Abstract:
:Ten patients (two male) suffering from acute exacerbations of long-standing chronic obstructive pulmonary disease and admitted in hypoxic, hypercapnic respiratory failure were treated with Nasal Intermittent Positive Pressure Ventilation (NIPPV) plus supplemental oxygen, on a general medical ward. The median (range) pH on admission was 7.30 (7.20-7.35), the median age was 67 years (47-77) with an FEV1 (percent of predicted) of 30 (17-39). On admission the median arterial oxygen tension (PaO2) was 4.71 kPa (3.45-6.26) on air, and the carbon dioxide tension (PaCO2) was 7.68 kPa (6.85-9.83). With controlled oxygen therapy there was no significant improvement in PaO2, but the median PaCO2 increased significantly to 9.75 kPa (7.04-11.70) (P < 0.05). By using NIPPV with supplemental oxygen it was possible to significantly improve the median PaO2 to 11.25 kPa (6.70-26.90) (P < 0.01) without worsening PaCO2 levels (8.96 kPa; 6.85-13.10). NIPPV was applied by a senior, respiratory physiotherapist and used intermittently depending on patient tolerance and clinical response. The median total time on NIPPV was 27 h, delivered over 1-5 days. One patient found the mask difficult to tolerate beyond a short period of time. NIPPV was well accepted on a general ward by nursing staff. Three patients later died with progressive hypercapnia, despite an initial response; with one of these patients also receiving intubation and mechanical ventilation. A further patient also received intubation and mechanical ventilation and was eventually discharged. NIPPV plus supplemental oxygen offers a method to correct hypoxaemia on a general medical ward without worsening hypercapnia for acute on chronic, hypoxic, hypercapnic respiratory failure, and warrants further investigation.
journal_name
Respir Medjournal_title
Respiratory medicineauthors
Conway JH,Hitchcock RA,Godfrey RC,Carroll MPdoi
10.1016/0954-6111(93)90054-4subject
Has Abstractpub_date
1993-07-01 00:00:00pages
387-94issue
5eissn
0954-6111issn
1532-3064pii
0954-6111(93)90054-4journal_volume
87pub_type
杂志文章abstract:BACKGROUND:Alpha1-antitrypsin (AAT) deficiency, although largely under-diagnosed, is the underlying cause of approximately 1% of COPD cases. Lack of awareness leads to long delays in diagnostic testing. Subsequently, lifestyle and treatment choices with potentially positive effects on prognosis may be postponed. METHO...
journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.rmed.2013.04.023
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND:Obstructive sleep apnea syndrome is associated with airway inflammation. Measurement of exhaled nitric oxide is a non-invasive method for evaluation of airway diseases. It seems that obesity is an exacerbating factor for airway inflammation. We aimed to evaluate the changes of exhaled nitric oxide after slee...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2014.05.010
更新日期:2014-08-01 00:00:00
abstract::Capsaicin has long been known to act selectively on a subpopulation of neurons to produce initial excitation, followed by a prolonged neuroinhibitory action commonly referred to as 'capsaicin desensitization'. This property has been exploited extensively as a tool with which to investigate the role of these nerves in ...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/s0954-6111(06)80252-0
更新日期:1991-01-01 00:00:00
abstract:PURPOSE:Interstitial lung disease is a common extra-articular manifestation of rheumatoid arthritis (RA-ILD) and is associated with significant morbidity and mortality. However, limited data exist regarding predictors of mortality. We sought to examine the prognostic value of the high-resolution computed tomography (HR...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2017.03.027
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:The synergistic interactions between pharmacotherapy and pulmonary rehabilitation has been provided, but it remains to be established whether this may also apply to more severe patients. OBJECTIVES:We have examined whether tiotropium enhances the effects of exercise training in patients with advanced COPD (...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2009.10.005
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:Gas trapping suggesting small airway disease is observed in adult asthmatic suffering from severe asthma. The aim of the study was to assess whether gas trapping could be evidenced in asthmatic children with/without severe exacerbation and with/without symptoms during the past three months. METHODS AND PATI...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2010.05.005
