Archivos de bronconeumología
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Arch. Bronconeumol. · Jan 2009
Review[Key features in the management of diffuse interstitial pulmonary disease].
Diffuse interstitial lung disease is a heterogeneous group of diseases in which the common denominator is involvement of the area between the basement membrane of the alveolar epithelium and the capillary endothelium, known as the interstitial space. Diffuse interstitial lung disease poses a tremendous challenge to the clinician due to the diagnostic approach, the complications that can appear in the natural history of these entities, and the scarcity of available therapeutic resources. This brief review discusses key features of the management of diffuse interstitial pulmonary disease, such as prognostic factors, the therapeutic options -including the role of lung transplantation- and the diagnosis and treatment of two complications with crucial impact on the clinical course of the disease: exacerbations and associated pulmonary hypertension.
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Arch. Bronconeumol. · Jan 2009
Review[Annual review of Archivos de Neumología in interventional pneumology, interstitial diseases and lung transplantation].
A review has been made of original articles on invasive pneumology techniques, interstitial diseases and lung transplantation, published in the Archivos de Bronconeumología during the year 2008. We have selected the publication by Martínez-Olondrins et al on the mediastinal staging of bronchogenic carcinoma by
transbronchial needle aspiration to highlight the role of this simple, safe and cost-effective technique at a time when aspiration by ultrasound-guided bronchoscopy is profiled as an alternative to staging by mediastinoscopy. ⋯ In diffuse interstitial disease, Morell et al analysed the diagnostic methods in 500 patients with this clinical-radiological presentation in which a definitive diagnosis was achieved in 85%, with 25% of them being obtained by non-invasively. Baloira et al analysed the characteristics of 19 patients with desquamative interstitial pneumonia and respiratory bronchiolitis associated-interstitial lung disease obtained from the National register of Interstitial Diseases. -
Oxygen-conserving devices include transtracheal catheters, reservoir cannulas, and demand oxygen delivery systems. They are designed to extend the amount of time portable oxygen cylinders will last and correct hypoxemia with a lower flow of oxygen. Transtracheal catheters increase the fraction of inspired oxygen by delivering oxygen directly to the trachea, bypassing the dead space of the oropharynx and improving the efficiency of the upper airway as a reservoir. ⋯ Demand oxygen delivery systems have a valve that is activated during inspiration, meaning that oxygen is only delivered during this stage of the respiratory cycle. Each system has advantages and disadvantages arising from differing design features. Prescription should be based on individual tests in all cases to ensure optimal oxygen delivery during rest, exercise, and sleep.