Bulletin européen de physiopathologie respiratoire
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Bull Eur Physiopathol Respir · Jul 1984
Comparative StudyLung transfer factor for carbon monoxide measured during a slow single breath without breath-holding and during slow exhalation.
We considered whether a slow single breath with neither breath-holding nor carefully controlled flows could provide estimates of lung transfer factor for CO (TLCO) similar to those obtained with the usual standardized single breath technique. This technique requires actual flow rates and volume variations to be taken into account [10], as well as the use of a fast CO analyser and computerized calculations. TLCO values found with this method (TLCOsb) for 5 normal subjects and 29 patients with various respiratory diseases did not differ from those obtained with the standardized test (p less than 0.001). ⋯ In patients where two TLCOex values were required to describe the exhaled CO course, we found that TLCOex decreased with lung volume. This decrease was also correlated with the argon slope (p less than 0.001). The observed difference between TLCOsb and TLCOex values and the decrease of TLCOex with lung volume probably reflect inhomogeneous ventilation distribution.
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Bull Eur Physiopathol Respir · May 1984
[Reliability of the transcutaneous PO2 measurement in the adult by the TCM 1 radiometer electrode].
The accuracy of transcutaneous PO2 measurements (PtcO2; Radiometer TCM 1) was evaluated by comparison with arterial PO2 (PaO2) on 115 recordings in 35 patients: 20 during exercise testing (group I) and 14 during assisted ventilation at different FIO2 values (group II). The correlation coefficient between PaO2 and PtcO2 was satisfactory (r = 0.977; n = 115). ⋯ In the adult, transcutaneous PO2 measurement by TCM 1 radiometer electrode seems to be interesting in the context of monitoring blood gases with exercise and assisted ventilation. The significant variation with arterial PO2 sometimes registered should make one cautious in the interpretation of accurate measurements.
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Bull Eur Physiopathol Respir · Jan 1984
Randomized Controlled Trial Clinical Trial[Pleural pressure during thoracocentesis in patients with pleural neoplasms].
In 45 patients with cancerous pleural effusion, thoracocentesis was performed according to the following technique : after local anaesthesia (5 ml of 2% lidocaine) in the posterior part of the 6th intercostal space, thoracocentesis was carried out with a blunt trocar connected to a water manometer. The pleural pressure was measured before removal of the fluid (Po). Then three different techniques of drainage (active suction at -- 80 or -- 40 mmHg or underwater sealed drainage) were randomized. ⋯ PT in these patients was statistically lower (-- 18 +/- 5.59 cmH2O) than in the 31 asymptomatic patients (--11.40 +/- 5.75 cmH2O) (p less than 0.001). In conclusion, the assessment of the pleural pressure during thoracocentesis seems to be convenient in order to prevent any complication of pleural evacuation : pleural evacuation should be stopped if the pleural pressure decreased below -- 18 cmH2O. A depression at -- 80 mmHg is too dangerous for pleural aspiration; -- 40 mmHg or under water sealed drainage are both convenient for a safe and complete evacuation.
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Sulphur dioxide inhalation (200 ppm) suppresses the inflation apnea in rabbits, but not in dogs. In rabbits, SO2 blocks airway slowly adapting stretch receptors (SAR) while rapidly adapting irritant receptors (RAR) remain largely unaffected. We studied cough elicited by mechanical irritation of the extrapulmonary airways and larynx in 13 rabbits and 4 dogs, anesthetized and spontaneously breathing, before and after SO2 inhalation. ⋯ We recorded the response to mechanical probing of tracheal RAR, before and after SO2 exposure, in 6 rabbits. We found that the activity of these RAR was still present after cough and inflation apnea had disappeared. These results suggest a significant role of slowly adapting airway receptors in the cough reflex.