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https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#1
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28079615/neuromuscular-weakness-in-chronic-obstructive-pulmonary-disease-chest-wall-diaphragm-and-peripheral-muscle-contributions
#2
Adam Alter, Loutfi S Aboussouan, Eduardo Mireles-Cabodevila
PURPOSE OF REVIEW: Chronic obstructive lung disease affects the lung parenchyma and airways leading to well described effects in respiratory function. This review describes the current knowledge and advances regarding neuromuscular function and chest wall mechanics, which are affected in chronic obstructive pulmonary disease (COPD). RECENT FINDINGS: In COPD, progressive lung hyperinflation becomes constrained by a chest wall with decreasing capacity to expand, resulting in respiratory muscle inefficiency...
January 11, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28066619/clinical-management-of-chronic-obstructive-pulmonary-disease-patients-with-muscle-dysfunction
#3
REVIEW
Joaquim Gea, Carme Casadevall, Sergi Pascual, Mauricio Orozco-Levi, Esther Barreiro
Muscle dysfunction is frequently observed in chronic obstructive pulmonary disease (COPD) patients, contributing to their exercise limitation and a worsening prognosis. The main factor leading to limb muscle dysfunction is deconditioning, whereas respiratory muscle dysfunction is mostly the result of pulmonary hyperinflation. However, both limb and respiratory muscles are also influenced by other negative factors, including smoking, systemic inflammation, nutritional abnormalities, exacerbations and some drugs...
November 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28040521/bronchodilator-response-in-fvc-is-larger-and-more-relevant-than-in-fev1-in-severe-airflow-obstruction
#4
Philip H Quanjer, Gregg L Ruppel, Arnulf Langhammer, Abhishek Krishna, Frans Mertens, Ane Johannessen, Ana M B Menezes, Fernando C Wehrmeister, Rogelio Perez-Padilla, Maureen P Swanney, Wan C Tan, Jean Bourbeau
BACKGROUND: Recommendations on interpreting tests of bronchodilator responsiveness (BDR) are conflicting. We investigated the dependence of BDR criteria on sex, age, height, ethnicity and severity of respiratory impairment. METHODS: BDR tests were available from clinical patients in the Netherlands, New Zealand and the USA (N=15,278, 51.7% females) and surveys in Canada, Norway and five Latin-American countries (N=16,250, 54.7% females). BDR in FEV1, FVC and FEV1/ FVC was expressed as absolute change, % baseline, % predicted and z-score...
December 28, 2016: Chest
https://www.readbyqxmd.com/read/28008243/efficacy-of-tiotropium-olodaterol-fixed-dose-combination-in-copd
#5
REVIEW
Eric Derom, Guy G Brusselle, Guy F Joos
Tiotropium-olodaterol, formulated in the Respimat soft-mist inhaler, is an inhaled fixed-dose combination (FDC) of a long-acting muscarinic antagonist (LAMA) and a long-acting β2-agonist (LABA), commercialized under the name of Spiolto or Stiolto. The efficacy of tiotropium-olodaterol 5-5 μg once daily in adult patients with COPD was documented in eleven large, multicenter trials of up to 52 weeks duration. Tiotropium-olodaterol 5-5 μg not only improved spirometric values to a significantly greater extent than placebo but also resulted in statistically significant beneficial effects on dyspnea, markers of hyperinflation, use of rescue medication, health-related quality of life, and exercise endurance...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27998300/is-increased-positive-end-expiratory-pressure-the-culprit-autoresuscitation-in-a-44-year-old-man-after-prolonged-cardiopulmonary-resuscitation-a-case-report
#6
Henning Hagmann, Katrin Oelmann, Robert Stangl, Guido Michels
BACKGROUND: The phenomenon of autoresuscitation is rare, yet it is known to most emergency physicians. However, the pathophysiology of the delayed return of spontaneous circulation remains enigmatic. Among other causes hyperinflation of the lungs and excessively high positive end-expiratory pressure have been suggested, but reports including cardiopulmonary monitoring during cardiopulmonary resuscitation are scarce to support this hypothesis. CASE PRESENTATION: We report a case of autoresuscitation in a 44-year-old white man after 80 minutes of advanced cardiac life support accompanied by continuous capnometry and repeated evaluation by ultrasound and echocardiography...
