Respiration; international review of thoracic diseases
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Although mixed venous O2 saturation (SvO2) accurately indicates the balance of O2 supply/demand and provides an index of tissue oxygenation, the use of a pulmonary artery (PA) catheter is associated with significant costs, risks and complications. Central venous O2 saturation (ScvO2), obtained in a less risky and costly manner, can be an attractive alternative to SvO2. ⋯ ScvO2 and SvO2 are closely related and are interchangeable for the initial evaluation of critically ill patients even if cardiac indices are different. SvO2 can be estimated with great accuracy by ScvO2 in 92% of the patients using a power model.
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Comparative Study
Effect of continuous positive airway pressure therapy on infectious complications in patients with obstructive sleep apnea syndrome.
Nasal continuous positive airway pressure (CPAP) is a well-established, widely used and effective treatment of obstructive sleep apnea syndrome (OSAS). Unfortunately, side effects are frequent during CPAP treatment. ⋯ Our results suggest that patients using CPAP therapy either with or without heated humidity seem to be at an increased risk of upper airway infections compared to conservatively treated patients.
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Increased interleukin-5 (IL-5) levels have been reported in bronchoalveolar lavage fluid (BALF) from patients with acute eosinophilic pneumonia (AEP); however, it still remains to be determined whether IL-5 is responsible for the eosinophil accumulation in the lung. ⋯ These findings suggest that locally produced IL-5 plays an important role in eosinophil accumulation of AEP.
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Case Reports
Aortobronchial fistula presenting as recurrent hemoptysis and successfully treated with an endovascular stent graft.
Aortobronchial fistula (ABF) (aortopulmonary fistula) may cause a massive fatal hemoptysis. We have recently seen a patient with ABF presenting with recurrent, massive hemoptysis. She was successfully treated with an endovascular stent graft. The endovascular stent graft may provide an alternative treatment of in patients considered to be poor surgical candidates.
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Erythromycin has been shown to diminish sputum production in hypersecretory states by a mechanism that is still unclear. ⋯ These results suggest that the presence of erythromycin in sputum neither alters the physical properties of the gel nor the activity of cilia. The clinical effects of erythromycin on pulmonary hypersecretory states therefore have another explanation.