Table 1 indicates that the original 48 patients spanned a broad spectrum of pulmonary function and arterial blood gas derangements. In addition, there was a significant drop from baseline awake Sa02 to mean nocturnal Sa02 (mean±SD, 92.6±3.8 vs regression analysis (r = 0.34, p<0.02), the impact of FEVx on mean nocturnal Sa02 is lost when [...]
Continue reading " Daytime Hypercapnia in the Development of Nocturnal Hypoxemia in COPD: RESULTS "
Model Development Subjects: The subjects consisted of 48 consecutive patients with COPD admitted to a chronic respiratory unit for rehabilitation. All were previous smokers and had a forced expiratory volume in one second (FEV^forced vital capacity (FVC) of <70 percent. None had a history of atopy or asthma nor of any other respiratory disease. All [...]
Continue reading " Daytime Hypercapnia in the Development of Nocturnal Hypoxemia in COPD: METHODS "
McNicholas et al have shown that there is a substantially higher incidence of death at night compared to daytime in patients with COPD which they attributed to worsening hypoxemia during sleep. In fact, several studies have demonstrated a worsening of hypoxemia during sleep in patients with COPE) which has been associated with transient elevations of [...]
Continue reading " Daytime Hypercapnia in the Development of Nocturnal Hypoxemia in COPD "
Tt has long been recognized that monotonous spontaneous or mechanical ventilation with a low Vt (5 to 7 ml/kg) of normal or minimally damaged lungs allows the development of alveolar atelectasis. As a result, an increase in intrapulmonary shunting and a decrease in lung compliance and Pa02 occur. These effects can be reversed by inflation [...]
Early in this century, the most frequent cause of laryngotracheal stenosis was ascribed to destructive processes of primary diseases, for example, diphtheria, syphilis, tuberculosis, or typhoid fever. This was followed by cicatricial stenosis after high tracheostomy. Since the introduction of endotracheal intubation for mechanical ventilation, there has been a significant increase in the frequency of [...]
The fortunate patient who achieves the status of “long-term survivor” (more than three months) of a heart-lung or lung transplantation still has a number of obstacles to face. A small but definite percentage of these will succumb to infection with a variety of viral and bacterial agents. Of the rest, past series have reported a [...]
Continue reading " Home Monitoring of the Transplanted Lung "
The advent of general thoracic surgery (surgery of the lung, esophagus, mediastinum, diaphragm, trachea, and chest wall) began in 1904 when Sauer- bruch, in Germany, published the principle of “operating on the lung under differential atmospheric pressure. This ultimately led to endotracheal intubation and the ability to safely operate on all structures within the chest. [...]
Continue reading " General Thoracic Surgery The Need for Excellence in Training "
