Journal of physiology and pharmacology : an official journal of the Polish Physiological Society
-
J. Physiol. Pharmacol. · Nov 2007
Comparative Study Clinical TrialNoninvasive ventilation during weaning.
Patients suffering from advanced chronic thoracic disorders are at higher risk to develop respiratory failure, requiring mechanical ventilation. Forty seven patients acutely decompensated were investigated. Twenty nine of them were primarily ventilated noninvasively, 7 were intubated and 11 had been intubated and tracheotomized prior to arriving at the weaning center. ⋯ We conclude that patients either ventilated nasally or intubated or tracheotomized can be prepared for home mechanical ventilation in a weaning unit with similar outcome. Noninvasive ventilation is highly important in such patients as only one remained on invasive ventilation. This may implicate that transfer to noninvasive ventilation prior to tracheotomy might be appropriate.
-
J. Physiol. Pharmacol. · Nov 2007
Comparative StudyTussigenic agents in the measurement of cough reflex sensitivity.
Different inhalation methods are used for cough reflex sensitivity (CRS) measurement. The single-breath method of tussigenic agent aerosol inhalation is widely used now. Comparison of two tussigenic agents--citric acid and capsaicin--in cough reflex sensitivity measurement was used in healthy volunteers. ⋯ Geometric mean and 95% confidence interval (CI) of citric acid C2 was 454.5 (284.8-725.4) mmol/l in 88.2% of volunteers; citric acid C5 was 1000 micromol/l (0) in 47.1% of volunteers. Capsaicin C2 was 23.5 (8.2-67.5) micromol/l in 100% of volunteers and C5 was 263.7 (111.2-625.1) micromol/l in 76.5% of volunteers. We conclude that capsaicin single-breath test is more relevant for cough reflex sensitivity measurement in healthy volunteers than citric acid cough test.
-
J. Physiol. Pharmacol. · Nov 2007
Case ReportsPleuritis as the first symptom of pulmonary embolism: a case report.
Pulmonary embolism (PE) is a common problem but its diagnosis is challenging since clinical signs and symptoms are not specific. Given the significant overlap between the presentation of PE and other not life threatening entities/diseases, it is important to be acquainted with diagnostic tests and treatment of PE. It is of vital importance to suspect PE in case of chest pain. We would like to present the patient complaining of acute left-sided chest pain, referred to the hospital after being unsuccessfully treated in outpatient clinic for chest infection.
-
J. Physiol. Pharmacol. · Nov 2007
Positron emission tomography findings in obstructive sleep apnea patients with residual sleepiness treated with continuous positive airway pressure.
Despite sufficient continuous positive airway pressure (CPAP) therapy, some patients with the obstructive sleep apnea syndrome (OSAS) still suffer from excessive daytime sleepiness (EDS). In some of them, no cause of the persistence of EDS can be found. Brain damage due to nocturnal hypoxemia is a potential cause for this unclear persistent sleepiness (UPS). ⋯ To investigate the brain morphology, positron emission tomography (PET) scanning with the tracer fluorine-18 fluorodeoxyglucose (FDG), called FDG-PET, were performed in 7 of the UPS patients. Abnormal PET findings were concentrated in frontal area (found in 4 patients). The frontal abnormality seems to distinguish the OSAS patients with UPS from the whole OSAS population, examined in previous studies.
-
J. Physiol. Pharmacol. · Nov 2007
Comparative StudyNon-invasive ventilation: comparison of effectiveness, safety, and management in acute heart failure syndromes and acute exacerbations of chronic obstructive pulmonary disease.
Continuous positive airway pressure ventilation (CPAP) and non-invasive positive pressure ventilation (NPPV) are accepted treatments in acute cardiogenic pulmonary edema (ACPE) and acute exacerbation of chronic obstructive pulmonary disease (AECOPD). The aim of the study was a comparison of effectiveness, safety, and management of NPPV in ACPE and AECOPD trying to find an approach for standard management in intensive care. Thirty patients with acute respiratory failure (14 due to ACPE, 16 due to AECOPD) were prospectively included into the study. ⋯ This effect was comparable in the AECOPD group, but only could be achieved by increasing the inspiratory ventilation pressure. In the ACPE group inspiratory ventilation pressure could be reduced. In conclusion, in acute respiratory failure, ACPE patients comparably profit from NPPV as do patients with AECOPD, but the algorithm of titration for non-invasive ventilation pressure is different.