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Markos Moukas

Publications and source records attributed to Markos Moukas.

3 recordsLinked to original sources

Immediate post-operative effects of tracheotomy on respiratory function during mechanical ventilation.

INTRODUCTION: Tracheotomy is widely performed in the intensive care unit after long-term oral intubation. The present study investigates the immediate influence of tracheotomy on respiratory mechanics and blood gases during mechanical ventilation. METHODS: Tracheotomy was performed in 32 orally intubated patients for 10.5 +/- 4.66 days (all results are means +/- standard deviations). Airway pressure, flow and arterial blood gases were recorded immediately before tracheotomy and half an hour afterwards. Respiratory system elastance (Ers), resistance (Rrs) and end-expiratory pressure (EEP) were evaluated by multiple linear regression. Respiratory system reactance (Xrs), impedance (Zrs) and phase angle (phirs) were calculated from Ers and Rrs. Comparisons of the mechanical parameters, blood gases and pH were performed with the aid of the Wilcoxon signed-rank test (P = 0.05). RESULTS: Ers increased (7 +/- 11.3%, P = 0.001), whereas Rrs (-16 +/- 18.4%, P = 0.0003), Xrs (-6 +/- 11.6%, P = 0.006) and phi rs (-14.3 +/- 16.8%, P = <0.001) decreased immediately after tracheotomy. EEP, Zrs, blood gases and pH did not change significantly. CONCLUSION: Lower Rrs but also higher Ers were noted immediately after tracheotomy. The net effect is a non-significant change in the overall Rrs (impedance) and the effectiveness of respiratory function. The extra dose of anaesthetics (beyond that used for sedation at the beginning of the procedure) or a higher FiO2 (fraction of inspired oxygen) during tracheotomy or aspiration could be related to the immediate elastance increase.

Adult↗

Early phase changes by concurrent endurance and strength training.

To compare regimens of concurrent strength and endurance training, 26 male basketball players were matched for stature, body composition, and physical activity level. Subjects completed different training programs for 7 weeks, 4 days per week. Groups were as follows: (a) the strength group (S; n = 7) did strength training; (b) the endurance group (E; n = 7) did endurance training; (c) the strength and endurance group (S + E; n = 7) combined strength and endurance training; and (d) the control group (C; n = 5) had no training. The S + E group showed greater gains in Vo(2)max than the E group did (12.9% vs. 6.8%), whereas the S group showed a decline (8.8%). Gains were noted in strength and vertical jump performance for the S + E and S groups. The S + E group had better posttraining anaerobic power than the S group did (6.2% vs. 2.9%). No strength, power, or anaerobic power gains were present for the E and C groups. We conclude that concurrent endurance and strength training is more effective in terms of improving athletic performance than are endurance and strength training apart.

Adult↗

Muscular mass assessed by ultrasonography after administration of low-dose corticosteroids and muscle relaxants in critically ill hemiplegic patients.

BACKGROUND AIMS: The present study investigates the influence of low-dose and short- term administration of corticosteroids and muscle relaxants on the muscular mass (MM) in hemiplegic ICU patients, with the aid of ultrasonography (U/S). METHODS: Thirty-seven patients hospitalised in the ICU for 18.6+/-3.6 days, were included in the study. Sixteen patients did not receive either drug (group A), five patients received dexamethasone (24 mg/day) for 4 days (group B), eight patients received dexamethasone (24 mg/day) for 4 days and atracurium (0.3-0.6 mg/kg/h) for 2.8+/-0.4 days (group C), whereas eight other non-hemiplegic ICU patients comprised the control group. MM was measured in cm by U/S and serum Albumin (ALB, g/l) at the first and the tenth ICU hospitalisation day. The corresponding differences (DeltaMM, DeltaALB) were compared between the four groups of patients. RESULTS: MM and ALB decreased significantly in all groups. DeltaMM was significantly higher in group C in comparison to all other groups, while DeltaMM was also higher in group B, when compared to the control and A groups. DeltaALB did not show significant inter-group differences. DeltaMM was significantly related to patients' age (r=0.41,P =0.001). CONCLUSIONS: Muscular atrophy of the ICU hemiplegic patients is significantly influenced by the synchronous treatment with muscle relaxants and corticosteroids at low doses and for short term. This myopathy should be taken into account for the better prognosis and the safer outcome of the patient and U/S is suitable for accurate and non-invasive monitoring of MM.

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