Respiratory care
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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.
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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.
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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.
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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.
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Noninvasive ventilation (NIV) has increasingly been used for the treatment of acute respiratory failure. Despite recommendations supporting its utilization in a limited group of patients, NIV is frequently relied on as a first line treatment. We conducted a retrospective study to assess whether the extended use of NIV is associated with worse clinical outcomes. ⋯ This study supports the extended utilization of NIV for subjects without contraindications, and for subjects with indications despite the presence or absence of contraindications.