Respiratory medicine
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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.
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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.
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Respiratory medicine · Jan 2009
Randomized Controlled Trial Multicenter Study Comparative StudyThe efficacy of tiotropium administered via Respimat Soft Mist Inhaler or HandiHaler in COPD patients.
Tiotropium, a once daily inhaled anticholinergic delivered via HandiHaler, provides bronchodilation for >24h and improves patient-centred outcomes. The Respimat Soft Mist Inhaler (SMI), a novel, propellant-free inhaler, has been developed and proposed as an alternative delivery device for use with tiotropium. ⋯ Tiotropium 5 microg Respimat SMI is comparable with tiotropium 18 microg HandiHaler in terms of efficacy, pharmacokinetics and safety. Respimat SMI is an effective alternative, multi-dose delivery device for tiotropium.
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Respiratory medicine · Jan 2009
Randomized Controlled Trial Comparative StudyLung function and asthma control with beclomethasone and formoterol in a single inhaler.
Lung deposition is crucial for asthma treatment. However, there is no study comparing the potential role of lung co-deposition of combination therapy (inhaled corticosteroid and long-acting beta2 agonist) in the same inhaler. In moderate to severe asthmatics, an extra-fine hydrofluoroalkane combination of beclomethasone dipropionate and formoterol given via a single pressurised metered-dose inhaler (pMDI) was compared with beclomethasone dipropionate chlorofluorocarbon (CFC) pMDI and formoterol dry powder inhaler (DPI) given via separate inhalers. ⋯ In patients with moderate to severe asthma, beclomethasone dipropionate/formoterol in a single inhaler was as effective as beclomethasone dipropionate plus formoterol and superior to beclomethasone dipropionate alone in improving lung function. For the first time with a single inhaler, beclomethasone dipropionate/formoterol was significantly superior to separate components for asthma control.
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Respiratory medicine · Nov 2008
Randomized Controlled TrialRandomised trial of inpatient versus outpatient initiation of home mechanical ventilation in patients with nocturnal hypoventilation.
Long-term home mechanical ventilation (HMV) is usually initiated in hospital. Admission to hospital has resource implications and may not be reimbursable in some healthcare systems. ⋯ Outpatient initiation of HMV is feasible with equivalent outcome in the outpatient and the inpatient groups.