Respiration; international review of thoracic diseases
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There are no recommendations about admission to an ICU after a major lung resection and there are considerable differences among institutions in this respect. ⋯ This empirical protocol was useful in identifying patients not likely to need admission to the ICU. ASA score, predictive postoperative DL(CO), and PPP are independent predictors of a need for admission to an ICU.
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Pulmonary lymphangiectasis is a rare anomaly in infancy that is characterized by dilatation of pulmonary lymphatic vessels resulting in fetal respiratory distress. Pulmonary lymphangiectasis is considered to occur exclusively in young children and neonates, and very few survive beyond an early age. ⋯ An exploratory video-assisted thoracoscopy revealed multiple yellowish cysts on the visceral pleura, which were histologically diagnosed as lymphangiectasis. In the present study, the pathogenesis and clinical characteristics are discussed.
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Obstructive sleep apnea (OSA) has a critical association with cardiovascular mortality and morbidity. Carotid intima-media thickness (IMT), flow-mediated dilatation (FMD) and aortic stiffness are early signs of atherosclerosis. The presence of subclinical atherosclerosis was assessed in OSA patients using these parameters. ⋯ We observed blunted endothelium-dependent dilatation, increased carotid IMT and aortic stiffness in patients with OSA compared with matched control subjects. This is evident in the absence of other diseases, suggesting that OSA is an independent cause of atherosclerosis. These simple and non-invasive methods help to detect subclinical atherosclerosis in OSA.
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Long-term oxygen therapy (LTOT) is the cornerstone mode of treatment in patients with chronic obstructive pulmonary disease (COPD). ⋯ We conclude that stationary liquid oxygen seems to be a satisfactory alternative mode for LTOT treatment in COPD patients, with higher patient compliance to therapy in comparison with concentrators.
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A 39-year-old-woman was treated successfully by a combination of endobronchial and bronchial artery embolization for massive hemorrhage originating from the posterior segment of the right upper lobe. Endobronchial embolization was performed using a silicone spigot placed via flexible bronchoscopy in order to prevent alveolar inundation preceding and during the time of bronchial artery embolization. Massive hemorrhage is a rare and severe condition associated with a high mortality that requires rapid intervention and management. We describe a case that emphasizes the efficacy of a multidisciplinary approach including the use of a new bronchoscopic technique.