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Query: UMLS:C0700208 (scoliosis)
 8,574 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aims were to examine the effects of scoliosis (angle), and age on lung volumes, elastic properties of the respiratory system, and the ventilatory response to CO2. The mean age of the 55 patients was 25.4 plus or minus SEM 2.5 yr, and the mean angle was 80 plus or minus SEM 4.2. The mean plus or minus SEM percent predicted lung volumes were vital capacity (VC), 60.5 plus or minus 2.7; total lung capacity (TLC), 70,2 plus or minus 2.6; functional residual capacity (frc), 79.3 plus or minus 3.2; and residual volume (RV), 99.7 plus or minus 5.2. The correlation coefficients between the angle of scoliosis and each of the following were significant: TLC (-0.548), percent predicted TLC (-0.547), VC (-0.485), percent predicted VC (-0.523), FRC (-0.533), percent predicted FRC (-0.338), RV (-0.438), and percent predicted RV (-0.318). The mean compliance of the total respiratory system (Crs) was 0.049 litter/cm H2O plus or minus SEM 0.004, and the mean compliance of the chest wall (Ccw) was 0.080 liter/cm H2O plus or minus SEM 0.012. The Crs and Ccw were inversely proportional to the angle (r-0.620 and -0.721) and directly proportional to the height and the weight. The mean deltaV/deltaPco2 was 1.32 liter/min per mm Hg (SEM 0.171), and the mean deltaVt/deltaPco2 was 28.9 ml/mm Hg (SEM 3.64). The correlation coefficients between deltaV/deltaPco2 and the following were height, 0.499; VC, 0.792; TLC, 0.632; AND Crs, 0.520; and between the deltaTt/deltaPco2 and the following were height, 0.500; VC, 0.878; TLC, 0.802; and Crs, 0.590. We conclude that body size and the deformity were the determinants of the lung volumes and the mechanical properties of the respiratory system, and that these variables were the major factors in both the magnitude and pattern of the ventilatory response to CO2. The correlations between age and the mechanical properties of the respiratory sytem, deltaV/deltaPco2, and deltaVt/deltaPco2, were not significant, but the correlation coefficients between age and several of the derivatives of deltaV/deltaPco2 and deltaVt/deltaPco2 were significant.
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PMID:Idiopathic scoliosis. Mechanical properties of the respiratory system and the ventilatory response to carbon dioxide. 113 65

We present two cases of fatal venous air embolism that occurred in previously healthy adolescents during posterior spine fusion and instrumentation for scoliosis. Previously recorded cases in the literature have been rare and only briefly discussed. Air embolism has been a complication noted in the anesthesia and neurosurgical literature, occurring primarily in total hip patients and those patients undergoing neurosurgical procedures in a sitting position. An examination of the pathophysiology of air embolism in posterior spinal procedures would indicate the use of properly placed central lines and end-expiratory CO2 monitoring as the primary modes of detection and treatment considering the potentially fatal risk factors for spinal patients.
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PMID:Air embolism in spinal surgery. 213 5

Pulmonary function and gas exchange at rest and during and after standard exercise on bicycle ergometer were studied in 49 girls, aged 10 to 16 years (mean, 13.7), with untreated idiopathic scoliosis, before and with Boston thoracic brace, and after treatment for 3 weeks, reducing the thoracic curve angle from a mean of 32.4 degrees (range, 19-60 degrees) to 17.3 degrees (range, 8-33 degrees). The bracing led to marked decrease in lung volumes, below functions, and CO transfer factor, moderate rise in resting O2 intake, CO2 output and ventilation, and marked rise in ventilatory and O2 cost of exercise, probably due to increased dead space ventilation and O2 cost of breathing. However, repeated studies after 1 day without brace, 6 months after onset of bracing, showed no persistent deterioration of pulmonary function or disturbances of gas exchange, as compared with the pre-bracing state.
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PMID:Pulmonary function and gas exchange at rest and exercise in adolescent girls with mild idiopathic scoliosis during treatment with Boston thoracic brace. 236 70

