Pulmonary Ventilation Research Articles

Physiological demands in simulated tennis matches and hitting tests take account of the translational and rotational kinetic energy ratio of the ball.

Assessment of fatigue effect on hitting ability in tennis has been controversial in previous studies. The purpose of this study was to determine the relationship between player fatigue and groundstroke type in tennis. We hypothesized that subjects with higher blood lactate concentration during play would apply heavier spin to the ball. We divided players into two groups based on their blood lactate concentration during a pre-measured hitting test (HIGH and LOW). Each group performed a simulated match-play protocol consisting of repeated running and hitting tests, which simulated a three-set match. Heart rate, percent of heart rate reserve, oxygen uptake, pulmonary ventilation, and respiratory exchange were measured. The distance between the ball's landing point and the target, and the ball's kinematics, were recorded during the hitting test between sets. We found no significant difference in ball kinetic energy between groups, but the HIGH group hit the ball with a greater ratio of rotational kinetic energy to total kinetic energy. However, the progression of the simulation protocol did not affect physiological responses (including blood lactate concentration) or hitting ability. Therefore, it is suggested that the type of groundstrokes used by players is one of the factors that should be considered when discussing fatigue in tennis.

The inspiratory activity of respiratory center and respiratory muscles strength after COVID-19

The respiratory pump that provides pulmonary ventilation includes the respiratory center, peripheral nervous system, chest and respiratory muscles.The aim of this study was to evaluate the activity of the respiratory center and the respiratory muscles strength after COVID-19 (COronaVIrus Disease 2019).Methods. The observational retrospective cross-sectional study included 74 post-COVID-19 patients (56 (76%) men, median age – 48 years). Spirometry, body plethysmography, measurement of lung diffusing capacity (DLCO), maximal inspiratory and expiratory pressures (MIP and MEP), and airway occlusion pressure after 0.1 sec (P0.1) were performed. In addition, dyspnea was assessed in 31 patients using the mMRC scale and muscle strength was assessed in 27 of those patients using MRC Weakness scale.Results. The median time from the COVID-19 onset to pulmonary function tests (PFTs) was 120 days. The total sample was divided into 2 subgroups: 1 – P0.1 ≤ 0.15 kPa (norm), 2 – > 0.15 kPa. The lung volumes, airway resistance, MIP, and MEP were within normal values in most patients, whereas DLCO was reduced in 59% of cases in both the total sample and the subgroups. Mild dyspnea and a slight decrease in muscle strength were also detected. Statistically significant differences between the subgroups were found in the lung volumes (lower) and airway resistance (higher) in subgroup 2. Correlation analysis revealed moderate negative correlations between P0.1 and ventilation parameters.Conclusion. Measurement of P0.1 is a simple and non-invasive method for assessing pulmonary function. In our study, an increase in P0.1 was detected in 45% of post-COVID-19 cases, possibly due to impaired pulmonary mechanics despite the preserved pulmonary ventilation as well as normal MIP and MEP values.

Crosstalk between Inflammation and Hemorrhage/Coagulation Disorders in Primary Blast Lung Injury.

Primary blast lung injury (PBLI), caused by exposure to high-intensity pressure waves from explosions in war, terrorist attacks, industrial production, and life explosions, is associated with pulmonary parenchymal tissue injury and severe ventilation insufficiency. PBLI patients, characterized by diffused intra-alveolar destruction, including hemorrhage and inflammation, might deteriorate into acute respiratory distress syndrome (ARDS) with high mortality. However, due to the absence of guidelines about PBLI, emergency doctors and rescue teams treating PBLI patients rely on experience. The goal of this review is to summarize the mechanisms of PBLI and their cross-linkages, exploring potential diagnostic and therapeutic targets of PBLI. We summarize the pathophysiological performance and pharmacotherapy principles of PBLI. In particular, we emphasize the crosstalk between hemorrhage and inflammation, as well as coagulation, and we propose early control of hemorrhage as the main treatment of PBLI. We also summarize several available therapy methods, including some novel internal hemostatic nanoparticles to prevent the vicious circle of inflammation and coagulation disorders. We hope that this review can provide information about the mechanisms, diagnosis, and treatment of PBLI for all interested investigators.

Effect of Short-Term Treatment with Continuous Positive Airway Pressure on Cardiopulmonary Exercise Tolerance, Pulmonary and Cardiac Function in Patients with Obstructive Sleep Apnea.

