Pneumologie
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In contrast to the obstructive sleep apnoea syndrome (OSA) the obesity-hypoventilation syndrome (OHS) is characterized by persistent hypercapnia during the day. After positive pressure ventilation (PPV) patients with OHS the daytime blood gases normalize after a short time. The aim of this study was to investigate whether blood gases at the end of a standardized exercise test separate both OSA and OHS after 3 months of PPV. ⋯ In OSA neither before nor after 3 months PPV the blood gases changed significantly during the exercise test. We conclude that the OHS associated hypercapnia during exercise is further on a reliable indicator for the diagnosis despite the daytime normocapnia during rest after PPV. However after PPV the PCO2-values of patients with OHS at rest are in the normal range.
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General anaesthetic agents are frequently used for paediatric bronchoscopy. A disadvantage of this open system anaesthesia seems to be the contamination of the working environment. The aim of this study was to determine the exposure of the endoscopist during paediatric bronchoscopy under general anaesthesia in different working environments and to compare these measurements with the currently valid international threshold limit values. ⋯ The main finding of the present study is that under inhalation anaesthesia with sevoflurane for paediatric bronchoscopy occupation exposure is higher than the limits stated in all known health regulation guidelines. Therefore, in case of such working conditions, the use of total intravenous anaesthesia is advocated also in very small infants.
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Continuous positive airway pressure (CPAP) therapy reduces sleeping time per day and daytime sleepiness in obstructive sleep apnoea (OSA) and heavy snoring. Due to sleep fragmentation the OSA and heavy snoring are associated with a daytime sleepiness and increased necessity of sleep. In this pilot study the effect of CPAP-therapy on daytime sleepiness and sleep time during 24 hours were assessed in patients with OSA or heavy snoring (daytime sleepiness, none or slight apnoea with AHI < 10/h and benefit of CPAP). ⋯ In respect of the change of sleeping time/day and of the sleepiness score there was no significant difference between the OSA and heavy snoring group. With CPAP the AHI in OSA patients was reduced from 34.5 +/- 23.6/h to 3.2 +/- 3.2/h. Due to the improvement of sleep-related breathing disorders CPAP therapy reduced the mean sleeping time/day by approximately 10% and the daytime sleepiness score both in patients with OSA and heavy snoring compared to the pretreatment period.