Abstract:
:The purpose of this study was to determine the incidence and severity of obstructive events and oxyhemoglobin desaturation (dSaO2) in 37 patients with paralytic/restrictive ventilatory insufficiency during use of nocturnal ventilatory assistance provided by means of negative-pressure body ventilators (BVs). Thirteen of the 37 patients had mean oxyhemoglobin saturation (SaO2) less than 95 percent and a mean of ten or more episodes per hour when the dSaO2 was greater than or equal to 4 percent (4%dSaO2/h). In all, 26 of the 37 patients had evidence of significant multiple episodes of dSaO2 while asleep on BVs. Polysomnography performed on three of these patients substantiated the obstructive nature of the dSaO2. Twenty-two of the 37 patients who had a mean SaO2 of 90.6 +/- 7.2 percent and a mean of 17.7 +/- 16.1 4%dSaO2/h on BVs were switched to noninvasive ventilatory assistance by intermittent positive airway pressure (NV-PAP). Their mean SaO2 improved to 96.0 +/- 2.2 percent, and the 4%dSaO2/h decreased to 1.2 +/- 1.8 per hour. All symptoms similar to those of obstructive sleep apnea were relieved. We conclude that BV use is associated with significant dSaO2 in over 50 percent of patients. The dSaO2 is predominantly obstructive in nature but may be due to chronic underventilation in patients using less effective BVs. Patients with a mean SaO2 less than 95 percent or 10 or more 4%dSaO2/h may benefit from conversion to NV-PAP via the nose, the mouth, or an oral-nasal interface.
journal_name
Chestjournal_title
Chestauthors
Bach JR,Penek Jdoi
10.1378/chest.99.6.1386subject
Has Abstractpub_date
1991-06-01 00:00:00pages
1386-93issue
6eissn
0012-3692issn
1931-3543pii
S0012-3692(16)40089-9journal_volume
99pub_type
杂志文章相关文献
CHEST文献大全abstract::Clear rhinorrhea is a common symptom in patients with obstructive sleep apnea (OSA) and may worsen with continuous positive airway pressure therapy. Clear rhinorrhea can also be the presenting symptom of cerebrospinal fluid (CSF) leak, which is evidence of a communication between the subarachnoid space and the nasal c...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.128.3.1882
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Despite increasing knowledge about partial liquid ventilation (PLV), the optimal dose of perfluorocarbon (PFC) is not yet established. Because there exist normal regions in the lung with ARDS and because PLV in the normal lung results in worsened gas exchange, we postulated that the optimal dose of PFC for P...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.1.199
更新日期:2000-01-01 00:00:00
abstract::The surgical treatment of the completely obstructed left main coronary artery is aortocoronary saphenous-vein bypass to the left coronary artery system. Without surgical intervention, this lesion has an exceedingly poor prognosis. This report describes a patient with atherosclerotic obstruction of the left main corona...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.69.2.238
更新日期:1976-02-01 00:00:00
abstract::The Loyola Open-Heart Registry is a fully operational database that contains detailed data on approximately 9,000 patients who have undergone coronary bypass or cardiac valve replacement from January 1970 to December 1984. We analyzed the registry data using multivariate discriminant analysis to identify and quantitat...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.91.3.394
更新日期:1987-03-01 00:00:00
abstract::In 283 patients referred for testing in an outpatient pulmonary function laboratory, we studied the single-breath diffusing capacity of the lungs for carbon monoxide (Dco) using the Ogilvie (Og), Jones-Meade (JM), Epidemiological Standardization Project (ESP), and three-phase iterative methods (3PIT, similar to the th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.2.594
更新日期:1994-02-01 00:00:00
abstract:STUDY OBJECTIVES:Quadriceps fatigue can occur in patients with COPD after exhaustive cycle exercise. The purpose of this study was to determine whether the degree of fatigue elicited by cycle exercise was greater in patients with COPD compared with matched control subjects. SUBJECTS:Nine male patients with COPD with a...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.123.4.1104
更新日期:2003-04-01 00:00:00
abstract:BACKGROUND:Central sleep apnea (CSA) is common among patients with heart failure (HF) and is promoted by elevated CO2 chemosensitivity. Left atrial size is a marker of the hemodynamic severity of HF. The aim of this study was to determine if left atrial size predicts chemosensitivity to CO2 and CSA in patients with HF....
