Research Topics
| A MalhotraSummaryAffiliation: Massachusetts General Hospital Country: USA Publications
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Publications
Is the way to man's heart (and lung) through the abdomen?Robert L Owens
Sleep Disorders Research Program, Division of Sleep Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02115, USA
Crit Care 13:199. 2009..However, their work raises several questions for clinicians and researchers regarding the pathophysiology and management of IAP...
Lung biopsy in ARDS: is it worth the risk?Atul Malhotra
Pulmonary and Critical Care and Sleep Medicine Divisions, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
Crit Care 10:160. 2006..In the future, various biomarkers may be available to non-invasively classify ARDS patients from the standpoint of responsiveness to various therapies, such as glucocorticoids...- Aging influences on pharyngeal anatomy and physiology: the predisposition to pharyngeal collapseAtul Malhotra
Sleep Medicine and Pulmonary/Critical Care Divisions, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA
Am J Med 119:72.e9-14. 2006 - Obesity and the lung: 3. Obesity, respiration and intensive careA Malhotra
Pulmonary and Critical Care and Sleep Medicine Divisions, Brigham and Women s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
Thorax 63:925-31. 2008.... - Postural effects on pharyngeal protective reflex mechanismsAtul Malhotra
Sleep Medicine and Pulmonary Critical Care Divisions, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02115, USA
Sleep 27:1105-12. 2004..We hypothesized that tongue protruder muscles are maximally responsive to negative pressure pulses during supine sleep, when posterior tongue displacement yields pharyngeal occlusion... - Low-tidal-volume ventilation in the acute respiratory distress syndromeAtul Malhotra
Pulmonary and Critical Care Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
N Engl J Med 357:1113-20. 2007 - What is central sleep apnea?Atul Malhotra
Division of Sleep, Department of Medicine, Brigham and Women s Hospital, Boston, Massachusetts 02115, USA
Respir Care 55:1168-78. 2010..A paucity of research exists in this area, emphasizing the opportunities for young investigators who are interested in this field... 
Pharyngeal pressure and flow effects on genioglossus activation in normal subjectsAtul Malhotra
Sleep Medicine Division and Pulmonary and Critical Care Division, Department of Medicine, Brigham and Women s Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
Am J Respir Crit Care Med 165:71-7. 2002..These data suggest that independent of central pattern generator activity, intrapharyngeal negative pressure itself modulates genioglossus activity both within breaths and between breaths...- The male predisposition to pharyngeal collapse: importance of airway lengthAtul Malhotra
Division of Sleep Medicine, Department of Medicine, Brigham and Women s Hospital, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts 02115, USA
Am J Respir Crit Care Med 166:1388-95. 2002..This study suggests that the male predisposition to pharyngeal collapse is anatomically based, primarily as the result of an increased length of vulnerable airway as well as increased soft palate size... - Obstructive sleep apnoeaAtul Malhotra
Brigham and Women s Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
Lancet 360:237-45. 2002..Continuous positive airway pressure, the treatment of choice for obstructive sleep apnoea, reduces sleepiness and improves hypertension... - Genioglossal activation in patients with obstructive sleep apnea versus control subjects. Mechanisms of muscle controlR B Fogel
Divisions of Sleep Medicine and Pulmonary and Critical Care, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
Am J Respir Crit Care Med 164:2025-30. 2001..Thus, the increased GGEMG seen in the patient with apnea during wakefulness appears to be a product of an increased tonic activation of the muscle, combined with increased negative-pressure generation during inspiration... - Upper-airway collapsibility: measurements and sleep effectsA Malhotra
Sleep Disorders Section, Divisions of Endocrinology and Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital and Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02115, USA
Chest 120:156-61. 2001.... 
