Archivos de bronconeumología
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Arch. Bronconeumol. · Apr 1998
Comparative Study[Role of endogenous nitric oxide (NO) in pulmonary vascular adaptation to one-lung ventilation during thoracic surgery].
To determine whether endogenous production of nitric oxide (NO) increases during one-lung lung ventilation (OLV) and to observe its possible influence on pulmonary vascular resistance (PVR). The experimental group consisted of 19 patients undergoing chest surgery with OLV, with monitoring by Swan-Ganz catheter. Hemodynamic parameters were measured and peripheral venous blood samples were taken at the start of surgery and 10 minutes after starting OLV. ⋯ PVR during OLV (134 +/- 45 din.s.cm-5) is lower than at the start of surgery (163 +/- 37 din.s.cm-5, p < 0.05). During OLV endogenous production of NO, measured as nitrite concentration in plasma, increases. PVR decreases, possibly because of the increase in nitrite concentration.
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Arch. Bronconeumol. · Feb 1998
Comparative Study Clinical Trial Controlled Clinical Trial[Training of inspiratory muscles in chronic obstructive lung disease. Its impact on functional changes and exercise tolerance].
The aim of this study was to evaluate the impact of inspiratory muscle training on lung function and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). Thirty-five patients with stable COPD were enrolled. We measured lung function variables and peak inspiratory and expiratory pressures (PImax and PEmax). ⋯ No changes were seen in VO2max or ventilatory response and/or gasometry during exercise in any of the groups. The trained group, on the other hand, experienced a significant decrease in dyspnea evaluated on the Borg scale exercise in maximal (5.7 +/- 1.1 versus 4.7 +/- 1.2, p < 0.005) and submaximal (5.9 +/- 0.9 versus 4.9 +/- 1.3, p < 0.005) and an increase in time of submaximal exercise tolerance (5.5 +/- 2 versus 7 +/- 3 min, p < 0.05), changes that were not observed in the control group. Based on these results, and although specific training of inspiratory muscles does not appear to improve lung function in patients with COPD, it is accompanied by a decreased sense of dyspnea during exercise and greater tolerance.
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Arch. Bronconeumol. · Feb 1998
Comparative Study[Fiber optic bronchoscopy in extraction of tracheo-bronchial foreign bodies in adults].
The aim of this study was to determine the clinical, radiologic and endoscopic characteristics of adults with tracheobronchial foreign bodies (FB), and to review the role of fiberoptic bronchoscopy in extracting them. We reviewed the case histories and bronchoscopic reports for all patients over 14 years of age with FB treated between 1976 and 1995. Fifty-nine FB were removed from 56 patients; 68% were male and 48% were over 60 years of age. ⋯ FB aspiration is common and diagnosis is difficult in the adult. Fiberoptic bronchoscopy resolved most aspirations in adults with no important complications. The rigid bronchoscope should be reserved for very specific cases.
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Arch. Bronconeumol. · Jan 1998
Comparative Study[Solitary pulmonary nodule: application of Bayes theorem in prediction of malignancy].
Most radiological signs are of low specificity for predicting malignancy in patients with a solitary pulmonary nodule (SPN), making clinical management difficult. Only certain calcification patterns in SPN or the absence of growth over a period two years assures that the nodule is benign. The clinical and radiological characteristics of 31 patients with SPN were studied. ⋯ There were no significant differences in the characteristics of the computerized tomography images for the two groups. Mean likelihood of malignancy for patients with carcinoma, by Bayes' theorem, was 83.7%, a rate that was significantly higher than that of tuberculoma patients (46%) (p < 0.05). The application of Bayes' probability theorem for a set of clinical and radiological characteristics can orient the physician as to whether an SPN is likely to be malignant or not, thereby providing guidance on the advisability of performing invasive diagnostic procedures to determine etiology.