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Gonzales Carazas MM, Gavidia CM, Davila Fernandez R, Vargas Zuñiga JA, Crespo Paiva A, Bocanegra W, Calderon J, Sanchez E, Perales R, Zeña B, Calcina Isique JF, Reategui J, Castañeda B, Casado FL. Biological evaluation of a mechanical ventilator that operates by controlling an automated manual resuscitator. A descriptive study in swine. PLoS One 2022; 17:e0264774. [PMID: 35239740 PMCID: PMC8893637 DOI: 10.1371/journal.pone.0264774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 02/17/2022] [Indexed: 11/26/2022] Open
Abstract
The Covid-19 outbreak challenged health systems around the world to design and implement cost-effective devices produced locally to meet the increased demand of mechanical ventilators worldwide. This study evaluates the physiological responses of healthy swine maintained under volume- or pressure-controlled mechanical ventilation by a mechanical ventilator implemented to bring life-support by automating a resuscitation bag and closely controlling ventilatory parameters. Physiological parameters were monitored in eight sedated animals (t0) prior to inducing deep anaesthesia, and during the next six hours of mechanical ventilation (t1-7). Hemodynamic conditions were monitored periodically using a portable gas analyser machine (i.e. BEecf, carbonate, SaO2, lactate, pH, PaO2, PaCO2) and a capnometer (i.e. ETCO2). Electrocardiogram, echocardiography and lung ultrasonography were performed to detect in vivo alterations in these vital organs and pathological findings from necropsy were reported. The mechanical ventilator properly controlled physiological levels of blood biochemistry such as oxygenation parameters (PaO2, PaCO2, SaO2, ETCO2), acid-base equilibrium (pH, carbonate, BEecf), and perfusion of tissues (lactate levels). In addition, histopathological analysis showed no evidence of acute tissue damage in lung, heart, liver, kidney, or brain. All animals were able to breathe spontaneously after undergoing mechanical ventilation. These preclinical data, supports the biological safety of the medical device to move forward to further evaluation in clinical studies.
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Affiliation(s)
| | - Cesar Miguel Gavidia
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | | | | | | | - William Bocanegra
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Joan Calderon
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Evelyn Sanchez
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Rosa Perales
- School of Veterinary Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Brandon Zeña
- Instituto Veterinario de Oftalmologia (IVO), Lima, Peru
| | | | | | - Benjamin Castañeda
- Institute of Omics and Applied Biotechnology, Pontificia Universidad Catolica del Peru, Lima, Peru
- Department of Engineering, Pontificia Universidad Catolica del Peru, Lima, Peru
| | - Fanny L. Casado
- Institute of Omics and Applied Biotechnology, Pontificia Universidad Catolica del Peru, Lima, Peru
- Department of Engineering, Pontificia Universidad Catolica del Peru, Lima, Peru
- * E-mail:
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Muraresku CC, McCormick EM, Falk MJ. Mitochondrial Disease: Advances in clinical diagnosis, management, therapeutic development, and preventative strategies. CURRENT GENETIC MEDICINE REPORTS 2018; 6:62-72. [PMID: 30393588 PMCID: PMC6208355 DOI: 10.1007/s40142-018-0138-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
PURPOSE OF REVIEW Primary mitochondrial disease encompasses an impressive range of inherited energy deficiency disorders having highly variable molecular etiologies as well as clinical onset, severity, progression, and response to therapies of multi-system manifestations. Significant progress has been made in primary mitochondrial disease diagnostic approaches, clinical management, therapeutic options, and preventative strategies that are tailored to major mitochondrial disease phenotypes and subclasses. RECENT FINDINGS The extensive phenotypic pleiotropy of individual mitochondrial diseases from an organ-based perspective is reviewed. Improved consensus on standards for mitochondrial disease patient care are being complemented by emerging therapies that target specific molecular subtypes of mitochondrial disease. Reproductive counseling options now include preimplantation genetic diagnosis at the time of in vitro fertilization for familial mutations in nuclear genes and some mtDNA disorders. Mitochondrial replacement technologies have promise for some mtDNA disorders, although practical and societal challenges remain to allow their further research analyses and clinical utilization. SUMMARY A dramatic increase has occurred in recent years in the recognition, understanding, treatment options, and preventative strategies for primary mitochondrial disease.
