Patients with chronic emphysema and pulmonary insufficiency commonly arrive at a new steady state in which the carbon dioxide pressure in the blood is increased and the pH lowered; this situation can be prolonged for months during which these patients must be in acid-base balance. This equilibrated state of mild respiratory acidosis is, at times, upset by complicating pneumonitis which aggravat...

A case is described of tracheobronchomegaly progressing to extensive tracheomalacia, complicated by episodic choking, recurrent pulmonary infections, and irreversible hypercapnic respiratory failure. A Y-shaped tracheobronchial stent was placed endoscopically to splint the trachea open, with excellent clinical and physiological improvement. New stent designs may provide long term palliation in ...

The effects of slow intravenous infusion of three different respiratory stimulants (dimeftine, nikethamide and prethcamide) on minute and alveolar ventilation, blood gases and pH were studied in 18 patients with chronic pulmonary emphysema and chronic respiratory failure. For a more accurate assessment of the results of the double blind controlled trial, a factorial design in a Youden square sc...

The present supplement of the European Respiratory Journal contains a number of reviews concerning Treatment of Respiratory Failure. Important progress has been made in this area since the early 1990s. This supplement is the result of a symposium held in Barcelona on January 18, 2003. The symposium was organised by the European Institute of Healthcare, set up by AstraZeneca. It was the fifth sy...

We investigated cardio-respiratory coupling in patients with heart failure by quantification of bidirectional interactions between cardiac (RR intervals) and respiratory signals with complementary measures of time series analysis. Heart failure patients were divided into three groups of twenty, age and gender matched, subjects: with sinus rhythm (HF-Sin), with sinus rhythm and ventricular extra...

A b st ra ct Although asthma is a condition that is managed in the outpatient setting in most patients, the poorly control­ led and severe cases pose a major challenge to the health-care team. Recognition of the more common insidious and the less common rapid onset “acute asphyxic” asthma are important. The intensivist needs to be familiar with the factors that denote severity of the exacerbati...