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Query: UMLS:C0034067 (emphysema)
 11,506 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In an intensive care unit an important role is assigned to respiratory physiotherapy. Its principal task is efficacious toilet of the bronchi by fluidifying the secretions, promoting their ungluing from the respiratory tree and facilitating their evacuation by cough or by aspiration with a catheter or bronchoscope. The technique comprises the inhalation of a secretolytic (e.g. Bisolvon, NaCl 9%) and, in the case of asthma, bronchospasmolytic (e.g. Ventoline) aerosol followed by breathing exercises. The other objectives of physiotherapy are to ensure a better distribution of inspired air, increase failing ventilation, ameliorate disturbed gas exchange, relax the contracted respiratory muscles and prevent bronchiolar collapse in emphysema during expiration. The field of application of respiratory physiotherapy is large; its purpose is prophylactic and therapeutic. The method is prophylactic in all patients confined to bed, where there is a risk of bronchial obstruction or ventilatory failure, especially in those with severe operation, traumatism or consciousness disorder. Physiotherapy has a therapeutic role in several, principally broncho-pulmonary diseases, such as asthma, obstructive emphysema, pneumonia, bronchiectasis, pulmonary abscess, atelectasis, and pulmonary and pleural fibrosis. Myocardial infarction and pulmonary embolism in the acute state, acute pulmonary edema, pneumothorax and pulmonary hemorrhage are contraindications for physiotherapy. If the method is to be effective the intensive care unit should have a specialized physiotherapist attached to it working there on a daily basis.
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PMID:[The role of respiratory physiotherapy in an intensive care unit]. 52 99

In many patients with chronic bronchitis and emphysema right and left ventricular ejection fractions (RVEF and LVEF) are reduced. A study was conducted using multiple gated equilibrium radionuclide ventriculography to compare the effects of oral salbutamol 4 mg and pirbuterol 15 mg on cardiac function in 12 patients with chronic bronchitis (forced expiratory volume in one second 0.86 (SEM 0.12) 1; arterial oxygen pressure 8.2 (SEM 0.5) kPa (61.7 (SEM 3.8) mm Hg)). Different doses of nebulised salbutamol (500 microgram and 5 mg) were also compared in nine of the patients. Both oral salbutamol and oral pirbuterol produced significant increases in RVEF and LVEF at 60 and 90 minutes after drug ingestion (p less than 0.01 in each case). There were no significant differences between salbutamol and pirbuterol in their effects on RVEF and LVEF. Inhaled salbutamol at doses commonly prescribed had no significant effect on RVEF and LVEF after 20 and 60 minutes. Salbutamol and pirbuterol given by mouth have similar actions on RVEF and LVEF. Further studies are necessary to assess the effects of long term B2 agonists in this group of patients.
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PMID:Effects of oral and inhaled salbutamol and oral pirbuterol on right and left ventricular function in chronic bronchitis. 614 48

The effects of inhaling 400 micrograms of salbutamol were compared with identical placebo inhaler in a double blind cross-over study of 20 patients with radiological evidence of pulmonary emphysema. There was a small but significant rise in the forced expiratory volume in one second (FEV1), but there was a much greater increase in vital capacity (VC), which was accompanied by a reduction in residual volume. Symptomatic improvement after salbutamol was reported by 14 of the patients and VC increased significantly in this group; there was no significant increase in VC in patients who did not prefer the active inhaler. There was no consistent change in the FEV1/VC ratio after salbutamol administration and this ratio is misleading as an indicator of bronchodilator responsiveness in patients with emphysema. Salbutamol is thus a valuable addition to treatment in patients with pulmonary emphysema and the response to treatment is best judged by measuring the improvement in VC.
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PMID:The effects of salbutamol aerosol on lung function in patients with pulmonary emphysema. 702 28

We studied 21 COPD patients in stable clinical conditions to evaluate whether changes in lung function induced by cumulative doses of salbutamol alter diffusing capacity for carbon monoxide (DL(CO)), and whether this relates to the extent of emphysema as assessed by high resolution computed tomography (HRCT) quantitative analysis. Spirometry and DL(CO) were measured before and after cumulative doses of inhaled salbutamol (from 200 microg to 1000 microg). Salbutamol caused significant increments of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and flows at 30% of control FVC taken from both partial and maximal forced expiratory maneuvers. Functional residual capacity and residual volume were reduced, while total lung capacity did not change significantly. DL(CO) increased progressively with the incremental doses of salbutamol, but this became significant only at the highest dose (1000 microg) and was independent of the extent of emphysema, as assessed by radiological parameters. No significant changes were observed in CO transfer factor (DLCO/VA) and alveolar volume (VA). The results suggest that changes in lung function induced by cumulative doses of inhaled salbutamol are associated with a slight but significant increase in DL(CO) irrespective of the presence and extent of emphysema.
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PMID:Effect of bronchodilatation on single breath pulmonary uptake of carbon monoxide in chronic obstructive pulmonary disease. 1804 4