Background: Obstructive sleep apnea (OSA) is a condition with a high prevalence, linked to an increased risk of cardiovascular disease as well as increased morbidity and death. CPAP is currently considered the "gold standard" treatment for OSA, but more thorough research and testing are required to assess its efficacy on cardiopulmonary function. Objectives: To evaluate pulmonary function of OSA patients, cardiopulmonary exercise tolerance test (CPET) performance, cardiac magnetic resonance imaging (MRI) parameters, and polysomnographic changes before and after 3 months of CPAP therapy. Materials and methods: A total of 34 patients diagnosed with moderate or severe OSA, as well as 17 patients as a control group for the evaluation of the cardiac MRI, were included in this study. All the subjects were obese (body mass index (BMI) > 30 kg/m2). Lung function tests, CPETs, cardiac MRIs, and polysomnography were performed at the time of the study's enrolment before the initiation of the CPAP therapy and after 3 months of the CPAP treatment. Results: The patients' VO2max during the CPAP treatment tended to increase, but no statistical significance was found (before treatment it was 17.52 ± 3.79 mL/kg/min and after 3 months of treatment, it was 18.6 ± 3,4 mL/kg/min; p = 0.255). The CPAP treatment had positive effects on pulmonary ventilation at the anaerobic threshold (VEAT): 44.51 L/min (43.21%) during the baseline visit and 38.60 L/min (37.86%) after the 3-month treatment period (p = 0.028). The ventilator equivalent for the carbon dioxide slope (VE/VCO2) at peak exercise decreased from 23.47 to 20.63 (p = 0.042). The patients' pulmonary function tests were without abnormalities and did not change after treatment. When assessing cardiac the MRIs, the RV ejection fraction was lower in the OSA group compared to that of the control subjects (53.69 ± 8.91 and 61.35 ± 9.08, p = 0.016). Both LA and RA global longitudinal strains (GLS) improved after 3 months of treatment with CPAP (20.45 ± 7.25 and 26.05 ± 14.00, p = 0.043; 21.04 ± 7.14 and 26.18 ± 7.17, p = 0.049, respectively). Additionally, it was found that CPAP therapy led to statistical improvements in RV end-diastolic volume (164.82 ± 32.57 and 180.16 ± 39.09, p = 0.042). The AHI and oxygen desaturation index (ODI) significantly changed after 3 months of the initiation of the CPAP treatment (p = 0.049 and p = 0.001, respectively). The REM sleep duration decreased, while the duration of non-REM sleep increased after treatment initiation with CPAP (p = 0.016 and p = 0.017, respectively). Conclusions: Short-term CPAP treatment improves pulmonary ventilation, sleep efficiency, and sleep architecture. Significant alterations in both atrias' GLS and RV end-diastolic volume were observed after 3 months of treatment. Longer-term follow-up and a larger patient sample are needed to confirm the reproducibility of our results.

Maximal pulmonary ventilation and lactate affect the anaerobic performance in young women exposed to hypobaric hypoxia.

Background: Athletes, tourists, and mining workers from all over the world ascend daily to an altitude greater than 3.000meters above sea level to perform different activities, all of which demand physical effort. A ventilation increase is the first mechanism once the chemoreceptors perceive hypoxia, and is key to maintaining blood oxygen levels during acute exposure to high altitudes and to buffering lactic acidosis during exercise. It has been observed that gender is a variable that can influence the ventilatory response. Still, the available literature is limited due to the few studies considering women as study subjects. The influence of gender on anaerobic performance and its effects under high altitudes (HA) environments have been poorly studied. Objective: The objectives of this study were to evaluate anaerobic performance in young women exposed to high altitudes and to compare the physiological response to multiple sprints between women and men measured by ergospirometry. Methodology: Nine women and nine men (22.9 ± 3.2 years old) carried out the multiple-sprint anaerobic tests under two conditions, sea level and high altitudes. Results: In the first 24h of exposure to a high altitudes, lactate levels were higher in women than those in men (2.57 ± 0.4Mmol/L, 2.18 ± 0.3Mmol/L, respectively; p < 0.05). Second, women had a decreased ventilatory response in exposure to high altitudes compared to men (p > 0.005). Third, there is a positive correlation between lactate levels prior to an anaerobic test and the ventilatory response developed by subjects at high altitudes (R2 = 0.33, slope = -41.7, and p < 0.05). Lastly, this ventilatory response can influence VO2peak (R2 = 0.60, slope = 0.02, and p < 0.001). Conclusion: This study provides insights into the mechanisms behind the reduced respiratory capacity observed in women during an anaerobic exercise test at high altitudes. An acute response to HA showed a greater work of breathing and increased the drive ventilatory response. It is possible to postulate the differences in the fatigue-induced metaboreflex of the respiratory muscles and aerobic-anaerobic transition between genders. These results on multiple sprint performance and the influences of gender in hypoxic environments deserve further investigation.

