Respiratory investigation
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Respiratory investigation · Jul 2014
Comparing surrogates of oxygenation and ventilation between airway pressure release ventilation and biphasic airway pressure in a mechanical model of adult respiratory distress syndrome.
No objective data directly comparing the 2 modes are available. Based on a simple mathematical model, APRV and BIPAP can presumably be set to achieve the same mean airway pressure (mPaw), end expiratory pressure, and tidal volume (V(T)). Herein, we tested this hypothesis when using a real ventilator and clinically relevant settings based on expiratory time constants. ⋯ We found that neither mode was superior to the other, and that a real ventilator does not behave like a mathematical model. Extreme prolongation of T high generated a higher mPaw at the expense of V(E), and vice versa. The lower V(T) with APRV was due to the higher total PEEP, which was higher than expected. Setting the T low according to the respiratory system time constant for either mode resulted in an unpredictable total PEEP.
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Respiratory investigation · Jul 2014
Formoterol and budesonide inhibit rhinovirus infection and cytokine production in primary cultures of human tracheal epithelial cells.
Long-acting β(2) agonists (LABAs) and inhaled corticosteroids (ICSs) reduce the frequency of exacerbations of chronic obstructive pulmonary disease and bronchial asthma. However, inhibitory effects of LABAs and ICSs on the replication of rhinovirus (RV), the major cause of exacerbations, have not been demonstrated. ⋯ Formoterol and budesonide may inhibit RV infection by reducing the ICAM-1 levels and/or acidic endosomes and modulate airway inflammation associated with RV infections.
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Respiratory investigation · May 2014
Relationship between the ratios of CD4/CD8 T-lymphocytes in the bronchoalveolar lavage fluid and lymph nodes in patients with sarcoidosis.
Evaluating the ratio of CD4/CD8 T-lymphocytes in the bronchoalveolar lavage fluid (BALF) is important for understanding the clinical and pathological conditions of patients with sarcoidosis. However, few studies have thus far demonstrated the usefulness of evaluating the relationship between the ratios of CD4/CD8 T-lymphocytes in the mediastinal lymph nodes and BALF. This study aimed to investigate and identify the relationships between CD4/CD8 T-lymphocyte ratio in the mediastinal lymph nodes and BALF in patients with sarcoidosis. ⋯ Performing EBUS-TBNA in patients with sarcoidosis allows correct diagnosis as well as the estimation of the ratio of CD4/CD8 T-lymphocytes in BALF.
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Respiratory investigation · May 2014
Case ReportsThree cases of mesalazine-induced pneumonitis with eosinophilia.
Oral mesalazine, or 5-aminosalicylate, is one of the first-choice medications for the treatment of ulcerative colitis and is commonly used for both induction and maintenance therapy. In a 6-month period, we treated three cases of mesalazine-induced pneumonitis. ⋯ Such images are commonly observed in patients with cryptogenic organizing pneumonia or chronic eosinophilic pneumonia. Computed tomography images for mesalazine-induced pneumonitis have been rarely reported in the literature.
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Respiratory investigation · May 2014
Review Case ReportsMorgagni hernia with respiratory failure aggravated by noninvasive positive pressure ventilation: a case report and overview of the literature.
An elderly woman diagnosed with multiple myeloma (MM) in 2007 had improved with chemotherapy. She had severe kyphosis and a diaphragmatic hernia (DH), but no respiratory symptoms. In 2011, because of thoracic deformity and emaciation, we advised her to continue the previously prescribed domiciliary noninvasive positive pressure ventilation (NPPV) therapy for chronic type II respiratory failure. ⋯ Her respiratory status subsequently improved. We hypothesize that NPPV increased intra-abdominal pressure, thereby worsening the MH and exacerbating respiratory failure. We believe that clinicians should be cautious when prescribing NPPV for MH patients.