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

The removal of one lung from a beagle puppy results in minimal interference with lung function or the arterial gases. The removal of air from the empty pleural cavity results in a shift of the mediastinum and overdistention of the contralateral lung. An immediate decrease in the PO2 and increase in the PCO2 is seen. Significant increase in the alveolar-arterial CO2 gradient reflected marked increase in dead space ventilation. Biopsies of the overdistended lung demonstrated emphysema and disruption of alveoli. These changes may explain some of the deterioration of lung function and the complication of contralateral pneumothorax following repair of a Bochdalek diaphragmatic hernia. Our study suggests that the mediastinum should be stabilized in the midline after repair of a diaphragmatic hernia or after a pneumonectomy in an infant or small child.
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PMID:The effect of overdistention of the lung on pulmonary function in beagle puppies. 12 44

In 15 patients with chronic bronchitis with or without emphysema breathing of room air was compared with breathing of 20.9% O2 in helium and in argon. Minute ventilation and alveolar ventilation showed no differences, whereas the alveolar and arterial pO2 and PCO2 showed an improvement of the CO2 gas exchange and a deterioration of the O2 gas exchange. This contradictory behaviour cannot be explained by shunts or inhomogeneities or influence of gaseous or alveolo-capillary diffusion. Perhaps the physicochemical properties of the alveolo-capillary membrane change by the depletion of nitrogen. The recommendation of helium-oxygen breathing, proposed by other authors for patients with obstructive airway diseases, cannot be supported, when the gas exchange for O2 is deteriorated.
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PMID:[Respiratory gas exchange during breathing of O2 in different inert gases (author's transl)]. 20 10

Studies of percutaneous transtracheal ventilation with intermittent jets of oxygen under high pressure have demonstrated a tendency toward carbon dioxide retention and poor alveolar washout. A modification of the percutaneous transtracheal ventilation fevice to include an expiratory phase improves pulmonary gas exchange and minimizes the possibility of CO2 retention. The most common complication is subcutaneous emphysema caused by incorrect catheter placement. Although endotracheal intubation is unquestionably the treatment of choice, percutaneous transtracheal ventilation does offer a viable alternative when intubation cannot be rapidly accomplished.
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PMID:A modified, simple device for the emergency administration of percutaneous transtracheal ventilation. 62 19

Respiratory drive (deltaP 0.1/deltaPCO2) and ventilatory response (deltaVE/deltaPCO2) to CO2 has been estimated in 20 normal subjects and 28 patients with chronic obstructive pulmonary disease (COPD). In patients with COPD, drive and ventilatory response to CO2 were diminished, but no statistical correlation with FEV1, MBC, TLC, FRC, RV/TLC was found. A statistically negative correlation was found between blood bicarbonate and drive or ventilatory response to CO2. Patients with emphysema and normal PaCO2 demonstrated normal deltaP 0.1/deltaPCO2. In contrast, patients with chronic bronchitis with the same pulmonary function abnormalities and hypercapnia had significant diminution of the deltaP 0.1/deltaPCO2. Therefore, we feel that pulmonary function abnormalities alone cannot explain the deltaP 0.1/deltaPCO2 decrease; in most cases there sould coexist a diminished respiratory sensitivity.
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PMID:Respiratory drive in patients with chronic obstructive pulmonary disease. 67 65

The present explanation of the shape of deformed expiratory partial pressure curves of O2, CO2, N2 and foreign gases as being caused by sequential convective emptying of compartments with decreasing VA/Q is put into question, since the same deformation can be observed in healthy subjects during simultaneous breathing of helium and SF6, where the SF6 curve is deformed and the helium curve has a normal shape. The high molecular weight of SF6 causes a delay of its gaseous diffusion from the peripheral air spaces of the lung. A similar delay can be caused by emphysematous changes such as a longer distance for diffusion, an increased alveolar volume and a reduction of the number of small airways, where the gas has to pass through. Different data from cross-sectional and longitudinal studies, from induced changes of bronchomotor tone, from comparison of patients with relatively pure emphysema and patients with airway obstruction and from autopsy suggest that stratification and serial inhomogeneities, caused by emphysema, are at least a reasonable, if not a better explanation for the deformation than the VA/Q concept with sequential emptying of parallel units.
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PMID:Emphysema as possible explanation for the alteration of expiratory PO2 and PCO2 curves. 101 96

A total of 281 patients were divided into groups according to their clinical diagnosis and were examined using capnography, spirometry and blood-gas analysis. The highest percentage of patients with arterial hypoxemia was found in the group with chronic bronchitis and emphysema. The same group had the highest number of patients with moderate hypoxemia and was the only group containing patients with severe hypoxemia. Alveolar hypoventilation and increased ventilation-perfusion ratio were most pronounced in patients with chronic bronchitis and emphysema. The greatest negative correlation between PaO2 and PaCO2 was found, again, in this group. We also found the greatest direct correlation between the oxygen and carbon dioxide gradients in this group. These results suggest that the relationships between the partial pressures of O2 and CO2 depend on the type of the pulmonary and cardiovascular diseases. The relationships between the partial pressures of O2 and CO2 as well as between their gradients, become stronger with the increase of the ventilation-perfusion ratio. The relationships between the expired alveolar gases are approximately the same as those of these gases in blood.
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PMID:Relationships between some oxygen and carbon dioxide indices in patients with chronic lung and cardiovascular diseases. 133 73

