OBJECTIVETo study the analgesic effect and safety of fentanyl in neonates receiving mechanical ventilation.

METHODSThirty neonates receiving mechanical ventilation between December 2010 and February 2011 were randomized into drug intervention group and control group (n=15 each). In addition to the conventional treatment for both groups, the drug intervention group received fentanyl as the analgesic treatment. Heart rate, respiratory rate, blood pressure changes, and premature infant pain profile (PIPP) score before treatment and at 30 minutes, 2 hours, and 4 hours after treatment were recorded in both groups. Follow-up visits were performed for these infants after discharge, and the CDCC intellectual development scale for infants was applied to measure mental development index (MDI) and psychomotor development index (PDI) at 3, 6, 9, and 12 months of age.

RESULTSThe respiratory rate and heart rate decreased in the drug intervention group after fentanyl treatment compared with the control group (P<0.05), and the PIPP scores in the drug intervention group was significantly lower than in the control group (P<0.05). The results of follow-up visits showed no significant differences in MDI and PDI at 3, 6, 9 and 12 months of age between the drug intervention and control groups (P>0.05).

CONCLUSIONSFentanyl can relieve the pain response in neonates receiving mechanical ventilation, with no long-term adverse effects on neurodevelopment.

Analgesics, Opioid ; pharmacology ; Child Development ; drug effects ; Female ; Fentanyl ; pharmacology ; Heart Rate ; drug effects ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Respiration ; drug effects ; Respiration, Artificial

People complain about nasal stuffiness after SO2 exposure. This study was to investigate the acute effects of SO2 on nasal vascular and airway resistances in anaesthetized pigs for elucidating the underlying vascular and control mechanisms. Controlled ventilation was passed to the lungs or retrogradely through each nasal cavity. Nasal airway and lower airway pressures were measured to reflect airflow resistance changes. Systemic arterial pressure and nasal arterial flow were measured to calculate nasal vascular resistance. Nasal and pulmonary SO2 challenges were given. At 2 ppm, SO2 decreased systemic blood pressure and nasal vascular resistance but increased nasal airway and lower airway resistances. With increasing level to 8 ppm, SO2 increased systemic arterial pressure, nasal vascular and lower airway resistances but decreased nasal airway resistance. Nasal and pulmonary challenges induced similar responses. Ipsilateral nasal challenge elicited bilateral responses. Ruthenium red abolished the responses to nasal challenges. Bilateral vagosympathectomy eliminated the responses to lung challenges. Hence, SO2 at 2 ppm causes nasal congestion through sensory reflex vasodilatation but at higher levels nasal decongestion through sensory reflex vasoconstriction. Nasal congestion coupled with bronchoconstriction at levels of SO2 below short-term exposure limit (STEL) (≤ 2 ppm) would limit SO2 entering the lungs. Nasal decongestion at levels of SO2 beyond STEL (> 2 ppm) can effectively decrease total airway resistance as concurrent strong bronchoconstriction may impair ventilation.
Administration, Inhalation ; Airway Resistance ; drug effects ; Animals ; Lung ; drug effects ; Nasal Cavity ; drug effects ; Respiration ; Sulfur Dioxide ; pharmacology ; Swine ; Vascular Resistance ; drug effects ; Vasodilation

OBJECTIVETo investigate the effect of high glucose on mitochondrial respiratory chain function in INS-1 cells.

METHODSThe pancreatic beta cell line INS-1 was divided into the normal control (NC), high glucose (HG), and N-acetyl-L-cysteine (NAC) pretreatment groups, which were cultured for 72 h in the presence of 5.5 mmol/L glucose, 16.7 mmol/L glucose, and 16.7 mmol/L glucose with 1.0 mmol/L NAC, respectively. The activities of the enzyme complexes I and III of the respiratory chain in the cells were assessed with spectrophotometry, the ATP levels were examined using a luciferinluciferase kit, and insulin levels detected by radioimmunoassay.

RESULTSThe activities of the respiratory chain enzyme complexes I and III were 1.53-/+0.24 and 1.08-/+0.22 micromol.mg(-1).min(-1) in high glucose group, respectively, significantly lower than those in the normal control group (2.31-/+0.33 and 1.92-/+0.39 micromol.mg(-1).min(-1), P<0.01). ATP and insulin levels also decreased significantly in high glucose group as compared with those in the normal control group (P<0.01). The addition of NAC partially inhibited high glucose-induced decreases in the enzyme complex activities, ATP levels and insulin secretion (P<0.05).

CONCLUSIONThe respiratory chain function is positively correlated to insulin secretion in INS-1 cells, and exposure to high glucose causes impairment of the two enzyme complexes activities through oxidative stress, resulting in the mitochondrial respiratory chain dysfunction. High glucose-induced damages of the mitochondrial respiratory chain function can be partially inhibited by NAC.

Cell Respiration ; drug effects ; Cells, Cultured ; Glucose ; pharmacology ; Humans ; Insulin-Secreting Cells ; cytology ; physiology ; Mitochondria ; physiology ; Oxidative Stress ; drug effects

OBJECTIVETo investigate the effect of different doses of dexmedetomidine (Dex) on early postoperative cognitive dysfunction in elderly patients undergoing laparoscopic surgery for colorectal cancer.