Assessment of lung ventilation of premature infants with bronchopulmonary dysplasia at 1.5 Tesla using phase-resolved functional lung magnetic resonance imaging.

The most common chronic complication of preterm birth is bronchopulmonary dysplasia (BPD), widely referred to as chronic lung disease of prematurity. All current definitions rely on characterizing the disease based on respiratory support level and do not provide full understanding of the underlying cardiopulmonary pathophysiology. To evaluate a rapid functional lung imaging technique in premature infants and to quantitate pulmonary ventilation using 1.5 Tesla magnetic resonance imaging (MRI). We conducted a prospective MRI study of 12 premature infants in the neonatal intensive care unit (NICU) using the phase resolved functional lung MRI technique to calculate pulmonary ventilation parameters in preterm infants with and without BPD grade 0/1 (n = 6) and grade 2/3 (n = 6). The total ventilation defect percentage showed a significant difference between groups (16.0% IQR (11.0%,18%) BPD grade 2/3 vs. 8.0% IQR (4.5%,9.0%) BPD grade 0/1, p = 0.01). Phase-resolved functional lung MRI is feasible for assessment of ventilation defect percentages in preterm infants and shows regional variation in localized lung function in this population.

Predicting alveolar ventilation heterogeneity in pulmonary fibrosis using a non-uniform polyhedral spring network model.

Pulmonary Fibrosis (PF) is a deadly disease that has limited treatment options and is caused by excessive deposition and cross-linking of collagen leading to stiffening of the lung parenchyma. The link between lung structure and function in PF remains poorly understood, although its spatially heterogeneous nature has important implications for alveolar ventilation. Computational models of lung parenchyma utilize uniform arrays of space-filling shapes to represent individual alveoli, but have inherent anisotropy, whereas actual lung tissue is isotropic on average. We developed a novel Voronoi-based 3D spring network model of the lung parenchyma, the Amorphous Network, that exhibits more 2D and 3D similarity to lung geometry than regular polyhedral networks. In contrast to regular networks that show anisotropic force transmission, the structural randomness in the Amorphous Network dissipates this anisotropy with important implications for mechanotransduction. We then added agents to the network that were allowed to carry out a random walk to mimic the migratory behavior of fibroblasts. To model progressive fibrosis, agents were moved around the network and increased the stiffness of springs along their path. Agents migrated at various path lengths until a certain percentage of the network was stiffened. Alveolar ventilation heterogeneity increased with both percent of the network stiffened, and walk length of the agents, until the percolation threshold was reached. The bulk modulus of the network also increased with both percent of network stiffened and path length. This model thus represents a step forward in the creation of physiologically accurate computational models of lung tissue disease.

Penerapan Intervensi Pursed-Lips Breathing Meningkatkan Arus Puncak Ekspirasi pada Pasien Penyakit Paru Obstruksi Kronik

This study aims to determine the magnitude of the effect of pursed-lip breathing (PLB) exercises on increasing the highest flow achieved by maximal expiration peak expiratory flow (APE) in COPD patients at Jakarta Islamic Hospital Cempaka Putih based on the latest research results (evidence-based Nursing Practice). This study uses a quantitative method with a type of quantitative experimental research with a quasi-experimental approach. The results showed that the results of APE measurements before and after PLB breathing exercises to male COPD sufferers at the Jakarta Islamic Hospital showed that, in general, the effects of APE before and after PLB breathing exercises on Day-1 were 278.3 liters or minutes and general after PLB Day-1 breathing exercise was 290.0 greater. From the results of the T-Test experiment, it can be interpreted that there is a significant comparison between APE before and after PLB with the number P = 0.000 or statistically in general APE before and after PLB is smaller than in general in male respondents by (290.0– 278.3 =11.7). In conclusion, age is related to the increased value of pulmonary ventilation function in COPD patients. Age may explain the increased peak expiratory pulmonary flow in COPD patients. Thus there is a significant relationship between age and an increase in the height expiratory flow (APE) value of COPD patients after receiving pursed-lips breathing intervention.&#x0D; &#x0D; Keywords: Peak Expiratory Flow, Chronic Obstructive Pulmonary Disease, Pursed-Lip Breathing&#x0D;

Effects of different simulated submarine escape depths by free ascent in animal models.