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.13-0309
更新日期:2014-07-01 00:00:00
abstract::Nd-YAG laser resection of a completely obstructing right mainstem tumor in a 36-year-old man was complicated by right lung hyperinflation and left lung collapse and accompanying ventilatory failure. This was attributed to obstruction of the right mainstem bronchus during exhalation, but not inhalation, in a patent but...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.93.6.1302
更新日期:1988-06-01 00:00:00
abstract:BACKGROUND:It would be valuable to have a noninvasive method of measuring impaired pulmonary gas exchange in patients with lung disease and thus reduce the need for repeated arterial punctures. This study reports the results of using a new test in a group of outpatients attending a pulmonary clinic. METHODS:Inspired a...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2018.02.001
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:ICU telemedicine improves access to high-quality critical care, has substantial costs, and can change financial outcomes. Detailed information about financial outcomes and their trends over time following ICU telemedicine implementation and after the addition of logistic center function has not been publishe...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2016.11.029
更新日期:2017-02-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the indications for preoperative localization of a small indeterminate pulmonary nodule. DESIGN:In this retrospective study, univariate and multivariate analyses were performed by the logistic regression procedure. SETTING:A single National Cancer Center Hospital in Japan. PATIENTS:A ser...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.115.2.563
更新日期:1999-02-01 00:00:00
abstract::Because T-piece breathing may impair oxygenation, the best airway pressure from which to extubate ventilated patients is controversial. We compared the effects of extubation after 1 h of either CPAP 5 and T-piece/ZEEP. Once weaned from mechanical ventilation and breathing spontaneously, 106 patients were randomized to...
journal_title:Chest
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1378/chest.100.6.1655
更新日期:1991-12-01 00:00:00
abstract::Workers exposed to a variety of wood dusts have been shown to exhibit occupational asthma, lung function deficits, and elevated levels of respiratory symptoms. Despite the popularity of pine and spruce, the health effects of exposures to these woods have not been extensively investigated. A study was undertaken to inv...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.108.3.642
更新日期:1995-09-01 00:00:00
abstract:BACKGROUND:Current treatment strategies for asthma and chronic obstructive pulmonary disease (COPD) emphasize the inhalation route, yet patients often misuse metered-dose inhalers (MDI). To address this problem, patient education by medical personnel has been recommended and a variety of alternate inhaler devices have ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.105.1.111
更新日期:1994-01-01 00:00:00
abstract::Using recently published data, a nomogram was constructed to estimate the likelihood of asthma following methacholine challenge. Based on Bayes' theorem, the nomogram makes use of the sensitivity and specificity of methacholine challenge to calculate the post-test probability of asthma once the physician makes a deter...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.3.562
更新日期:1990-03-01 00:00:00
abstract:OBJECTIVE:To formulate recommendations for the development of early intensive care unit (ICU) discharge criteria for low-risk monitor patients. DESIGN:Literature review of published reports over the period 1966 to 1991 pertaining to ICU discharge criteria. PATIENTS:Studies identifying patients admitted to ICUs who co...
journal_title:Chest
pub_type: 指南,杂志文章
doi:10.1378/chest.104.6.1812
更新日期:1993-12-01 00:00:00
abstract::Histochemical quantification of goblet cells and measurements of the epithelial thickness were made in the trachea of male and female rats exposed to fresh whole tobacco smoke for 30 consecutive days. Exposure to tobacco smoke resulted in an increase in the total goblet cell count in both sexes, with the female rats d...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.73.4.515
更新日期:1978-04-01 00:00:00
abstract:BACKGROUND:Club cell secretory protein (CCSP) is a protective biomarker associated with annual decline in lung function. COPD progression results from an imbalance between injury and repair initially triggered by cigarette smoking. OBJECTIVE:We investigated the effect of CCSP as a therapeutic strategy to restore the b...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.14-1174
更新日期:2015-06-01 00:00:00
abstract:STUDY OBJECTIVES:To evaluate the cost-effectiveness of inhaled fluticasone propionate (FP) in children aged 12 to 47 months with asthma symptoms. DESIGN:A retrospective economic analysis conducted from the perspective of the Danish health-care system, based on clinical data from a 12-week study. SETTING:Thirty-three ...