METHODSEighty ASAI-III elderly patients (over 65 years) were randomized equally into 4 groups including a control group without dexmedetomidine and 3 dexmedetomidine groups (groups D1, D2, and D3) with loading dexmedetomidine doses of 0.2, 0.5, and 0.8 µg/kg and maintenance doses of 0.2, 0.5, and 0.8 µg·kg(-1)·h(-1), respectively. Dex was discontinued 30 min before the end of surgery. The time of operation, adverse reactions, time from the end of surgery to spontaneous breathing recovery (TR), time from spontaneous breathing recovery to opening eyes (TO), and time from opening eyes to extubation (TE) were recorded. Mini-Mental State (MMSE) test was used to assess the cognitive function 1 day before and at 1 day and 3 days after the operation.

RESULTSThe incidence of postoperative cognitive dysfunction (POCD) was significantly lower in groups D2 and D3 than in the control group and group D1 (P<0.05). The incidences of hypotension and bradycardia were the highest in group D3 (P<0.05), which also had longer significantly TO and TE than the other 3 groups (P<0.05).

CONCLUSIONDexmedetomidine with a loading dose of 0.5 µg/kg followed by maintenance doses of 0.5 and 0.8 µg·kg(-1)·h(-1) (preferentially 0.5 µg·kg(-1)·h(-1)) can reduce the incidence of POCD in elderly patients undergoing laparoscopic surgery for colorectal cancer.

Aged ; Cognition ; drug effects ; Colorectal Neoplasms ; surgery ; Dexmedetomidine ; administration & dosage ; Humans ; Laparoscopy ; Postoperative Complications ; Respiration

Controlled mechanical ventilation (CMV) with positive and expiratory pressure (PEEP) is often used to improve the pulmonary gas exchange in patients with acute respiratory distress syndrome. However, this ventilatory technique may induce hemodynamic and hormonal changes which may lead to vital organ dysfunction, such as oliguria. Low dose dopamine, acting as a dopaminergic receptor agonist, may improve vital organ perfusions, i.e. renal, mesenteric and coronary perfusions. The purpose of this current study was to evaluate the effects of low dose dopamine on renal function and hemodynamic change during controlled mechanical ventilation with PEEP. The study was performed on 10 patients treated with PEEP in the surgical intensive care unit. Starting with 0 cmH2O of PEEP and adding 4 cmH2O of PEEP at 4-hour intervals until it reached 12 cmH2O of PEEP, dopamine, 2 ug/kg/min, was selectively, administered, intravenously during the last two hours of each four hour intervals. Following each procedure, hemodynamic parameters, urine output, creatinine clearance and fractional excretion of sodium were measured. The cardiac index and mean arterial pressure had both decreased, but the mean pulmonary arterial pressure was increased at 12 cmH2O of PEEP compared with 0 cmH2O of PEEP in both groups with and without low dose dopamine. The main result of this study was that low dose dopamine attenuated the decrease of the cardiac index, urine output and creatinine clearance induced by mechanical ventilation with PEEP at 12 cmH2O.
Adult ; Aged ; Dopamine/therapeutic use ; Dopamine/administration & dosage* ; Dose-Response Relationship, Drug ; Female ; Hemodynamics/drug effects ; Human ; Kidney/physiopathology* ; Kidney/drug effects* ; Male ; Middle Age ; Positive-Pressure Respiration*

OBJECTIVETo study the effects of pentobarbital sodium in generation and modulation of rhythmical respiration in neonatal rats.

METHODSThe effects of pentobarbital sodium were examined on hypoglossal nerve (XII) rootlets and inspiratory neurons in the medullary preparations including the medial region of the nucleus retrofacialis, pre-Bötzinger complex and the dorsal respiratory group of neonatal rats aged 0-3 days. The electrical activity of XII nerve rootlets and inspiratory neurons were recorded. Different doses of pentobarbital sodium (20, 40, 60, 80 micromol/L) were added into modified Krebs solution to observe changes in the discharge activity of XII nerve and inspiratory neurons. Bicuculline was used to further investigate the mechanisms that pentobarbital sodium suppresses respiration.

RESULTSThe discharge activity inhibition of XII nerve was increased as pentobarbital sodium doses increased from 20 to 60 micromol/L, but no significant difference was observed between the doses of 60 and 80 micromol/L. Bicuculline can partly restore the rhythmical respiration discharge activity.

CONCLUSIONPentobarbital sodium can suppress respiration partly via GABAA receptors.

Adjuvants, Anesthesia ; pharmacology ; Animals ; Animals, Newborn ; Dose-Response Relationship, Drug ; Medulla Oblongata ; cytology ; drug effects ; physiology ; Neurons ; drug effects ; physiology ; Pentobarbital ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Receptors, GABA-A ; physiology ; Respiration ; drug effects ; Respiratory Center ; drug effects ; physiology

OBJECTIVETo investigate the effects of prenatal alcohol exposure on rhythmic respiratory discharge activity (RRDA) in the medullary slices of neonatal rats.

