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PubMed1985

[Value of a brief ergometric test in the functional evaluation of chronic bronchopneumopathy].

The purpose of this work was to study the usefulness of short muscular exercise as part of standard respiratory function testing. A group of 19 patients with chronic bronchitis performed moderate load exercise (30 to 60 watts) on a cycle ergometer for 10 mn. Blood gases and acid-base balance were measured at rest, at the 2nd and the 10th mn of pedaling. In spite of highly significant relationships between resting values (blood gases, spirometry) and exercise data (blood gases), the scattering of the results precludes predicting the latter from the former. In contrast, the comparison between each of the two exercise results (2nd and 10th mn) shows not only a highly significant correlation but also a standard deviation to the regression lines which is objectively diminished. Thus, muscular exercise seems to give specific information that could be a useful component of respiratory function testing. Further, blood gas results obtained at the 2nd mn of muscular exercise suffice, thus obviating the need for a longer exercise programme that might be badly tolerated by patients.

Acid-Base Equilibrium↗
PubMed1988

A comparison of diazepam and midazolam as endoscopy premedication assessing changes in ventilation and oxygen saturation.

1. One hundred and two consecutive patients undergoing upper gastrointestinal endoscopy were randomised to be sedated with either intravenous diazepam (Diazemuls-Kabi Vitrum) or intravenous midazolam (Hypnovel-Roche). It was assumed that midazolam was likely to be approximately twice as potent as diazepam on the basis of previous work. 2. All patients had an ear oximeter attached throughout the procedure to record continuously their level of oxygen saturation. 3. All 102 patients had pre-endoscopy respiratory function tests measured and 100 wore an induction plethysmograph vest to allow continuous estimation of respiratory rate and excursion. The plethysmograph was calibrated using a pneumotachygraph, so baseline, post-injection and post-endoscopy minute volumes could be estimated. 4. The age, sex ratio and pre-endoscopy respiratory function tests of the 51 patients given intravenous diazepam in a mean dose (s.d.) of 11.5 (5.8) mg over a mean of 3.4 (0.9) min) were similar to that of the 51 patients sedated with intravenous midazolam (mean dose 6.0 (2.8) mg over 3.3 (0.9) min. 5. Both drugs significantly reduced minute volume (P less than 0.001) and oxygen saturation (P less than 0.001). Midazolam appeared to produce slightly greater hypoxaemia with 57% having falls in oxygen saturation of greater than 2.5% compared with only 35% given an equivalent dose of diazepam. 6. Ventilation was still less than baseline when re-checked some minutes after removal of the gastroscope. The speed of recovery appeared faster after diazepam sedation which is in contrast to its longer pharmacological half-life.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Functional respiratory diagnosis].

The timing of the examination is an important stage in recognising asthma and its repercussion on haematosis. It consists of exploring the broncho-mototricity and of evaluation of the effect of asthma on ventilation and gas exchange. Respiratory function tests contribute additional information to the clinical history, and etiology and to the decision of therapy strategy.

Airway Obstruction↗
PubMed1980

Effects of doxapram on postoperative pulmonary complications following thoracotomy.

An i.v. solution of 5% dextrose with doxapram 2 mg ml-1 or 5% dextrose alone was administered to 53 patients following lateral thoracotomy. Estimations of arterial PO2, PCO2 and pH were made before operation, during infusion and 7 days after after operation. Respiratory function tests were carried out before and 7 days after operation. There were no significant differences in arterial PO2, PCO2 and pH or in respiratory function tests between those who received doxapram and those who did not. In this study doxapram did not affect the frequency of postoperative pulmonary complications.

Carbon Dioxide↗
PubMed1985

[Different models for the study of a new anti-asthmatic substance].

The various physiopathological components of asthmatic disease are interwoven. Experimental models used to study the sites of impact of an anti-asthmatic substance seek to separate the different mechanisms. The in vitro bronchial tissue model is rarely available in man. Progress is being made towards the development of a multicellular and membrane experimental model. However, it is still difficult to establish links between clinical findings, the results of respiratory function tests and biological results at cell or membrane level. There would seem to be a number of essential basic factors in this area: determination of the categories of asthma studied, regular surveillance of respiratory function tests combining spirometric and plethysmographic studies with pharmacodynamic tests, precise therapeutic protocols and the simultaneous use of several cellular biological models.

Anaphylaxis↗
PubMedDate not supplied

Non-invasive diagnostic and functional evaluation of cardiac and pulmonary involvement in systemic sclerosis.

BACKGROUND: The aim of the present study was to evaluate the role of non-invasive methods in the early detection of pulmonary and cardiac involvement in Systemic sclerosis (SSc) and to identify clinical and/or instrumental patterns of prognostic value. PATIENTS AND METHODS: Twenty female patients affected by SSc (8 with diffuse cutaneous SSc and 12 with limited cutaneous SSc) were enrolled in our study. Cardiac and pulmonary involvement (respiratory function tests and carbon monoxide lung diffusion [DLCO], chest radiography, high resolution computed tomography [HRCT] and lung perfusion magnetic resonance) were evaluated. RESULTS: All 18 patients studied with respiratory function tests showed a significant reduction of DLCO. HRCT was considerably more sensitive than traditional chest radiography (59% versus 28%; p<0.05). Lung perfusion MRI revealed normal findings in 15 patients. Abnormal lung perfusion MRI results were found only in 3 patients. Angina pectoris with electrocardiographic and scintigraphic ischemic changes, severe regional wall motion abnormalities and complex arrhythmias seemed to be associated with poor prognosis. CONCLUSION: Taken together these results indicate that a pulmonary involvement occurs both in limited and in diffuse cutaneous SSc patients and develops, in 83% of the cases, without any regional lung perfusion abnormality. Furthermore, cardiac involvement is detected in 65% of the cases as a consequence of a range of noxious events including myocardial ischemia, fibrosis and pressure overload which may result in ventricular dysfunction and arrhythmias. Lung perfusion MRI should be considered as a complementary diagnostic method for the functional evaluation of these symptoms in systemic sclerosis.

Adult↗
PubMed2006

Evidence for central abnormality in respiratory control in primary lateral sclerosis.

Primary lateral sclerosis (PLS) is a very rare disease characterized by pure upper motor neuron findings. Although a number of previous reports have evaluated this condition, no study has addressed the respiratory function in PLS. Six patients meeting previously proposed diagnostic criteria for PLS were submitted to a number of respiratory tests: forced vital capacity, maximal pressures, phrenic nerve responses, needle electromyography of the respiratory muscles, percutaneous nocturnal oximetry (PNO) and polysomnography (two patients). Our results show that the diaphragm is not affected in this condition, but some respiratory function tests (RFT) and PNO had abnormal values. Voluntary muscular activation to perform RFT may be limited in these patients. PNO and polysomnography suggest that respiratory central drive dysfunction can occur when upper motor neurons are severely affected, in PLS. However, we did not verify progression on follow-up.

Adult↗