journal_title:Chest
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1378/chest.120.6.1835
更新日期:2001-12-01 00:00:00
abstract::The effect of combined administration of different dose ratios of dobutamine (DB) and dopamine (DA) (DB/DA ratio of 1:1; 1.5:0.5; 2:0; 0.5:1.5; and 0:2), with the added dose kept constant (10 micrograms/kg/min-20 micrograms/kg/min), on right ventricular function (measured by the thermal washout method with the aid of ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.101.5.1197
更新日期:1992-05-01 00:00:00
abstract::Bronchoalveolar lavage was used to provide important diagnostic information for a patient found to have idiopathic pulmonary fibrosis and concomitant cytomegalovirus infection. The use of this procedure may not only provide useful information regarding the underlying disease, but may also suggest alternative diagnosti...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.84.4.500
更新日期:1983-10-01 00:00:00
abstract::Eighteen newly diagnosed cases of symptomatic cocidioidomycosis developed two to four weeks following exposure to a severe natural dust storm. The population at risk consisted of 26,000 residents of the San Joaquin Valley with access to health care at the Naval Hospital, Lemoore, Calif. Eight patients were white, and ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.76.5.566
更新日期:1979-11-01 00:00:00
abstract::A case of acute tuberculous pneumonia diagnosed by transbronchial biopsy is presented. We postulate that the unusually rapid progression was due to an exudative hypersensitivity reaction to aspirated tuberculoprotein. ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.71.6.774
更新日期:1977-06-01 00:00:00
abstract::Our current understanding of the pathogenesis of sepsis suggests that bacteria as well as bacterial-derived products activate an uncontrolled network of host-derived mediators such as proinflammatory cytokines (ie, tumor necrosis factor [TNF] and interleukin [IL]-1beta), which can ultimately lead to cardiovascular col...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.121.4.1329
更新日期:2002-04-01 00:00:00
abstract::To assess the diagnostic value of telescoping plugged catheters (TPC) in human immunodeficiency virus (HIV)-infected patients with pulmonary infiltrates (PI), we performed a prospective clinical study in 71 episodes of fever and PI in 66 HIV-infected patients (five patients had two different episodes of fever and PI)....
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.102.1.76
更新日期:1992-07-01 00:00:00
abstract::Administration of glucagon has been shown to decrease pulmonary vascular resistance, but its primary site of action is undetermined. Whether this is on the arterial or venous side of the capillary would be reflected in the microvascular hydrostatic pressure. We used the pulmonary flow of lymph, a sensitive index of th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.74.2.196
更新日期:1978-08-01 00:00:00
abstract::In order to identify correlates of fibrosis in acute respiratory failure, autopsies were performed on 16 patients who died after an episode of more than two weeks' duration, and the left lower lung lobe was obtained for biochemical measurements. The average amount of lobar collagen in one group of patients was nearly ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.85.5.641
更新日期:1984-05-01 00:00:00
abstract:CASE PRESENTATION:A previously healthy 62-year-old woman was transferred to the ICU from the medical ward with acute bronchospastic respiratory failure requiring intubation and mechanical ventilation. Four weeks before, the patient was vacationing in Arizona and acquired a mildly productive cough as well as mild dyspne...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2017.04.168
更新日期:2017-09-01 00:00:00
abstract:STUDY OBJECTIVE:To assess factors associated with initiating therapy and compliance with treatment for latent tuberculosis infection among health-care workers with positive tuberculin skin test results. DESIGN:Prospective cohort study. SETTING:An urban midwestern teaching hospital in St. Louis, MO. STUDY POPULATION:...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.122.5.1609
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To describe and correlate pulmonary function and high-resolution CT (HRCT) scan scores in individuals with a high risk for development of pulmonary fibrosis, ie, Hermansky-Pudlak syndrome (HPS) patients with mutations in the HPS-1 gene. DESIGN:Cross-sectional analysis of consecutive, eligible patients. PATI...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.117.1.129
更新日期:2000-01-01 00:00:00