Respiratory medicine
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Respiratory medicine · Mar 2000
Lung volume and its correlation to nocturnal apnoea and desaturation.
The cross-sectional area of the upper airway is known to be lung volume dependent. If, and to what extent, lung volume variables correlate to nocturnal obstructive apnoeas and oxygen desaturations independently of other factors known to affect lung volumes and sleep disordered breathing is still unclear. A total of 92 subjects were examined by ambulatory recording of nocturnal obstructive apnoeas and desaturations. ⋯ Multiple regression analysis also revealed that ERV, body mass index (BMI) and habitual smoking together accounted for 43% of the variation in AI and 48% of the variation in ODI. We find a significant independent association between ERV and nocturnal obstructive apnoea and oxygen desaturation frequency. Our results indicate that ERV is correlated to these events to a similar extent, as is obesity.
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Respiratory medicine · Mar 2000
Assisted pressure control ventilation via a mini-tracheostomy tube for postoperative respiratory management of lung cancer patients.
Assisted pressure control ventilation (PCV) via a min-tracheostomy tube (MTT) was conducted to improve gas exchange and reduce the work of breathing of lung cancer patients after surgery. Thirty-two patients with lung cancer underwent lobectomy and were managed postoperatively by assisted PCV via an MTT. On the basis of a simulation study using a lung model for clinical use, we set the inspiratory pressure to 20 cmH2O and inspiratory time to 1.0 sec to produce a 450-ml supported volume via the MTT per breath. ⋯ In addition, no complications or morbidity were seen related to either MTT insertion or PCV via an MTT. Assisted PVC via an MTT increased the tidal volume, improved the gas exchange, reduced the respiratory rate by providing adequate ventilatory support and increased the PaO2, even after withdrawal following lung surgery. Even though we did not observe any benefit of clinical outcome with PCV via an MTT in the present study, this procedure appears to be a potentially useful respiratory management modality for patients with high risk of postoperative pulmonary complications.
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Respiratory medicine · Feb 2000
Multicenter Study Clinical TrialEfficacy and safety of ten day moxifloxacin 400 mg once daily in the treatment of patients with community-acquired pneumonia. Community Acquired Pneumonia Study Group.
Community-acquired pneumonia (CAP) remains a common and serious illness with approximately 2-4 million cases reported annually. Management of CAP is therapeutically challenging due to the increasing prevalence of penicillin- and macrolide-resistant pneumococci and beta-lactamase producing Haemophilus influenzae, as well as the increased recognition of 'atypical' pathogens, such as Chlamydia pneumoniae and Mycoplasma pneumoniae, and the frequent need for empiric therapy. We aimed to evaluate the safety and efficacy of moxifloxacin in the treatment of patients with CAP. ⋯ Atypical organisms were isolated in high frequency among patients with CAP. Moxifloxacin 400 mg once daily for 10 days was effective and well-tolerated in the treatment of these adult patients with CAP. Moxifloxacin offers an effective treatment alternative for CAP due to both typical and atypical bacterial pathogens.
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Respiratory medicine · Feb 2000
Randomized Controlled Trial Clinical TrialRehabilitation of patients with chronic obstructive pulmonary disease. Exercise twice a week is not sufficient!
Several studies of chronic obstructive pulmonary disease (COPD) have shown that pulmonary rehabilitation, consisting of at least three training sessions a week, improves exercise performance and health status. This study investigates feasibility, effect and economic aspects of a rehabilitation programme consisting of two sessions a week for 8 weeks. Twenty-four patients with moderate COPD were randomized to rehabilitation and 21 to placebo. ⋯ Health-status, assessed by SGRQ and The Psychological General Well-being (PGWB) Index, did not improve. Rehabilitation resulted in an insignificant improvement in the 6MWD [29 m (95% confidence interval: -8 -66 m)]. We conclude that a rehabilitation program consisting of exercise and education twice a week for 8 weeks had no effect on exercise performance and well being in patients with moderate COPD.
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Respiratory medicine · Jan 2000
Clinical and in vitro evaluation of membrane humidifier that does not require addition of water.
It is well known that conventional bubbling humidifiers are capable of producing micro-aerosols contaminated with bacteria. We developed a unique humidifier, named a membrane humidifier, that does not require an external water supply. This new system obtains moisture from room air. ⋯ Cultures of the humidified-oxygen passed through the hollow fibres were negative for bacteria. The membrane humidifier could produce good humidification. The new device appeared to prevent bacterial contamination, and may help to reduce the risk of infection in patients at hospital and home.