Respiration; international review of thoracic diseases
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An effective treatment of advanced states of chronic obstructive pulmonary disease (COPD) has yet to be established. We report the case of a COPD patient with severe hypoxemia (pO2 = 32.0 mm Hg) and hypercapnia (pCO2 = 90.0 mm Hg) who was successfully treated for 8 months with nasal intermittent positive-pressure ventilation (NIPPV) plus supplemental O2 in a domiciliary treatment. The reduction of hypoxemia parallel to the alleviation of hypercapnia reversed the patient's continuously declining condition.
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The clinical utility of the newly developed pressure swing adsorption (PSA)-type oxygen concentrator with a membrane humidifier that does not require added water for humidification was evaluated in 13 patients with chronic pulmonary disease who were receiving long-term oxygen therapy. PaO2 and the relative humidity were measured when the patient breathed air and oxygen from the new device via a nasal cannula. After using the new concentrator for 5 h, the patients were asked whether they experienced dry nasal passages or a dry throat. ⋯ A significant difference was observed between the relative humidity of room air (44.7 +/- 18.6%) and that of the oxygen flow (72.7 +/- 14.8%) from the new device. None of the patients experienced dry nasal passages, dry throat, or any other adverse effects. Since this new PSA-type oxygen concentrator with a membrane humidifier supplies well-humidified nasal oxygen without water, laborious cleaning of the container and changing of the water are not necessary, and may help to improve the patient's quality of life.
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Randomized Controlled Trial Clinical Trial
Breathing pattern and respiratory mechanics in chronically tracheostomized patients with chronic obstructive pulmonary disease breathing spontaneously through a hygroscopic condenser humidifier.
Hygroscopic condenser humidifiers (HCHs) have been proposed to artificially condition gases breathed by intubated and mechanically ventilated patients. These devices may improve viscosity and coloring of secretions, preventing further bacterial colonization, and heat inspiratory flow in chronically tracheostomized (CT) patients during spontaneous breathing. The aim of this study was to evaluate the effects of HCH on respiratory mechanics and breathing pattern in CT patients with chronic obstructive pulmonary disease (COPD) breathing spontaneously during quiet breathing and maximal voluntary ventilation (MVV). ⋯ These changes were not significantly different without the application of HCH. In CT COPD patients spontaneously breathing. HCHs have no significant effects on the breathing pattern and respiratory mechanics both during quiet breathing and MVV.
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Comparative Study
Features of idiopathic pulmonary fibrosis with organizing pneumonia.
To characterize the clinical features of patients with idiopathic pulmonary fibrosis (IPF) having organizing pneumonia (OP), we retrospectively reviewed the clinical charts, chest X-rays, CT scans, and transbronchial lung biopsy (TBLB) specimens of patients with IPF. Patients with IPF and OP had a subacute onset of symptoms (within 2 months) (87.5%), leukocytosis (> 10,000/mm3) (62.5%), and a strong C-reactive protein (CRP) reaction (> 3+) (75%). Some of these features were distinctly different from those of IPF patients without OP (subacute onset of symptoms 0%, leukocytosis 0%, strong CRP reaction 16.7%). ⋯ Clinical features of IPF patients with OP differed from those of patients with IPF without OP. IPF patients with OP showed good clinical response to corticosteroid therapy. These findings warrant further study of the presence of OP in TBLB specimens in predicting corticosteroid responsiveness and prognosis of patients with IPF.