December 20, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27992862/endobronchial-valves-for-endoscopic-lung-volume-reduction-best-practice-recommendations-from-expert-panel-on-endoscopic-lung-volume-reduction
#7
Dirk-Jan Slebos, Pallav L Shah, Felix J F Herth, Arschang Valipour
Endoscopic lung volume reduction (ELVR) is being adopted as a treatment option for carefully selected patients suffering from severe emphysema. ELVR with the one-way endobronchial Zephyr valves (EBV) has been demonstrated to improve pulmonary function, exercise capacity, and quality of life in patients with both heterogeneous and homogenous emphysema without collateral ventilation. In this "expert best practices" review, we will highlight the practical aspects of this therapy. Key selection criteria for ELVR are hyperinflation with a residual volume >175% of predicted, forced expiratory volume <50% of predicted, and a 6-min walking distance >100 m...
December 20, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27983888/eosinophilic-and-neutrophilic-airway-inflammation-in-the-phenotyping-of-mild-to-moderate-asthma-and-chronic-obstructive-pulmonary-disease
#8
Katarzyna Górska, Magdalena Paplińska-Goryca, Patrycja Nejman-Gryz, Krzysztof Goryca, Rafał Krenke
Asthma and chronic obstructive pulmonary disease (COPD) are heterogeneous diseases with different inflammatory phenotypes. Various inflammatory mediators play a role in these diseases. The aim of this study was to analyze the neutrophilic and eosinophilic airway and systemic inflammation as the phenotypic characterization of patients with asthma and COPD. Twenty-four patients with asthma and 33 patients with COPD were enrolled in the study. All the patients were in mild-to-moderate stage of disease, and none of them were treated with inhaled corticosteroids...
December 16, 2016: COPD
https://www.readbyqxmd.com/read/27922741/how-do-dual-long-acting-bronchodilators-prevent-exacerbations-of-chronic-obstructive-pulmonary-disease
#9
Kai M Beeh, Pierre-Regis Burgel, Frits M E Franssen, Jose Luis Lopez-Campos, Stelios Loukides, John R Hurst, Matjaž Fležar, Charlotte Suppli Ulrik, Fabiano Di Marco, Daiana Stolz, Arschang Valipour, Brian Casserly, Björn Ställberg, Konstantinos Kostikas, Jadwiga A Wedzicha
Decreasing the frequency and severity of exacerbations is one of the main goals of treatment for patients with chronic obstructive pulmonary disease (COPD). Several studies have documented that long-acting bronchodilators (LABDs) can reduce exacerbation rate and/or severity, and others have shown that combinations of long-acting β2-adrenergic agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) provide greater reductions in exacerbation frequency than either their monocomponents or LABA/inhaled corticosteroids (LABA/ICS) combinations in patients at low and high risk for these events...
December 6, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27892756/use-of-high-non-invasive-respiratory-support-pressures-in-preterm-neonates-a-single-centre-experience
#10
Abdulaziz Binmanee, Salhab El Helou, Sandesh Shivananda, Christoph Fusch, Amit Mukerji
PURPOSE: To describe the incidence, indications and clinical outcomes following high pressures on non-invasive respiratory support (NRS) in preterm neonates. STUDY DESIGN: Retrospective cohort study of all neonates with BW < 1,500 g admitted from July 2012 to June 2014 and placed on high NRS, defined as mean airway pressure ≥ 10 cm H2O for at least 12 continuous hours using NCPAP and/or nasal high frequency ventilation (NIHFV). Clinical and physiological outcomes following high NRS were ascertained...
November 28, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27888991/pulmonary-function-and-adverse-cardiovascular-outcomes-can-cardiac-function-explain-the-link
#11
Melissa S Burroughs Peña, Allison Dunning, Phillip J Schulte, Michael T Durheim, Peter Kussin, William Checkley, Eric J Velazquez
BACKGROUND: The complex interaction between pulmonary function, cardiac function and adverse cardiovascular events has only been partially described. We sought to describe the association between pulmonary function with left heart structure and function, all-cause mortality and incident cardiovascular hospitalization. METHODS: This study is a retrospective analysis of patients evaluated in a single tertiary care medical center. We used multivariable linear regression analyses to examine the relationship between FVC and FEV1 with left ventricular ejection fraction (LVEF), left ventricular internal dimension in systole and diastole (LVIDS, LVIDD) and left atrial diameter, adjusting for baseline characteristics, right ventricular function and lung hyperinflation...
