Biomedical subjects

E Ingenito

Publications and source records attributed to E Ingenito.

5 recordsLinked to original sources

PubMed1992

Development and testing of a PC-based system with menu-driven software for evaluating lung function in ICU patients.

This paper describes a portable PC-based system for measuring respiratory system resistance (Rrs) and dynamic lung compliance (Cdyn) in intubated and mechanically ventilated patients. A pneumotachometer placed immediately proximal to the endotracheal tube measures flow, and a pressure catheter with its tip at the distal end of the endotracheal tube measures lateral airway pressure. The software is menu driven and allows the user to select from options including patient information display and entry, data collection, data editing, and waveform display. Up to ten consecutive breaths can be analyzed per run. Rrs and Cdyn are calculated on a breath by breath basis. Results are displayed to the screen, output to the system printer, and written to a user-specified ACSII data file. The system was tested by measuring resistance and compliance in a model of the lung, and results compared with those calculated from analog signals. It was then used to make measurements in intubated post-operative patients. Results were comparable to those previously reported in intubated ICU patients without primary lung disease. We conclude that our system provides reliable measurements of lung mechanics in the intubated patient, and represents an inexpensive and more versatile alternative to microprocessor-based ventilator systems currently being marketed.

Intensive Care Units↗

PubMed1988

A model of constant-flow ventilation in a dog lung.

A semiempirical model of constant-flow ventilation (CFV) is developed to test the hypothesis that a three-zone serial model with the following characteristics can explain the adequate CO2 transport observed during CFV: 1) a zone of jet recirculation immediately downstream of the catheter in which convection dominates; 2) a zone influenced by turbulence but with little or no bulk flow; and 3) a peripheral zone, free of turbulence, in which transport is governed by molecular and augmented diffusion. Interactions between turbulent eddies and cardiogenic oscillations are included using a modification of Taylor dispersion theory according to the formulation of Kamm et al. Predicted values for arterial PCO2 are reasonably similar to experimental results for He-O2, air, and SF6-O2 mixtures for catheter flow rates from 0.2 to 1.6 l/s. Specific impedance to gas exchange was found to be largest immediately proximal to the end of turbulent mixing zone, where transport is governed by low-level eddy mixing and molecular diffusion. Simulations suggest that, during CFV, cardiogenic oscillations augment gas exchange primarily by promoting turbulent eddy dispersion in the distal airways and by extending the length of the turbulent mixing zone. Even small displacements of the catheter are shown to have a dramatic effect on gas exchange.

Animals↗

PubMed1988

Dissociation of temperature-gradient and evaporative heat loss during cold gas hyperventilation in cold-induced asthma.

We examined temperature-gradient and evaporative energy losses during cold gas inhalation challenges in patients with exercise-induced asthma by using gases with similar water-carrying capacities but significantly different volume heat capacities. Seven subjects were asked to hyperventilate mixtures of 80% helium/20% oxygen (HeO2) or 80% sulfur hexafluoride/20% oxygen (SF6O2) for 5 min at a fixed target minute ventilation of 20 x FEV1 and an inspired gas temperature of 0 degrees C. Each subject equilibrated his or her lungs with the appropriate gas mixture prior to testing: PETCO2 and FIO2 were monitored and maintained at constant values (CO2 = 0.05; O2 = 0.20) by CO2 scrubbing and addition of compressed gas to the system. Gas composition, inspired and expired flow rates, and gas temperatures at the airway opening were recorded in real time using a computer-based data collection system that calculated respiratory heat loss on a per breath basis. Bronchoconstriction was quantitated using specific airway conductance measured before and serially after each challenge. The degree of bronchoconstriction correlated closely with evaporative respiratory heat loss (r = 0.658 p less than 0.05), but poorly with both temperature-gradient (r = 0.114, p greater than 0.20) and total (r = 0.268, p greater than 0.15) heat loss. These findings suggest that total respiratory heat loss is not the primary stimulus in exercise-induced asthma, and further suggest that total water loss, or focal heat/water loss, may be important in inducing bronchospasm in this subset of asthmatics.

Adult↗

PubMed1987

Gas exchange during constant flow ventilation with different gases.

To investigate the mechanisms of CO2 transport during constant flow ventilation, we measured arterial blood gases using air, 80% He-20% O2 (He) or 80% SF6-20% O2 (SF6) as the insufflating gas. At any given flow rate (0.2 to 1.0 L/s), PaCO2 was greatest with He and lowest with SF6. Data for all gases could be described by the equation PaCO2/Pb = 0.044 V-0.64 v0.23, where Pb = barometric pressure, PaCO2 is in mm Hg, V = insufflated flow in L/s, and v = kinematic viscosity (cm2/s). At any given flow rate, the AaPO2 was greater using SF6 than using He. These results are consistent with a 2-zone model of gas transport in which the enhancement of gas transport as V increases may be due to an increase in the turbulent diffusivity in zone I (the region affected by the jet). The decreased gas transport with He compared to air and SF6 at any V may be due to either the decreased penetration depth of zone I caused by the greater kinematic viscosity of He, or the decreased rate of gas transport in the region affected by cardiogenic oscillations (zone II) secondary to the higher molecular diffusivity of He.

Animals↗

PubMed1985

Thermal mapping of the airways in humans.

To characterize the intrathoracic thermal events that occur during breathing in humans, we developed a flexible probe (OD 1.4 mm) containing multiple thermistors evenly spaced over 30.2 cm, that could be inserted into the tracheobronchial tree with a fiberoptic bronchoscope. With this device we simultaneously recorded the airstream temperature at six points from the trachea to beyond the subsegmental bronchi in six normal subjects while they breathed ambient and frigid air at multiple levels of ventilation (VE). During quiet breathing of room air the average temperature ranged from 32.0 +/- 0.05 degrees C in the upper trachea to 35.5 +/- 0.3 degrees C in the subsegmental bronchi. As ventilation was increased, the temperature along the airways progressively decreased, and at a VE of 100+ 1/min the temperature at the above two sites fell to 29.2 +/- 0.5 and 33.9 +/- 0.8 degrees C, respectively. Interval points were intermediate between these extremes. With cold air, the changes were considerably more profound. During quiet breathing, local temperatures approximated those recorded in the maximum VE room-air trial, and at maximum VE, the temperatures in the proximal and distal airways were 20.5 +/- 0.6 and 31.6 +/- 1.2 degrees C, respectively. During expiration, the temperature along the airways progressively decreased as the air flowed from the periphery of the lung to the mouth: the more the cooling during inspiration, the lower the temperature during expiration. These data demonstrate that in the course of conditioning inspired air the intrathoracic and intrapulmonic airways undergo profound thermal changes that extend well into the periphery of the lung.

Adult↗