Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
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Monaldi Arch Chest Dis · Oct 1996
ReviewHome mechanical ventilation in children: techniques, outcomes and ethics.
Various neuromuscular and pulmonary disorders can cause ventilatory failure in children. Tracheostomy ventilation in the home is especially valuable in younger children who require ventilatory support for most of the day and who have bulbar dysfunction but newer noninvasive techniques especially nasal mask ventilation are often preferable. It is important to select the type of ventilator and to choose the interface with the patient carefully in order to maximise the child's quality of life.
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Monaldi Arch Chest Dis · Aug 1996
ReviewThe complications of lung resection in adults: acute respiratory distress syndrome (ARDS).
Postoperative lung injury is a recognized complication of pulmonary resection. In adults, this is manifest in its most severe form as the acute respiratory distress syndrome (ARDS). ARDS is characterized by high permeability pulmonary oedema resulting in refractory and often terminal hypoxaemia. ⋯ Perioperative fluid overload, increased blood flow through the remaining lung postoperatively, reoxygenation injury and activation of inflammatory mediators have been postulated as possible causes. Conventional parameters for preoperative assessment do not predict those patients most likely to develop lung injury in these circumstances. Clinical management strategies for acute respiratory distress syndrome complicating lung resection are discussed.
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Ambulatory oxygen therapy in patients with COPD and exercise hypoxaemia may improve exercise capacity and breathlessness. The improvement in exercise tolerance is related to the degree of exercise hypoxaemia. ⋯ For effective ambulatory oxygen delivery, oxygen should be provided either by small liquid oxygen tanks or by small lightweight cylinders and conserving devices. Studies are required to evaluate the longer term effects of ambulatory oxygen on daily life.