Effect of oxygen in obstructive sleep apnea: role of loop gainAndrew Wellman
Division of Sleep Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, MA, USA
Respir Physiol Neurobiol 162:144-51. 2008..These data suggest that ventilatory instability is an important mechanism causing obstructive sleep apnea in some patients (those with a relatively high LG), since lowering LG with oxygen in these patients significantly reduces AHI...- Genioglossal inspiratory activation: central respiratory vs mechanoreceptive influencesG Pillar
Department of Medicine, Sleep Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
Respir Physiol 127:23-38. 2001..We conclude that both central output to the GG and local reflex mediated activation are important in maintaining upper airway patency... - Effects of pentobarbital on upper airway patency during sleepM Eikermann
Dept of Anesthesia and Critical Care, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114 2696, USA
Eur Respir J 36:569-76. 2010..Pentobarbital did not affect the genioglossus negative-pressure reflex. Pentobarbital increases the time to arousal and stimulates genioglossus muscle activity, but it also increases upper airway resistance during sleep... - Trazodone increases arousal threshold in obstructive sleep apnoeaR C Heinzer
Sleep Medicine Division, Brigham and Women s Hospital, Harvard Medical School, Boston, MA, USA
Eur Respir J 31:1308-12. 2008..Trazodone at 100 mg increased the effort-related arousal threshold in response to hypercapnia in obstructive sleep apnoea patients and allowed them to tolerate higher CO(2) levels... - The influence of aging on pharyngeal collapsibility during sleepMatthias Eikermann
Department of Sleep Medicine, Brigham and Women s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA
Chest 131:1702-9. 2007..We tested the hypotheses that upper airway closing pressure (PCLOSE) and the increase in pharyngeal resistance during sleep (primary outcomes) as well as measures of arousal threshold (secondary outcomes) increase with age... - Increased prevalence of obstructive sleep apnea syndrome in obese women with polycystic ovary syndromeR B Fogel
Sleep Disorders Section, Divisions of Endocrinology, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts 02115, USA
J Clin Endocrinol Metab 86:1175-80. 2001..05) in women with PCOS. We conclude that obese women with PCOS are at increased risk of OSA when compared with matched reproductively normal women. Women with PCOS should be carefully questioned regarding symptoms of sleep apnea... - Effect of expiratory positive airway pressure on sleep disordered breathingRaphael Heinzer
Sleep Medicine Division, Brigham and Women s Hospital, Harvard Medical School, Boston, MA, USA
Sleep 31:429-32. 2008..We sought to determine the effect of expiratory positive airway pressure on end expiratory lung volume (EELV) and sleep disordered breathing in obstructive sleep apnea patients... - Genioglossus muscle responsiveness to chemical and mechanical stimuli during non-rapid eye movement sleepMichael L Stanchina
Sleep Medicine and Pulmonary/Critical Care Divisions, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
Am J Respir Crit Care Med 165:945-9. 2002..When hypercapnia is combined with resistive loading, the muscle does respond. However, the possibility that higher levels of PCO2 or greater resistive loading alone could activate the muscle cannot be excluded... - Computational simulation of human upper airway collapse using a pressure-/state-dependent model of genioglossal muscle contraction under laminar flow conditionsYaqi Huang
Department of Medicine, Division of Sleep Medicine, Brigham and Women s Hospital, Boston, MA 02115, USA
J Appl Physiol 99:1138-48. 2005..The model-predicted muscle deformations are consistent with previous observations regarding upper airway behavior in normal subjects... - The effect of sleep onset on upper airway muscle activity in patients with sleep apnoea versus controlsRobert B Fogel
Harvard Medical School and Division of Sleep Medicine, Brigham and Women s Hospital, 75 Francis Street, Boston, MA 02115, USA
J Physiol 564:549-62. 2005.... - The influence of obstructive sleep apnea and gender on genioglossus activity during rapid eye movement sleepDanny J Eckert
Brigham and Women s Hospital, Division of Sleep Medicine, Sleep Disorders Program, 221 Longwood Avenue, Boston, MA 02115, USA
Chest 135:957-64. 2009.... - Airway dilator muscle activity and lung volume during stable breathing in obstructive sleep apneaAmy S Jordan
Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
Sleep 32:361-8. 2009.... - Chemical control stability in the elderlyAndrew Wellman
Division of Sleep Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02115, USA
