Microalbuminuria, uric acid, uric acid clearance, gamma glutamyl transferase and cholesterol level in patients with chronic obstructive airway disease

This study was performed on thirty-two patients with chronic obstructive airway disease [COPD] subdivided into sixteen patients not receiving theophylline [group A] and sixteen patients taking regular theophylline [group B] and a control group of ten healthy individuals. Microalbuminuria was increased significantly in the patients compared with the controls, with the use of theophylline no significant difference was noted between group A and B. Serum gamma glutamyl transferase [GGT] was increased significantly in the patients compared with the controls and no difference was noted with the use of theophylline between groups A and B. Serum uric acid was increased significantly in the patients group compared with the controls. In the patients using aminophylline, it was significantly increased than patients not using theophylline. Serum uric acid clearance was increased significantly in the patients group as a whole compared with the controls. This increase was significantly higher in patients not using theophylline [group A] than patients using theophylline [group B]. Serum cholesterol was significantly increased in the patients group than the controls, this increase was more significant in the patients not using theophylline [group A] than patients using theophylline [group B]. Serum triglycerides, fasting blood sugar, serum creatinine and urea all showed no significant difference in the patients compared with the controls or with the use of theophylline. As regards the respiratory function, all patients with COPD showed a statistically significant decrease in all the studied parameters compared with the control and no significant difference was noted between the patients using theophylline [group B] and those not using theophylline [group A]. No correlation was found between microalbuminuria, uric acid clearance, cholesterol or respiratory functions in the study, while serum GGT was found to be correlated to cholesterol, but not by any other parameter

Assessment of the left ventricular performance in patients with respiratory failure

Forty male patients with chronic obstructive airway disease with respiratory failure were studied with the aim of assessing the left ventricular function using the Swan Ganz catheterization, thermodilution and thoracic electrical bio-impedance [TEB]. Left ventricular dysfunction existed in 45% of the cases [25% manifested and 20% latent left cardiac dysfunction]. At room air, both manifest as well as latent left ventricular dysfunction showed elevated pulmonary capillary wedge pressure [PCWP] initially or upon fluid challenge. By measuring the left ventricular ejection fraction by TEB, left ventricular dysfunction was mainly diastolic as expressed by an inappropriate increase in LVEDP initially or upon fluid challenge. Both manifested and latent ventricular dysfunction showed limited increase in cardiac output in response to increasing Fio2 to 0.4 and 1 on mechanical ventilation. The drop in PCWP or the negative fluid challenge test in response to increase Fio2 to both 0.4 and 1.0 was evident in only 38.8% of the patients with left ventricular dysfunction indicating that changes in arterial blood oxygenation were not the sole factor affecting the left ventricle in these patients. The mean pulmonary artery pressure was significantly lower in patients with normal left ventricular function than those with left ventricular dysfunction indicating a possible significant role of ventricular interdependence. There was no significant difference between the mean hemoglobin of patients with normal left ventricular function and left ventricular dysfunction indicating that polycemia is not a determinant factor. Finally, the results obtained by TEB and thermodilution were significantly correlated which indicated that TEB is a reliable method in cardiac output assessment