Archivos de bronconeumología
-
Arch. Bronconeumol. · May 2014
Randomized Controlled Trial Comparative StudyEndobronchial ultrasound for the diagnosis of peripheral pulmonary lesions. A controlled study with fluoroscopy.
Fluoroscopy-guided bronchoscopy is usually performed for the diagnosis of peripheral pulmonary lesions (PPL), but the diagnostic yield varies widely among studies. Endobronchial ultrasound (EBUS) can increase the diagnostic yield of bronchoscopic diagnosis of PPL. ⋯ Bronchoscopy under EBUS plus fluoroscopy guidance is a technique that has become useful for the diagnostic of LPPs, especially those smaller than 30 mm in diameter.
-
Oxygen therapy is defined as the therapeutic use of oxygen and consists of administering oxygen at higher concentrations than those found in room air, with the aim of treating or preventing hypoxia. This therapeutic intervention has been shown to increase survival in patients with chronic obstructive pulmonary disease (COPD) and respiratory failure. ⋯ The choice of the oxygen source must be made on the basis of criteria such as technical issues, patient comfort and adaptability and cost. Flow must be adjusted to achieve appropriate transcutaneous oxyhaemoglobin saturation correction.
-
Cystic fibrosis is a single gene, autosomal recessive disorder, in which more than 1,900 mutations grouped into 6 classes have been described. It is an example a disease that could be well placed to benefit from personalised medicine. There are currently 2 very different approaches that aim to correct the basic defect: gene therapy, aimed at correcting the genetic alteration, and therapy aimed at correcting the defect in the CFTR protein. ⋯ In the last 5 years, CFTR has been designated as a therapeutic target. Ivacaftor is the first drug to treat the basic defect in cystic fibrosis, but only provides a response in a small number of patients. New drugs capable of restoring the CFTR protein damaged by the most common mutations are required.
-
Arch. Bronconeumol. · Mar 2014
ReviewWeaning from mechanical ventilation in paediatrics. State of the art.
Weaning from mechanical ventilation is one of the greatest volume and strength issues in evidence-based medicine in critically ill adults. In these patients, weaning protocols and daily interruption of sedation have been implemented, reducing the duration of mechanical ventilation and associated morbidity. ⋯ Several indices have been developed to predict the outcome of weaning. However, these have failed to replace clinical judgement, although some additional measurements could facilitate this decision.