The American review of respiratory disease
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Am. Rev. Respir. Dis. · Dec 1982
Case ReportsDynamic hyperinflation and ventilator dependence in chronic obstructive pulmonary disease.
In advanced chronic obstructive pulmonary diseases, functional residual capacity (FRC) can be markedly increased by dynamic mechanisms involving expiratory flow limitation. We studied respiratory mechanics in a seated ventilator-dependent patient with such changes. Relaxed expiration was flow-limited; pressures of 9 to 27 cm H2O (varying with lung volume) could be applied to the airway opening (Pao) without decreasing expiratory flow rate. ⋯ More importantly, recoil pressures at end inspiration and end expiration, respectively, were 6.5 and 1.5 cm H2O for the lung, 33 and 11 cm H2O for chest wall, and 38 and 12 cm H2O for the respiratory system. Thus the chest wall recoiled inward at all times, pleural pressure was always substantially positive (11 to 33 cm H2O), expiratory flow was maximal, and jugular veins were always full and nonpulsating. Inspiratory work was about 0.27 kg-m per breath (7 times normal), most of it elastic work done on the chest wall.
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Am. Rev. Respir. Dis. · Dec 1982
Case ReportsBlastomyces dermatitidis and the adult respiratory distress syndrome. Case reports and review of the literature.
The adult respiratory distress syndrome (ARDS) developed in 2 patients with blastomycosis. In one, ARDS apparently followed the rupture of an infected subcarinal lymph node into a bronchus. ⋯ Four additional cases of blastomycosis with definite or presumed ARDS are reviewed. The clinical course of these 6 patients was characterized by a prolonged prodrome (median, 36 days), consistent with pulmonary blastomycosis, and a rapid demise (median, 5 days) associated with ARDS.