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Biomedical subjects

J M Bedicam

Publications and source records attributed to J M Bedicam.

10 recordsLinked to original sources
PubMed1994

Nasal intermittent positive pressure ventilation. Long-term follow-up in patients with severe chronic respiratory insufficiency.

Prior studies have shown that nasal intermittent positive pressure ventilation (NIPPV) can improve arterial blood gas values, prevent symptoms resulting from alveolar hypoventilation, and decrease hospitalization in patients with chronic respiratory failure. Most studies have involved small samples of patients followed up for a limited time. This study reviews our experience during 5 years use of NIPPV in 276 patients with kyphoscoliosis, posttuberculosis sequelae, Duchenne-type muscular dystrophy, COPD, and bronchiectasis followed up for > or = 3 years while receiving NIPPV. Outcomes were compared for patients who survived short term eg, died or converted to management with a tracheostomy and intermittent positive ventilation (TIPPV) during year 1 or year 2 on a regimen of NIPPV and long term, eg, survived more > or = 2 years on a regimen of NIPPV. The most favorable outcome was achieved by patients with kyphoscoliosis and posttuberculosis sequelae with improvement in PaO2 and PaCO2 (p < 0.0001) and a reduction in days of hospitalization for respiratory illness (p < 0.0001) for > or = 2 years while receiving NIPPV. Patients with Duchenne-type muscular dystrophy also had fewer hospital days during NIPPV (p < 0.003) but only 9 of 16 patients (56 percent) continued using NIPPV for the duration of followup. Benefit was also more short term for patients with COPD and bronchiectasis. NIPPV can sustain improvement in gas exchange, while reducing hospitalization for substantial periods of time. NIPPV can be an attractive and effective alternative to other methods of assisted ventilation such as TIPPV.

Adult↗
PubMed1994

[Long-term oxygen therapy at home. Compliance with the medical prescription and observance of the daily duration of at least 15 hours].

Long-term domiciliary oxygen therapy in patients with chronic respiratory failure significantly improves both survival and quality of life. These therapeutic objetives are only achieved by daily oxygen therapy of more than 15 hours. For a period of 3 months, we have prospectively measured the duration of oxygen therapy in 930 patients with chronic airflow obstruction. This is carried out by reading the meters on the oxygen concentrators, or for liquid oxygen by checking the weight of the cylinders at each delivery, making allowances for the flow rate and also for natural loss from evaporation. The instructions for oxygen therapy and the true therapy of the patient were then gathered using a questionnaire. The practitioners were questioned on the prescription for oxygen therapy which had been made for each patient, and more generally on their usual criteria for prescribing long-term oxygen therapy. The patients (82% male) were aged between 67 +/- 8 years, and were on domiciliary oxygen therapy 36 +/- 24 months, with hypoxaemia (PaO2 = 56 +/- 9 mmHg), hypercapnea (PaCO = 47 +/- 8 mmHG) and suffering from airflow obstruction (FEV1/VC = 42 +/- 14%). The duration of prescribed oxygen therapy was on average 16 +/- 3 hours. The mean duration of oxygen therapy achieved was 14.5 +/- 5 hours, but only 45% of the patients (419/930) managed daily oxygen therapy superior of equal to 15 hours and were categorised as compliant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

[Diffuse interstitial pneumopathy associated with limited Sjögren's syndrome (author's transl)].

Diffuse interstitial pneumopathy was found to be associated with limited Sjögren's syndrome (i.e. without connective tissue involvement) in 5 women aged from 48 to 83 years. The respiratory symptoms (dyspnoea, unproductive cough and crepitations) appeared before the dry-eye-and-mouth syndrome was diagnosed in two patients and several years afterwards in three. Respiratory function studies showed a mixed restrictive and obstructive syndrome, perturbed Co transfer and increased total expiratory airways resistance. These changes reflected the underlying pathology, as revealed by bronchial and lung biopsies, which consisted of lymphocyte and plasmocyte infiltration and fibrosis of the interalveolar septa, peribronchial spaces and bronchial glands. Abnormal respiratory function tests in 5 other patients without any respiratory symptom suggest that subclinical and subradiological lesions of the lungs and bronchi are not uncommon in Sjögren's syndrome.

Aged↗
PubMedDate not supplied

[Effects of different levels of PEEP on PaO2, PaCO2, shunt and static compliance in A.R.D.S. (author's transl)].

This study points out that in acute respiratory distress syndrome, the positive end-expiratory pressure (PEEP) had in every case the same action on functional residual capacity and static lung compliance. However its results on PaO2, PaCO2 and circulation are often different from patient to patient according also to the different levels of PEEP. The level of optimal PEEP is that which opens the largest number of alveoli; it is better defined by the value of PaO2 on 100% oxygen than by static compliance.

Carbon Dioxide↗
PubMedDate not supplied

[Mechanical ventilation by nasal mask in children with cystic fibrosis. Initial results of a non-invasive method].

BACKGROUND: Chronic respiratory failure (CRF) with hypoxia and hypercapnia is the last ineluctable phase in cystic fibrosis (CF). Nasal positive pressure ventilation (NPPV), a non-invasive method, may be given to CF children with CRF, especially to patients accepted for transplantation (T). This method improves ventilatory function by resting the chronically exhausted respiratory muscles, facilitates bronchial drainage by physiotherapy, prevents the exacerbations of the illness and prepares patients for T. METHODS AND PATIENTS: NPPV was used in 6 CF patients (mean age 13 years 6 months). One of them was transplanted 15 days later, two of them were accepted for T. All had hypoxia. Five of them had hypercapnia. RESULTS: NPPV was given to four patients for 3 to 14 months. The preliminary results were positive. One patient gained weight, two had more fluid sputum. One patient showed an increase in functional respiratory tests (FRT: PaO2, vital capacity, FEV-1) while these tests were stabilized in the others. CONCLUSIONS: NPPV in an effective non-invasive method for use with CF children. It is indicated for CF patients accepted for T and also earlier, for CF patients with CRF in order to prevent acute exacerbations and functional respiratory deterioration.

Adolescent↗