ABSTRACT
Serial blood gas measurement must be made for at least three months following an acute exacerbation of chronic obstructive pulmonary disease, to secure stable arterial oxygen tension (PaO2) values. The borderline indications of oxygen therapy concern the patients who have PaO2 over 8 kPa (60 mmHg), but have nocturnal hypoxaemia and/or pulmonary hypertension. The indications of specific drugs such as almitrine are still subject to discussion. The presence of obstructive sleep apnoeas together with ventilatory troubles related to chronic obstructive lung disease (overlap syndrome), is associated with many diagnostic and therapeutic problems.
Subject(s)
Hypoxia/diagnosis , Lung Diseases, Obstructive/complications , Oxygen Inhalation Therapy , Blood Gas Analysis , Humans , Hypoxia/etiology , Hypoxia/therapy , Long-Term Care , Middle Aged , Respiration, Artificial , Respiratory Function Tests , Sleep Apnea Syndromes/therapyABSTRACT
27 patients (17 F, 10 M) with a mean age of 65 +/- 11 years and suffering from recurrent pleural effusions were treated with locally administered Doxycycline by lavage-drainage to achieve pleural symphysis (17 adeno-carcinomas, 3 large cell carcinomas; 3 epidermoid cancers; 3 non-Hodgkin's lymphoma; 1 small cell carcinoma). The solution used was a dilution of 50 ml doxycycline in 250 cc of isotonic saline. 22 of the 27 patients could be evaluated long term, 5 were lost to follow up, of whom two had recurred straight away despite local treatment. An immediate response was obtained in 23 out of the 28 patients (85%). Later the absence of recurrence was seen in 90% of the patients evaluated. The incidence of antimitotic therapy did not seem to be the determining factor in the 7 patients who received this in parallel. The duration of drainage was 11 +/- 6 days, the local treatment was well tolerated in the majority of cases. The use of the technique of lavage-drainage of doxycycline could be an alternative in those patients with a malignant pleural effusion whose general condition contra-indicates a symphysis under pleuroscopy.
Subject(s)
Doxycycline/therapeutic use , Pleural Neoplasms/drug therapy , Aged , Doxycycline/administration & dosage , Drainage , Female , Humans , Male , Middle Aged , Pleura , Pleural Effusion/drug therapy , Pleural Effusion/etiology , Pleural Neoplasms/complications , Recurrence , Therapeutic IrrigationABSTRACT
The authors describe an optical technique enabling patients with chronic respiratory insufficiency, at first to get used to assisted ventilation, then to control it, to obtain an active ventilation operated by machine corresponding to a particular shape of the pressure curve and the lesser haemodynamic repercussion.
Subject(s)
Intermittent Positive-Pressure Breathing/methods , Positive-Pressure Respiration/methods , Humans , Male , Middle Aged , Mouth Protectors , Patient Compliance , Pressure , Respiratory Insufficiency/therapyABSTRACT
The authors described an optical technique enabling patients with chronic respiratory insuffiency, at first to get used to assisted ventilation, then to control it, to obtain an active ventilation operated by machine corresponding to a particular shape of the pressure curve and to the lesser haemodynamic repercussion.
Subject(s)
Intermittent Positive-Pressure Breathing/methods , Positive-Pressure Respiration/methods , Ventilators, Mechanical , Humans , Intermittent Positive-Pressure Breathing/instrumentation , Respiratory Insufficiency/rehabilitationABSTRACT
Having given a definition of chronic pulmonary patients and of readaptation by reference to the W.H.O. and to the results of an international survey and the study group of the special Unit of the European Society of respiratory Physiopathology, the authors report a critical study of the conception and the present aims of readaptation. They successively present the therapeutical, medico-social and psychological aspects of readaptation, the different techniques used today, and summarize the present functioning of Europeans centres of readaptation. Finally they draw the main lines of a program of readaptation with the public health scheme and envisage the problems of organization and functioning.
