Bulletin européen de physiopathologie respiratoire
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Bull Eur Physiopathol Respir · Aug 1987
Clinical Trial Controlled Clinical TrialAlmitrine bismesylate: a long-term placebo-controlled double-blind study in COAD--Vectarion International Multicentre Study Group.
701 patients, age 61.9 +/- 8.3 yr (mean +/- SD), with hypoxaemic chronic obstructive airways disease (COAD) were entered into a one yr placebo-controlled double-blind study to determine the effect of oral almitrine bismesylate on arterial blood gas tensions and clinical condition. Initial arterial O2 tension (PaO2) was 7.6 +/- 0.8 kPa (57.0 +/- 6.2 mmHg) and arterial CO2 tension (PaCO2) was 6.0 +/- 0.9 kPa (45.2 +/- 6.7 mmHg). Forced expiratory volume in one second (FEV1) was 0.87 +/- 0.35 l and forced vital capacity (FVC) was 2.31 +/- 0.72 l. 163 patients, evenly distributed between treated and untreated groups, were receiving long-term O2 therapy; other conventional therapy was continued. ⋯ A smaller proportion of patients in group A were hospitalized and had episodes of right heart failure during the study than in group P (p less than 0.05). Vital signs, biochemistry and ECG characteristics did not change. 139 patients (40%) in this group did not complete the study, 35 (10%) through deterioration of respiratory symptoms or death (4.9%); 43 (12.5%) withdrew because of adverse reactions, either drug-related or not. The most frequent adverse reactions were gastro-intestinal, central nervous system disturbances, increased dyspnoea and peripheral paraesthesiae.(ABSTRACT TRUNCATED AT 400 WORDS)
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Bull Eur Physiopathol Respir · Mar 1987
Comparative StudyComparison of mouth and oesophageal pressure fluctuations during panting against an occlusion.
In four normal volunteers, differences between oesophageal pressure fluctuations (delta Pes) in the upper and lower parts of the oesophagus and mouth pressure fluctuations (delta Pm), simultaneously measured during panting against an occlusion, were evaluated. Averaged quasi static pressure-volume curves were obtained by measuring pressure in the upper and lower thirds of the oesophagus. The differences between delta Pes and delta Pm during panting, due to elastic recoil changes, were predicted from an exponential relationship fitted to the pressure-volume curves. ⋯ At lung volumes above 90% of Vmax for the upper oesophagus and above 70% of Vmax for the lower oesophagus, the ratio of delta Pes to delta Pm exceeded 1 and progressively increased. The measured values were often higher than those predicted from the fitted curves, presumably due to a narrowed glottic aperture. We concluded that in normals both the positioning of the oesophageal balloon in the lower oesophagus and a lung volume near functional residual capacity (FRC) are prerequisites for the use of delta Pm as a control for delta Pes, or vice versa, during panting against an occlusion.
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Topically and intravenously administered local anaesthetic agents are widely used to inhibit cough, but little quantitative, pharmacological data seems to be available. Various aspects of local anaesthetic agents as inhibitors of cough and other airway reflexes are discussed. Nebulized lidocaine dose-dependently inhibited both mechanically (trachea, carina) and ammonia vapour-induced cough. ⋯ This observation is compatible with the view that the cough receptors are located close to the airway lumen and those mediating the Hering-Breuer reflex within the smooth muscle. Airway anaesthesia is commonly used to block the cough reflex during endoscopic procedures. Nebulized lidocaine has been reported also to suppress severe chronic cough but further studies on airway anaesthesia and cough in acute and chronic lung disease are warranted.
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Bull Eur Physiopathol Respir · Jul 1986
Air entrainment during high-frequency jet-ventilation. Simulation of a bronchoscopy with a lung model.
Air entrainment contribution to jet-ventilation during bronchoscopy was evaluated as a lung model (increasing compliance and airway resistance). Ventilation was provided through a 10 mm internal diameter tube using either jet alone without air entrainment, or injection with air entrainment (coaxial and lateral injectors). Three I/E ratios (0.25, 0.43 and 0.67) and nine rates of ventilation, ranging from 20 to 300 c X min-1, were assessed. ⋯ CO2 elimination is related to the magnitude of ventilated volumes. The amount of entrained air interferes with the FIO2 of delivered gases. During bronchoscopy, lateral injection should be preferred because of smaller airway pressures (- 31.2 +/- 0.6%) and lung volumes, while tidal volumes remain adequate.
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Bull Eur Physiopathol Respir · May 1986
The relationship between breathlessness and ventilation during steady-state exercise.
In clinical studies on breathlessness, the relationship between breathlessness and ventilation is a convenient way of summarizing the responses of single subjects or groups of subjects. This relationship is usually based on measurements during progressive exercise. The objective of this study was to determine whether the relationship was maintained in different conditions or whether breathlessness could alter independently of ventilation. ⋯ The same subjects also undertook exercise at two constant workloads. After 4 min, stable values of ventilation were achieved but the breathlessness scores continued to increase (p less than 0.05). These findings show that the relationship between breathlessness and ventilation may be disturbed without external intervention, and this provides further evidence that breathlessness is not simply a sensing of the ventilation achieved.