Respiration; international review of thoracic diseases
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Multicenter Study Clinical Trial
Pneumothorax following endobronchial valve therapy and its impact on clinical outcomes in severe emphysema.
Patients who achieve significant target lobe volume reduction (TLVR) following endobronchial valve (EBV) treatment may experience substantial improvements in clinical outcome measures. However, in cases of rapid TLVR, the risk of pneumothorax increases due to parenchymal rupture of the adjacent untreated lobe. Target lobe collapse may be more likely in EBV-treated patients who have low collateral ventilation. ⋯ Although pneumothorax is a complication of EBV placement, it does not appear to have a negative impact on clinical outcome in terms of FEV1 and health-related quality of life.
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Pleural manometry can predict the presence of trapped lung and guide large-volume thoracentesis. The current technique for pleural manometry transduces pressure from the needle or intercostal catheter, necessitating intermittent cessation of fluid drainage at the time of pressure recordings. ⋯ Pleural manometry can be transduced from an epidural catheter passed through the drainage tube into the pleural space, which gives continuous recording of the pleural pressure throughout the procedure. This allows for automated calculation and display of the pleural pressure and PEL in real time, if the system is connected to a computer with appropriate software.
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Randomized Controlled Trial
Exercise training-based pulmonary rehabilitation program is clinically beneficial for idiopathic pulmonary fibrosis.
Idiopathic pulmonary fibrosis (IPF) is a chronic, devastating, interstitial lung disease, with few therapeutic options. IPF is characterized by pulmonary restriction, dyspnea, hypoxemia, exercise intolerance and poor quality of life (QOL). ⋯ ET improves exercise tolerance, functional capacity, pulmonary function, dyspnea and QOL in patients with IPF, suggesting a short-term treatment efficacy for clinical improvement, and should be considered the standard care for IPF.
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Human herpes viruses (HHVs) are important pathogens in acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). Rapid and efficient diagnostic tools are needed to detect HHVs in the lung in ALI/ARDS patients. ⋯ The implementation of multiplex and real-time PCR of BALF was feasible in ALI/ARDS patients, which allowed efficient detection and quantification of HHV DNA.
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The effectiveness of worksite interventions to reduce smoking is debatable. ⋯ A comprehensive smoking cessation intervention at the workplace achieves high, stable, long-term abstinence rates. Elderly, well-educated employees with breathlessness on exertion have higher odds of quitting smoking. In contrast, those with high physical dependency and more intense craving, and those reporting use of antidepressant medication or sputum production have poorer chances to quit.