The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology
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Randomized Controlled Trial Clinical Trial
Influence of posture on mechanical parameters derived from respiratory impedance.
The influence of posture on respiratory mechanics was investigated in 10 healthy volunteers, using the forced pseudorandom noise technique. Subjects were studied in four randomly selected positions: sitting; sitting with the head turned sideways; supine; and prone with the head turned sideways. ⋯ R4 was significantly higher in the supine position than in either of the sitting or the prone positions. These results demonstrate that changes in lung volume cannot completely explain the influence of posture on respiratory resistance, and indicate upper airway geometry as a determinant factor of respiratory resistance.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Sequential treatment with low dose almitrine bismesylate in hypoxaemic chronic obstructive airways disease.
Daily dose schedules of 100-200 mg of almitrine bismesylate improve arterial blood gases in patients with hypoxaemic chronic obstructive airways disease (COPD) but dose related side effects are evident. In the present study, daily doses approximately half of those previously used were employed in a randomised double blind manner in 85 patients (age 35-79 years) with hypoxaemic COPD. After a one month period to check stability of arterial blood gases, patients were allocated to almitrine (A) or placebo (P) using an unequal code (60% A, 40% P). ⋯ After withdrawal of therapy arterial blood gases and spirometry reverted to pre-treatment levels, suggesting no permanent reversal of pathophysiology. Dose related side effects of breathlessness, indigestion and peripheral neuropathy were not observed. Nerve conduction studies revealed no difference in peripheral nerve dysfunction in hypoxaemic COPD between active and placebo therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of nebulized and sprayed topical anaesthesia for fibreoptic bronchoscopy.
We compared the efficacy of nebulized (N) and sprayed (S) topical anaesthesia prior to fibreoptic bronchoscopy in a blinded study involving 54 patients aged 57 +/- 26 yrs (mean +/- SD). Cough frequency, recorded on cassette tape, was the index of efficacy. All patients received 100 mg lignocaine sprayed into the pharynx, or nebulized in random order prior to bronchoscopy, and all received intravenous diazepam sedation. ⋯ Furthermore, no differences were found in cough frequency between N and S among smokers, patients with asthma and COPD, and patients who had a biopsy procedure, although a trend was seen in all comparisons towards a lower cough frequency with the nebulized route. Most patients in the S group found the spray unpleasant, whereas only one in the N group complained. We conclude that nebulized and sprayed lignocaine have similar efficacy as topical anaesthetics in fibreoptic bronchoscopy, but patient preference favours the nebulized route.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Bronchodilator reversibility, exercise performance and breathlessness in stable chronic obstructive pulmonary disease.
Partial bronchodilator reversibility can be demonstrated in many patients with stable chronic obstructive pulmonary disease (COPD), but its relevance to exercise capacity and symptoms is uncertain. Previous data suggest that anticholinergic bronchodilators do not improve exercise tolerance in such patients. We studied 32 patients with stable COPD, mean age 65 yrs, in a double-blind, placebo-controlled, cross-over trial of the inhaled anticholinergic drug, oxitropium bromide. ⋯ Oxitropium bromide increased baseline FEV1 from 0.70 (0.28) l (mean (SD)) to 0.88 (0.36) l. The 6 min walking distance increased by 7% compared with placebo, whilst resting breathlessness scores fell from 2.0 to 1.23 at rest and 4.09 to 3.28 at the end of exercise after the active drug. Improvements in walking distances and symptoms were unrelated to changes in either FEV1 or FVC, indicating that routine reversibility testing is not a good predictor of symptomatic benefit in these patients.
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Randomized Controlled Trial Clinical Trial
Portable oxygen therapy: use and benefit in hypoxaemic COPD patients on long-term oxygen therapy.
In 159 chronic obstructive pulmonary disease (COPD) patients (139 males, mean age 62 +/- 8 yrs, arterial oxygen tension (PaO2) 7.2 +/- 0.9 kPa), on long-term oxygen therapy (LTOT), we evaluated the effects of portable oxygen therapy both on the daily duration of oxygen therapy and on daily activities. They were given two types of LTOT at random: group A (n = 75), oxygen concentrators only (OC); group B (n = 84), either small oxygen cylinders plus OC (B1 = 51) or liquid oxygen (B2 = 33). ⋯ Only 60% of patients in group B (55% of B1; 67% of B2) use their portable devices outdoors and for walking. No strict predictive criterion of this use is found in our study.(ABSTRACT TRUNCATED AT 250 WORDS)