We investigated the effect of a novel analgesic compound, flupirtine on the respiratory center in 8 healthy controls and patients with lung emphysema (n = 6), bronchial asthma (n = 7) and lung fibrosis (n = 5). All patients received a in a double blind, randomized fashion on three separate study days 100 mg and 200 mg flupirtine and placebo, respectively. Respiratory drive was estimated from measurements of CO2-rebreathing curves and mouth occlusion pressure at rest and during CO2-rebreathing performed before, 1.5 and 3 hours after medication. We were unable to detect any significant depression of respiratory drive neither in the controls nor in the patients and therefore suggest that flupirtine is a safe analgetic compound even in patients with severe obstructive and restrictive lung function impairment.
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PMID:[The effect of flupirtine on respiratory drive in healthy probands and patients with various lung diseases]. 147 68

Patients with cardiopulmonary insufficiency undergoing laparoscopic surgery with carbon dioxide (CO2) pneumoperitoneum may retain CO2 resulting in clinically significant respiratory acidosis. A canine model of pulmonary emphysema induced by papain inhalation was utilized to evaluate the respiratory effects of both CO2 and helium pneumoperitoneum. Prior to papain inhalation and 5 and 8 weeks after initial treatment under general anesthesia, mechanical ventilation was adjusted to maintain the end-tidal CO2 (ETCO2) at 40 mm Hg during baseline and pneumoperitoneum physiologic monitoring periods. Utilizing an analysis of variance, hemodynamic and respiratory physiologic parameters were compared. In this canine model, all dogs demonstrated consistent hypercarbia during CO2 pneumoperitoneum prior to papain treatments, but CO2 retention was significantly increased in the emphysematous state. The occurrence of hypercarbia during CO2 pneumoperitoneum may be underestimated by ETCO2 monitoring as was revealed by an increased PaCO2 (arterial carbon dioxide pressure)-ETCO2 gradient with an increasing time interval between papain exposure and period of physiologic monitoring. Irrespective of the pulmonary condition of the dog, helium pneumoperitoneum did not produce any hypercarbic or acidic changes when compared with the concomitant baseline period of dogs prior to the induction of pneumoperitoneum, thus suggesting that helium pneumoperitoneum may be a reasonable alternative in patients at risk for CO2 retention.
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PMID:Hypercarbia during carbon dioxide pneumoperitoneum. 173 68

From August 1990 to August 1991, sixteen patients with bullae or blebs (pneumothorax 9, giant bullae 5, bullous emphysema 2) were treated by CO2 laser ablation under limited thoracotomy. We found the irradiation of bullae or blebs by CO2 laser quite effective in eliminating these bullous lesions which were often multiple and inoperable by conventional methods. Histological examination revealed the wall of bullae where CO2 laser was applied became thick with dense fibrous tissues and degenerated collagen fibers which, however, were not disrupted. The procedure was safe and we were able to operate patients with disabling emphysema. Because CO2 laser can penetrate only 0.2-0.3 mm of tissue thickness, it is suitable for the ablation of bullous lesions which have thin walls and rapidly shrink and collapse by irradiation leaving thick walled scar tissues. Removing multiple bullae and blebs in patients with bullous emphysema can improve gas exchange by reducing dead spaces and elevating the diaphragm which is often flat and downward displaced because of hyperinflation in these patients. We are planning to incorporate thoracoscopy for this operation to make the procedure less invasive.
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PMID:[Application of laser in the treatment of spontaneous pneumothorax and emphysema]. 173 44

The effects of high frequency jet ventilation (HFJV, f = 2 Hz and 8 Hz, I:E = 0.43, FiO2 = 0.4) were studied and compared with intermittent positive pressure ventilation (IPPV, f = 10-14 breaths/min, VT = 15 ml/kg, I:E = 0.5, FiO2 = 0.4) in 8 dogs before and after induction of panlobular emphysema (PLE). PLE increased alveolar-arterial PO2 difference (PA-aO2) during all modes of ventilation, whereas PaCO2 did not change significantly. In both periods of the study, HFJV8 Hz was less effective in terms of CO2-elimination and oxygenation. In the control-period, functional residual capacity (FRC) was 937 +/- 212 ml. The increase during HFJV (HFJV2 Hz: 1156 +/- 508 ml, HFJV8 Hz: 1153 +/- 433 ml) did not reach significance (P = 0.09). Closing volume (CV) increased from 1.5 +/- 4.3% of vital capacity (%VC) (IPPV) to 6.3 +/- 7.1%VC (HFJV2 Hz) and 10.8 +/- 9.8% VC (HFJV8 Hz), respectively. In the PLE-period, FRC and CV increased significantly to 1107 +/- 207 ml and 14.1 +/- 7.0% VC respectively during IPPV (P less than 0.05). Application of HFJV neither increased FRC (HFJV2 Hz: 1153 +/- 433 ml, HFJV8 Hz: 1005 +/- 344 nor CV 14.8 +/- 6.0% VC and 13.9 +/- 8.1% VC, respectively). It is concluded that HFJV induces no alveolar overdistension in dogs with emphysematous lungs.
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PMID:High frequency jet ventilation in experimental pulmonary emphysema. 177 88


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