Respiratory care
-
Asthma is more prevalent in obese, compared with normal weight, subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy. Several studies have shown that overweight and obesity is associated with more severe asthma and impaired quality of life, compared with normal weight individuals. ⋯ Most studies show that overweight and obesity is associated with less favorable response to asthma therapy, with regard to symptoms, level of FEV1, fraction of exhaled nitric oxide, and airway responsiveness. Some studies suggest that asthma in the obese patient might be more responsive to leukotriene modifiers, orchestrated by leptin and/or adiponectin derived from adipose tissue, than to inhaled corticosteroids, possibly reflecting differences in the underlying airway inflammation in obese versus non-obese asthmatics. In conclusion, overweight and obesity is associated with poorer asthma control and, very importantly, overall poorer response to asthma therapy, compared with normal weight individuals.
-
The contribution of obesity to hypoxemia has not been reported in a community-based study. Our hypothesis was that increasing obesity would be independently associated with lower SpO2 in an ambulatory elderly population. ⋯ We found a narrow distribution of SpO2 values in a community-based sample of ambulatory elderly. Obesity was a strong independent contributor to a low SpO2, with effects comparable to or greater than other factors clinically associated with lower SpO2.
-
Controlled Clinical Trial
Early respiratory therapy reduces postoperative atelectasis in children undergoing lung resection.
Early physiotherapy reduces pulmonary complications after lung resection in adult patients. However, the effectiveness and the techniques used in postoperative physiotherapy in children undergoing lung resection have not been well described. Therefore, the standardization of a physiotherapeutic attendance after lung resection in children is necessary. ⋯ Implementation of a standardized physiotherapeutic protocol after lung resection in children decreases atelectasis but does not reduce the time of chest tube removal or the duration of hospital stay.
-
Case Reports
Massive intractable hemoptysis due to idiopathic granulomatous pulmonary veno-occlusive disease.
Pulmonary veno-occlusive disease is a rare condition with limited treatment options. The pathological hallmark of the disease is occlusion of pulmonary venules and small veins in the lobular septa. The etiology of the disease remains obscure. We report and discuss an extremely unusual case presenting as massive and intractable hemoptysis, in which pulmonary venous occlusion was attributed to granulomatous venulitis in the absence of other pulmonary or systemic inflammatory abnormalities.
-
Comparative Study
High frequency oscillatory ventilation versus conventional ventilation in a newborn piglet model with acute lung injury.
High frequency oscillatory ventilation (HFOV) is considered a protective strategy for human lungs. This study was designed to define microscopic structural features of lung injury following HFOV with a high lung volume strategy in newborn piglets with acute lung injury. ⋯ Histopathologic lung damage in newborn piglets with lung injury was more severe in the gravitation-dependent region than in the gravitation-nondependent region. HFOV with high lung volume strategy reduced pulmonary PMNL infiltration, hemorrhage, alveolar edema, and hyaline membrane formation with improved oxygenation.