Reduction in dead space through conventional tracheostomy has been used to treat patients with chronic CO2 retention. The insufflation of air directly into the trachea by transtracheal catheter (airway insufflation, AI) provides reductions in dead space as great or greater than those of tracheostomy. The physiologic effects of AI on gas exchange have not been adequately studied because instillation of gases into the trachea contaminates minute ventilation (VL), dead space volume (VD), tidal volume (VT), and other indices of gas exchange, as measured by usual technics. We overcame this problem by devising special methods of measuring inspired and expired ventilation, alveolar and dead space ventilation, and VT and VD by using pneumotachographic timing of inspiration and expiration so that true inspired and expired ventilation were calculated. We studied 5 patients with chronic CO2 retention from either COPD, scoliosis, or muscular dystrophy (annual average PaCO2 = 45 to 75 mm Hg) during 75 min of AI with serial gas exchange and arterial blood gas measurements. AI at about 5 L/min of room air through the trachea in 5 patients reduced VL by 18% (from 7.91 to 6.48 L/min), VT by 25% (from 450 to 338 ml), and VD by 37% (from 223 to 141 ml), while not affecting PaCO2 (from 51.8 to 48.2 mm Hg) or PaO2 (from 65.1 to 63.4 mm Hg). In 2 patients, AI administered continuously for 4 to 12 months (as 30 to 50% O2) maintained PaCO2 as well as or better than breathing enriched O2 from a tracheal collar via an open tracheostomy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Airway insufflation: physiologic effects on acute and chronic gas exchange in humans. 250 22

Adolescents with mild, asymptomatic scoliosis (thoracic curvature less than 35 degrees) may have little or no impairment of resting lung volumes. Progression to more severe disease may, however, be accompanied by lung restriction, impaired exercise tolerance, and respiratory failure with CO2 retention. We wished to see whether adolescents with mild scoliosis and minimally abnormal resting pulmonary mechanics had impairment of their responses to hypercapnia, hypoxia, and progressive cycle exercise. Forty-four adolescents with idiopathic scoliosis were studied. The mean forced vital capacity (FVC), expressed as a percentage of the predicted value, was 94.3 +/- 2.2 (SE). The mean ventilatory response to hypercapnia (2.57 +/- 0.24 L/min/mm Hg) was within the normal range but was achieved with a tidal volume response (1.87 +/- .17% vital capacity [VC]/mm Hg) that was significantly lower than that previously reported in healthy young adults. Ventilatory responses to exercise were also within the normal range, the mean dyspnea index (VE-max/maximal voluntary ventilation) = 0.92 +/- 0.04. However, at a ventilation of 30 L/min, the tidal volume was 0.38 +/- 0.01% FVC, which was considerably lower than predicted. The tidal volume response to hypoxia was also abnormally low, the mean response being 0.52 +/- 0.059% VC/% decrease in arterial O2 saturation. These findings indicated that, even when scoliosis is asymptomatic and associated with minimal impairment of resting pulmonary function, abnormal patterns of ventilation occur during exercise or in response to chemical stimuli.
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PMID:Ventilatory patterns during hypoxia, hypercapnia, and exercise in adolescents with mild scoliosis. 370 36

In 14 patients, kyphoscoliotics, at the time without cardiorespiratory diseases, of average age 28 years +/- 17 (range 12-64), the average values for the vital capacity was 79.6 +/- 21.2% (range 49-125), for the Tiffeneau Index was 77.9% +/- 10.3% (range 56-91), for the RV/TLC ratio was 39.6% +/- 10.8% (range 18-56), for the MEF 25 was 2,192.8 +/- 732.1 ml/s (range 1,300-3,800), for the MEF 50 was 3,689.3 +/- 1,310.9 ml/s (range 1,750-5,500). The average value for the PaO2 was 90.3 +/- 8.3 mm Hg (range 75-109), and for the PaCO2 35.3 +/- 4.66 mm Hg (range 27.8-46). The average value for the alveolar-arterial gradient of O2 was 11.96 +/- 7.37 mm Hg (range 0.74-27.94) and for the arterial-alveolar gradient of CO2 2.30 +/- 2.41 mm Hg (range 0.22-9.98). The average value for the CO transfer was 20.06 +/- 6.84 ml/min/mm Hg (range 8-31.4). As the angle of scoliosis and the age of the subject increase, the vital capacity and the Tiffeneau Index decrease, the RV/TLC ratio and the respiratory rate increase, the MEF 25, the MEF 50, the PaO2, and the transfer of CO decrease, while PaCO2 increases. The alveolar-arterial gradient of O2 and the arterial-alveolar gradient of CO2 increase as the angle of scoliosis increases. The data so obtained show, therefore, that in kyphoscoliosis a restrictive type of respiratory dysfunction appears, along with hypoxemia due to alveolar hypoventilation and disturbances in diffusion and in the ventilation-perfusion ratio.
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PMID:Alveolar-arterial gradients and small airways in kyphoscoliosis. 641 Apr 77

