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ACC : Acute and Critical Care



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Original Article
Agreement between two methods for assessment of maximal inspiratory pressure in patients weaning from mechanical ventilation
Emanuelle Olympia Silva Ribeiro, Rik Gosselink, Lizandra Eveline da Silva Moura, Raissa Farias Correia, Wagner Souza Leite, Maria das Graças Rodrigues de Araújo, Armele Dornelas de Andrade, Daniella Cunha Brandão, Shirley Lima Campos
Acute Crit Care. 2022;37(4):592-600.   Published online October 27, 2022
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  • 195 Download
AbstractAbstract PDF
Respiratory muscle strength in patients with an artificial airway is commonly assessed as the maximal inspiratory pressure (MIP) and is measured using analogue or digital manometers. Recently, new electronic loading devices have been proposed to measure respiratory muscle strength. This study evaluates the agreement between the MIPs measured by a digital manometer and those according to an electronic loading device in patients being weaned from mechanical ventilation. Methods: In this prospective study, the standard MIP was obtained using a protocol adapted from Marini, in which repetitive inspiratory efforts were performed against an occluded airway with a one-way valve and were recorded with a digital manometer for 40 seconds (MIPDM). The MIP measured using the electronic loading device (MIPELD) was obtained from repetitively tapered flow resistive inspirations sustained for at least 2 seconds during a 40-second test. The agreement between the results was verified by a Bland-Altman analysis. Results: A total of 39 subjects (17 men, 55.4±17.7 years) was enrolled. Although a strong correlation between MIPDM and MIPELD (R=0.73, P<0.001) was observed, the Bland-Altman analysis showed a high bias of –47.4 (standard deviation, 22.3 cm H2O; 95% confidence interval, –54.7 to –40.2 cm H2O). Conclusions: The protocol of repetitively tapering flow resistive inspirations to measure the MIP with the electronic loading device is not in agreement with the standard protocol using one-way valve inspiratory occlusion when applied in poorly cooperative patients being weaned from mechanical ventilation.
Review Article
Basic science and research
Two-photon intravital imaging of leukocyte migration during inflammation in the respiratory system
Young Min Kim, Soi Jeong, Young Ho Choe, Young-Min Hyun
Acute Crit Care. 2019;34(2):101-107.   Published online May 31, 2019
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  • 185 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract PDF
Two-photon intravital imaging is a powerful method by which researchers are able to directly observe biological phenomena in live organisms. Researchers in various biomedical research fields have applied two-photon imaging to a variety of target organs by utilizing this technology’s ability to penetrate to significant depths with minimal phototoxicity. The mouse respiratory system in inflammation models is a good example, as two-photon intravital imaging can provide insights as to how the immune system is activated in response to inflammation within the respiratory system. Inflammation models can be generated via influenza viral, bacterial, or lipopolysaccharide injection. To exteriorize the lungs or trachea, thoracotomy or tracheotomy is performed, respectively; the appropriate combination of inflammation induction and organ exposure is selected depending on the study purpose. On the other hand, visualizing the movement of leukocytes is also an important component; to this end, immune cell populations of interest are either labeled via the genetic attachment of fluorescent proteins or stained with antibodies or dyes. With the proper selection of methods at each step, twophoton intravital imaging can yield visual evidence regarding immune responses to inflammation.


Citations to this article as recorded by  
  • Live-Cell Imaging Quantifies Changes in Function and Metabolic NADH Autofluorescence During Macrophage-Mediated Phagocytosis of Tumor Cells
    Shelby N. Bess, Matthew J. Igoe, Timothy J. Muldoon
    Immunological Investigations.2024; 53(2): 210.     CrossRef
  • Integration of immune cells in organs-on-chips: a tutorial
    Lisette Van Os, Britta Engelhardt, Olivier T. Guenat
    Frontiers in Bioengineering and Biotechnology.2023;[Epub]     CrossRef
  • Intravital Imaging of Pulmonary Immune Response in Inflammation and Infection
    Nazli Alizadeh-Tabrizi, Stefan Hall, Christian Lehmann
    Frontiers in Cell and Developmental Biology.2021;[Epub]     CrossRef
  • Probe-based intravital microscopy: filling the gap between in vivo imaging and tissue sample microscopy in basic research and clinical applications
    Katrien Van Dyck, Eliane Vanhoffelen, Jonas Yserbyt, Patrick Van Dijck, Marco Erreni, Sophie Hernot, Greetje Vande Velde
    Journal of Physics: Photonics.2021; 3(3): 032003.     CrossRef

ACC : Acute and Critical Care