J Physiol 581:291-8. 2007..26). We conclude that the chemical control of breathing does not become unstable with ageing and is thus an unlikely cause of central (and possibly obstructive) apnoeas in this population... - Esophageal pressures in acute lung injury: do they represent artifact or useful information about transpulmonary pressure, chest wall mechanics, and lung stress?Stephen H Loring
Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
J Appl Physiol 108:515-22. 2010..We suggest that Pes can be used to estimate transpulmonary pressures that are consistent with known physiology and can provide meaningful information, otherwise unavailable, in critically ill patients... - The influence of lung volume on pharyngeal mechanics, collapsibility, and genioglossus muscle activation during sleepMichael L Stanchina
Pulmonary Critical Care Division, Brigham and Women s Hospital, Harvard Medical School, Boston, Mass, USA
Sleep 26:851-6. 2003..We hypothesized that lower lung volumes would lead to increased pharyngeal collapsibility, airflow resistance, and, in compensation, augmented genioglossus muscle activation... - Mechanisms used to restore ventilation after partial upper airway collapse during sleep in humansAmy S Jordan
Sleep Disorders Program BIDMC, 75 Francis St, Boston, Massachusetts 02115, USA
Thorax 62:861-7. 2007..The aims of this study were to compare the ability to recover ventilation and the mechanisms of compensation following a sudden reduction of continuous positive airway pressure (CPAP) in subjects with and without OSA... - Upper airway myopathy is not important in the pathophysiology of obstructive sleep apneaDanny J Eckert
Brigham and Women s Hospital, Division of Sleep Medicine, Sleep Disorders Program, Harvard Medical School, Boston, MA 02115, USA
J Clin Sleep Med 3:570-3. 2007..Thus, future studies should carefully explore the functional consequences of UAM abnormalities and define which patients, if any, are susceptible to these potentially detrimental effects... - Respiratory system loop gain in normal men and women measured with proportional-assist ventilationAndrew Wellman
Division of Sleep Medicine, Department of Medicine, Brigham and Women s Hospital, Boston, Massachusetts 02115, USA
J Appl Physiol 94:205-12. 2003..We conclude that LG is low in the majority of normal men and women and that higher volume amplification factors are needed to determine whether gender differences exist in this low range... - The current prevalence of sleep disordered breathing in congestive heart failure patients treated with beta-blockersMary MacDonald
Division of Cardiovascular Diseases, Brigham and Women s Hospital, Boston, MA 02115, USA
J Clin Sleep Med 4:38-42. 2008..Our objective was to determine the current prevalence of sleep disordered breathing in a state-of-the-art congestive heart failure clinic... - Measuring upper and lower airway resistance during sleep with the forced oscillation techniqueLisa M Campana
Boston University, Boston, MA, USA
Ann Biomed Eng 40:925-33. 2012..The FOT was well tolerated and resistance was separated into upper and lower airway components. This setup is suitable for monitoring both upper and lower airway obstruction during sleep in those with and without asthma... - Sleep. 2: pathophysiology of obstructive sleep apnoea/hypopnoea syndromeR B Fogel
Division of Sleep Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02115, USA
Thorax 59:159-63. 2004..The primary defect is probably an anatomically small or collapsible pharyngeal airway, in combination with a sleep induced fall in upper airway muscle activity... - Influence of wakefulness on pharyngeal airway muscle activityYu Lun Lo
Brigham and Women s Hospital, Sleep Disorders Research Program, 75 Francis Street, Boston, Massachusetts 02115, USA
Thorax 62:799-805. 2007..A study was therefore undertaken to assess the isolated impact of sleep on upper airway muscle activity after minimising respiratory/mechanical inputs... - Unwarranted administration of acetylcholinesterase inhibitors can impair genioglossus and diaphragm muscle functionMatthias Eikermann
Brigham and Women s Hospital and Harvard Medical School, Boston, Massachusetts 02114 2696, USA
Anesthesiology 107:621-9. 2007..The authors hypothesized that cholinesterase inhibition when given the in absence of neuromuscular blockade (NB) would decrease upper airway dilatory muscle activity and consequently upper airway volume... - Differential effects of isoflurane and propofol on upper airway dilator muscle activity and breathingMatthias Eikermann
Department of Anesthesia, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts 02114 2696, USA
Anesthesiology 108:897-906. 2008..The authors sought to understand which anesthetics increase or decrease upper airway dilator muscle activity and to study the mechanisms mediating the effect... - Recruitment and rate-coding strategies of the human genioglossus muscleJulian P Saboisky
