Revue des maladies respiratoires
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To determine the effects of a pressure support ventilation (PSV) of 6 cm H(2)O during spontaneous breathing on oxygen consumption of the respiratory muscles (VO(2) resp), gas exchange, respiratory rate, tidal volume and to determine if these low levels of PSV can reduce or cancel the increase in work of breathing induced by the resistances of the endotracheal tube and the circuit of the respirator. ⋯ Despite a significant increase in spontaneous tidal volume, adding a PSV level of 6 cm H(2)O did not improve VO(2) resp. Thus, low level of PSV did not reduce the increased work of breathing induced by the resistances of the ventilator tubing and the endotracheal tube.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Comparison of volume preset and pressure preset ventilators during daytime nasal ventilation in chronic respiratory failure].
Both volume preset and pressure preset ventilators are available for domiciliary nasal ventilation. Owing to their technical characteristics, it has been suggested that impaired ventilatory mechanics might cause a drop in the tidal volume (Vt) delivered by pressure preset devices, thereby placing mechanical ventilation at risk of inefficacy. We have assessed two ventilator systems (one pressure preset and one volume preset) with regard to the tidal volume and end-tidal carbon dioxide tension (PetCO(2)) changes that may be achieved in a group of awake patients with stable chronic respiratory failure (CRF). ⋯ Comparison of the volume preset and pressure preset ventilators for RR, I/E and PetCO(2) did not reveal any difference. Compared to the volume preset ventilator, the efficacy of PPV to ventilate is not affected by the restrictive or obstructive nature of CRF. Our results show that pressure-preset ventilator is an adequate alternative to the volume-preset device for daytime non invasive ventilation in chronic respiratory insufficiency.
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The purpose of this study was to determine whether good-quality care for patients with lung cancer can be delivered without a full hospitalization unit. Our study included all consecutive untreated lung cancer patients admitted over a two-year period. The following criteria were analyzed retrospectively: residence, age, sex, histology, staging, treatments, administrative data during the first 6 months of treatment, place of death, and duration of last stay before death in the unit. ⋯ During the first year, 71% of the patients dies: 36% in our unit (47% of them were inpatients for more than 6 days during their last stay). Diagnosis, initial treatment, management of treatment complications and supportive care are not compatible with weekly hospitalization. Full hospitalization is mandatory for good-quality care in a referral cancer unit.