Respiratory medicine
-
Respiratory medicine · Feb 2009
Multicenter StudyEpidemiology of community-acquired pneumonia in older adults: a population-based study.
This study assessed incidence, aetiology, clinical outcomes and risk factors for community-acquired pneumonia (CAP) in older adults. ⋯ CAP remains a major cause of morbidity and mortality in older adults. Incidence rates in this study largely doubled prior rates reported in Southern European regions.
-
Respiratory medicine · Feb 2009
Randomized Controlled TrialImpact of volume targeting on efficacy of bi-level non-invasive ventilation and sleep in obesity-hypoventilation.
Volume targeting by bi-level positive pressure ventilation (BPPV) has recently been made available by several manufacturers for home care ventilators. Although it may improve nocturnal ventilation, we hypothesized that increased pressure swings related to volume targeting may have a deleterious effect on sleep structure and patient comfort. ⋯ In stable patients treated by BPPV for obesity-hypoventilation, volume targeting improved control of nocturnal hypoventilation at the expense of a slight decrease in objective and subjective sleep quality, and comfort of ventilation.
-
Respiratory medicine · Feb 2009
Randomized Controlled TrialModulation of operational lung volumes with the use of salbutamol in COPD patients accomplishing upper limbs exercise tests.
Pulmonary dynamic hyperinflation (DH) is an important factor limiting the physical capacity of patients with COPD. Inhaled bronchodilator should be able to reduce DH. ⋯ We conclude that the use of bronchodilator increases the IC of patient with COPD and may help not to increase the DH during a maximal exercise with the arms.
-
Respiratory medicine · Feb 2009
A quick and easy method of measuring the hypercapnic ventilatory response in patients with COPD.
Hypercapnic ventilatory response (HCVR) techniques have not previously been adequately validated in patients with chronic obstructive pulmonary disease (COPD). We have tested the hypothesis that end-tidal PCO(2) may be used to test the HCVR in COPD during non-steady-state rebreathing, despite the fact that large (arterial-end-tidal) PCO(2) differences (P(a-et)CO(2)) exist during air breathing. ⋯ In COPD patients non-steady-state HCVR using PetCO(2) is well tolerated, which is as accurate as PaCO(2). HCVR slope may be derived using PetCO(2) during steady-state testing, though there may be errors in intercept compared to use of PaCO(2). In healthy volunteers PetCO(2) may be used to estimate PaCO(2) during steady-state but not rebreathing HCVR.
-
Respiratory medicine · Feb 2009
Impact of pulmonary hypertension on gas exchange and exercise capacity in patients with pulmonary fibrosis.
Pulmonary hypertension is a relevant interceding morbidity in patients with pulmonary fibrosis that has significant impact on exercise tolerance and outcome. The aim of this study was to further characterize the exercise intolerance, dyspnoea and ventilatory inefficiency of patients with pulmonary fibrosis in the presence or absence of pulmonary hypertension via cardiopulmonary exercise testing. Thirty-four patients underwent pulmonary function testing, symptom-limited exercise testing on a bicycle and dyspnoea evaluation according to the BORG scale. ⋯ In addition, the increased ventilatory requirements significantly influenced the extent of dyspnoea in patients with pulmonary hypertension. We conclude that pulmonary hypertension has a significant impact on exercise capacity and dyspnoea in patients with interstitial lung disease (ILD). The further impairment of exercise capacity as well as the extent of dyspnoea in patients with interceding PHT is attributable to a significantly impaired ventilatory inefficiency.