Archivos de bronconeumología
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Arch. Bronconeumol. · Feb 2014
Comparative StudyExperience and development of the video-assisted thoracic surgery lobectomy technique: comparative study with conventional surgery in stage I non-small cell lung cancer.
Surgical treatment of stage I non-small cell lung cancer (NSCLC) can be performed either by thoracotomy or by employing video-assisted thoracic surgery (VATS). The aim of this study was to compare long and short-term results of conventional surgery (CS) vs. VATS lobectomy in the treatment of stage I NSCLC. ⋯ VATS lobectomy is a safe and effective approach, with a shorter hospital stay and lower morbidity than CS; no statistically significant differences were observed in survival in patients undergoing surgery for stage I NSCLC.
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Arch. Bronconeumol. · Feb 2014
ReviewRespiratory muscle dysfunction: a multicausal entity in the critically ill patient undergoing mechanical ventilation.
Respiratory muscle dysfunction, particularly of the diaphragm, may play a key role in the pathophysiological mechanisms that lead to difficulty in weaning patients from mechanical ventilation. The limited mobility of critically ill patients, and of the diaphragm in particular when prolonged mechanical ventilation support is required, promotes the early onset of respiratory muscle dysfunction, but this can also be caused or exacerbated by other factors that are common in these patients, such as sepsis, malnutrition, advanced age, duration and type of ventilation, and use of certain medications, such as steroids and neuromuscular blocking agents. In this review we will study in depth this multicausal origin, in which a common mechanism is altered protein metabolism, according to the findings reported in various models. The understanding of this multicausality produced by the same pathophysiological mechanism could facilitate the management and monitoring of patients undergoing mechanical ventilation.