Objective: If a damaged submarine cannot be rescued in time, it is necessary to carry out a submarine escape by free ascent. Decompression illness is the greatest threat to the safety of submariners. The maximum depth at which a safe escape can be carried out is unknown. This study intends to explore the maximum safe escape depth by observing the effects of simulated submarine escape at different depths on animal models. Methods: We evaluated pulmonary function indexes, blood gas values, blood cell counts, the myocardial enzyme spectrum, coagulation parameters, and proinflammatory cytokine levels in rats, electrocardiographic activity in rabbits after simulated 150-m, 200-m, 220-m, and 250-m submarine escape by free ascent. Results: An escape depth of 150m did not cause significant changes in the indicators. An escape depth of >200m led to pulmonary ventilation and gas diffusion dysfunction, hypoxemia, myocardial ischemia, and activation of the fibrinolytic and inflammatory systems. The magnitudes of the changes in the indicators were proportional to escape depth. Conclusion: An escape depth of 150m in animal models is safe, whereas escape at > 200m can be harmful.

Kidney dysfunction and in-hospital complications in patients with acute cardiovascular pathology infected with COVID-19

This study aimed to assess kidney function and its significance for the development of in-hospital complications in patients hospitalized with acute cardiovascular pathology infected with COVID-19.&#x0D; Methods. This prospective cohort single-center study included 139 patients with acute cardiovascular pathology diagnosed with COVID-19. Sixty-nine (49.6%) patients had acute coronary syndrome (47 with acute myocardial infarction (AMI), 33 (23.7%) patients had hypertension, 24 (17.3%) patients had acute decompensated heart failure, 9 (6.5%) patients had tachysystolic paroxysms of atrial fibrillation, 2 (1.4%) patients had an acute pulmonary embolism, and 2 (1.4%) patients had syncope. The mean age was 67.9±12.7 years, and 70 (50.4%) patients were male. Arterial hypertension was present in 87.1% of patients, diabetes mellitus in 20.9%, congestive heart failure in 30.9%, chronic obstructive pulmonary disease in 9.4%, AMI in 20.1%, and ischemic stroke in 9.4%.&#x0D; Results. The initial creatinine level was 110.7±66.1 μmol/l and eGFR (CKD-EPI) was 63.3±20.3 ml/min/1.73m2 (eGFR&lt;60 ml/min/1.73m2 was diagnosed in 46.0% of the patients). The patients with eGFR&lt;60 ml/min/1.73m2 were older, more often female, frequently had a history of atrial fibrillation, had lower hemoglobin and blood pressure on admission, a greater number of complications (need for noninvasive ventilation, inotropic therapy), and higher in-hospital mortality (25.0% vs. 5.3 %, p=0.002). Acute kidney injury, which was evaluated according to KDIGO criteria (increase in creatinine level ≥ 26.5 μmol/l within 48 hours or ≥ 1.5 times within 7 days) was observed in 21 (15.4%) patients (12.0% in patients with eGFR≥60 ml/min/1.73m2 and 18.8% with eGFR&lt;60 ml/min/1.73m2, p&lt;0.05).&#x0D; These patients did not differ significantly in basic clinical and anamnestic data from patients without AKI but had lower spO2 on admission (86.9±11.2% vs. 93.4±5.0%, p=0.016). Patients with AKI had a significantly higher number of in-hospital complications: acute hypoxic delirium (47.6% vs. 8.7%, p=0.003), venous thromboembolism (14.3% vs. 0.9%, p=0.070), death from all causes (47.6% vs. 7.0%, p=0.002) and more often required organ supportive therapy: non-invasive/invasive pulmonary ventilation (52.4% vs. 11.3%, p&lt;0.001), inotropic therapy (57.1% versus 5.2%, p&lt;0.001). Using the simplified criterion of AKI, the category of patients at high risk for hospital complications and death could also be distinguished (37.9% vs. 8.2%, p=0.004). Vaccination against COVID-19 (at least 2 weeks before hospitalization prevented the development of AKI (16.5% vs. 5.0%, p=0.046) and tended to prevent in-hospital mortality (15.7% vs. 5.0%, p=0.076).&#x0D; Conclusions. Renal dysfunction in patients with acute cardiovascular pathology infected with COVID-19 is associated with in-hospital complications and can be prevented by prophylactic vaccination.

