The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology
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Comparative Study
Survival and prediction of successful ventilator weaning in COPD patients requiring mechanical ventilation for more than 21 days.
We studied survival and failure or success of weaning from mechanical ventilation (MV) in 42 consecutive chronic obstructive pulmonary disease (COPD) patients requiring prolonged MV (more than 21 days) after an episode of acute respiratory failure requiring admission to our Intermediate Intensive Care Unit (IICU). Parameters including arterial blood gases, pulmonary function tests, respiratory muscle force, neuromuscular drive, and nutritional status were recorded during a phase of clinical stability, in order to identify the features related to survival and weaning. All the patients were submitted to a comprehensive rehabilitation programme. ⋯ The discriminant equation considering PaCO2 and MIP could separate the two groups with an accuracy of 84%. The overall survival at 2 yrs was 40%; in Group B it was significantly lower than in Group A (22 vs 68%). Most of the deaths occurred within the first 120 days after intubation.(ABSTRACT TRUNCATED AT 250 WORDS)
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The increasing availability of appliances for measuring lung function in infants may allow clinical and epidemiological applications. The aim of the present study was to establish reference values for tidal breathing lung function in awake newborn infants and to investigate potential sources of variability. Tidal flow-volume loops were measured in 803 awake, healthy infants (427 males and 376 females) and passive respiratory mechanics (single-breath occlusion technique) in 664. ⋯ Respiratory rates correlated significantly with tidal flows (r = 0.66), inversely with Vt (r = 0.40), but not with flow ratios. Mean compliance of the respiratory system was 1.18 ml.cmH2O-1.kg birthweight (95% confidence interval (95% CI) 1.15-1.21) and mean resistance 0.051 cmH2O.ml-1.s (95% CI 0.049-0.054). These results demonstrate that lung function in awake healthy infants varies according to weight, gender and postnatal age.(ABSTRACT TRUNCATED AT 250 WORDS)
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Comparative Study
Granulocyte-macrophage colony-stimulating factor, eosinophils and eosinophil cationic protein in subjects with and without mild, stable, atopic asthma.
Increasing evidence implicates the eosinophil as an important effector cell in asthma, but little is known regarding its regulation in vivo. Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been shown to regulate eosinophil function in vitro. We investigated the in vivo role of eosinophils and GM-CSF in mild asthma. ⋯ These results demonstrate that there are increased numbers of activated eosinophils and GM-CSF is increased in patients with mild asthma. Furthermore, GM-CSF is correlated with eosinophil number and function in vivo and these indices are significantly correlated with airway function. These findings emphasize the importance of eosinophils, potentially regulated in vivo by GM-CSF, in contributing to the disordered airway function evident even in mild asthma.