Division of Sleep Medicine, Sleep Disorders Program, Brigham and Women s Hospital, 221 Longwood Ave, Boston, MA 02115, USA
J Appl Physiol 109:1939-49. 2010..Understanding upper airway muscle recruitment/derecruitment may yield therapeutic targets for maintenance of pharyngeal patency... - Aging and sleep: physiology and pathophysiologyBradley A Edwards
Division of Sleep Medicine, Brigham and Women s Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA 02115, USA
Semin Respir Crit Care Med 31:618-33. 2010.... - Sleep-disordered breathing and COPD: the overlap syndromeRobert L Owens
Sleep Disorders Research Program, Brigham and Women s Hospital, Boston, MA 02115, USA
Respir Care 55:1333-44; discussion 1344-6. 2010..Treatment currently consists of continuous positive airway pressure, and oxygen as needed. Noninvasive ventilation may be helpful in overlap syndrome patients, but this has not yet been well studied... - Obstructive sleep apnea and aging effects on macrovascular and microcirculatory functionSusie Yim-Yeh
Brigham and Women s Hospital, Boston, MA 02115, USA
Sleep 33:1177-83. 2010..We hypothesize that OSA, independent of obesity, contributes to abnormal vascular function... - The influence of end-expiratory lung volume on measurements of pharyngeal collapsibilityRobert L Owens
Sleep Disorders Research Program, Div of Sleep Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA 02115, USA
J Appl Physiol 108:445-51. 2010..Changes in lung volume alter Pcrit substantially. This work supports a role for lung volume in the pathogenesis of OSA, and lung volume changes should be a consideration during assessment of pharyngeal mechanics... - Potential therapeutic targets in obstructive sleep apnoeaJulian P Saboisky
Brigham and Women s Hospital, Harvard Medical School, Division of Sleep Medicine, 221 Longwood Avenue, Boston, Massachusetts 02115, USA
Expert Opin Ther Targets 13:795-809. 2009.... - Pentobarbital dose-dependently increases respiratory genioglossus muscle activity while impairing diaphragmatic function in anesthetized ratsMatthias Eikermann
Department of Anesthesia and Critical Care, Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114 2696, USA
Anesthesiology 110:1327-34. 2009..The authors assessed the effects of pentobarbital on upper airway dilator and respiratory pump muscle function in rats and compared these results with the effects of normal sleep... - Obstructive airway disease and obstructive sleep apnea: effect of pulmonary functionBhavneesh Sharma
Division of Sleep Medicine, Harvard Medical School Brigham and Women s Hospital, Boston, MA 02115, USA
Lung 189:37-41. 2011..However, the high prevalence of OSA in OAD patients appears to be due to obesity, and reduced pulmonary function is not an independent risk factor for OSA... - Obstructive sleep apnea and the risk for cardiovascular diseasePuja Kohli
Brigham and Women s Hospital, Brookline, MA 02446, USA
Curr Atheroscler Rep 13:138-46. 2011..This chapter reviews these epidemiologic studies, the current understanding of the mechanisms by which OSA may contribute to the progression of cardiovascular diseases, and the effects of OSA treatment on cardiovascular disease outcomes... - Upper airway function in the pathogenesis of obstructive sleep apnea: a review of the current literatureRobert L Owens
Pulmonary and Critical Care Division, Brigham and Women s Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA
Curr Opin Pulm Med 14:519-24. 2008..However, recent work has focused on the function, rather than structure alone, of the upper airway... - Pathophysiology & genetics of obstructive sleep apnoeaLisa Campana
Brigham and Women s Hospital, Division of Sleep Medicine, Sleep Disorders Program and Harvard Medical School Boston, MA, USA
Indian J Med Res 131:176-87. 2010..We briefly review the state-of-the-art knowledge regarding OSA pathogenesis in adults and highlight the potential role of genetics in influencing key OSA pathophysiological traits... - Respiratory control stability and upper airway collapsibility in men and women with obstructive sleep apneaAmy S Jordan
Harvard Medical School and Division of Sleep Medicine, Brigham and Women s Hospital, Sleep Disorders Research Program, Boston, MA 02115, USA
J Appl Physiol 99:2020-7. 2005..38 +/- 0.02 vs. 0.33 +/- 0.03; P = 0.14). These results suggest that women may be protected from developing OSA by having a less collapsible upper airway for any given degree of obesity... - Ventilatory control and airway anatomy in obstructive sleep apneaAndrew Wellman
Sleep Disorders Program at BI, Brigham and Women s Hospital, 75 Francis Street, Boston, MA 02115, USA