December 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27888824/clinico-radiological-parameters-predicting-early-diagnosis-of-foreign-body-aspiration-in-children
#12
Pradipta Kumar Parida, Nirmal Shanmugasundaram, Surianarayanan Gopalakrishnan
OBJECTIVES: This study aims to investigate clinical and radiological findings to make early diagnosis of foreign body (FB) aspiration in children. PATIENTS AND METHODS: This prospective study was conducted on 45 children younger than 12 years with a clinical diagnosis of FB aspiration undergone rigid bronchoscopy between September 2010 and May 2014. The results of 37 children (22 males, 15 females; mean age 2.6 years; range 1 to 12 years) with positive for FB on bronchoscopy were analyzed...
September 2016: Kulak Burun Boğaz Ihtisas Dergisi: KBB, Journal of Ear, Nose, and Throat
https://www.readbyqxmd.com/read/27887950/cyslt2-receptor-activation-is-involved-in-ltc4-induced-lung-air-trapping-in-guinea-pigs
#13
Tomohiko Sekioka, Michiaki Kadode, Yasuo Yonetomi, Akihiro Kamiya, Manabu Fujita, Takeshi Nabe, Kazuhito Kawabata
CysLT1 receptors are known to be involved in the pathogenesis of asthma. However, the functional roles of CysLT2 receptors in this condition have not been determined. The purpose of this study is to develop an experimental model of CysLT2 receptor-mediated LTC4-induced lung air-trapping in guinea pigs and use this model to clarify the mechanism underlying response to such trapping. Because LTC4 is rapidly converted to LTD4 by γ-glutamyltranspeptidase (γ-GTP) under physiological conditions, S-hexyl GSH was used as a γ-GTP inhibitor...
January 5, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27882425/assessment-of-regional-emphysema-air-trapping-and-xenon-ventilation-using-dual-energy-computed-tomography-in-chronic-obstructive-pulmonary-disease-patients
#14
Sang Min Lee, Joon Beom Seo, Hye Jeon Hwang, Namkug Kim, Sang Young Oh, Jae Seung Lee, Sei Won Lee, Yeon-Mok Oh, Tae Hoon Kim
OBJECTIVES: To compare the parenchymal attenuation change between inspiration/expiration CTs with dynamic ventilation change between xenon wash-in (WI) inspiration and wash-out (WO) expiration CTs. METHODS: 52 prospectively enrolled COPD patients underwent xenon ventilation dual-energy CT during WI and WO periods and pulmonary function tests (PFTs). The parenchymal attenuation parameters (emphysema index (EI), gas-trapping index (GTI) and air-trapping index (ATI)) and xenon ventilation parameters (xenon in WI (Xe-WI), xenon in WO (Xe-WO) and xenon dynamic (Xe-Dyna)) of whole lung and three divided areas (emphysema, hyperinflation and normal) were calculated on virtual non-contrast images and ventilation images...
