Abstract:
:Gas exchange between the atmosphere and the human body depends on the lungs and the function of the respiratory pump. The respiratory pump consists of the respiratory control center located in the brain, bony rib cage, diaphragm, and intercostal, accessory, and abdominal muscles. A variety of muscles serve to fine-tune adjustments of ventilation to metabolic demands. Appropriate evaluation and interventions can prevent respiratory complications and prolong life in individuals with neuromuscular diseases. This article discusses normal function of the respiratory pump, general pathophysiologic issues, and abnormalities in more common neuromuscular diseases.
journal_name
Clin Chest Medjournal_title
Clinics in chest medicineauthors
Benditt JOdoi
10.1016/j.ccm.2018.01.011subject
Has Abstractpub_date
2018-06-01 00:00:00pages
297-308issue
2eissn
0272-5231issn
1557-8216pii
S0272-5231(18)30011-Xjournal_volume
39pub_type
杂志文章,评审abstract::This article review available strategies for mechanically ventilating patients with the adult respiratory distress syndrome. The authors first present the conventional strategies of mechanical ventilation: volume-limited mechanical ventilation with positive end-expiratory pressure (PEEP) at normal inspiratory-expirato...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-12-01 00:00:00
abstract::This article reviews several important noninfectious pulmonary complications that threaten survival, pulmonary function, and quality of life after lung transplantation. Topics reviewed include primary graft dysfunction (PGD), native lung hyperinflation, anastomotic complications, phrenic nerve injury, pleural complica...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2005.06.006
更新日期:2005-12-01 00:00:00
abstract::Interventional pulmonology encompasses diagnostic and therapeutic bronchoscopic procedures, and pleural interventions. In the last 10 years older techniques have been refined and exciting new technologies have extended the reach and application of the instruments used. The main areas within pulmonary medicine for whic...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2010.10.007
更新日期:2011-03-01 00:00:00
abstract::There will be many changes in the sleep field in the next 5 to 10 years. These will include increments in our knowledge of the basic neurobiologic mechanisms driving sleep and the impact of sleep loss on general health. The technology used in the sleep laboratory will likely change as well, leading to a larger range o...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70444-5
更新日期:1998-03-01 00:00:00
abstract::Obesity is a major risk factor for asthma. This association appears related to altered dietary composition and metabolic factors that can directly affect airway reactivity and airway inflammation. This article discusses how specific changes in the western diet and metabolic changes associated with the obese state affe...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2018.10.007
更新日期:2019-03-01 00:00:00
abstract::This article gives a broad overview of the increasingly important applications of bronchoscopy, flexible (FOB) and rigid (RB), in a modern medical intensive care unit. Special emphasis is made to bronchoscopy use in mechanically ventilated patients. Therapies such as endobronchial stenting and Nd:YAG laser are being u...
journal_title:Clinics in chest medicine
pub_type: 杂志文章
doi:10.1016/s0272-5231(05)70041-1
更新日期:2001-06-01 00:00:00
abstract::Elevated serum IgE has many etiologies including parasitic infection, allergy and asthma, malignancy, and immune dysregulation. The hyper-IgE syndromes caused by mutations in STAT3, DOCK8, and PGM3 are monogenic primary immunodeficiencies associated with high IgE, eczema, and recurrent infections. These primary immuno...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2016.04.016
更新日期:2016-09-01 00:00:00
abstract::A number of different imaging modalities can be used in the assessment of pleural disease. Although ultrasound has been the more traditional method, CT has found increasing utility for the assessment of the empyema and loculated pleural fluid collections prior to drainage and the evaluation of benign and malignant ple...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70076-9
更新日期:1998-06-01 00:00:00
abstract::The heart and lungs are intimately linked. Hence, impaired function of one organ may lead to changes in the other. Accordingly, heart failure is associated with airway obstruction, loss of lung volume, impaired gas exchange, and abnormal ventilatory control. Cardiopulmonary exercise testing is an excellent tool for ev...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2019.02.010
更新日期:2019-06-01 00:00:00
abstract::This article provides a systematic review of the literature on the application of noninvasive ventilation in various forms of hypercapnic and hypoxemic respiratory failures. A description of the underlying pathophysiology is followed by a review of physiologic data explaining the mechanisms of action of noninvasive ve...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70330-0
更新日期:1996-09-01 00:00:00
abstract::Hypoxemia is a prevalent problem in the chronically critically ill patient. This article reviews the pathophysiologic mechanisms of hypoxemia in this patient population, discusses how oxygenation is evaluated, and reviews methods for delivery of oxygen. Other topics directly related to oxygen use, such as oxygen toxic...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70029-0
更新日期:2001-03-01 00:00:00
abstract::Sleep-related breathing disorders are strongly associated with increased risk of stroke independent of known risk factors. The direction of causation favors sleep-disordered breathing leading to stroke rather than the other way around, although definitive proof of this awaits the results of prospective cohort studies....
