Respirology : official journal of the Asian Pacific Society of Respirology
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In the last 20 years, research efforts have been focused on the use of non-invasive ventilation (NIV) as a mean of avoiding tracheostomy in patients affected by neuromuscular diseases (NMD). Nocturnal NIV has been a particular focus as sleep is a risk factor for respiratory failure in NMD patients. The objective of our study was to evaluate the efficacy of nocturnal NIV in improving the respiratory function of NMD patients evaluated by polysomnography (PSG) and arterial blood gas (ABG) analysis parameters. ⋯ NIV was effective in improving respiratory parameters at night in patients affected by respiratory muscular weakness, as evaluated by PSG and ABG analysis.
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Randomized Controlled Trial Multicenter Study
Acute haemodynamic effects of continuous positive airway pressure in awake patients with heart failure.
Continuous positive airway pressure (CPAP) has been used to treat patients with chronic heart failure (CHF) and sleep-disordered breathing (SDB). CPAP treatment in severe CHF with concomitant SDB and atrial fibrillation has been linked to impairment of cardiac output (CO) as a potential cause for adverse outcome. The aim of the present study was to test whether incremental CPAP application in awake CHF patients with SDB, with and without atrial fibrillation, induces acute alterations of blood pressure (BP), heart rate (HR) and CO. ⋯ These results contribute to the evidence that CPAP does not cause haemodynamic compromise in the vast majority of normotensive CHF patients with SDB.
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Detection of chronic obstructive pulmonary disease (COPD) is crucial in the management of COPD. The aim of this study was to establish the utility of a community-based lung cancer screening for detecting COPD. ⋯ COPD screening added to a community-based lung cancer screening programme may be effective in the detection of patients with COPD.
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Quadriceps muscle dysfunction is an important contributor to exercise limitation in chronic obstructive pulmonary disease, but little is known about skeletal muscle function and its impact on exercise capacity in patients with fibrotic idiopathic interstitial pneumonia (IIP). The aim of the study was to compare quadriceps strength and endurance in patients with fibrotic IIP and healthy controls, and relate it to exercise capacity. ⋯ Quadriceps strength and endurance are reduced in patients with fibrotic IIP compared with healthy controls, but are less tightly correlated with exercise performance.
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Observational Study
Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: an observational study.
The objective of this study was to evaluate the long-term cardiovascular mortality in patients with severe obstructive sleep apnoea (OSA) treated with either continuous positive airway pressure (CPAP) or mandibular advancing device (MAD). ⋯ Both CPAP and MAD may be equally effective therapy in reducing the risk of fatal cardiovascular events in patients with severe OSA.