Hemodynamic effects of noninvasive bilevel positive airway pressure on patients with chronic congestive heart failure with systolic dysfunction.

Abstract:

BACKGROUND AND STUDY OBJECTIVES:Noninvasive positive airway pressure may play a significant role in treating patients with congestive heart failure (CHF). We tested our hypothesis that noninvasive bilevel positive airway pressure improves left ventricular performance in patients with chronic CHF secondary to severe systolic dysfunction. OBJECTIVES:To determine the cardiac performance of patients using bilevel positive airway pressure, and to describe the hemodynamic effects of bilevel positive airway pressure and its use as a therapeutic adjunct in these patients. DESIGN:Prospective, cohort, nonrandomized study. SETTING:Outpatient medicine clinic. PATIENTS:Fourteen patients (9 men and 5 women) with stable chronic CHF with left ventricular ejection fraction < or =35%; mean age was 60.6 years (range, 43 to 87 years). INTERVENTIONS:Bilevel positive airway pressure via nasal mask at an inspiratory pressure of 5 cm H(2)O and an expiratory pressure of 3 cm H(2)O on spontaneous mode at room air for 1 h. MEASUREMENTS AND RESULTS:Myocardial performance and changes were measured using clinical and echocardiographic parameters. Baseline clinical and echocardiographic parameters were compared with the same parameters after 1 h of bilevel positive airway pressure. Statistically significant (p<0.05, Wilcoxon matched pair signed-rank test) decreases were noted in these mean values: systolic BP from 136.21 to 124.14 mm Hg (p = 0.008), heart rate from 85.07 to 74.71 beats/min (p = 0.002), respiratory rate from 23.07 to 15.43 breaths/min (p = 0.001), and systemic vascular resistance from 1671. 46 to 1236.27 dyne. s. cm(3) (p = 0.001). Statistically significant increases were noted in these mean values: cardiac output from 5.09 to 6.37 L/min (p = 0.004), ejection fraction from 28.71% to 34.36% (p = 0.001), and end-diastolic volume from 224.36 to 246.21 mL (p = 0.045). CONCLUSION:Bilevel positive airway pressure has excellent potential for improving left ventricular performance of patients with chronic CHF secondary to severe systolic dysfunction.

journal_name

Chest

journal_title

Chest

authors

Acosta B,DiBenedetto R,Rahimi A,Acosta MF,Cuadra O,Van Nguyen A,Morrow L

doi

10.1378/chest.118.4.1004

subject

Has Abstract

pub_date

2000-10-01 00:00:00

pages

1004-9

issue

4

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)37700-X

journal_volume

118

pub_type

临床试验,杂志文章

相关文献

CHEST文献大全
  • N-terminal pro-brain natriuretic peptide and renal insufficiency as predictors of mortality in pulmonary hypertension.

    abstract:BACKGROUND:N-terminal pro-brain natriuretic peptide (NT-proBNP) is a byproduct of the brain natriuretic peptide (BNP) that was shown to be of prognostic value in pulmonary hypertension (PH). The role of NT-proBNP in PH has to be determined, especially under the influence of renal impairment that might lead to an accumu...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.06-1758

    authors: Leuchte HH,El Nounou M,Tuerpe JC,Hartmann B,Baumgartner RA,Vogeser M,Muehling O,Behr J

    更新日期:2007-02-01 00:00:00

  • Bronchial thermoplasty: reappraising the evidence (or lack thereof).

    abstract::Bronchial thermoplasty (BT) involves the application of radiofrequency energy to visible proximal airways to selectively ablate airway smooth muscle. BT is the first nonpharmacologic interventional therapy approved by the US Food and Drug Administration (FDA) for severe asthma. This approval was based on the results o...

    journal_title:Chest

    pub_type: 杂志文章,评审

    doi:10.1378/chest.14-0536

    authors: Iyer VN,Lim KG

    更新日期:2014-07-01 00:00:00

  • The epidemiology of acute respiratory failure in critically ill patients(*).

    abstract:STUDY OBJECTIVES:To describe the risk factors for the development of and mortality resulting from acute respiratory failure (ARF) in a large patient population. DESIGN:A substudy of a prospective, multicenter, observational cohort study, which was designed to validate the sequential organ failure assessment score. SE...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.121.5.1602

    authors: Vincent JL,Akça S,De Mendonça A,Haji-Michael P,Sprung C,Moreno R,Antonelli M,Suter PM,SOFA Working Group. Sequntial organ failure assessment.

