Pulmonary medicine

Article Abstract:

Chronic obstructive pulmonary disease (COPD) is the fifth leading cause of death in the US and, in a population that continues to smoke and age, cannot be expected to decline in incidence. Long-term oxygen therapy (LTOT) improves survival in many COPD patients, but payment for this treatment by Medicare is controversial. Two recent conferences reiterated the importance of oxygen during ambulation and rest, but the Six Point Plan of the Health Care Financing Administration sets payment limits. Another conference to consider these conflicting situations is set for 1990. Some COPD sufferers take an alpha-antitrypsin replacement (Prolastin) to increase their levels of this protective substance. More trials of this drug are needed. Prevention of chronic respiratory disease is being approached in a large study (5,887 patients) of smokers with mild or moderate lung disease. Over a five-year period, the effects of smoking cessation plus a drug that dilates the airway will be compared with the effects of smoking cessation alone. The effects of treatment in different settings will also be studied. The incidence of lung cancer increases in patients with airway obstruction, and physicians are well-advised to consider this possibility when treating high-risk patients. Bronchial asthma, another obstructive illness, can be treated effectively with cromolyn sodium, according to a recent research report; this agent deserves wider use. Acute respiratory distress syndrome (sudden respiratory insufficiency) is difficult to prevent and treat. Prevention of both acute and chronic lung disease remains the goal of pulmonary medicine. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Economic aspects, Oxygen therapy, Lung diseases, Obstructive, Chronic obstructive lung disease, Emphysema, Pulmonary, Emphysema, Lung cancer, Cromolyn sodium

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Initial experience with partial liquid ventilation in adult patients with the acute respiratory distress syndrome

Article Abstract:

Partial liquid ventilation with a perfluorocarbon solution may be useful in treating patients with acute respiratory distress syndrome (ARDS). ARDS is a severe form of respiratory insufficiency characterized by difficulty breathing and low blood levels of oxygen. Researchers administered a perfluorocarbon solution called perflubron (LiquiVent) through an endotracheal tube to 10 patients with ARDS. Seven of the patients had pneumonia and all were on life support. All of the patients tolerated the treatment and five recovered. The most common side effects were bleeding in six patients, kidney failure in three and central nervous system injury in three. Bronchoscopy revealed no significant damage to the lungs as a result of the treatment.

Perfluorocarbons

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Preoperative intensive inspiratory muscle training to prevent postoperative pulmonary complications in high-risk patients undergoing CABG surgery: A randomized clinical trial

Article Abstract:

The efficacy of preoperative pulmonary therapy that included intensive respiratory muscle training to reduce pulmonary complications was assessed in a trial of patients scheduled for elective coronary artery bypass graft (CABG) surgery and at high risk of postoperative pulmonary complications. It was found that patients who received preoperative inspiratory muscle training were significantly less likely to have pulmonary complications after surgery.

Risk factors, Coronary artery bypass, Disease/Disorder overview

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