Pneumologie
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Home ventilation of spontaneous breathing during wake and chiefly during sleep has gained great importance in the last 10 years by means of noninvasive nasal pressure support ventilation (PSV). Intensive care and weaning has been complemented, or even replaced by this method. ⋯ Historical development is outlined, contrasted by the actual procedures, their advantages and disadvantages. Long term therapy implies functional and probably even morphological adaptation of spontaneous control of breathing which is briefly touched, according to recent investigations.
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Review Case Reports
[Tracheobronchomegaly--Mounier-Kuhn syndrome--case report and review of the literature].
Tracheobronchomegaly is a rare disorder. A marked dilatation of the trachea and the main stem bronchi is the characteristic sign measured as an enlarged transverse diameter (mean +/- 3 SD). Bronchiectasis is usual. ⋯ The number and seize of the diverticula are documented by tracheography or by bronchography. In a part of all cases of tracheobronchomegaly the cause of the disorder is known. Therefore a division into congenital and acquired tracheobronchomegaly is useful.
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We report the case of a 35 years old female patient suffering from Staphylococcus aureus induced abortion in the 7th/8th week of gestation. Sepsis with acute respiratory failure (ARDS) developed, which could be treated successfully. Pneumonia, caused by Pseudomonas aeruginosa, induced a recurrence of ARDS, complicated by a persistent incomplete atelectasis of the left lung. Independent ventilation of both lungs with increased pressure on the left side combined with bronchoscopy guided instillation of 1 g of bovine surfactant (Alveofact), caused improvement of arterial oxygenation and radiological signs, signalling airation of collapsed lung areas.