    更新日期:2002-05-01 00:00:00

  • Thoracotomy for postchemotherapy resection of pulmonary residual tumor mass in patients with nonseminomatous testicular germ cell tumors: aggressive surgical resection is justified.

    abstract::In patients with disseminated nonseminomatous testicular germ cell tumors (NSTGCT), a retroperitoneal residual tumor mass (RRTM) and/or a pulmonary residual tumor mass (PRTM) are often present after successful treatment with cisplatin-based polychemotherapy. Results and complications of postchemotherapy resection of P...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.112.4.967

    authors: Gels ME,Hoekstra HJ,Sleijfer DT,Nijboer AP,Molenaar WM,Ebels T,Schraffordt Koops H

    更新日期:1997-10-01 00:00:00

  • Natural killer cell activity in a rat model of amiodarone-induced interstitial lung disease.

    abstract::The role of lymphocytes in the pathogenesis of amiodarone-induced lung disease is controversial. Increases in the percentages of lymphocytes in bronchoalveolar fluid of both patients and animals with amiodarone pulmonary toxicity have been reported. To assess whether these lymphocytes are functionally activated, we me...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.1.230

    authors: Karpel JP,Mitsudo S,Norin AJ

    更新日期:1991-01-01 00:00:00

  • Treatment of sarcoidosis-associated pulmonary hypertension. A two-center experience.

    abstract:BACKGROUND:Pulmonary hypertension (PH) is a common complication of sarcoidosis that is associated with increased mortality. The pathogenesis of PH in sarcoidosis is uncertain, and the role of pulmonary arterial hypertension (PAH)-specific therapies remains to be determined. METHODS:We conducted a retrospective study o...

    journal_title:Chest

    pub_type: 杂志文章,多中心研究

    doi:10.1378/chest.08-1881

    authors: Barnett CF,Bonura EJ,Nathan SD,Ahmad S,Shlobin OA,Osei K,Zaiman AL,Hassoun PM,Moller DR,Barnett SD,Girgis RE

    更新日期:2009-06-01 00:00:00

  • Spontaneous dissection of the ascending aorta diagnosed by two-dimensional echocardiography.

    abstract::In two patients with acute dissection of the ascending aorta, the diagnosis was made with two-dimensional echocardiography and confirmed by aortography. The echocardiograms localized the intimal flap and false channel in both cases. Although clinical evaluation and indicated radiologic studies remain the primary modal...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.80.5.587

    authors: Rubenson DS,Fowles RE,Miller DC,Guthaner DF,Popp RL

    更新日期:1981-11-01 00:00:00

  • Effect of inhaled magnesium sulfate on sodium metabisulfite-induced bronchoconstriction in asthma.

    abstract:BACKGROUND:Inhaled magnesium (Mg) seemed to have a mild protective (nonbronchodilator) effect against histamine and methacholine. Inhaled sodium metabisulfite (MBS) causes bronchoconstriction in asthma through indirect mechanisms that involve sensory nerve stimulation, and it is extensively used to study airway hyperre...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.111.4.858

    authors: Nannini LJ Jr,Hofer D

    更新日期:1997-04-01 00:00:00

  • Use of pulmonary artery catheters in patients with acute myocardial infarction. Analysis of experience in 5,841 patients in the SPRINT Registry. SPRINT Study Group.

    abstract::This study analyzes the use of PAC in a registry comprising 5,841 hospitalized patients with AMI. A total of 371 patients received PAC. In-hospital mortality was higher in patients with CHF who received PAC, while there was no difference in patients with cardiogenic shock or persistent hypotension. Mortality in patien...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.98.6.1331

    authors: Zion MM,Balkin J,Rosenmann D,Goldbourt U,Reicher-Reiss H,Kaplinsky E,Behar S

