Altered pulmonary function in bronchial asthma

Asthma has attracted a great deal of attention over the centuries both because it is common and because of its frequent dramatic manner of presentation (Ellul-Micallef, 1976). Up to comparatively recently, knowledge of physiological changes occurring in asthmatic patients, both during an attack and following therapy has been scanty. Over the past few years various tests have been developed enabling the clinical pulmonary physiologist and the chest physician to measure a number of different variables. It is only by considering all the changes in pulmonary function which take place in this condition that a reasonably clear picture can be obtained and a rational approach to therapy instituted. In this article discussion of altered pulmonary function in asthma includes changes in airway resistance, lung volumes, lung elastic recoil pressure, pulmonary diffusing capacity and arterial blood gas tensions and pulmonary gas exchange.peer-reviewe

A new approach to non-invasive oxygenated mixed venous PCO(sub)2

A clinically practical technique was developed to calculate mixed venous CO2 partial pressure for the calculation of cardiac output by the Fick technique. The Fick principle states that the cardiac output is equal to the CO2 production divided by the arterio-venous CO2 content difference of the pulmonary vessels. A review of the principles involved in the various techniques used to estimate venous CO2 partial pressure is presented

Состояние амбулаторно-поликлинической помощи больным с заболеваниями органов дыхания

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Оказание экстренной помощи больным с заболеваниями органов дыхания: 5-летний опыт скорой медицинской помощи Екатеринбурга

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Asma em adultos : grau de conhecimentos sobre sua doença

Dissertação (mestrado) - Universidade Federal de Santa Catarina. Centro de Ciencias da SaudeObjetivou-se determinar o nível de conhecimentos que asmáticos hospitalizados têm sobre sua doença alem de oferecer subsídios para a criação de um centro para atendimento e educação destes pacientes e desenvolvimento de pesquisas nesta área. Foram estudados 43 asmáticos adultos internados em 3 hospitais de Florianópolis em crise de agudização de sua doença com idade média de 41,9 anos. Oitenta e seis por cento (86%) era portadores de asma moderada ou grave com evolução média da doença de 24,8 anos e em uso predominante de broncodilatadores. Dezoito (41,9%) tinham alguma noção do que era asma, doze (27,9%) conheciam o mecanismo de ação das drogas empregadas e 46% dos que usavam broncodilatores por via inalatória não usavam corretamente o nebulímetro dosificador. Somente 16,3% correlacionavam as crises agudas com a piora da doença. Apenas 32,5% faziam acompanhamento ambulatorial e cumpriam ordens médicas nos 6 meses que antecederam a internação. Cerca de metade dos pacientes foi orientado por seus médicos para evitar fatores desencadeantes da crise e como utilizar o nebulímetro. Conclue-se que os pacientes possuem poucos conhecimentos sobre sua doença e sobre a terapêutica usada além de terem controle inadequado de sua doença os resultados indicam a necessidade de criação de um centro de estudos multidisciplinar para assistência, educação continuada e pesquisas sobre asma

In vivo oximetry of human bulbar conjunctival and episcleral microvasculature using snapshot multispectral imaging

A retinal-fundus camera fitted with a custom Image-Replicating Imaging Spectrometer was used to image the bulbar conjunctival and episcleral microvasculature in ten healthy human subjects at normoxia (21% Fraction of Inspired Oxygen [FiO2]) and acute mild hypoxia (15% FiO2) conditions. Eyelid closure was used to control oxygen diffusion between ambient air and the sclera surface. Four subjects were imaged for 30 seconds immediately following eyelid opening. Vessel diameter and Optical Density Ratio (ODR: a direct proxy for oxygen saturation) of vessels was computed automatically. Oximetry capability was validated using a simple phantom that mimicked the scleral vasculature. Acute mild hypoxia resulted in a decrease in blood oxygen saturation (SO2) (i.e. an increase in ODR) when compared with normoxia in both bulbar conjunctival (p < 0.001) and episcleral vessels (p = 0.03). Average episcleral diameter increased from 78.9 ± 8.7 μm (mean ± standard deviation) at normoxia to 97.6 ± 14.3 μm at hypoxia (p = 0.02). Diameters of bulbar conjunctival vessels showed no significant change from 80.1 ± 7.6 μm at normoxia to 80.6 ± 7.0 μm at hypoxia (p = 0.89). When exposed to ambient air, hypoxic bulbar conjunctival vessels rapidly reoxygenated due to oxygen diffusion from ambient air. Reoxygenation occured in an exponential manner, and SO2 reached normoxia baseline levels. The average ½ time to full reoxygenation was 3.4 ± 1.4 s. As a consequence of oxygen diffusion, bulbar conjunctival vessels will be highly oxygenated (i.e. close to 100% SO2) when exposed to ambient air. Episcleral vessels were not observed to undergo any significant oxygen diffusion, instead behaving similarly to pulse oximetry measurements. This is the first study to the image oxygen dynamics of bulbar conjunctival and episcleral microvasculature, and consequently, the first study to directly observe the rapid reoxygenation of hypoxic bulbar conjunctival vessels when exposed to ambient air. Oximetry of bulbar conjunctival vessels could potentially provide insight into conditions where oxygen dynamics of the microvasculature are not fully understood, such as diabetes, sickle-cell diseases, and dry-eye syndrome. Oximetry in the bulbar conjunctival and episcleral microvasculature could be complimentary or alternative to retinal oximetry

Комбинированная терапия ипратропиумом и β2-агонистами при обострении хронической обструктивной болезни легких

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