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Affiliation(s)
- Colleen C. Muraresku
- Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Elizabeth M. McCormick
- Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Marni J. Falk
- Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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Piekutowska-Abramczuk D, Rutyna R, Czyżyk E, Jurkiewicz E, Iwanicka-Pronicka K, Rokicki D, Stachowicz S, Strzemecka J, Guz W, Gawroński M, Kosierb A, Ligas J, Puchala M, Drelich-Zbroja A, Bednarska-Makaruk M, Dąbrowski W, Ciara E, Książyk JB, Pronicka E. Leigh syndrome in individuals bearing m.9185T>C MTATP6 variant. Is hyperventilation a factor which starts its development? Metab Brain Dis 2018; 33:191-199. [PMID: 29116603 PMCID: PMC5769826 DOI: 10.1007/s11011-017-0122-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 10/04/2017] [Indexed: 02/02/2023]
Abstract
Leigh syndrome (LS), subacute necrotizing encephalomyelopathy is caused by various genetic defects, including m.9185T>C MTATP6 variant. Mechanism of LS development remains unknown. We report on the acid-base status of three patients with m.9185T>C related LS. At the onset, it showed respiratory alkalosis, reflecting excessive respiration effort (hyperventilation with low pCO2). In patient 1, the deterioration occurred in temporal relation to passive oxygen therapy. To the contrary, on the recovery, she demonstrated a relatively low respiratory drive, suggesting that a "hypoventilation" might be beneficial for m.9185T>C carriers. As long as circumstances of the development of LS have not been fully explained, we recommend to counteract hyperventilation and carefully dose oxygen in patients with m.9185T>C related LS.
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Affiliation(s)
- Dorota Piekutowska-Abramczuk
- Department of Medical Genetics, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Rafał Rutyna
- Chair and Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Elżbieta Czyżyk
- Clinical Department of Child Neurology, Clinical Central Hospital No 2 in Rzeszow, Rzeszow, Poland
| | - Elżbieta Jurkiewicz
- Department of Radiology, The Children’s Memorial Health Institute, Warsaw, Poland
| | | | - Dariusz Rokicki
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Sylwia Stachowicz
- Department of Neurology, Public Independent Clinic Hospital No 4 in Lublin, Lublin, Poland
| | - Joanna Strzemecka
- Department of Orthopaedics and Rehabilitation, Public Independent Clinic Hospital No 4 in Lublin, Lublin, Poland
- Institute of Health Sciences, Pope John Paul II State School of Higher Education, Biała Podlaska, Poland
| | - Wiesław Guz
- Department of Electroradiology, Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszow, Rzeszów, Poland
- Clinical Department of Radiology, Clinical Central Hospital No 2, Rzeszow, Poland
| | - Michał Gawroński
- Student Academic Club at The Chair and Department of Anaesthesiology and Intensive Therapy, II Faculty of Medicine with English Language Division, Medical University of Lublin, Lublin, Poland
| | - Aneta Kosierb
- Student Academic Club at The Chair and Department of Anaesthesiology and Intensive Therapy, II Faculty of Medicine with English Language Division, Medical University of Lublin, Lublin, Poland
| | - Joanna Ligas
- Student Academic Club at The Chair and Department of Anaesthesiology and Intensive Therapy, II Faculty of Medicine with English Language Division, Medical University of Lublin, Lublin, Poland
| | - Mateusz Puchala
- Student Academic Club at The Chair and Department of Anaesthesiology and Intensive Therapy, II Faculty of Medicine with English Language Division, Medical University of Lublin, Lublin, Poland
| | - Anna Drelich-Zbroja
- Department of Interventional Radiology and Neuroradiology Medical University of Lublin, Lublin, Poland
| | | | - Wojciech Dąbrowski
- Chair and Department of Anaesthesiology and Intensive Therapy, Medical University of Lublin, Lublin, Poland
| | - Elżbieta Ciara
- Department of Medical Genetics, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland
| | - Janusz B. Książyk
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Ewa Pronicka
- Department of Medical Genetics, The Children’s Memorial Health Institute, Aleja Dzieci Polskich 20, 04-730 Warsaw, Poland
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children’s Memorial Health Institute, Warsaw, Poland
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