT。
    METHODS: Little is known about self-induced cognitive trance (SICT) on respiratory function. The aims of this prospective, single-center, non-randomized, open-label study of healthy volunteers, were to characterize spirometry changes during SICT, confirm the safety of this technique, and investigate the potential clinical benefits of SICT.
    RESULTS: Nine people participated. There were no significant difference in FEV1 FVC or FEF 25-75 before, during, and after SICT. There were significant improvements in grip strength during SICT (+2.2 kg/5.7 %, p<0.05) and in self-efficacy score related to physical activity at the end of the trance. One participant had a significant worsening of FEV1 during SICT in the context of a recent upper airway infection.
    CONCLUSIONS: SICT does not significantly modify spirometry data in healthy volunteers and can improve self-efficacy related to physical activity. SICT should probably be performed with caution during upper airway infections.
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  • 文章类型: Journal Article
    背景:高流量气管吸氧(HFTO)在气管造口术难以脱离有创机械通气的患者断奶期间被用作支持治疗。有,然而,没有这种策略的临床证据。因此,我们进行了系统综述,以总结评估HFTO在气管造口辅助断奶过程中的生理效应的研究,并确定该领域未来研究的潜在领域.
    方法:在2022年12月22日之前发表的关于通过气管造口术从机械通气撤机的危重病受试者的观察性和介入性研究符合资格。高流量氧气的研究,只有在儿童中,非人类模型或动物,仅在临床结果上,没有全文可用性的摘要,病例报告,和评论被排除在外。主要结果为呼气末肺容积(EELV)和潮气量,使用电阻抗断层显像,通过食管测压评估呼吸努力,通过隔膜(EAdi)信号的电活动评估的呼吸和神经通气驱动工作,气道压力(Paw),氧合(PaO2/FIO2或SpO2/FIO2),呼吸频率,潮气量,PaCO2
    结果:总计,确定了1,327个参考文献,其中包括5个。在所有研究中,HFTO以50升/分钟的流量给药,并以交叉设计与常规O2治疗进行比较。测量时有创通气的总平均持续时间为11-27d。在两项研究中,HFTO组PaO2/FIO2和平均Paw较高。EELV,潮气量,食管压力波动,在高流量气管吸氧和常规O2治疗期间,EAdi和EAdi相似。
    结论:在脱离机械通气的气管造口术患者中,与常规O2治疗相比,HFTO的主要生理作用是改善氧合,这可能是流量依赖性的。呼吸努力,肺通气,神经通气驱动,HFTO和常规O2治疗的通气相似。未来对HFTO的研究应在断奶过程的早期进行,并应评估其对痰液清除和以患者为中心的预后如呼吸困难的影响。
    BACKGROUND: High-flow tracheal oxygen (HFTO) is being used as supportive therapy during weaning in tracheostomized patients difficult to wean from invasive mechanical ventilation. There is, however, no clinical evidence for such a strategy. Therefore, we conducted a systematic review to summarize studies evaluating the physiologic effects of HFTO during tracheostomy-facilitated weaning and to identify potential areas for future research in this field.
    METHODS: Observational and interventional studies on critically ill subjects weaning from mechanical ventilation via tracheostomy published until December 22, 2022, were eligible. Studies on high-flow oxygen, only in children, non-human models or animals, on clinical outcome only, abstracts without full-text availability, case reports, and reviews were excluded. Main outcomes were end-expiratory lung volume (EELV) and tidal volume using electrical impedance tomography, respiratory effort assessed by esophageal manometry, work of breathing and neuroventilatory drive as assessed by electrical activity of the diaphragm (EAdi) signal, airway pressure (Paw), oxygenation (PaO2 /FIO2 or SpO2 /FIO2 ), breathing frequency, tidal volume, and PaCO2 .
    RESULTS: In total, 1,327 references were identified, of which 5 were included. In all studies, HFTO was administered with flow 50 L/min and compared to conventional O2 therapy in a crossover design. The total average duration of invasive ventilation at time of measurements ranged from 11-27 d. In two studies, PaO2 /FIO2 and mean Paw were higher with HFTO. EELV, tidal volumes, esophageal pressure swings, and EAdi were similar during high-flow tracheal oxygen and conventional O2 therapy.
    CONCLUSIONS: The main physiological effect of HFTO as compared to conventional O2 therapy in tracheostomized subjects weaning from mechanical ventilation was improved oxygenation that is probably flow-dependent. Respiratory effort, lung aeration, neuroventilatory drive, and ventilation were similar for HFTO and conventional O2 therapy. Future studies on HFTO should be performed early in the weaning process and should evaluate its effect on sputum clearance and patient-centered outcomes like dyspnea.
