Respiratory care
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Randomized Controlled Trial
Randomized controlled trial of exercise training in chronic respiratory failure due to kyphoscoliosis.
Research has provided evidence for the safety, feasibility, and efficacy of exercise training in patients with COPD. However, little is known about the impact of exercise training in patients with chronic respiratory failure due to kyphoscoliosis. We evaluated the effect of an exercise training program on exercise capacity, muscle strength, dyspnea, and quality-of-life indices in subjects with chronic respiratory failure due to kyphoscoliosis. ⋯ In patients with chronic respiratory failure due to kyphoscoliosis, exercise training improved exercise capacity, peripheral muscle strength, dyspnea, and quality of life. (Deutschen Register Klinischer Studien DRKS00000443).
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The administration of a high FIO2 to COPD patients breathing spontaneously may result in hypercapnia, due to reversal of preexisting regional hypoxic pulmonary vasoconstriction, resulting in a greater dead space. Arterial blood gas trends have not been reported in these patients. In a 31-bed medical ICU in a teaching hospital we prospectively investigated the response of 17 CO2-retaining COPD patients, after acute respiratory crisis stabilization with noninvasive ventilation, to an FIO2 of 1.0 for 40 min, after having been noninvasively ventilated with an FIO2 of ≤ 0.50 for 40 min. ⋯ During noninvasive ventilation with an FIO2 sufficient to maintain a normal PaO2, a further increase in FIO2 did not increase PaCO2 in our CO2-retaining COPD patients.
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Pulmonary hypertension is frequently associated with parenchymal lung disease. We evaluated the association between spirometry values and pulmonary artery systolic pressure (PASP) in young subjects without lung disease ⋯ PASP in young healthy subjects is not significantly associated with spirometry values. Lung mechanics probably do not contribute significantly to PASP in this population.
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Case Reports
Histopathology and exercise: a winning combination in pulmonary fibrosis. Report of a case.
The diffuse parenchymal lung diseases form a heterogeneous group of disorders characterized by varying degrees of inflammation and fibrosis involving the space between epithelial and endothelial basement membranes. Among the diffuse parenchymal lung diseases of unknown etiology, one of the most common is usual interstitial pneumonia/idiopathic pulmonary fibrosis, which carries the worst prognosis. In contrast, nonspecific interstitial pneumonia, which belongs to the same diffuse parenchymal lung disease group, has a more favorable prognosis. ⋯ The long-term prognosis is excellent for patients with nonspecific interstitial pneumonia with a cellular pattern, as compared to patients with a fibrosing pattern. We describe here a patient with nonspecific interstitial pneumonia with a fibrosing pattern in a highly practiced runner, showing an unexpectedly long-term favorable course, and consider the possible role of exercise in the diagnosis and clinical course of the disease. This case reinforces the evidence that exercise training, which is a principal component of pulmonary rehabilitation, may have clinically important effects on functional exercise capacity, especially if it is delivered early in the course of the disease.