Thorax
-
Randomized Controlled Trial Clinical Trial
Physiotherapy after coronary artery surgery: are breathing exercises necessary?
One hundred and ten men undergoing coronary artery bypass grafting took part in a prospective randomised study comparing three physiotherapy protocols. All patients were taught self supported huffing and coughing by a physiotherapist and encouraged to move about. This comprised the sole treatment for the 37 control patients (group 3). ⋯ The mean arterial oxygen tension was 7.37 kPa on day 2 and 8.58 kPa on day 4. Four patients in group 1, two in group 2, and five in group 3 developed a chest infection. It is concluded that the addition of breathing exercises or incentive spirometry to a regimen of early mobilisation and huffing and coughing confers no extra benefit after uncomplicated coronary artery bypass grafting.
-
Comparative Study
Topical nasal anaesthesia for fibreoptic bronchoscopy: patients' preference for lignocaine gel.
Two techniques for anaesthetising the nose before fibreoptic bronchoscopy have been compared. Fourteen of 16 patients given lignocaine spray found it unpleasant, compared with three of 20 patients given lignocaine gel. The two forms of local anaesthetic were found to be equally effective. Lignocaine gel is therefore recommended for topical nasal anaesthesia before fibreoptic bronchoscopy.
-
Asymptomatic bacteraemia following balloon dilatation was assessed in 20 adults with oesophageal stricture. Asymptomatic bacteraemia occurred in 12 of 19 patients. The source of the bacteraemia appeared to be the patients' oropharyngeal flora. The bacteraemia was not of clinical importance in our patients, but might lead to endocarditis in predisposed individuals.
-
Randomized Controlled Trial Clinical Trial
Effect of low dose nebulised morphine on exercise endurance in patients with chronic lung disease.
Low dose nebulised morphine may relieve dyspnoea through a direct effect on lung afferent nerves. To study this further 11 adult patients with advanced chronic lung disease (FEV1 range 0.4-1.41), whose exercise endurance was limited by dyspnoea, were entered into a double blind, randomised, crossover study in which low dose morphine or a placebo was inhaled. The effects were assessed by an endurance exercise test at 80% of maximum work load. ⋯ The mean dose of morphine nebulised was 1.7 (0.66) mg, giving a mean inhaled dose of about 0.6 mg, on the assumption of 30% retention of the nebulised dose by each patient. No side effects were reported. Possibly small amounts of morphine delivered to the lungs act directly on lung afferent nerves to reduce dyspnoea.
-
Case Reports
Mitral prosthetic valve regurgitation due to stent fracture of a porcine bioprosthesis.
Mitral prosthetic valve regurgitation due to stent fracture with consequent cusp prolapse occurred in two patients with a Wessex porcine bioprosthesis.