Pulmonary ventilation and gas exchange during prolonged exercise in humans: Influence of dehydration, hyperthermia and sympathoadrenal activity.

What is the central question of the study? Ventilation increases during prolonged intense exercise, but the impact of dehydration and hyperthermia, with associated blunting of pulmonary circulation, and independent influences of dehydration, hyperthermia and sympathoadrenal discharge on ventilatory and pulmonary gas exchange responses remain unclear. What is the main finding and its importance? Dehydration and hyperthermia led to hyperventilation and compensatory adjustments in pulmonary CO2 and O2 exchange, such that CO2 output increased and O2 uptake remained unchanged despite the blunted circulation. Isolated hyperthermia and adrenaline infusion, but not isolated dehydration, increased ventilation to levels similar to combined dehydration and hyperthermia. Hyperthermia is the main stimulus increasing ventilation during prolonged intense exercise, partly via sympathoadrenal activation. The mechanisms driving hyperthermic hyperventilation during exercise are unclear. In a series of retrospective analyses, we evaluated the impact of combined versus isolated dehydration and hyperthermia and the effects of sympathoadrenal discharge on ventilation and pulmonary gas exchange during prolonged intense exercise. In the first study, endurance-trained males performed two submaximal cycling exercise trials in the heat. On day 1, participants cycled until volitional exhaustion (135± 11min) while experiencing progressive dehydration and hyperthermia. On day 2, participants maintained euhydration andcore temperature (Tc ) during a time-matched exercise (control). At rest and during the first 20min of exercise, pulmonary ventilation ( ), arterial blood gases, CO2 output and O2 uptake were similar in both trials. At 135±11min, however, was elevated with dehydration and hyperthermia, and this was accompanied by lower arterial partial pressure of CO2 , higher breathing frequency, arterial partial pressure of O2 , arteriovenous CO2 and O2 differences, and elevated CO2 output and unchanged O2 uptake despite a reduced pulmonary circulation. The increased was closely related to the rise in Tc and circulating catecholamines (R2 ≥0.818, P≤0.034). In three additional studies in different participants, hyperthermia independently increased to an extent similar to combined dehydration and hyperthermia, whereas prevention of hyperthermia in dehydrated individuals restored to control levels. Furthermore, adrenaline infusion during exercise elevated both Tc and . These findings indicate that: (1) adjustments in pulmonary gas exchange limit homeostatic disturbances in the face of a blunted pulmonary circulation; (2) hyperthermia is the main stimulus increasing ventilation during prolonged intense exercise; and (3) sympathoadrenal activation might partly mediate the hyperthermic hyperventilation.

The influence of mouth opening on pharyngeal pressure loss and its underlying mechanism: A computational fluid dynamic analysis.

Objective: During inspiration, mechanical energy generated from respiratory muscle produces a negative pressure gradient to fulfill enough pulmonary ventilation. The pressure loss, a surrogate for energy loss, is considered as the portion of negative pressure without converting into the kinetic energy of airflow. Mouth opening (MO) during sleep is a common symptom in patients with obstructive sleep apnoea-hypopnea syndrome (OSAHS). This study aimed to evaluate the effects of mouth opening on pharyngeal pressure loss using computational fluid dynamics (CFD) simulation. Methods: A total of four subjects who were morphologically distinct in the pharyngeal characteristics based on Friedman tongue position (FTP) grades were selected. Upper airway computed tomography (CT) scan was performed under two conditions: Mouth closing (MC) and mouth opening, in order to reconstruct the upper airway models. computational fluid dynamics was used to simulate the flow on the two different occasions: Mouth closing and mouth opening. Results: The pharyngeal jet was the typical aerodynamic feature and its formation and development were different from mouth closing to mouth opening in subjects with different Friedman tongue position grades. For FTP I with mouth closing, a pharyngeal jet gradually formed with proximity to the velopharyngeal minimum area plane (planeAmin). Downstream the planeAmin, the jet impingement on the pharyngeal wall resulted in the frictional loss associated with wall shear stress (WSS). A rapid luminal expansion led to flow separation and large recirculation region, corresponding to the interior flow loss. They all contributed to the pharyngeal total pressure loss. While for FTP I with mouth opening, the improved velopharyngeal constriction led to smoother flow and a lower total pressure loss. For FTP IV, the narrower the planeAmin after mouth opening, the stronger the jet formation and its impingement on the pharyngeal wall, predicting a higher frictional loss resulted from higher WSS. Besides, a longer length of the mouth opening-associated constant constrictive segment was another important morphological factor promoting frictional loss. Conclusion: For certain OSAHS patients with higher Friedman tongue position grade, mouth opening-related stronger jet formation, more jet breakdown and stronger jet flow separation might contribute to the increased pharyngeal pressure loss. It might require compensation from more inspiratory negative static pressure that would potentially increase the severity of OSAHS.

