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 "
Of the several pulmonary function tests available for identifying and evaluating patients with lung diseases, simple spirometry is one of the most practical and useful. The American College of Chest Physicians, the American Thoracic Society (ATS), and the Association for the Advancement of Medical Instrumentation (AAMI)4 have all published recommendations for spirometry performance and instrumentation. [...]
Continue reading " State of the Art of Spirometric Instrumentation "
Cardiopulmonary exercise testing (CPX) is rooted in a classic view of the heart, lungs, and circulation functioning together during exercise to accomplish gas exchange while maintaining the internal milieu. Disorders of this integrated unit are distinguished by analysis of expired gases, which has become practical with the advent of computerized metabolic carts. By virtue of [...]