November 23, 2016: European Radiology
https://www.readbyqxmd.com/read/27882084/staged-bilateral-single-port-thoracoscopic-lung-volume-reduction-surgery-a-report-of-11-cases
#15
Miao Zhang, Heng Wang, Xue-Feng Pan, Wen-Bin Wu, Hui Zhang
The aim of the present study was to investigate the feasibility and efficacy of staged bilateral single-port thoracoscopic lung volume reduction surgery (LVRS) for patients with chronic obstructive pulmonary emphysema (COPE). Eleven male patients with a mean age of 60.27±12.11 years with bilateral COPE and bullae were admitted to the Department of Thoracic Surgery, Xuzhou Central Hospital from January 2013 to June 2014. The patients underwent staged bilateral single-port thoracoscopic LVRS. The hyperinflated bullae were resected using endoscopic staplers (Endo-GIA), followed by continuous suture and biological glue for reinforcement of the margin...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27876834/the-measurement-of-lung-volumes-using-body-plethysmography-and-helium-dilution-methods-in-copd-patients-a-correlation-and-diagnosis-analysis
#16
Yongjiang Tang, Mingke Zhang, Yulin Feng, Binmiao Liang
Chronic obstructive pulmonary disease (COPD) is a chronic airway disease characterized by persistent airflow limitation. Moreover, lung hyperinflation evaluated by lung volumes is also the key pathophysiologic process during COPD progression. Nevertheless, there is still no preferred method to evaluate lung volumes. For this study, we recruited 170 patients with stable COPD to assess lung volumes stratified by airflow limitation severity. Lung volumes including residual volume (RV) and total lung capacity (TLC) were determined by both body plethysmography and helium dilution methods...
November 23, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27870822/comparison-of-total-lung-capacity-determined-by-plethysmography-with-computed-tomographic-segmentation-using-caliper
#17
Andrew J Matsumoto, Brian J Bartholmai, Mark E Wylam
PURPOSE: Traditionally, determination of total lung capacity (TLC) by plethysmography (TLCpleth) has been important in the diagnosis of lung diseases. Alternatively, data acquired from computerized tomography (CT) can be utilized to calculate a measure of TLC (TLCCT). The clinical utility of TLCCT is not certain. We sought to determine, in a clinical setting, whether TLCCT correlates with TLCpleth across a range of lung diseases and scanning techniques. In addition, we determined whether TLCCT affects the interpretation of pulmonary function tests...
November 18, 2016: Journal of Thoracic Imaging
https://www.readbyqxmd.com/read/27858901/primary-mucoepidermoid-carcinoma-at-the-carina-of-trachea-presenting-with-wheezing-in-an-asthmatic-child-mimicking-an-attack-of-asthma-a-case-report
#18
Chien-Heng Lin, Yu-Hua Chao, Kang-Hsi Wu, Wei-Ching Lin
BACKGROUND: Asthma is a very common disease, but primary tracheal tumors are extremely rare in children. Wheezing is not pathognomonic, but is the typical presentation of asthma and could also be found in patients with tracheal tumors. CLINICAL FINDINGS: This report describes a 12-year-old boy with a previous history of frequent asthma attacks and experienced responses to antiasthma treatment. He was admitted to the hospital due to persistent wheezing and progressive dyspnea...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27855687/diagnostic-accuracy-of-methacholine-challenge-tests-assessing-airway-hyperreactivity-in-asthmatic-patients-a-multifunctional-approach
#19
Richard Kraemer, Hans-Jürgen Smith, Thomas Sigrist, Gabi Giger, Roland Keller, Martin Frey
BACKGROUND: There are few studies comparing diagnostic accuracy of different lung function parameters evaluating dose-response characteristics of methacholine (MCH) challenge tests (MCT) as quantitative outcome of airway hyperreactivity (AHR) in asthmatic patients. The aim of this retrospectively analysis of our database (Clinic Barmelweid, Switzerland) was, to assess diagnostic accuracy of several lung function parameters quantitating AHR by dose-response characteristics. METHODS: Changes in effective specific airway conductance (sGeff) as estimate of the degree of bronchial obstruction were compared with concomitantly measured forced expiratory volume in 1 s (FEV1) and forced expiratory flows at 50% forced vital capacity (FEF50)...
November 17, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27842746/managing-respiratory-failure-in-obstructive-lung-disease
#20
REVIEW
Stephen P Bergin, Craig R Rackley
Exacerbations of obstructive lung disease are common causes of acute respiratory failure. Short-acting bronchodilators and systemic glucocorticoids are the foundation of pharmacologic management. For patients requiring ventilator support, use of noninvasive ventilation reduces the risk of mortality and progression to invasive mechanical ventilation. Challenges associated with invasive ventilation include ventilator dyssynchrony, air trapping, and dynamic hyperinflation. Careful monitoring and adjustment of ventilatory support parameters helps to optimize the patient-ventilator interaction and minimizes the risk of associated morbidity...
December 2016: Clinics in Chest Medicine
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