    更新日期:1990-12-01 00:00:00

  • Treatment of bronchial asthma with terbutaline inhaled by conespacer combined with positive expiratory pressure mask.

    abstract::The influence of positive expiratory pressure (PEP) applied during inhalation of a beta 2-agonist in treatment of bronchial asthma was investigated in a randomized crossover study with two-week treatment periods. In one period, two puffs (0.5 mg) of terbutaline was given from a metered dose inhaler and inhaled through...

    journal_title:Chest

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1378/chest.100.2.317

    authors: Frischknecht-Christensen E,Nørregaard O,Dahl R

    更新日期:1991-08-01 00:00:00

  • Conservative Management in Traumatic Pneumothoraces: An Observational Study.

    abstract:BACKGROUND:Traumatic pneumothoraces are a common consequence of major trauma. Despite this, there is a paucity of literature regarding their optimal management, including the role of conservative treatment. The aim of this study was to assess the treatment, complications, and outcomes of traumatic pneumothoraces in pat...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2017.10.015

    authors: Walker SP,Barratt SL,Thompson J,Maskell NA

    更新日期:2018-04-01 00:00:00

  • Human Epididymis Protein 4: A Novel Serum Inflammatory Biomarker in Cystic Fibrosis.

    abstract:BACKGROUND:Increased expression of the human epididymis protein 4 (HE4) was previously described in lung biopsy samples from patients with cystic fibrosis (CF). It remains unknown, however, whether serum HE4 concentrations are elevated in CF. METHODS:Seventy-seven children with CF from six Hungarian CF centers and 57 ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1016/j.chest.2016.04.006

    authors: Nagy B Jr,Nagy B,Fila L,Clarke LA,Gönczy F,Bede O,Nagy D,Újhelyi R,Szabó Á,Anghelyi A,Major M,Bene Z,Fejes Z,Antal-Szalmás P,Bhattoa HP,Balla G,Kappelmayer J,Amaral MD,Macek M Jr,Balogh I

    更新日期:2016-09-01 00:00:00

  • Is it possible to differentiate malignant mediastinal nodes from benign nodes by size? Reevaluation by CT, transesophageal echocardiography, and nodal specimen.

    abstract:STUDY OBJECTIVE:To reevaluate whether it is possible to reliably differentiate malignant mediastinal lymph nodes from benign nodes by size, and to determine the frequency of metastases to normal-sized mediastinal lymph nodes that directly affects the sensitivity for detecting malignant mediastinal lymph nodes (N2 nodes...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.110.4.1004

    authors: Arita T,Matsumoto T,Kuramitsu T,Kawamura M,Matsunaga N,Sugi K,Esato K

    更新日期:1996-10-01 00:00:00

  • Screening of pediatric sleep-disordered breathing: a proposed unbiased discriminative set of questions using clinical severity scales.

    abstract:BACKGROUND:Identification of sleep-disordered breathing (SDB) using questionnaires is critical from a clinical and research perspective. However, which questions to use and how well such questionnaires perform has thus far been fraught with substantial uncertainty. We aimed at delineating the usefulness of a set of que...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.11-3164

    authors: Spruyt K,Gozal D

    更新日期:2012-12-01 00:00:00

  • Short- and long-term hemodynamic effects of captopril in patients with pulmonary hypertension and selected connective tissue disease.

    abstract::To assess the pulmonary and systemic hemodynamic effects of oral captopril in patients with connective tissue disease and pulmonary hypertension, we performed right heart catheterization in eight patients with diffuse systemic sclerosis, the CREST syndrome, or mixed connective tissue diseases prior to and immediately ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.102.5.1407

    authors: Alpert MA,Pressly TA,Mukerji V,Lambert CR,Mukerji B

    更新日期:1992-11-01 00:00:00

  • Respiratory control during independent lung ventilation.