Possibilities of physical therapy and electrophysical modalities in the complex therapy of pneumonia

Pneumonia is one of the most common infectious diseases and the leading infectious cause of death worldwide. High rates of morbidity, frequency of complications, mortality, the emergence of new highly virulent strains of pneumonia pathogens, antibiotic resistance determine the global medical and social problem of community-acquired pneumonia. The economic consequences of pneumonia are represented not only by direct medical costs (the cost of maintaining a patient in a medical institution, the cost of medical services, the cost of medicines, laboratory and instrumental studies, other medical procedures, etc.), but also include non-material costs from pneumonia, which include pain, psycho-emotional experiences of the patient due to a decrease in the quality of life during the illness. One of the directions of increasing the effectiveness of pneumonia therapy is the widespread introduction of physical therapy (PT) and electrophysical modalities (EM) into complex treatment, which are an important part of the medical rehabilitation for pneumonia, aimed at the speedy restoration of the health and working capacity of patients. The effectiveness of EM in the treatment of pneumonia is due to the versatile therapeutic effect of physical factors that have anti-inflammatory, desensitizing, bacteriostatic, broncholytic, mucolytic, immunostimulant effects, improve blood supply to the lungs. PT contributes to the normalization of pulmonary ventilation, has an expectorant effect, strengthens the respiratory muscles, accelerates the resorption of the inflammatory focus, prevents the formation of pleural adhesions, activates blood and lymph circulation. PT and EM are relevant in the comprehensive treatment of community-acquired pneumonia since they accelerate the regression of clinical symptoms, decrease the drug load, reduce the duration of inpatient treatment, that is confirmed by the results of clinical studies. We assume that the inclusion of PT and EM in the comprehensive treatment of pneumonia can lead to minimizing the total cost of the disease while reducing the duration and volume of drug treatment.

Effect of visual endotracheal tube combined with bronchial occluder on pulmonary ventilation and arterial blood gas in patients undergoing thoracic surgery.

To investigate the effect of visual endotracheal tube combined with bronchial occluder on pulmonary ventilation and arterial blood gas in patients undergoing thoracic surgery. Ninety patients who underwent thoracic surgery under anesthesia and required pulmonary ventilation at our hospital from May 2020 to December 2021 were collected. The patients were divided into three groups according to different intubation methods: visual double-lumen endotracheal tube group (VDLT group), bronchial occluder group (BO group), and VDLT + BO group. Clinical data and laboratory test data were collected from the three groups. Additionally, the three groups were compared in terms of peak airway pressure, time to correct positioning, pulmonary ventilation time, hemodynamics before and after intubation, intubation success rate, and postoperative recovery. The VDLT + BO group was superior to the BO group or VDLT group in airway peak pressure, time to correct positioning, pulmonary ventilation time, intubation success rate, and hemodynamics after intubation (P < 0.05). In the comparison of postoperative recovery, the postoperative pain score, white blood cell level, incidence rate of pneumonia, hospital stay and hospitalization costs in the VDLT + BO group were significantly lower than those in the BO group or VDLT group (P < 0.05). The visual endotracheal tube combined with bronchial occluder is effective in pulmonary ventilation during thoracic surgery under anesthesia, and can improve arterial blood gas in patients.

