Cheyne-stokes respiration in patients with heart failure: prevalence, causes, consequences and treatments

Cheyne-Stokes respiration (CSR) is characterized by a pattern of cyclic oscillations of tidal volume and respiratory rate with periods of hyperpnea alternating with hypopnea or apnea in patients with heart failure. CSR harms the failing heart through intermittent hypoxia brought about by apnea and hypopnea and recurrent sympathetic surges. CSR impairs the quality of life and increases cardiac mortality in patients with heart failure. Thus, CSR should actively be pursued in patients with severe heart failure. When CSR persists despite optimal therapy of heart failure, noninvasive adaptive servoventilation is currently the most promising treatment

Effect of shape of sodium salicylate particles on physical property and in vitro aerosol performance of granules prepared by pressure swing granulation method

The purpose of this research was to investigate the effect of the shape of sodium salicylate (SS) particles on the physical properties as well as the in vitro aerosol performance of the granules granulated by the pressure swing granulation method. SS was pulverized with a jet mill (JM) to prepare the distorted particles, and SS aqueous solution was spray dried (SD) to prepare the nearly spherical particles. The particle size distribution, crushing strength, and pore size distribution of the granules were measured. The adhesive force of the primary particles in the granules was calculated according to Rumpf's equation. The in vitro aerosol performance of the granules was evaluated using a cascade impactor. Both JM and SD particles can be spherically granulated by the pressure swing granulation method without the use of a binder. The size of SD granules was smaller than that of JM granules. Although the crushing strength of the JM and SD granules is almost the same, the internal structures of JM granules and SD granules were found to differ, and the SD particles appear to have been condensed uniformly, resulting in a nearly spherical shape. In the inhalation investigation, the percentage of SS particles of appropriate size delivered to the region for treatment was noticeably higher for SD granules than for JM granules. This finding might be because the adhesive force of the SD primary particles was smaller than that of the JM primary particles in the granules and because the SD granules could be easily separated by air current to obtain the primary particles