Thomas Similowski

..Phrenic nerve stimulation applied during wakefulness is a unique tool to assess Upper airway dynamic properties and to measure the overall mechanical effects of the inspiratory process on UA stability...

..We hypothesized that efficient continuous control of the endotracheal cuff pressure using a pneumatic device would reduce tracheal ischemic lesions in piglets ventilated for 48 hours through a high-volume, low-pressure endotracheal tube...

..When this body of knowledge is available, the question of the putative benefits of raising haemoglobinaemia in chronic obstructive pulmonary disease will have to be addressed...

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..In this paper, we present the results of the French part of the international survey "Confronting COPD in North America and Europe" concerning the impact of COPD from the perspective patients'...

..5 Tesla. These findings may be the result of phrenic nerve depolarization occurring more distally than expected with CMS, which may have clinical implications regarding the diagnosis and follow-up of phrenic nerve lesions...

..The effects of hypoxemia on cellular functions make chronic respiratory insufficiency a systemic disease...

..In normal humans during noninvasive ventilation, the authors used an experimental model of patient-ventilator asynchrony to determine whether premotor cortical activation occurs in this setting...

..The objective of this study was to assess the prevalence of dyspnea in mechanically ventilated patients, identify its clinical correlates, and examine its impact on clinical outcomes...

..The authors reasoned that NAVA should produce a more "natural" or variable breathing pattern than other modes. This study compared respiratory variability and complexity during pressure support ventilation (PSV) and NAVA...

..The present experimental work assesses the feasibility, safety and efficacy of a trans-mediastinal implantation of intradiaphragmatic phenic nerve stimulation electrodes using a flexible gastroscope through a cervical incision...

..rCMS appears feasible and should be investigated for diaphragm conditioning in appropriate clinical populations...

..We hypothesized that respiratory-related evoked potentials' alterations during wake, if indeed a feature of the obstructive sleep apnoea syndrome, should be present in untreated severe patients...

..g. asthma attacks) would have important pathophysiological implications: it could for example contribute to explain why sleep is both altered and deleterious in such situations...

..In conclusion, in these severe patients not expected to experience spontaneous improvements, diaphragm conditioning improved sleep and there were hints at diaphragm function changes...

..CMS is an easy noninvasive tool to assess PN integrity, but co-activates muscles that could contaminate surface chest electromyographic recordings...

..35+/-1.48 cm H2O) than in IBM and in PM (P<0.05). Diaphragm weakness is frequent and probably overlooked in inflammatory myopathies. Further studies are needed to delineate the clinical relevance of these results...

..2+/-1.6 ms, p=0.003, with facilitation). These results are closely comparable with similar data in locomotor muscle. They provide a neurophysiological basis for the capacity of normal humans to rapidly acquire diaphragmatic skills...

..How this translates to respiratory disease involving acute changes in respiratory mechanics remains to be determined...

..Phrenic pacing is an alternative to positive-pressure ventilation in selected patients, mostly in cases of upper spinal cord injury. We evaluated results of phrenic pacing performed by video-assisted thoracic surgery (VATS)...

..This confirms the noxious nature of certain types of breathlessness, thus opening new physiological and perhaps therapeutic perspectives...

..The aim of this study was to test this hypothesis by examining the effects of inspiratory resistive loading on the response of the diaphragm to transcranial magnetic stimulation...

..To measure phrenic nerve conduction velocity in the neck in humans...

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..Chronic venous insufficiency (CVI) promotes fluid accumulation in the legs that can be counteracted by compression stockings...

..This could make the study of respiratory premotor potentials easier in difficult clinical environments...

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..According to the ventilatory generators homology theory, this may also be the case in mammals...

..Variability indices are sufficient to separate success from failure cases...

..01, respectively). Studies using paired stimuli confirmed a likely intracortical mechanism for this depression. Our data confirm significant depression of both diaphragm and quadriceps MEPs after incremental treadmill exercise...

..However, its clinical application is limited because of the strong discomfort associated with the electrical stimuli required to elicit the RIII reflex...

..To compare the respective impact of pressure support ventilation and naturally adjusted ventilatory assist, with and without a noninvasive mechanical ventilation algorithm, on patient-ventilator interaction...

..Taken together these findings reinforce the role of ventilation in the CVC process...