INFLUÊNCIAS DA GINÁSTICA NA COMPOSIÇÃO CORPORAL E NA FUNÇÃO CARDIOPULMONAR DE ATLETAS

ABSTRACT Introduction: Aerobics is a recreational, ornamental, rhythmic, and expressive sport. It is widely used in physical education in colleges and universities because it is also believed that this sport benefits the cardiopulmonary function and the body composition of the practitioners. Objective: Study the influences of aerobic gymnastics on body composition and cardiopulmonary function in its practitioners. Methods: 40 college students volunteered for the research sample. The living conditions and learning level of the subjects were the same. The students were divided into two groups for research. There was no significant difference between the groups comparing the volunteers’ age, height, and weight. The high-load group performed exercises with a maximum heart rate of 220, while the low-load group performed the same protocol under a maximum heart rate of 195 beats per minute. The intervention took place over 40 and 60 minutes of exercise, respectively, for eight weeks. The POLAR monitor was used to check the kinematic performance of the athletes. The data were processed statistically. Results: Aerobic gymnastics influenced the body composition of college students with significant differences in bust circumference, waist, hip, thigh, and skinfold thickness (P&lt;0.05). The athletes' heart rate, pulmonary ventilation, and diastolic pressure increased significantly after aerobic gymnastics. The study showed that the resting heart rate of the volunteers decreased significantly after exercise, and their lung function returned to normal (P&lt;0.05). Conclusion: Aerobic exercise can improve the body composition, physiology, and cardiopulmonary function of its practitioners, and its greater encouragement in colleges and universities is recommended. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Fibrinolytic therapy in patients with COVID-19 and ARDS: protocol for a systematic review and meta-analysis

IntroductionIn COVID-19-related acute respiratory distress syndrome (ARDS), the clot play a role in gas exchange abnormalities. Fibrinolytic therapy can improve alveolar ventilation by restoring blood flow. In this systematic review...

OSTEOPOROSIS IN PATIENTS WITH COPD AND IMPACT ON QUALITY OF LIFE

Chronic obstructive pulmonary disease (COPD) is a progressive disease parenchyma destruction. Smoking is a major risk factor for this disease with frequent comorbidities. Osteoporosis is a common comorbidity in patients with COPD. Osteoporosis is characterized by lower bone density and changes in bone microarchitecture, leading to increased sensitivity and bone fractures occur. Fractures cause pain, further worsen already damaged pulmonary ventilation, reduced mobility and disability, and increased risk of thromboembolic disease, and even death. Osteoporosis in patients with COPD is probably evolving as the basis for both diseases there is systemic inflammation, but also because of the influence of inhaled tobacco smoke, reduced mobility of patients, vitamin D deficiency, lower body weight and older age. The use of systemic corticosteroids in the treatment of exacerbations of COPD increases the risk of developing osteoporosis. In addition, exacerbation of the intensification of inflammation, hypoxia and oxidative stress, as well as the imbalance between protease and anti-protease may contribute to increased bone resorption in patients with COPD. Osteoporosis can lead to kyphosis, which limits physical activity, leads to dyspnea, exacerbations and inadequate ventilation, which leads to a decrease in pulmonary function parameters. Osteoporosis can cause fractures that further limit movement, increasing the risk of thromboembolism and death. All of that have large impact on the quality of life COPD patients. Early prevention, timely diagnosis and treatment of osteoporosis are very important for patients with COPD. It is necessary significantly increase awareness of the connection between these two diseases.

СТРУКТУРНО-ФУНКЦИОНАЛЬНАЯ ХАРАКТЕРИСТИКА БРОНХИОЛИТОВ, ВЫЗВАННЫХ БЫСТРОРАСТУЩИМИ ШТАММАМИ НЕТУБЕРКУЛЕЗНЫХ МИКОБАКТЕРИЙ

The relevance of the research is associated with the need to study changes in the lungs caused by rapidly growing strains of nontuberculous mycobacteria (NTM). Objective: to analyze results obtained by the complex study of the lungs for evaluation of the frequency and nature of terminal bronchiole lesions in patients with nontuberculous mycobacterial (NTM)infection caused by rapidly growing strains. Materials and methods. We carried out clinical, radiological, morphological, and spirometric studies of the lungs of 35 patients with rapidly growing NTM strains isolated by real-time PCR. All the patients underwent multislice CT (MSCT) of the chest using the Somatom Emotion 16 scanner (Siemens, Germany) based on the high resolution computed tomography (HRCT) algorithm with 0.8 mm slice thickness and 1.5 mm slice increment. Lung ventilation was studied using the standard spirometry. Morphological studies were performed using resection samples from 11 patients with pulmonary TB comorbidity and 7 patients with only TB (the comparison group). Results. Rapidly growing strains of NTM cause exudative lymphocytic bronchiolitis, cell infiltration of the peribronchial tissue, which is not typical for TB infection. Later, lymphocytic bronchiolitis of terminal bronchioles develops into chronic constrictive bronchiolitis accompanied by the development of bronchiolectasis, atelectasis, and emphysema confirmed by HRCT results. They show prevailing bronchogenic lesions of small airways, accompanied by obstructive-type pulmonary ventilation disorders in 80% of cases (FEV1 is more than 70% of the predicted values). The results of the complex study should be considered in diagnosis and treatment of patients with NTM infection of the lungs.