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  • 文章类型: Editorial
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    背景:胶原蛋白XIII是一种与神经肌肉接头发育相关的跨膜胶原蛋白,在人类中,其缺乏导致19型先天性肌无力综合征(CMS19),导致呼吸困难.CMS19患者通常肺活量受限,一名患者出现慢性肺病。在单细胞RNA测序研究中,胶原蛋白XIII已被确定为肺脂成纤维细胞的标志物,这与肺纤维化的解决有关。
    方法:我们研究了胶原蛋白XIII在肺中的位置和功能,以了解人类CMS19患者肺部症状的起源。此外,我们对特发性肺纤维化(IPF)样本(N=5)以及正常和纤维化小鼠肺进行了免疫染色。为了研究缺乏胶原蛋白XIII是否容易导致限制性肺病,我们将Col13a1修饰的小鼠暴露于博来霉素诱导的肺纤维化。
    结果:IPF患者肺的肺泡隔切片明显正常,对胶原蛋白XIII有微弱的染色,其表达在小鼠肺中隔成纤维细胞中被精确定位。缺乏胶原蛋白XIII的小鼠的肺容量增加超过10%。在IPF样本中,胶原XIII由基底上皮细胞表达,增生性肺泡上皮细胞和纤维化区域的基质细胞,但是,在胶原蛋白XIII缺乏的小鼠中,肺纤维化的发展不受影响。
    结论:小鼠肺功能的变化似乎代表了XIII型胶原缺乏的肌无力表现。我们建议呼吸肌肌无力是CMS19患者除骨骼畸形外还遭受呼吸问题的主要原因。IPF患者肺中胶原蛋白XIII表达的诱导值得进一步研究以揭示胶原蛋白XIII依赖性疾病机制。
    BACKGROUND: Collagen XIII is a transmembrane collagen associated with neuromuscular junction development, and in humans its deficiency results in congenital myasthenic syndrome type 19 (CMS19), which leads to breathing difficulties. CMS19 patients usually have restricted lung capacity and one patient developed chronic lung disease. In single-cell RNA sequencing studies, collagen XIII has been identified as a marker for pulmonary lipofibroblasts, which have been implicated in the resolution of pulmonary fibrosis.
    METHODS: We investigated the location and function of collagen XIII in the lung to understand the origin of pulmonary symptoms in human CMS19 patients. Additionally, we performed immunostainings on idiopathic pulmonary fibrosis (IPF) samples (N=5) and both normal and fibrotic mouse lung. To study whether the lack of collagen XIII predisposes to restrictive lung disease, we exposed Col13a1-modified mice to bleomycin-induced pulmonary fibrosis.
    RESULTS: Apparently normal alveolar septum sections of IPF patients\' lungs stained faintly for collagen XIII, and its expression was pinpointed to the septal fibroblasts in the mouse lung. Lung capacity was increased in mice lacking collagen XIII by over 10%. In IPF samples, collagen XIII was expressed by basal epithelial cells, hyperplastic alveolar epithelial cells and stromal cells in fibrotic areas, but the development of pulmonary fibrosis was unaffected in collagen XIII-deficient mice.
    CONCLUSIONS: Changes in mouse lung function appear to represent a myasthenic manifestation of collagen XIII deficiency. We suggest that respiratory muscle myasthenia is the primary cause of the breathing problems suffered by CMS19 patients in addition to skeletal deformities. Induction of collagen XIII expression in the IPF patients\' lungs warrants further studies to reveal collagen XIII-dependent disease mechanisms.
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  • 文章类型: Journal Article
    高强度低频声源在声学生物效应研究中有着重要的应用,机场鸟类排斥,锅炉除灰。然而,在开放空间中产生高强度低频声波是困难的。在本文中,开发了一种具有谐振腔的低频声发生器,用于增强开放空间中的声强,这是一个空气动力声发生器辐射的高强度声波52Hz。进行了一些实验来测量该发电机的内部流场和辐射声场特性,包括100m处的传播特性。实验结果表明,谐振增强效应在预定谐振频率附近呈现,增强值约为4dB。在1m位置52Hz的声强为124dB。通过将赫姆霍兹共振器与气流调节器相结合,谐振器中的气流谐振增强了腔室内的气压脉动,并增加了声辐射对空气的干扰。从而提高低频范围内的声强和辐射效率。
    The high-intensity low-frequency acoustic sources have essential applications in acoustic biological effects research, airport bird repelling, and boiler ash removal. However, generating high-intensity low-frequency acoustic waves in open space is difficult. In this paper, a low-frequency acoustic generator with a resonant cavity used to enhance the acoustic intensity in open space was developed, which is an aerodynamic acoustic generator to radiates a high-intensity acoustic wave of 52Hz. Some experiments were carried out to measure this generator\'s internal flow field and radiated acoustic field characteristics, including the propagation characteristics at 100m. The experimental results show that the resonant enhancement effect is presented near the predetermined resonance frequency, and the enhanced value is about 4dB. The acoustic intensity for 52Hz at 1m position is 124dB. By combining the Helmholtz resonator with the airflow modulator, the airflow resonance in the resonator enhances the air pressure pulsation inside the chamber and increases the disturbance of acoustic radiation to the air. So as to improve the sound intensity and radiation efficiency in the low-frequency range.
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