Respiratory medicine
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Respiratory medicine · Mar 1992
Comparative StudyNeonatal respiratory support and lung function abnormalities at follow-up.
We have investigated if respiratory distress syndrome (RDS) treated by an increased inspired oxygen concentration, rather than mechanical ventilation, was associated with impaired lung function at follow-up and/or an increase in respiratory symptoms. Thoracic gas volume (TGV) and airways resistance (RAW) were measured in eight pre-term infants (median gestational age 29 weeks) at 6 and 12 months of age. The infants had suffered from RDS but had not required mechanical ventilation. ⋯ The lung function of the infants requiring oxygen in the neonatal period was similar to those who had not suffered from RDS, but their airways resistance was significantly lower at 6 but not 12 months than that of infants ventilated in the neonatal period (P less than 0.05). There was no significant difference in recurrent respiratory symptoms between the three groups although a greater proportion of the infants ventilated in the neonatal period were symptomatic in the first 6 months of life. These results suggest that oxygen therapy alone does not result in an impairment of lung function which is independent of the effect of prematurity.
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Respiratory medicine · Jan 1992
Simplifying the assessment of patients with chronic airflow limitation for home nebulizer therapy.
One-hundred nebulizer trials were performed in 98 adult patients with chronic airflow limitation who had remained symptomatic despite regular use of bronchodilators by metered dose or dry powder inhalation. Mean baseline FEV1 was 0.9 (SD = 0.41) 1, FVC -2.0 (0.74) 1 and PEFR 169 (77) 1 min-1. After laboratory measurements of reversibility to inhaled salbutamol (5 mg) and ipratropium bromide (0.5 mg), patients were supplied with a compressor and a peak flow meter to make twice daily measurements at home for 3 weeks. ⋯ We conclude that an appropriate protocol for assessing the value of long-term nebulized bronchodilators is for patients to measure their PEFR during a week of nebulized saline and a week of nebulized beta-agonist/ipratropium mixture. Those with an increase of 15% in mean PEFR in the week on active treatment and who experienced subjective benefit should be supplied with a compressor. Had we conducted our 100 trials in this way we would have started 25 of our 98 patients on long-term home nebulized bronchodilators.
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Respiratory medicine · Sep 1991
Cystic fibrosis: what do patients know, and what else would they like to know?
As the survival of patients with cystic fibrosis (CF) improves, it becomes increasingly important to address such issues as employment, reproduction, and quality of life in adulthood. In this study, 22 patients and 20 parents completed a questionnaire about the natural history, treatment and genetics of cystic fibrosis. Patients and parents knew as much as each other about the natural history of cystic fibrosis. ⋯ All the patients indicated that they would like further information on the future and how they would cope, through CF literature, organized patient groups and, in adolescence, would prefer to obtain information from medical staff rather than parents. Patients had received considerable information about the disease and its treatment from parents and clinical staff, but few had discussed the day to day problems of living with cystic fibrosis. This study has identified specific areas of ignorance in patients with cystic fibrosis, areas that need addressing in view of the improved survival associated with this disease.
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Eight infants (gestational age 27-32 weeks) ventilated in the neonatal period had significantly higher airway resistances at 6 months, but not 1 year, than eight infants matched for gestational age but without any neonatal respiratory problems. We conclude that neonatal ventilation or respiratory distress causes a temporary impairment of lung function.