The variation of the ventilatory response to CO2 and its pattern among normals and in the presence of pulmonary disease is wide. In normal subjects the relationship between the slopes of the ventilatory (delta V/delta PCO2), tidal volume (delta VT/delta PCO2) and the frequency (delta f/delta PCO2) responses and body size, metabolic rate, resting ventilation and pattern, lung volumes or mechanical properties of the respiratory system have only been demonstrated in a few studies. In idiopathic scoliosis there is a positive correlation between the delta V/delta PCO2 and delta VT/delta PCO2 and body size, resting ventilation and tidal volume, lung volumes and compliance of the respiratory system. Although there were significant correlations between the delta V/delta PCO2 and the delta VT/delta PCO2 and th delta f/delta PCO2 the correlation between the delta VT/delta PCO2 and delta f/delta PCO2 was not significant. Correlations between the delta f/delta PCO2 and lung volumes, compliance or body size were also not significant. Therefore variation in the frequency response to CO2 contribute to the variation between individuals of the delta V/delta PCO2 and this variation is unrelated to respiratory mechanics or body size. We conclude that in human studies any examination of possible relationships between ventilatory response to CO2 and body size, lung volumes and mechanics should examine separately the tidal volume and frequency response to CO2. We postulate that the tidal volume response is the most appropriate variable to normalize for lung volumes, e.g., vital capacity (delta VT/VC/delta/ PCO2).
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PMID:Regulation of the tidal volume and ventilatory responses to CO2 in normal man and in scoliosis. 678 70

Idiopathic scoliosis is in nearly 80% associated with an EEG deviating from a normal pattern. Therefore a possible cerebral dysfunction as one of the etiologic factors in the development of idiopathic scoliosis is discussed. In consequence, we studied the central respiratory regulation in 26 patients with idiopathic scoliosis by means of CO2 response with the CO2 rebreathing technique, also vital capacity (VC), maximal voluntary ventilation (MVV), respiratory minute volume at 50, 60 and 70 mm Hg arterial pCO2 and EEG. The CO2-index (1/min/mm Hg CO2) was significantly lower in patients with idiopathic scoliosis (0.92 +/- 0.43) than in normals (1.5 +/- 0.3). The decrease of CO2-index is mainly associated with the smaller VC of the patients (76 +/- 26% of predicted). There is no sign of an additional influence of cerebral dysfunction. Patients with idiopathic scoliosis are able to utilize 70% of the individual breathing reserve like normals when stimulated with CO2. The EEG and the VC show a negative correlation. This may possibly be due to a compensation of the preexisting cerebral dysfunction. VC however decreases during the natural course of disease. No significant correlation could be found between CO2-index and the angle of scoliosis, indicating the absence of a causal relation between the degree of deformation itself and the function of the center of respiratory regulation.
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PMID:[Central regulation of breathing in idiopathic scoliosis (author's transl)]. 680 Feb 7

Ten patients with idiopathic scoliosis and seven controls were studied for the purpose of investigating the ventilatory response and drive due to CO2 inhalation by the steady state CO2 response test. To evaluate the ventilatory drive for the respiratory output mouth occlusion pressure (P0.1) was used. The ventilatory response to CO2 of the patients was not significantly different from that of the controls. P0.1 for a given PCO2 stimulation or tidal volume in the patients was significantly higher than the control. Ventilatory output against P0.1, however, was not different in the two groups. The small tidal volume of the scoliotic patients seemed to be compensated by the high respiratory frequency with a large ventilatory drive in order to maintain adequate ventilation.
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PMID:Ventilatory response and drive due to carbon dioxide stimulation in idiopathic scoliosis. 681 May 1

Thirty-nine patients with idiopathic scoliosis before and after operation and 20 controls were studied. The minute volume ventilatory response to CO2 stimulation of the scoliosis was not significantly different from that of the control. The restricted tidal volume response to CO2 stimulation appeared to be compensated by the high respiratory frequency and ventilatory drive in order to maintain adequate ventilatory output. The characteristic response of the ventilatory pattern to CO2 stimulation in the scoliotic patients (higher respiratory frequency and smaller tidal volume than the control) was enhanced with increasing the angle of the scoliotic curvature.
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PMID:Studies on chemical regulation of respiration in idiopathic scoliosis before and after orthopaedic correction. 681 77


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