Objective To choose one optimal extrinsic positive end-expiratory pressure (PEEPe) for ventilated patients with chronic obstructive pulmonary disease (COPD) and to compare two methods for choosing the optimal level o...Objective To choose one optimal extrinsic positive end-expiratory pressure (PEEPe) for ventilated patients with chronic obstructive pulmonary disease (COPD) and to compare two methods for choosing the optimal level of PEEPe.Methods Ten ventilated patients with COPD were included in the study. First, static intrinsic positive end-expiratory pressure (PEEPi,st) was measured when PEEPe was zero, and the PEEPi,st was called PEEPi,stz. PEEPe at 0%, 40%, 50%, 60%, 70%, 80%, 90% and 100% of PEEPi,stz, respectively, were applied randomly. Respiratory mechanics, hemodynamics, and oxygen dynamics were recorded 30 minutes after the level of PEEPe was changed.Results When PEEPe was not higher than 80% of PEEPi,stz, no measurement changed significantly. When PEEPe was increased to 90% and 100% of PEEPi,stz, PEEPi,st, peak inspiratory pressure, plateau pressure, pulmonary capillary wedge pressure and central venous pressure increased significantly, P<0.01. Cardiac output and left ventricular work index decreased significantly, P<0.01. Oxygen delivery decreased significantly, P<0.05. When PEEPe was increased to 100% of PEEPi,stz, the right ventricular work index decreased significantly, P<0.05.Conclusion Eighty percent of PEEPi,stz was the upper limit of PEEPe. The results of the two methods used to set the level of PEEPe were identical.展开更多
Thioredoxin is a redox protein while adiponectin is an adipokine. Their relationship has been less appreci- ated. Here we show that in serum of patients with acute exacerbations of chronic obstructive Pulmonary Diseas...Thioredoxin is a redox protein while adiponectin is an adipokine. Their relationship has been less appreci- ated. Here we show that in serum of patients with acute exacerbations of chronic obstructive Pulmonary Disease, decreased activity of thioredoxin coexists with increased level of adiponectin as partial pressure of arterial oxygen decreases. From the results with adiponectin-knockout mice and in vitro experiments, we have found a reciprocal inhibitory relationship, by which adiponectin inhibits cytosolic thioredoxin （Trxl） expression, whereas serum Trxl influences adiponectin multimerization. The associa- tion between extracellular Trxl and adiponectin attenuates their functions. This relationship is dynamic, and correlated with a body＇s physiological conditions.展开更多
文摘Objective To choose one optimal extrinsic positive end-expiratory pressure (PEEPe) for ventilated patients with chronic obstructive pulmonary disease (COPD) and to compare two methods for choosing the optimal level of PEEPe.Methods Ten ventilated patients with COPD were included in the study. First, static intrinsic positive end-expiratory pressure (PEEPi,st) was measured when PEEPe was zero, and the PEEPi,st was called PEEPi,stz. PEEPe at 0%, 40%, 50%, 60%, 70%, 80%, 90% and 100% of PEEPi,stz, respectively, were applied randomly. Respiratory mechanics, hemodynamics, and oxygen dynamics were recorded 30 minutes after the level of PEEPe was changed.Results When PEEPe was not higher than 80% of PEEPi,stz, no measurement changed significantly. When PEEPe was increased to 90% and 100% of PEEPi,stz, PEEPi,st, peak inspiratory pressure, plateau pressure, pulmonary capillary wedge pressure and central venous pressure increased significantly, P<0.01. Cardiac output and left ventricular work index decreased significantly, P<0.01. Oxygen delivery decreased significantly, P<0.05. When PEEPe was increased to 100% of PEEPi,stz, the right ventricular work index decreased significantly, P<0.05.Conclusion Eighty percent of PEEPi,stz was the upper limit of PEEPe. The results of the two methods used to set the level of PEEPe were identical.
基金Acknowledgments This work was supported by the National Natural Science Foundation of China （31170764）, the Main Direction Pro- gram of Knowledge Innovation of Chinese Academy of Sciences （KSCX2-EW-J-29）, and Science and Education Integration Project of University of Chinese Academy of Sciences （KJRH2015-008）.
文摘Thioredoxin is a redox protein while adiponectin is an adipokine. Their relationship has been less appreci- ated. Here we show that in serum of patients with acute exacerbations of chronic obstructive Pulmonary Disease, decreased activity of thioredoxin coexists with increased level of adiponectin as partial pressure of arterial oxygen decreases. From the results with adiponectin-knockout mice and in vitro experiments, we have found a reciprocal inhibitory relationship, by which adiponectin inhibits cytosolic thioredoxin （Trxl） expression, whereas serum Trxl influences adiponectin multimerization. The associa- tion between extracellular Trxl and adiponectin attenuates their functions. This relationship is dynamic, and correlated with a body＇s physiological conditions.