Am J Respir Crit Care Med 170:1225-32. 2004..88, p = 0.0016). We conclude that loop gain has a substantial impact on apnea severity in certain patients with sleep apnea, particularly those with a pharyngeal closing pressure near atmospheric... - Lung volume and continuous positive airway pressure requirements in obstructive sleep apneaRaphael C Heinzer
Division of Sleep Medicine, Sleep Disorders Program BI, Brigham and Women s Hospital, 75 Francis Street, Boston, MA 02115, USA
Am J Respir Crit Care Med 172:114-7. 2005..These results demonstrate that relatively small changes in lung volume have an important effect on the upper airway in subjects with sleep apnea during non-REM sleep... - The role of open-lung biopsy in ARDSSanjay R Patel
Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston, MA 02115, USA
Chest 125:197-202. 2004..The goals of this study were to better define the frequency of unexpected diagnoses made by open-lung biopsy, the frequency biopsy results lead to a change in clinical management, and the frequency of procedural complications... - Control of upper airway muscle activity in younger versus older men during sleep onsetRobert B Fogel
Harvard Medical School and Division of Sleep Medicine, Brigham and Women s Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
J Physiol 553:533-44. 2003..Sleep onset per se does not appear to have a greater effect on upper airway muscle activity as one ages... - Anatomic and physiologic predictors of apnea severity in morbidly obese subjectsRobert B Fogel
Divisions of Sleep Medicine and Pulmonary Critical Care, Department of Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston MA, USA
Sleep 26:150-5. 2003..We thus attempted to identify anatomic and physiologic predictors of apnea severity... - Within-breath control of genioglossal muscle activation in humans: effect of sleep-wake stateRobert B Fogel
Harvard Medical School and Division of Sleep Medicine, Brigham and Women s Hospital, 221 Longwood Avenue, Boston, MA 02115, USA
J Physiol 550:899-910. 2003..The loss of this protective mechanism during sleep suggests that an airway dependent upon such mechanisms (as in the patient with sleep apnoea) will be prone to collapse during sleep... - Mechanical ventilation and air leaks after lung biopsy for acute respiratory distress syndromeMichael H Cho
Division of Pulmonary, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
Ann Thorac Surg 82:261-6. 2006..Persistent air leak is the most common postoperative complication. Risk factors in this setting are not known... - Genioglossal muscle response to CO2 stimulation during NREM sleepYu Lun Lo
Department of Thoracic Medicine, Chang Gang Memorial Hospital, Taipei, Taiwan
Sleep 29:470-7. 2006..The objective was to evaluate the responsiveness of upper airway muscles to hypercapnia with and without intrapharyngeal negative pressure during non-rapid eye movement (NREM) sleep and wakefulness... - The effect of lung stretch during sleep on airway mechanics in overweight and obese asthmaL M Campana
Department of Biomedical Engineering, Boston University, Boston, MA, United States Division of Sleep Medicine, Brigham and Women s Hospital, Harvard Medical School, Boston, MA, United States Electronic address
Respir Physiol Neurobiol 185:304-12. 2013..01), but R(low) was unchanged. High R(up) was observed in asthma, which reduced with BPAP. We conclude that the upper airway is a major component of R(rs) and larger lung volume changes may be required to alter R(low)... - Phase-rectified signal averaging as a sensitive index of autonomic changes with agingL M Campana
Boston University, Department of Biomedical Engineering, and Brigham and Women s Hospital, 44 Cummington St, Boston, MA 02215, USA
J Appl Physiol 108:1668-73. 2010..We propose that the decrease in DC and AC may be a sensitive marker for autonomic changes with aging. Further work will be required to determine whether the observed changes predict poorer cardiac health prognosis... - The impact of anatomic manipulations on pharyngeal collapse: results from a computational model of the normal human upper airwayYaqi Huang
Sleep Medicine Division and Pulmonary/Critical Care Division, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02115, USA
Chest 128:1324-30. 2005..We believe that, in the future, finite element modeling will provide a useful tool to help advance our understanding of OSA and its response to various therapies... - Genioglossus premotoneurons and the negative pressure reflex in ratsNancy L Chamberlin
Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, USA
J Physiol 579:515-26. 2007..These results suggest that perihypoglossal GG premotoneurons near the obex mediate the NPR and those caudal to the obex are important mediators of respiratory-related GG activity but are not involved in the NPR... - Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 12-2003. An 82-year-old man with dyspnea and pulmonary abnormalitiesAtul Malhotra