    abstract::We describe the case of a lung transplant patient with primary graft failure and an emphysematous native lung, who displayed different respiratory rates between the transplanted lung and the native lung. Inflation of the native lung delayed the next inspiratory effort relative to inflation of the denervated transplant...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.120.2.678

    authors: Officer TM,Wheeler DR,Frost AE,Rodarte JR

    更新日期:2001-08-01 00:00:00

  • Relationship of resting lung mechanics and exercise pattern of breathing in patients with chronic obstructive lung disease.

    abstract::To investigate the influence of resting pulmonary mechanics on the pattern of breathing during exercise in chronic obstructive pulmonary disease (COPD), we studied 29 patients with moderate to severe COPD (FEV1 50 +/- 20 percent predicted), and 10 normal subjects. Lung mechanics were studied using esophageal balloon t...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.104.3.705

    authors: Marin JM,Hussain SN,Gibbons WJ,Polverino M,Levy RD,Cosio MG

    更新日期:1993-09-01 00:00:00

  • Abdominal placement of tube thoracostomy due to lack of recognition of paralysis of hemidiaphragm.

    abstract::Tube thoracostomy is an invasive procedure that carries a risk of complications. We report a patient with liver cirrhosis, ascites and large left-sided pleural effusion, in whom a trocar type chest tube was inserted at the seventh left intercostal space in the midaxillary line. Chest roentgenogram revealed that the dr...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.102.1.292

    authors: Foresti V,Villa A,Casati O,Parisio E,De Filippi G

    更新日期:1992-07-01 00:00:00

  • Outcomes in post-ICU mechanical ventilation: a therapist-implemented weaning protocol.

    abstract:BACKGROUND:Therapist-implemented protocols have been used to extubate or wean patients in the ICU setting. Barlow Respiratory Hospital (BRH) functions as a center for weaning patients from prolonged mechanical ventilation (PMV) in the post-ICU setting of a long-term acute-care (LTAC) facility. A therapist-implemented p...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.119.1.236

    authors: Scheinhorn DJ,Chao DC,Stearn-Hassenpflug M,Wallace WA

    更新日期:2001-01-01 00:00:00

  • Antihypertensive therapy with prazosin in patients with left ventricular dysfunction. Improvement in cardiac performance and exercise tolerance.

    abstract::Although the relationship between blood pressure and cardiac performance has been widely recognized, there are few published clinical observations concerning the effect of blood pressure control on cardiac function. We evaluated the effect of prazosin, an antihypertensive agent which also improves hemodynamic measurem...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.80.6.692

    authors: Massie BM,Chan S

    更新日期:1981-12-01 00:00:00

  • Acute pulmonary effects of nitrogen dioxide exposure during exercise in competitive athletes.

    abstract::The acute pulmonary responses of athletes after short-term exposure to ambient concentrations of NO2 during heavy exercise have been examined. Intercollegiate male athletes were screened for history of cardiac disease, respiratory disease, allergic conditions and extensive exposure to pollutants. After completion of s...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.99.4.815

    authors: Kim SU,Koenig JQ,Pierson WE,Hanley QS

    更新日期:1991-04-01 00:00:00

  • Repetitive ventricular fibrillation preceded by both ST segment depression and elevation during acute myocardial ischemia.

    abstract::A patient had repetitive ventricular fibrillation preceded by alternating ST segment depression and elevation. The ECG changes were confined to the precordial leads only, reflecting subendocardial and transmural ischemia, respectively. It is speculated that the patient exhibited consecutive episodes of subtotal and to...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.93.6.1296

    authors: Rechavia E,Sagie A,Kusniec J,Mager A,Sclarovsky S

    更新日期:1988-06-01 00:00:00

  • Echocardiography of Right Ventriculoarterial Coupling Combined With Cardiopulmonary Exercise Testing to Predict Outcome in Heart Failure.

    abstract:BACKGROUND:Pulmonary hypertension, which is related to right ventricular (RV) failure, indicates a poor prognosis in heart failure (HF). Increased ventilatory response and exercise oscillatory ventilation (EOV) also have a negative impact. We hypothesized that the severity classification of HF and risk prediction could...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.14-2065

    authors: Guazzi M,Naeije R,Arena R,Corrà U,Ghio S,Forfia P,Rossi A,Cahalin LP,Bandera F,Temporelli P

