The following case describes the favorable application of airway pressure release ventilation (APRV) in a patient with pulmonary hypertension who developed respiratory failure and abdominal compartment syndrome after ...The following case describes the favorable application of airway pressure release ventilation (APRV) in a patient with pulmonary hypertension who developed respiratory failure and abdominal compartment syndrome after abdominal closure from an incarcerated umbilical hernia. A 66-year-old male with past medical history of restrictive lung disease, obstructive sleep apnea and pulmonary hypertension, presented to the operating room for an incarcerated inguinal hernia. After abdominal closure, he gradually developed decreased oxygen saturation and hypotension. APRV was initiated during post operative day 2 after inability to maintain adequate oxygen saturation with resultant hypotension on pressure control ventilation with varying degrees of positive end expiratory pressure and 100% inspired oxygen concentration. The initial set high pressure on APRV was 35 mm Hg. Yet, in lieu of decreasing lung compliance, it peaked at 50 mm Hg. Eventually, inhaled Nitric Oxide was initiated post operative day 3 due to increasing pulmonary arterial pressures. A bedside laparotomy was eventually performed when bladder pressures peaked to 25 mm Hg. APRV gradually and temporally improved the oxygen saturation and decreased the pulmonary arterial pressures with subsequent increase in systemic blood pressures. APRV promoted alveolar recruitment and decreased the shunting associated with abdominal compartment syndrome. Better oxygen saturations lead to increases in blood pressure by decreasing the effects of hypoxic pulmonary vasoconstriction on the right ventricle (RV). In patients with decreasing lung compliance and pulmonary comorbidities, APRV appears safe and allows for improve oxygenation, after failure with conventional modes of ventilation.展开更多
In this paper, we propose a simulative experimental system in wind tunnel conditions lbr the separation of auxiliary fuel tanks from an aircraft. The experimental system consists of a simulative release mechanism, a s...In this paper, we propose a simulative experimental system in wind tunnel conditions lbr the separation of auxiliary fuel tanks from an aircraft. The experimental system consists of a simulative release mechanism, a scaled model and a pose measuring system. A new release mechanism was designed to ensure stability of the separation. Scaled models of the auxiliary fuel tank were designed and their moment of inertia was adjusted by installing counterweights inside the model. Pose param- eters of the scaled model were measured and calculated by a binocular vision system. Additionally, in order to achieve high brightness and high signal-to-noise ratio of the images in the dark enclosed wind tunnel, a new high-speed image acquisition method based on miniature self-emitting units was pre- sented. Accuracy of the pose measurement system and repeatability of the separation mechanism were verified in the laboratory. Results show that the position precision of the pose measurement system can reach 0.1 mm, the precision of the pitch and yaw angles is less than 0.1° and that of the roll angle can be up to 0.3°. Besides, repeatability errors of models＂ velocity and angular velocity controlled by the release mechanism remain small, satisfying the measurement requirements. Finally, experiments for the separation of auxiliary fuel tanks were conducted in the laboratory.展开更多
文摘The following case describes the favorable application of airway pressure release ventilation (APRV) in a patient with pulmonary hypertension who developed respiratory failure and abdominal compartment syndrome after abdominal closure from an incarcerated umbilical hernia. A 66-year-old male with past medical history of restrictive lung disease, obstructive sleep apnea and pulmonary hypertension, presented to the operating room for an incarcerated inguinal hernia. After abdominal closure, he gradually developed decreased oxygen saturation and hypotension. APRV was initiated during post operative day 2 after inability to maintain adequate oxygen saturation with resultant hypotension on pressure control ventilation with varying degrees of positive end expiratory pressure and 100% inspired oxygen concentration. The initial set high pressure on APRV was 35 mm Hg. Yet, in lieu of decreasing lung compliance, it peaked at 50 mm Hg. Eventually, inhaled Nitric Oxide was initiated post operative day 3 due to increasing pulmonary arterial pressures. A bedside laparotomy was eventually performed when bladder pressures peaked to 25 mm Hg. APRV gradually and temporally improved the oxygen saturation and decreased the pulmonary arterial pressures with subsequent increase in systemic blood pressures. APRV promoted alveolar recruitment and decreased the shunting associated with abdominal compartment syndrome. Better oxygen saturations lead to increases in blood pressure by decreasing the effects of hypoxic pulmonary vasoconstriction on the right ventricle (RV). In patients with decreasing lung compliance and pulmonary comorbidities, APRV appears safe and allows for improve oxygenation, after failure with conventional modes of ventilation.
基金co-supported by the National Natural Science Foundation of China(Nos.51375075,51227004)the Special Funds of the National Natural Science Foundation of China(No.51227004)+2 种基金the National Basic Research Program of China(No.2014CB046504)the Fundamental Research Funds for the Central Universities of Chinathe Science Fund for Creative Research Groups of China(No.51321004)
文摘In this paper, we propose a simulative experimental system in wind tunnel conditions lbr the separation of auxiliary fuel tanks from an aircraft. The experimental system consists of a simulative release mechanism, a scaled model and a pose measuring system. A new release mechanism was designed to ensure stability of the separation. Scaled models of the auxiliary fuel tank were designed and their moment of inertia was adjusted by installing counterweights inside the model. Pose param- eters of the scaled model were measured and calculated by a binocular vision system. Additionally, in order to achieve high brightness and high signal-to-noise ratio of the images in the dark enclosed wind tunnel, a new high-speed image acquisition method based on miniature self-emitting units was pre- sented. Accuracy of the pose measurement system and repeatability of the separation mechanism were verified in the laboratory. Results show that the position precision of the pose measurement system can reach 0.1 mm, the precision of the pitch and yaw angles is less than 0.1° and that of the roll angle can be up to 0.3°. Besides, repeatability errors of models＂ velocity and angular velocity controlled by the release mechanism remain small, satisfying the measurement requirements. Finally, experiments for the separation of auxiliary fuel tanks were conducted in the laboratory.