更新日期:2010-08-01 00:00:00
abstract:BACKGROUND:Natriuretic peptides are considered as reliable indicators of left-heart failure (HF) and are useful for differential diagnosis of dyspnoea. AIM:We evaluated the clinical significance of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with chronic hypercapnic respiratory failure (CHRF). ME...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2007.04.001
更新日期:2007-09-01 00:00:00
abstract:INTRODUCTION:The duration of bronchodilator action of the long-acting beta agonist salmeterol when administered in the evening has not been investigated. In this study we have investigated whether a single evening dose of salmeterol, administered from the combination salmeterol/fluticasone (SFC) Accuhaler significantly...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.rmed.2004.10.001
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:There is little information available on the features of initial presentation of bronchiectasis and documentation of the onset and progress of symptoms leading up to this. Therefore a study was performed on a large cohort of adult patients presenting to Monash Medical Centre (MMC) to survey the course of the...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2006.03.012
更新日期:2006-12-01 00:00:00
abstract:BACKGROUND:Individuals with chronic respiratory conditions are at-risk for depression and anxiety. In the largest mental health screening study of over 6000 people with cystic fibrosis (CF) and 4000 parent caregivers (TIDES, 2014), rates of symptomatology were two to three times higher than in the general population. I...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2020.106147
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To determine the efficacy of oral theophylline compared with placebo in people with stable chronic obstructive pulmonary disease (COPD). METHODS:Systematic review of randomized-controlled trials comparing oral theophylline with placebo for a minimum of 7 days in people with stable COPD. RESULTS:Twenty rand...
journal_title:Respiratory medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.rmed.2004.10.009
更新日期:2005-02-01 00:00:00
abstract:PURPOSE:We conducted a randomised controlled trial to assess the effects of daily breathing pattern changes to stable patients with COPD excluding the confounding factors of inspiratory muscle mobilization, by ensuring the load intensities of two inspiratory training devices were equal. PATIENTS AND METHODS:Sixty pati...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2017.10.001
更新日期:2017-11-01 00:00:00
abstract::Patients with congestive heart failure and Cheyne-Stokes respiration have a low arterial oxygen saturation, especially during sleep, which can be increased by breathing oxygen. Chronic alterations in blood gases are known to modulate the hypercapnic ventilatory response (HCVR). We therefore evaluated whether the HCVR ...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0954-6111(98)90286-4
更新日期:1998-03-01 00:00:00
abstract::Inhaled lignocaine appeared to have considerable steroid sparing properties in an uncontrolled trial in 20 patients with oral-steroid-dependent asthma. Since it can also cause bronchoconstriction, safety needs to be studied under controlled conditions. We have performed a randomized, double-blind, placebo-controlled s...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0954-6111(98)90142-1
更新日期:1998-12-01 00:00:00
abstract::The need for efficient use of resources in the provision of health care is now an accepted reality. Despite its economic significance, respiratory disease has been the subject of very few examples of the application of techniques of economic evaluation. There are a number of examples of cost-minimization studies, and ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(06)80169-1
更新日期:1991-09-01 00:00:00
abstract::The HandiHaler is a novel breath-actuated dry powder system designed for the delivery of tiotropium 18microg daily in the treatment of COPD. We compared patient ability to use the HandiHaler or metered dose inhaler (MDI) device correctly 4 weeks after receiving brief instructions and device demonstration. A single-bli...