Pulmonary and Critical Care Unit, Brigham and Women's Hospital and Massachusetts General Hospital, and the Department of Medicine, Harvard Medical School, Boston, USA
N Engl J Med 348:1574-85. 2003 - Effect of the chest wall on pressure-volume curve analysis of acute respiratory distress syndrome lungsRobert L Owens
Departments of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
Crit Care Med 36:2980-5. 2008..We sought to quantify the effect of the chest wall by considering the chest wall and lung in series... - Pathophysiology of adult obstructive sleep apneaDanny J Eckert
Division of Sleep Medicine, Sleep Disorders Program, Brigham and Women s Hospital, and Havard Medical School, Boston, MA 02115, USA
Proc Am Thorac Soc 5:144-53. 2008..Finally, the potential for novel treatment strategies, based on an improved understanding of the underlying pathophysiology, is also discussed with the ultimate aim of stimulating research ideas in areas where knowledge is lacking... - Gas exchange impairment induced by open suctioning in acute respiratory distress syndrome: impact of permissive hypercapniaMaria Paula Caramez
Department of Anesthesia and Critical Care, and Respiratory Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
Crit Care Med 36:560-4. 2008..To determine whether hypercarbia occurs following the use of open suctioning in lung lavage injured sheep and whether the baseline PaCO2 and duration of suctioning affect gas exchange... - Assessment of automated scoring of polysomnographic recordings in a population with suspected sleep-disordered breathingStephen D Pittman
Division of Sleep Medicine, Brigham and Women's Hospital, Boston, Mass 02115-5817, USA
Sleep 27:1394-403. 2004..The automated classification of sleep stages was also close to this standard. The automated scoring system holds promise as a rapid method to score polysomnographic records, but expert verification of the automated scoring is required... - Using a wrist-worn device based on peripheral arterial tonometry to diagnose obstructive sleep apnea: in-laboratory and ambulatory validationStephen D Pittman
Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA 02115-5817, USA
Sleep 27:923-33. 2004..The device can be used with a low failure rate for single use in the lab and home for self-administered testing... - Pulmonary characteristics in COPD and mechanisms of increased work of breathingStephen H Loring
Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
J Appl Physiol 107:309-14. 2009..Extrinsic restriction, in which the chest wall fails to achieve and maintain abnormally high lung volumes in COPD, can limit ventilatory function and contribute to disability... - The pharyngeal lumen: both length and size matterAmy Jordan
Brigham and Women's Hospital, Boston, MA 02115, USA
J Clin Sleep Med 1:264-5. 2005 - Effect of increased lung volume on sleep disordered breathing in patients with sleep apnoeaR C Heinzer
Sleep Medicine Division, Brigham and Women s Hospital, Harvard Medical School, Boston, MA, USA
Thorax 61:435-9. 2006..We sought to determine the effect of a constant lung volume increase on sleep disordered breathing during non-REM sleep... - Telomerase activity in rat cardiac myocytes is age and gender dependentA Leri
Department of Medicine, New York Medical College, Valhalla, NY 10595, USA
J Mol Cell Cardiol 32:385-90. 2000..The greater growth potential of female myocytes may be critical for the longer lifespan and decreased incidence of heart failure in women... - Neostigmine but not sugammadex impairs upper airway dilator muscle activity and breathingM Eikermann
Division of Sleep Medicine, Brigham and Women s Hospital and Harvard Medical School, Boston, MA, USA
Br J Anaesth 101:344-9. 2008..Sugammadex reverses neuromuscular block by encapsulating rocuronium. However, its effects on upper airway integrity and breathing are unknown... - The influence of gender and upper airway resistance on the ventilatory response to arousal in obstructive sleep apnoea in humansAmy S Jordan
Brigham and Women s Hospital, Sleep Disorders Research Program BIDMC, 75 Francis Street, Boston, MA 02115, USA
J Physiol 558:993-1004. 2004..These results demonstrate that the ventilatory response to arousal is influenced by pre-arousal airway resistance and gender. Whether this contributes to the perpetuation of respiratory events and the pathogenesis of OSA is unclear... - Sleep in congestive heart failureBhavneesh Sharma
Division of Sleep Medicine, Harvard Medical School, Brigham and Women s Hospital, 75 Francis Street Asb1, Boston, MA 02115 6106, USA
