A5054772138- Respiratory Support and Mechanisms
- Chronic Obstructive Pulmonary Disease (COPD) Research
- Pleural and Pulmonary Diseases
- Neonatal Respiratory Health Research
- Inhalation and Respiratory Drug Delivery
- Neuroscience of respiration and sleep
- Airway Management and Intubation Techniques
- Tracheal and airway disorders
- Congenital Diaphragmatic Hernia Studies
- Cardiac Arrest and Resuscitation
- Asthma and respiratory diseases
- Intensive Care Unit Cognitive Disorders
- Obstructive Sleep Apnea Research
- Trauma Management and Diagnosis
- Mechanical Circulatory Support Devices
- Voice and Speech Disorders
- Pulmonary Hypertension Research and Treatments
- Dysphagia Assessment and Management
- Cardiovascular and Diving-Related Complications
- Tribology and Lubrication Engineering
- Lung Cancer Diagnosis and Treatment
- Allergic Rhinitis and Sensitization
- Shoulder Injury and Treatment
- Marine animal studies overview
- Abdominal Surgery and Complications
Harvard University
2013-2024
Beth Israel Deaconess Medical Center
2014-2024
Pain and Rehabilitation Medicine
2009-2021
Hadassah Medical Center
1998-2017
Harvard University Press
1988-2013
Pulmonary and Critical Care Associates
2013
Beth Israel Deaconess Hospital
2009-2010
National Museum of Natural History
2009
Brigham and Women's Hospital
1980-2006
National Heart Lung and Blood Institute
2006
Survival of patients with acute lung injury or the respiratory distress syndrome (ARDS) has been improved by ventilation small tidal volumes and use positive end-expiratory pressure (PEEP); however, optimal level PEEP difficult to determine. In this pilot study, we estimated transpulmonary esophageal balloon catheters. We reasoned that pleural-pressure measurements, despite technical limitations accuracy such would enable us find a value could maintain oxygenation while preventing due...
Obstructive sleep apnea is an important disorder because of both its prevalence and cardiovascular neurocognitive sequelae. Despite the fact that male sex a major risk factor for this disorder, mechanisms underlying predisposition are unclear. To understand pathophysiologic basis pharyngeal collapse, we performed detailed analysis anatomic physiologic features upper airway in cohort normal near-normal subjects (equal number men women). Although no (genioglossal electromyogram, airflow...
Adjusting positive end-expiratory pressure (PEEP) to offset pleural might attenuate lung injury and improve patient outcomes in acute respiratory distress syndrome (ARDS).To determine whether PEEP titration guided by esophageal (PES), an estimate of pressure, was more effective than empirical high PEEP-fraction inspired oxygen (Fio2) moderate severe ARDS.Phase 2 randomized clinical trial conducted at 14 hospitals North America. Two hundred mechanically ventilated patients aged 16 years older...
A 33-year-old woman underwent a right-sided pneumonectomy in 1995 for treatment of lung adenocarcinoma. As expected, there was an abrupt decrease her vital capacity, but unexpectedly, it increased during the subsequent 15 years. Serial computed tomographic (CT) scans showed progressive enlargement remaining left and increase tissue density. Magnetic resonance imaging (MRI) with use hyperpolarized helium-3 gas overall acinar-airway dimensions that were consistent alveolar number rather than...
Precision medicine for obstructive sleep apnea (OSA) requires noninvasive estimates of each patient's pathophysiological "traits." Here, we provide the first automated technique to quantify respiratory arousal threshold—defined as level ventilatory drive triggering from sleep—using diagnostic polysomnographic signals in patients with OSA. Ventilatory preceding clinically scored arousals was estimated studies by fitting a control model (Terrill et al.) pattern ventilation during spontaneous...
Pressure inflating the lung during mechanical ventilation is difference between pressure applied at airway opening (Pao) and pleural (Ppl). Depending on chest wall's contribution to respiratory mechanics, a given positive end-expiratory and/or end-inspiratory plateau may be appropriate for one patient but inadequate or potentially injurious another. Thus, failure account wall mechanics affect results in clinical trials of strategies acute distress syndrome. By measuring esophageal (Pes), we...
To explore mechanisms of restrictive respiratory physiology and high pleural pressure (P(Pl)) in severe obesity, we studied 51 obese subjects (body mass index = 38-80.7 kg/m(2)) 10 nonobese subjects, both groups without lung disease, anesthetized, paralyzed for surgery. We measured esophageal gastric pressures (P(Es), P(Ga)) using a balloon-catheter, airway (P(AO)), flow, volume. compared P(Es) to another estimate P(Pl) based on P(AO) flow. Reasoning that the lungs would not inflate until...
At high oscillation frequencies (4 to 30 hertz), effective alveolar ventilation can be achieved with tidal volumes much smaller than the anatomic dead space. An explanation of this phenomenon is given in terms combined effects diffusion and convection data consistent hypothesis. Theory experimental results both show that significant variable determining effectiveness gas exchange amplitude oscillatory flow rate independent individual values frequency stroke volume.
To assess forced expiratory tracheal collapsibility in healthy volunteers by using multidetector computed tomography and to compare the results with current diagnostic criterion for tracheomalacia.An institutional review board approved this HIPAA-compliant study. After informed consent was obtained, 51 (age range, 25-75 years) normal spirometry no history of smoking or risk factors tracheomalacia were prospectively studied. Volunteers imaged a 64-detector row scanner, spirometric monitoring...
Diaphragmatic volume displacements cause equal of abdominal contents. Since the rib cage forms a variable part container (the being its area apposition with diaphragm) and ventral wall share in displacements. The fraction total displacement (delta Vrc) contributing to is predicted from anatomic considerations measurements. During quiet inspirations it estimated that more than half delta Vrc goes into expansion. This plus outward anterolateral constitute diaphragmatic displacement. In typical...
Acute lung injury can be worsened by inappropriate mechanical ventilation, and numerous experimental studies suggest that ventilator-induced is increased excessive inflation at end inspiration or inadequate expiration. Lung depends not only on airway pressures from the ventilator but, also, pleural pressure within chest wall. Although esophageal (Pes) measurements are often used to estimate in healthy subjects patients, they widely mistrusted rarely critical illness. To assess credibility of...
Both anatomical and nonanatomical traits are important in obstructive sleep apnea (OSA) pathogenesis. We have previously described a model combining these traits, but not determined its diagnostic accuracy to predict OSA. A valid model, knowledge of the published effect sizes trait manipulation, would also allow us number patients with OSA who might be effectively treated without using positive airway pressure (PAP).Fifty-seven subjects underwent standard clinical research studies measure...
Body habitus is a major determinant of obstructive sleep apnea (OSA). However, many individuals do not have OSA despite being overweight/obese (body mass index > 25 kg/m(2)) for reasons that are fully elucidated.To determine the key physiologic traits (upper-airway anatomy/collapsibility, upper-airway muscle responsiveness, chemoreflex control ventilation, arousability from sleep) responsible absence in individuals.We compared 18 subjects without (apnea-hypopnea < 15 events per hour) with...
PURPOSE: To compare dynamic expiratory and end-expiratory computed tomography (CT) for depicting central airway collapse in patients with acquired tracheobronchomalacia (TBM). MATERIALS AND METHODS: Institutional review board approval was obtained, informed consent not needed. Retrospective performed of all a CT diagnosis TBM 10-month period (n = 34) who underwent evaluation disease by means three different sequences at multi–detector row CT: end inspiration, expiration, expiration (the...