    更新日期:2015-07-01 00:00:00

  • Soluble form of fas and fas ligand in BAL fluid from patients with pulmonary fibrosis and bronchiolitis obliterans organizing pneumonia.

    abstract:STUDY OBJECTIVES:The Fas-Fas ligand (FasL) pathway is a representative system of apoptosis-signaling receptor molecules. We previously described that this pathway may play an important role in the pathogenesis of fibrosing lung diseases. In this study, we hypothesized that soluble form of Fas (sFas) and FasL (sFasL) ma...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.118.2.451

    authors: Kuwano K,Kawasaki M,Maeyama T,Hagimoto N,Nakamura N,Shirakawa K,Hara N

    更新日期:2000-08-01 00:00:00

  • Increased levels of outdoor air pollutants are associated with reduced bronchodilation in children with asthma.

    abstract:BACKGROUND:Increased outdoor air pollution levels are associated with more frequent use of rescue inhalers in subjects with asthma. However, it is unknown whether this phenomenon is explained by an air pollution-mediated increase in respiratory symptom severity or whether air pollutants decrease the efficacy of short-a...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.08-1463

    authors: Hernández-Cadena L,Holguin F,Barraza-Villarreal A,Del Río-Navarro BE,Sienra-Monge JJ,Romieu I

    更新日期:2009-12-01 00:00:00

  • Myocardial infarction with normal coronary arteries after acute exposure to carbon monoxide.

    abstract::This report describes a 46-year-old white man who suffered an acute myocardial infarction after carbon monoxide exposure. The electrocardiogram and serum enzymes showed myocardial infarction. The coronary angiogram performed one week after admission failed to reveal evidence of coronary obstructive lesions. The case p...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.97.2.491

    authors: Marius-Nunez AL

    更新日期:1990-02-01 00:00:00

  • Effects of weight loss on peak flow variability, airways obstruction, and lung volumes in obese patients with asthma.

    abstract:STUDY OBJECTIVES:To clarify the pathophysiologic features of the relation between asthma and obesity, we measured the effects of weight reduction on peak expiratory flow (PEF) variability and airways obstruction, compared to simultaneous changes in lung volumes and ventilatory mechanics in obese patients with stable as...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.118.5.1315

    authors: Hakala K,Stenius-Aarniala B,Sovijärvi A

    更新日期:2000-11-01 00:00:00

  • Inspiratory work and airway pressure with continuous positive airway pressure delivery systems.

    abstract::To determine work-of breathing with continuous positive airway pressure (CPAP) delivery systems, we used a lung model to simulate spontaneous breathing. "Additional work" during tidal breathing was derived by comparing change in airway pressure with change in tidal volume. Seven demand-flow CPAP delivery systems were ...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.88.4.519

    authors: Katz JA,Kraemer RW,Gjerde GE

    更新日期:1985-10-01 00:00:00

  • Antibacterial properties of lidocaine.

    abstract::The inhibitory effect of lidocaine and lidocaine plus methylparaben as a preservative was studied with 25 strains of bacteria. The tested strains were mixed with each topical anesthetic preparation, and quantitative cultures were performed on aspirates at 0, 30, 60, and 120 minutes. Results were compared to counts obt...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.76.1.37

    authors: Wimberley N,Willey S,Sullivan N,Bartlett JG

    更新日期:1979-07-01 00:00:00

  • Rupture of the left main-stem bronchus with a polyvinylchloride double-lumen tube.

    abstract::Double-lumen tubes have proved to be a useful adjunct in thoracic surgery. Their use has become quite commonplace, particularly since the introduction of the softer polyvinylchloride (PVC) tubes, which are technically easier to use and may carry less risk for serious complications. Any such tube, however, can cause li...

    journal_title:Chest

    pub_type: 杂志文章

    doi:10.1378/chest.83.6.928

    authors: Burton NA,Fall SM,Lyons T,Graeber GM

    更新日期:1983-06-01 00:00:00