THE CURRENT STATE AND WAYS TO IMPROVE THE ORIENTATION OF YOUNG QUALIFIED ATHLETES’ TRAINING IN KAYAKING AND CANOEING

Introduction. The data of classical and modern scientific and methodical literature testify that the formation of a structure of functional maintenance of special work capacity of qualified sportsmen is a long-term process which takes into account factors of physical development and regularities of formation of sports skill in a concrete sport [6, 7]. At the same time, there is a clear understanding that the development of functional capabilities of sportsmen, as well as the formation of the structure of functional support of special work capacity at the stages of sports improvement requires taking into account the specifics of a sport, a kind of sport, specialization, qualification, sex, age of sportsmen [2]. This affects the structure of special functional fitness of athletes and, as a result, requires the use of adequate means and methods of control, selection and orientation, modeling of training and fitness of athletes. The purpose of the study is to substantiate the orientation of training of athletes in kayaking and canoeing taking into account the complex manifestation of motor skills and energy supply. Materials and methods. Young skilled athletes of China, girls and boys specializing in kayaking and canoeing - 100 athletes, winners of regional regattas and championships. Analysis of specialized literature. Measurements of gas exchange using the ergospirometric complex "Oxycon mobile". Biochemical measurements with Biosen S. line lab+. Testing of physical performance using the ergometer "Dansprint" and testing in the conditions of a training session. Methods of statistical analysis. Results. The well-known indicators of physical fitness of rowers have a wide range of individual differences. This is evidenced by the average data and differences of the number of rowers who had five points - 14.3±6.1; three points - 37.8±13.5; one point - 47.9±14.6 on indicators of general physical fitness. The priority physical qualities that influence the general level of physical fitness are determined - coordination, flexibility and balance, mobility of joints and muscles; flexibility; balance. All athletes who had the highest and average scores in functional fitness had high indicators of coordination, flexibility, joint and muscle mobility; balance. It is shown that a high level of development of the above physical qualities forms prerequisites for realization of functional reserves of an organism determined by indicators of aerobic power, glycolytic capacity, reactivity of reaction of pulmonary ventilation to increase of physiological tension of load. Conclusions. The priority characteristics of physical fitness identified in the study affect neurodynamic functions, reactive properties of the cardiorespiratory system, and the reaction of the musculoskeletal system. They contribute to adaptation processes in the conditions of intense training competitive activity of young rowers. The presented results of theoretical analysis and experimental research have created prerequisites for improving the target orientation of the training process of young rowers, defined a certain algorithm of actions that allows to realize the functions of selection and sports orientation as a component of the training process management. It forms certain prospects of the research in this direction.

Exoskeleton-Assisted Walking for Pulmonary and Exercise Performances of SCI Individuals.

To determine whether exoskeleton-assisted walking (EAW) improves pulmonary ventilation function, motor function and related body structure, and activities equivalently as the conventional exercise program for people with spinal cord injury (SCI). Forty participants (7 females and 33 males; age 37.1±12.0 years) with thoracic SCI were randomized into two groups and undertook 16 sessions of 50-60 min training (4 days/week). Participants in the EAW group received EAW trainings, such as assisted standing, walking, and climbing the stairs. The control group received a conventional exercise program. Outcomes were measured at baseline and upon completion of treatment. After trainings, the EAW group improved more than the control group in the forced vital capacity (FVC, 0.53 L [0.01-1.06 L]), predicted FVC% (19.59 [6.63-32.54]) and forced expiratory volume in 1s (0.61 L [0.15-1.07 L]), basic activities of daily living (BADL) (19.75 [10.88-28.62]), and distal femoral cartilage. Participants in the EAW group completed 6-minute walk test with median 17.3 meters while wearing the exoskeleton. There was no difference in trunk and lower extremity motor function, bone mineral density, and adverse events ( P > 0.05). In people with lower thoracic neurological level of SCI, EAW training has potential benefits to facilitate pulmonary ventilation function, walking, BADL and thickness of cartilage comparing to a conventional excise program. This study provided more evidence for using EAW in clinic, and partly proved EAW had equivalent effects as conventional exercise program, which may combine with conventional exercise program for reducing burden of therapists in the future.