RESUMO
Although spinal cord injury is devastating and can compromise the respiratory system, particularly when the cervical cord is injured, aggressive use of noninvasive respiratory muscle aids can reduce the otherwise commonly seen complications of pneumonia, bronchial mucous plugging, atelectasis, and respiratory failure. Accessory muscle function can also usually be improved and the muscles then recruited to help maintain adequate alveolar ventilation during the acute spinal cord injury recovery period. Noninvasive assisted ventilation can be successful for patients with compromised lung function during the acute rehabilitation period as well as on a long-term basis. Removal of an indwelling tracheostomy tube results in improved quality of life from many points of view, a decreased number of local tracheostomy complications, a decreased number of serious respiratory infections, an improved ability to communicate, and an increased ability to use the mouth for functions such as operating computers and wheelchairs.
Assuntos
Ventilação com Pressão Positiva Intermitente/métodos , Quadriplegia/reabilitação , Qualidade de Vida , Adolescente , Adulto , Feminino , Humanos , Ventilação com Pressão Positiva Intermitente/instrumentação , Masculino , Quadriplegia/etiologia , Quadriplegia/mortalidade , Quadriplegia/fisiopatologia , Mecânica Respiratória , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/mortalidade , Traumatismos da Medula Espinal/fisiopatologia , Estados Unidos/epidemiologiaRESUMO
Fibreoptic bronchoscopy with bronchial washing and trasnbronchial biopsy was performed in 8 patients with miliary tuberculosis and helped establish the diagnosis in 6 (75%). This procedure may provide a valuable adjunct to the diagnosis of miliary tuberculosis.
Assuntos
Tuberculose Miliar/diagnóstico , Adulto , Idoso , Biópsia , Broncoscopia , Feminino , Tecnologia de Fibra Óptica , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A sensitive technic using indium111 chloride was devised to investigate the occurrence of pharyngeal aspiration. Twenty normal subjects and 10 patients with depressed consciousness were studied. Forty-five per cent of the normal subjects aspirated during deep sleep. Normal subjects who did not aspirate were noted to sleep poorly. Seventy per cent of the patients with depressed consciousness aspirated. Aspiration of pharyngeal secretions occurs frequently in patients with depressed sensorium and also in normal adults during deep sleep. Bacterial pneumonia may result when aspirated bacteria are not effectively cleared. This may result when clearance mechanisms are impaired or when they are overwhelmed by large volumes of aspirated secretions.