Med Clin North Am 94:447-64. 2010..Periodic limb movements are also common in CHF... - A secondary reflex suppression phase is present in genioglossus but not tensor palatini in response to negative upper airway pressureDanny J Eckert
Sleep Disorders Program, Div of Sleep Medicine, Brigham and Women s Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA 02115, USA
J Appl Physiol 108:1619-24. 2010..These differential responses support the hypothesis that GG reflex suppression may be mediated via inhibition of respiratory-related premotor input... - Follow-up assessment of CPAP efficacy in patients with obstructive sleep apnea using an ambulatory device based on peripheral arterial tonometryStephen D Pittman
Division of Sleep Medicine, Brigham and Women s Hospital, 75 Francis Street, Boston, MA 02115 5817, USA
Sleep Breath 10:123-31. 2006..The Watch_PAT device accurately identified participants with moderate-severe SDB while using CPAP in the attended setting of a sleep laboratory... - Central sleep apnea: Pathophysiology and treatmentDanny J Eckert
Division of Sleep Medicine, Sleep Disorders Program, Brigham and Women s Hospital, Harvard Medical School, Boston, MA 02115, USA
Chest 131:595-607. 2007..The clinical implications of improved CSA pathophysiology knowledge and the potential for novel therapeutic treatment approaches are also discussed... - Esophageal and transpulmonary pressures in acute respiratory failureDaniel Talmor
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA
Crit Care Med 34:1389-94. 2006..Systematic use of esophageal manometry has the potential to improve ventilator management in acute respiratory failure by providing more direct assessment of lung distending pressure... - Negative pressure pulmonary hemorrhageD R Schwartz
Pulmonary and Critical Care Unit, Massachusetts General Hospital, Boston 02114 2696, USA
Chest 115:1194-7. 1999..We describe a case of negative pressure pulmonary hemorrhage, and we propose that its etiology is stress failure, the mechanical disruption of the alveolar-capillary membrane... - Regulation of contractile proteins in diabetic heartA Malhotra
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA
Cardiovasc Res 34:34-40. 1997..The focus of this review has been the explication of a biochemical defect which underlies cardiac contractile dysfunction in experimental models of diabetes... - Association between reduced sleep and weight gain in womenSanjay R Patel
Division of Pulmonary and Critical Care Medicine, University Hospitals of Cleveland, Case Western Reserve University, Cleveland, OH 44106, USA
Am J Epidemiol 164:947-54. 2006..These data suggest that short sleep duration is associated with a modest increase in future weight gain and incident obesity. Further research is needed to understand the mechanisms by which sleep duration may affect weight... - Inspiratory efforts during mechanical ventilation: is there risk of barotrauma?Stephen H Loring
Chest 131:646-8. 2007 - Use of computational modeling to predict responses to upper airway surgery in obstructive sleep apneaYaqi Huang
Sleep Medicine Division, Pulmonary and Critical Care Division, Brigham and Women s Hospital and Harvard Medical School, Boston, Massachusetts, USA
Laryngoscope 117:648-53. 2007..Computational models of the upper airway using finite element analysis to simulate the effects of various anatomic and physiologic manipulations on pharyngeal mechanics could be helpful in predicting surgical success... - Awake negative pressure reflex response of the genioglossus in OSA patients and normal subjectsRichard B Berry
Medical Health Care Group, Long Beach Veterans Affairs Medical Center, University of California, Irvine, California 90822, USA
J Appl Physiol 94:1875-82. 2003..05) at a suction pressure of approximately 13 cmH(2)O. We conclude that the response of the genioglossus to NPA during wakefulness is not impaired in OSA patients compared with normal subjects and is greater at low suction pressures... - Prone positioning of patients in acute respiratory failureAtul Malhotra
N Engl J Med 346:295-7. 2002 - Interactions between hypoglycemia and sleep architecture in children with type 1 diabetes mellitusGiora Pillar
Pediatrics Department A, Rambam Medical Center, and Technion-Israel Institute of Technology, Haifa, Israel
J Pediatr 142:163-8. 2003..Rapid changes in glucose levels, independent of absolute glucose levels, may result in awakening from sleep. Continuous measurement of glucose levels during sleep may add important features in the treatment of children with DM... - Muscle weakness after administration of neuromuscular blocking agents: do not immobilize the diaphragm unnecessarilyMatthias Eikermann
Crit Care Med 35:1634-5; author reply 1635. 2007 - The impact of cardiac resynchronization therapy on obstructive sleep apnea in heart failure patients: a pilot studyMichael L Stanchina