journal_title:Respiratory medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0954-6111(03)00162-8
更新日期:2003-10-01 00:00:00
abstract::The fraction of the emitted dose from an inhaler that has the potential to be deposited into the lungs is known as the fine particle dose (also the respirable dose). During inhalation all dry powder inhalers require a 'force' to be created inside the device so that a fine particle dose is generated from the formulatio...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1053/rmed.2003.1351
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Pulmonary rehabilitation improves functional capacity and symptoms in the interstitial lung diseases (ILDs), however there is marked variation in outcomes between individuals. The aim of this study was to establish the impact of the aetiology and severity of ILD on response to pulmonary rehabilitation. METH...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2011.11.014
更新日期:2012-03-01 00:00:00
abstract::Total lung capacity was measured in 16 workers with pulmonary asbestosis using four standard methods: body plethysmography, radiographic lung area, helium dilution by multiple breath and by single breath (alveolar volume). All men had irregular opacities of ILO profusion category 2/1 or greater and four had pleural pl...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/0954-6111(93)90138-p
更新日期:1993-02-01 00:00:00
abstract::Invasive pulmonary aspergillosis is a frequent complication in immunocompromised patients. The role of the prolonged use of steroids in predisposing to invasive aspergillosis has been recognized, but exceptionally described in asthmatic patients. We report the case of a 59-year-old woman with bronchial asthma treated ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/0954-6111(95)90198-1
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Although baker's asthma (BA) is a common occupational asthma, there have been few reports on this disease in Korean subjects. OBJECTIVES:We evaluated the prevalence of serum-specific IgE, IgG1, and IgG4 antibodies in relation to work-related respiratory symptoms in a single industrial bakery. METHODS:Three...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2007.11.015
更新日期:2008-04-01 00:00:00
abstract::Current asthma management guidelines state that where a patient is receiving a low to moderate dose of inhaled corticosteroids and is still experiencing symptoms the dose of corticosteroid should be increased and, if necessary, a long-acting bronchodilator should be added. Many studies have now shown that the addition...
journal_title:Respiratory medicine
pub_type: 杂志文章,meta分析
doi:10.1053/rmed.2001.1140
更新日期:2001-08-01 00:00:00
abstract::The marked female predominance in cases of idiopathic chronic cough and its association with mild chronic lymphocytic airway inflammation suggests an underlying autoimmune process. We set out to test the hypothesis that idiopathic chronic cough is associated with other organ-specific autoimmune diseases in a case cont...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2003.10.005
更新日期:2004-03-01 00:00:00
abstract:RATIONALE:Combination therapy with corticosteroid and long-acting β(2)-agonists (LABA) in a single inhaler is associated with superior effects on airway function and exercise performance in COPD compared with LABA monotherapy. The physiological effects of adding inhaled corticosteroid monotherapy to maintenance broncho...
journal_title:Respiratory medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.rmed.2011.08.021
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:The histologic diagnosis of Pulmonary Langerhans cell histiocytosis (PLCH) is invasive and can cause complications. To confirm the diagnosis of PLCH, guidelines therefore recommend measuring CD1a-positive bronchoalveolar lavage fluid (BALF) cells despite its poor sensitivity and specificity. Thus, an improve...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2016.09.004
更新日期:2016-10-01 00:00:00
abstract::Systemic inflammation may be present in patients with chronic obstructive pulmonary disease (COPD). Exercise is known to elicit an inflammatory response. We hypothesized that the systemic inflammatory response to exercise might be exaggerated in COPD patients compared to healthy subjects. Sixteen COPD patients and 11 ...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2005.03.028
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:Changes in management of COPD in primary care were studied following a training exercise among Spanish general practitioners (GPs). The exercise involved dissemination of the Spanish Society for Pulmonology and Thoracic Surgery (SEPAR) guidelines. The use of a portable device to perform spirometry tests was ...
journal_title:Respiratory medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.rmed.2009.08.003
更新日期:2010-01-01 00:00:00
abstract::In response to the introduction of ethnic monitoring within the U.K. hospital inpatient data set, this study investigates the variations in secondary healthcare utilization by Black and minority ethnic communities whose cause of admission is related to asthma. The study examines all residents of the West Midlands: ove...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/s0954-6111(98)90511-x
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVE:Dipyrone (Novalgin) is an effective analgesic, antipyretic agent also with spasmolytic effects on various types of smooth muscles. It has recently been reported that dipyrone relaxes tracheal smooth muscle of guinea pig. In this present study, we aimed to investigate whether this and previously reported in vi...
journal_title:Respiratory medicine
pub_type: 杂志文章
doi:10.1016/j.rmed.2005.09.002
更新日期:2006-05-01 00:00:00
abstract::Given the high prevalence of chronic obstructive pulmonary disease (COPD), the impact of exacerbations on quality of life, and the costs incurred, effective ways for the prevention of exacerbations, and for reductions in the severity and duration of COPD symptoms are needed. Bacterial immunostimulation has been advoca...
journal_title:Respiratory medicine
pub_type: 杂志文章,评审
doi:10.1016/j.rmed.2007.11.002
更新日期:2008-03-01 00:00:00