Respirology : official journal of the Asian Pacific Society of Respirology
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Primary spontaneous pneumothorax (PSP) is a common condition that typically affects young adults. With recent advances in techniques, VATS is now a safe and accepted procedure for treating PSP. Lung isolation techniques have been commonly used to facilitate surgical procedures in the past. The purpose of this study was to evaluate the feasibility of using a single-lumen endotracheal tube for thoracoscopic surgery in patients with PSP. ⋯ VATS for the treatment of PSP was easily performed using a single-lumen endotracheal tube, and resulted in lower intubation-related costs, fewer complications and equivalent outcomes, compared with procedures performed using double-lumen endotracheal tube anaesthesia.
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Long-term non-invasive ventilation to manage persistent ventilatory failure after COPD exacerbation.
Patients with ventilatory failure at discharge from hospital following an exacerbation of COPD (ECOPD) have increased work of breathing and reduced inspiratory muscle strength compared with those with a normal arterial carbon dioxide tension (PaCO(2)). They also have a significantly worse prognosis. Long-term non-invasive positive pressure ventilation (NIPPV) may offer a treatment strategy but benefits have not been established. ⋯ NIPPV was well tolerated in this group and appears to improve ventilation. Our preliminary data support further investigation of NIPPV in patients who remain hypercapnic after hospital admission with ECOPD.
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Pulmonary rehabilitation guidelines recommend cycle ergometry training at an intensity that exceeds 60% of peak power (P(peak)) with the aim of achieving a physiologic response. However, many clinicians do not have access to an incremental cycle ergometry test (ICET) to allow prescription of training intensity. No studies have investigated whether the 6MWT can be used to estimate the P(peak) achieved during an ICET in subjects with IPF or in Asian subjects with COPD. ⋯ P(peak) can be estimated from the 6MWT in Japanese subjects with IPF and COPD. This may allow individualized prescription of the intensity for cycle-based training based on the 6MWT.
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Although non-invasive ventilation (NIV) has been shown to be effective in a wide variety of respiratory diseases, its role in severe asthma attacks remains uncertain. The aim of this study was to clarify the effectiveness of NIV in patients experiencing severe attacks of asthma. ⋯ The need for ETI in patients with severe attacks of asthma was decreased after introduction of NIV. The ready availability of NIV enabled the rapid commencement of MV and may decrease the need for ETI. NIV is an acceptable and useful method of stabilizing patients experiencing severe attacks of asthma.