METHODSTen pregnant female SD rats were exposed to 0, 4%, 6%, 8%, and 10% alcohol in drinking water from 1 week before till 3 days after delivery. The medullary slices of the neonatal rats containing the medial region of the nucleus retrofacialis (mNRF) with the hypoglossal nerve rootlets were prepared and perfused with modified Kreb's solution to record RRDA from the hypoglossal nerve rootlets using suction electrodes.

RESULTSNo significant difference was found in RRDA in 50 min among the neonatal rats with prenatal exposure to 0, 4%, 6%, and 8% alcohol, but the RRDA in 10% alcohol exposure group became irregular. Prenatal exposure to increased alcohol concentrations caused attenuated RRDA attenuated in the neonatal rats, shown by shortened inspiratory time (TI), decreased respiratory frequency (RF), and reduced integral amplitude (IA) as compared with those in the control group.

CONCLUSIONPrenatal alcohol exposure inhibits RRDA in medullary slices of neonatal rats, which might be a mechanism by which maternal alcohol exposure causes suppressed offspring respiratory functions.

Animals ; Animals, Newborn ; Ethanol ; adverse effects ; Female ; Hypoglossal Nerve ; drug effects ; physiopathology ; Medulla Oblongata ; drug effects ; physiopathology ; Pregnancy ; Prenatal Exposure Delayed Effects ; Rats ; Rats, Sprague-Dawley ; Respiration ; drug effects

This study was performed to clarify the analgesic effect of ketamine injected into the first intercoccygeal (Co1-Co2) epidural space in standing cattle. Five adult cows were randomly received 3 treatments at least 1 week interval: 5, 10 and 20 mL of 5% ketamine. Sedation, analgesia, ataxia and other effects on cardiopulmonary and rumen functions were assessed before ketamine administration and until 120 min. The analgesia without sedation was shown at tail and perineum about 5 min after all three treatments. The duration of analgesia was significantly increased according to the volume of ketamine (p < 0.01). There was a similar tendency of ataxia with individual variation. There were minimal effects on cardiopulmonary and rumen functions. The present study showed that caudal epidural ketamine administration induced analgesia without sedation in cows, and the duration of analgesia was dose dependent with ataxia. However, the duration of analgesia after 5 and 10 mL ketamine administration is short for common surgical procedures and pain relief of perineum. Further studies are needed to prolong the duration of analgesia without side effects.
Analgesia, Epidural/*veterinary ; Analgesics/*administration & dosage ; Animals ; Blood Pressure/drug effects ; Body Temperature/drug effects ; Cattle/*physiology ; Female ; Heart Rate/drug effects ; Ketamine/*administration & dosage ; Respiration/drug effects ; Rumen/metabolism

Animals ; Blood Pressure ; drug effects ; Electric Stimulation ; Female ; Habenula ; physiology ; Lidocaine ; pharmacology ; Male ; Raphe Nuclei ; physiology ; Rats ; Rats, Wistar ; Respiration ; drug effects ; Serotonin ; physiology

OBJECTIVETo investigate the composition and resistance of main pathogens isolated form Lower respiratory tract in coalminer's pneumoconiosis patients complicated with infection to provide the basis for clinical treatment.

METHODCoalminer's pneumoconiosis patients complicated with infection during 2009 to 2010 were divided into mechanical ventilation group and non mechanical ventilation group. Specimens were obtained from lower respiratory tract by fibrobronchoscopy with protected specimen brush in patients of both groups to perform isolation, culture, identification and susceptibility test of pathogen.

RESULTTotal 111 patients were enrolled, 36 of them in mechanical ventilation group and 75 patients in non mechanical ventilation group. The pathogenic bacteria detection rate of patients in mechanical ventilation group was significantly higher than that of patients in non mechanical ventilation group (88.9% vs. 46.7%, P < 0.01). In non mechanical ventilation group, Mycobacterium tuberculosis was detected in 3 patients, and 27 strains of G- bacilli, 3 strains of G+ coccus, and 2 strains of fungus; and 26 strains of G- bacilli, 3 strains of G+ coccus, and 3 strains of fungus were detected in mechanical ventilation group. There was no significant difference in term of strains between the two groups (P > 0.05). Rate of resistance to main antibiotics of patients in mechanical ventilation group was higher than that of patients in non mechanical ventilation group.

CONCLUSIONResistance of pathogenic bacteria isolated from lower respiratory tract was severe in coalminer's pneumoconiosis patients complicated with infection, which was higher in patients treated with mechanical ventilation than patients without mechanical ventilation. Mycobacterium tuberculosis and fungal infection and increasing resistance prompted that clinicians must attach importance to rational drug use and keep to monitoring bacterial resistance.

Aged ; Aged, 80 and over ; Anthracosis ; microbiology ; Drug Resistance, Bacterial ; Humans ; Male ; Middle Aged ; Mycobacterium tuberculosis ; drug effects ; isolation & purification ; Respiration, Artificial ; adverse effects ; Respiratory Tract Infections ; microbiology