Pulmonary, Critical Care, and Sleep Medicine Division, Rhode Island Hospital, 1285 South County Trail, East Greenwich, RI 02818, USA
Chest 132:433-9. 2007..We hypothesized that through increased cardiac output CRT/pacing would reduce obstructive events and daytime symptoms of sleepiness... - Risk factors for ARDS in patients receiving mechanical ventilation for > 48 hXiaoming Jia
Massachusetts Institute of Technology, Cambridge, MA, USA
Chest 133:853-61. 2008..However, controversy persists regarding the optimal ventilator settings for patients without ARDS receiving mechanical ventilation. This study tested the hypothesis that ventilator settings influence the development of new ARDS... - Cytokine release following recruitment maneuversDaniel Talmor
Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Rd, CC 470, Boston MA 02215, USA
Chest 132:1434-9. 2007..There are reports of rigors and/or clinical deterioration following recruitment maneuvers (RMs), leading us to question whether the use of sustained high-pressure inflation could lead to release of inflammatory mediators... - Influence of gender and age on upper-airway length during developmentOhad Ronen
Department of Otolaryngology, Head and Neck Surgery, Carmel Medical Center, Haifa, Israel
Pediatrics 120:e1028-34. 2007.... - Treatment adherence and outcomes in flexible vs standard continuous positive airway pressure therapyMark S Aloia
Department of Psychiatry and Human Behavior, Brown Medical School, Providence RI, USA
Chest 127:2085-93. 2005..To compare adherence and clinical outcomes between flexible positive airway pressure (PAP) [C-Flex; Respironics; Murraysville, PA] and standard PAP therapy (ie, continuous positive airway pressure [CPAP])... - The impact of endotracheal suctioning on gas exchange and hemodynamics during lung-protective ventilation in acute respiratory distress syndromeMaria Paula Caramez
Department of Anesthesia and Critical Care, Massachusetts General Hospital, and with Harvard Medical School, Boston Massachusetts 02114, USA
Respir Care 51:497-502. 2006..CONCLUSION: PaO2/FIO2) was better maintained during CS with both VC and PC modes during lung-protective ventilation for ARDS, as compared with OS, and shunt fraction post-suctioning changed least with PC... - The debate about gender differences in obstructive sleep apneaKelly Carden
Sleep Med 4:485-7. 2003 - Discharge patterns of human genioglossus motor units during sleep onsetVanessa Wilkinson
Department of Psychology, University of Melbourne, Parkville, Australia
Sleep 31:525-33. 2008..The aim of the present study was to determine the effect of sleep onset on the activity of individual motor units as a function of their particular discharge pattern... - Auto-titrating versus standard continuous positive airway pressure for the treatment of obstructive sleep apnea: results of a meta-analysisNajib T Ayas
Department of Medicine, University of British Colombia
Sleep 27:249-53. 2004.... - Profile of neonates admitted in pediatric ICU and validation of Score for Neonatal Acute Physiology (SNAP)Anil Vasudevan
Department of Pediatrics, All India Institute of Medical Science, Ansari Nagar, New Delhi 110 029, India
Indian Pediatr 43:344-8. 2006..8 +/- 9.8 and 10.1 +/- 6.4 in survivors (P<0.001). There was no correlation between SNAP score and mean length of stay in hospital (P=0.5). We conclude that SNAP correlates well with mortality in neonates admitted to the PICU... - Paradoxical responses to positive end-expiratory pressure in patients with airway obstruction during controlled ventilationMaria Paula Caramez
Respiratory and Emergency Intensive Care Unit, Emergency Department, , , Brazil
Crit Care Med 33:1519-28. 2005..An empirical PEEP trial investigating plateau pressure response in these patients appears to be a reasonable strategy with minimal side effects...
Research Grants
- Mechanisms Underlying the Aging Predisposition to Obstructive Sleep ApneaAtul Malhotra; Fiscal Year: 2010..We plan to characterize many of the variables important in causing sleep apnea so that we can develop a better understanding of why the elderly develop this disease, and how best to prevent or minimize its complications. ..
- Single Motor Unit Genioglossus Recordings to Understand Sleep Apnea PathogenesisAtul Malhotra; Fiscal Year: 2009....
- Aging Influence on the Development of Sleep ApneaAtul Malhotra; Fiscal Year: 2007..abstract_text> ..
- Sleep Apnea and Obesity: Cardiovascular Risk AssessmentAtul Malhotra; Fiscal Year: 2007..This data may have important implications for the diagnosis and treatment of these abnormalities. ..
- Single Motor Unit Genioglossus Recordings to Understand Sleep Apnea PathogenesisAtul Malhotra; Fiscal Year: 2010....