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(03)00027-3
更新日期:2003-06-01 00:00:00
abstract::VAP is clearly associated with an increased mortality, principally because of virulent pathogens such as P. aeruginosa. Part of the increased mortality may be due to inadequacies of antibiotic therapy. Apparent failure of antibiotic therapy has many causes; some are related to deficiencies of the antibiotic therapy, b...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-03-01 00:00:00
abstract::Sleep-related breathing disorder or sleep-disordered breathing (SDB) encompasses central sleep apnea (CSA), obstructive sleep apnea (OSA), and sleep-related hypoventilation or hypoxemic syndromes. SDB is common in neurologic conditions that affect the central and/or peripheral nervous systems. Patients with neurologic...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2014.06.009
更新日期:2014-09-01 00:00:00
abstract::Controversy over the use of inhaled beta-agonists has dated almost from their introduction as a treatment for asthma. Their effectiveness as bronchodilators is not disputed, but there is concern that they may worsen asthma control if used regularly and that excessive use may increase the risk of death from asthma. Fiv...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-12-01 00:00:00
abstract::Pregnancy induces significant physiologic stresses on the pulmonary and cardiovascular systems that may precipitate respiratory compromise. In addition, certain disease states that are unique to the pregnant woman, such as amniotic fluid emboli syndrome, may be associated with respiratory failure. The physiologic chan...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2004.01.010
更新日期:2004-06-01 00:00:00
abstract::The adult respiratory distress syndrome is a reaction of the lung to a variety of severe direct or indirect pulmonary insults. It is characterized by acute respiratory distress, severe hypoxemia requiring high oxygen fractions, and "stiff lungs" requiring approaches to ventilatory management cited elsewhere in this is...
journal_title:Clinics in chest medicine
pub_type: 杂志文章
doi:
更新日期:1982-01-01 00:00:00
abstract::Pseudomonas aeruginosa remains an important cause of pulmonary disease in patients who have cystic fibrosis. The development of antimicrobial therapy directed against this organism has resulted in the preservation of lung function and improved longevity. Efficacy has been demonstrated with agents administered via pare...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2007.02.003
更新日期:2007-06-01 00:00:00
abstract::Traditionally, a subset of patients diagnosed as having idiopathic pulmonary fibrosis had positive results on cellular biopsies (prominent lymphoplasmacytic inflammation), bronchoalveolar lavage lymphocytosis, a clinical response to steroids, and a better long-term prognosis. On review of the lung histopathology, the ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2011.11.003
更新日期:2012-03-01 00:00:00
abstract::Pulmonary embolism remains a leading cause of morbidity and mortality in the United States. However, with improved recognition and diagnosis, the risk of death diminishes. The diagnosis depends on the clinician's suspicion. Pulmonary emboli are categorized into low, intermediate, or high risk based on the scoring scal...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2018.04.013
更新日期:2018-09-01 00:00:00
abstract::The cause and presentation of empyema thoraces has changed little since it was first described. The natural history of the disease can be divided into different stages. Different therapeutic measures, medical and surgical, are available for the treatment at various stages. The management of empyema is discussed, empha...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/s0272-5231(05)70086-1
更新日期:1998-06-01 00:00:00
abstract::The tuberculosis (TB) epidemic is well controlled in most developed countries and the focus in these areas has shifted to TB eradication. Transmission within nonendemic areas is limited and most cases of TB result from reactivation of distant (latent) infection. With adequate resources, wide-scale use of preventive th...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2009.08.012
更新日期:2009-12-01 00:00:00
abstract::As specialized laboratory tests became more widely available, Legionella species were found to be common causes of nosocomial and community-acquired pneumonia. Patients with chronic lung disease and organ transplants are at greatest risk. Clinical manifestations are non-specific, although fever greater than 39 degrees...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1991-06-01 00:00:00
abstract::Fungal pneumonias cause unacceptable morbidity among patients with hematologic malignancies (HM) and recipients of hematopoietic stem cell transplantation (HSCT). The high incidence of fungal pneumonias in HM/HSCT populations arises from their frequently severe, complex, and persistent immune dysfunction caused by the...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2017.04.009
更新日期:2017-09-01 00:00:00
abstract::Pulmonary rehabilitation is an art of medical practice incorporating many therapeutic modalities with the goal of improving the patient's functional ability. The gains to be realized and the basis for improvement following pulmonary rehabilitation are detailed in this article. ...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1986-12-01 00:00:00
abstract::In therapy for ventilator-associated pneumonia, it is essential to get initial empiric therapy correct; this is challenging because many patients are infected with multidrug-resistant pathogens. The need for achieving appropriate therapy can lead to broad-spectrum empiric therapy, which can represent antibiotic overus...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2011.05.009
更新日期:2011-09-01 00:00:00
abstract::As parenchymal lung disease in chronic obstructive pulmonary disease becomes increasingly severe there is a diminishing prospect of drug therapies conferring clinically useful benefit. Lung volume reduction surgery is effective in patients with heterogenous upper zone emphysema and reduced exercise tolerance, and is p...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2013.10.011
更新日期:2014-03-01 00:00:00
abstract::Many pathologists and pulmonologists have trained and practiced in an era during which therapeutic options for patients have increased manyfold with regard to pharmacologic agents. Toxicity to the lung may be recognized as data accumulate in the form of case reports and clinical reviews to document the clinical and pa...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::Bronchodilator therapy with adrenergic agonists in asthma is discussed and the therapeutic efficacy and side effects of various routes of administration of beta agonists are compared. The aerosol administration, the most effective route, is described in detail as to the optimal technique of administration, to the vari...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:
更新日期:1984-12-01 00:00:00
abstract::Pulmonary hypertension is a frequently encountered problem in older patients. True idiopathic pulmonary arterial hypertension can also be seen and requires careful exclusion in older patients. Institution of therapies must be tempered with an appreciation of individual comorbidities and functional limitations that may...
journal_title:Clinics in chest medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ccm.2007.08.006
更新日期:2007-12-01 00:00:00