Importance of airflow obstruction after thoracoplasty.
نویسندگان
چکیده
Thirty six patients previously treated for pulmonary tuberculosis by thoracoplasty were studied to determine the prevalence and effect of airflow obstruction. The mean (SD) FEV1 was 1.3 (0.65) 1 and the mean forced expiratory ratio (FER) 64% (12%). FEV1 was less than predicted in every patient whereas FER was less than predicted in 30, being below the lower 98th percentile in 15 (42%). In the 18 patients who complained of breathlessness the means of the standardised residuals (SR) for FEV1, peak expiratory flow (PEF), and FER were significantly lower and that for residual volume/total lung capacity (RV/TLC) significantly higher than those for the 18 patients who were not breathless (all p less than 0.0001). There was no difference in the smoking history of the two groups. Only three of the 23 patients in whom reversibility of airflow obstruction was assessed showed a greater than 25% increase in PEF. None showed an increase in FEV1 of greater than 15%. The 18 who were breathless had significantly lower values of arterial oxygen tension (PaO2) and higher values of arterial carbon dioxide tension (PaCO2) (p less than 0.0001). Thirteen of these patients were in chronic respiratory failure (PaO2 less than 8.0 kPa or PaCO2 greater than 5.9 kPa, or both) compared with only one of the 18 who were not breathless. The indices correlating best with PaO2 and PaCO2 were SR FEV1 and SR PEF respectively. SR FEV1 accounted for 34% of the variance in PaO2 and SR PEF for 29% of the variance in PaCO2. Airflow obstruction has been found to be common in patients with a thoracoplasty and to be associated with hypoxia and hypercapnia.
منابع مشابه
Noninvasive Positive-Pressure Ventilation.
Prince Andrew married Sarah Ferguson on July 23 1986. That day also saw the first use in the United Kingdom of non-invasive positive pressure ventilation by nasal mask. Aged about fifty years, the patient had suffered pulmonary tuberculosis as a youngster and, in the days before antituberculous chemotherapy, had been treated with bilateral pneumothoraces, phrenic crush and finally an apical tho...
متن کاملThe Relationship between the Severity of Airway Obstruction and COPD Diagnostic Questionnaire Score in COPD Patients
Background & objectives: Chronic obstructive pulmonary disease (COPD) is characterized by irreversible airflow limitation and systemic inflammation which is also associated with pulmonary and extra-pulmonary complications. COPD Diagnostic Questionnaire (CDQ) is a valid questionnaire that is used to identify patients with COPD. The purpose of this study was to determine the relationship between ...
متن کاملExercise-induced airflow obstruction in a healthy military population.
Clinical asthma is estimated to occur in 4 to 7 percent of the US population, but respiratory symptoms are much more common. The correlation between asthma, tests of bronchial hyperresponsiveness, and symptoms is imprecise and difficult to ascertain. The prevalence of exercise-induced airflow obstruction is not well known in healthy adults. We studied 100 consecutive US Air Force members to det...
متن کاملUnderestimation of airflow obstruction among young adults using FEV1/FVC <70% as a fixed cut-off: a longitudinal evaluation of clinical and functional outcomes.
BACKGROUND Early detection of airflow obstruction is particularly important among young adults because they are more likely to benefit from intervention. Using the forced expiratory volume in 1 s (FEV(1)) to forced vital capacity (FVC) (FEV(1)/FVC) <70% fixed ratio, airflow obstruction may be underdiagnosed. The lower limit of normal (LLN), which is statistically defined by the lower fifth perc...
متن کاملCharacterization of postoperative changes in nasal airflow using a cadaveric computational fluid dynamics model: supporting the internal nasal valve.
IMPORTANCE Collapse or compromise of the internal nasal valve (INV) results in symptomatic nasal obstruction; thus, various surgical maneuvers are designed to support the INV. OBJECTIVE To determine the effect on nasal airflow after various surgical techniques focused at the level of the INV and lateral nasal sidewall. DESIGN AND SETTING A fresh cadaver head was obtained and underwent sutur...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Thorax
دوره 42 5 شماره
صفحات -
تاریخ انتشار 1987