Respiration; international review of thoracic diseases
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Measurement of intrapleural pressure is useful during various pleural procedures. However, a pleural manometer is rarely available. ⋯ In the face of very limited offer of commercially available pleural manometers, it is possible to successfully construct a self-made, reliable, electronic pleural manometer at modest costs. The device is easy to use and enables data display and storage in the personal computer.
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In 2007, the American Thoracic Society (ATS) and Infectious Disease Society of America (IDSA) published new diagnostic guidelines for nontuberculous mycobacterial (NTM) disease. Bacteriological criteria have become simpler compared to the 1997 ATS diagnostic criteria. ⋯ These data suggest that we can shorten the time to diagnose NTM lung disease and diagnose more simply by using the 2007 ATS/IDSA guidelines. Further study will be needed to assess that these changes affect the management of NTM disease.
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In patients with severe chronic obstructive pulmonary disease (COPD), pursed-lips breathing (PLB) improves the pulmonary gas exchange and hyperinflation measured by electro-optic coupling. The response to PLB in inspiratory lung function tests is not known. ⋯ Improved IC after PLB indicates less hyperinflation in patients with severe COPD; there was no effect on parameters of flow.
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We report a 12-year-old boy who underwent stent implantation into the left main bronchus at the age of 9.5 years for palliation of severe bronchial stenosis. He had developed complete obstruction of the stent by granulation tissue resulting in respiratory deterioration and the requirement of mechanical ventilation. The stent obstruction was treated at the age of 11.5 years by cryorecanalization. ⋯ Seven months after the initial procedure there was a complete patency of the stent. According to our experience, cryorecanalization is a safe and effective alternative for the treatment of stent obstruction by granulation tissue. Due to the introduction of a miniaturized probe, this method is well applicable in children since it can be performed via the working channel of a flexible pediatric bronchoscope.
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Exertional dyspnea is the primary symptom that limits exercise in patients with chronic obstructive pulmonary disease (COPD). It is unknown which activated brain area is associated with this symptom in COPD patients. ⋯ Exertional dyspnea was related to activation (oxygenation) of the prefrontal cortex in COPD patients and control subjects.