..An averaging method triggered from a respiratory flow signal can identify and characterize a low phasic inspiratory activity of the scalenes within a noisy surface signal...

..It is possible to reliably measure the latency of the diaphragm response to transcranial magnetic stimulation with adequately positioned surface electrodes...

..Upper airway dysfunction in PD may promote obstructive sleep apnea. However, the frequency and clinical relevance of sleep-disordered breathing in PD remains unclear...

..These results demonstrate that 5-Hz rTMS over the SMA can increase the excitability of M1(DIA). These observations are consistent with the hypothesis of a functional connection between SMA and M1(DIA)...

..The aim of the present study was to compare the presence, the latencies and the amplitudes of the P1, N1, P2, and N2 components of the RREPs in children with chronic lung or neuromuscular disease...

..The aim of this experimental work is to demonstrate the feasibility of trans-mediastinal bilateral implantation of PN electrodes using a flexible gastroscope introduced through a cervical incision in human cadavers...

..Liver failure has been suspected to be a risk factor for aspergillosis...

..This is the first documented case of pharmacologically restored chemosensitivity in CCHS. It suggests that a very potent progestin such as desogestrel could unveil latent chemosensitive neural circuits...

..Hematocrit is negatively associated with mortality and morbidity. Whether the association is causative or not and whether or not corrective measures are warranted remain to be determined...

..This case report illustrates the powerful adaptability of the respiratory and sleep control systems to maintain each vital function...

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..016) and a median 42% reduction in the increase in neck circumference (P=0.016). These results provide proof-of-principle that overnight fluid displacement into the neck plays a causative role in OSA...

..However, complexity persists in the quasi-absence of automatic drive. Ventilatory variability and complexity could be determined by the interaction between the respiratory central pattern generator and suprapontine structures...

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..The prevention of acute episodes of COPD is best achieved through tobacco cessation and influenza vaccine. Finally, an acute episode may be an opportunity to make a diagnosis of COPD if this has not been done before...

..The aim of this preliminary study is to compare the management and outcome of patients aged 90 years or older admitted to a respiratory ICU with those of patients aged 70 years or younger...

..In the absence of automation, this can be uneasy in clinical practice. The objective of this study was to test an alternative approach (expiratory pause) that should be easier to apply...

..Indeed, the interchangeability of the methods is a clinically relevant question; for instance, in view of the debate about the risk-benefit balance of right heart catheterization...

..Desogestrel should not be prescribed to CCHS patients with a respiratory purpose until the results of a pending clinical trial (clinicaltrials.gov. NCT01243697) are available...

..This strategy can, exceptionally, be considered if removal and subsequent implantation is impossible or refused...

..05). Mouth opening alone did not exert any significant influence. We conclude that the position of the neck has a discernible impact on the flow behavior through the nonphasically active UA faced with a negative Pd...

..Medullary infarcts can be associated with breathing disorders that usually consist in central hypoventilation...

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..We conclude that DH-induced mechanical constraints and excessive ventilatory demand occurred in these young nonsmoking PAH patients with no spirometric obstruction and was associated with exertional dyspnoea...

..7 ml. cmH(2)O x s(-1). These included five nonapneic and six apneic patients. We conclude that UA dynamic properties studied with BAMPS during wakefulness significantly differ between nonapneic and apneic patients...

..With ES and CMS, apparently uncontaminated signals could be consistently recorded from surface electrodes...

..Further MA reduced resistances. CONCLUSIONS: As with CPAP, MA in normal subjects decreases the propensity of the upper airway to collapse in response to a negative pressure pulse...

..We conclude that Pmask-CMS is a better surrogate of Pes-CMS than Pm-CMS...

..This study shows that the noise titration approach evidences a chaotic dimension to the behavior of ventilatory flow over time in normal humans during tidal breathing...

..This opens the possibility of predicting the behaviour of the respiratory system during diseases involving changes in its mechanical or geometrical characteristics...

..CONCLUSION: Helical thin-collimation CT at controlled lung volume and at full expiration associated with bronchial challenge may help evaluate bronchoreactivity and inflammation in mild intermittent asthma...

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..Per contra, in this setting, pulmonary afferents do not suffice to evoke these components...

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..We conclude that transcranial magnetic stimulation applied in the genioglossus area induces a concomitant motor response of upper airway stabilizing muscles with consistent changes in their motor responses during inspiratory manoeuvres...