Ventilatory Function In Patients Research Articles

Effects of acetylcysteine on micro-inflammation and pulmonary ventilation in chronic obstructive pulmonary disease exacerbation.

Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a serious complication of chronic obstructive pulmonary disease, often characterized by increased morbidity and mortality. In traditional Chinese medicine, AECOPD is linked to phlegm-heat and blood-stasis, presenting symptoms like thick sputum, fever, and chest pain. It has been shown that acetylcysteine inhalation in conjunction with conventional therapy significantly reduced inflammatory markers and improved lung function parameters in patients with AECOPD, suggesting that acetylcysteine may be an important adjunctive therapy for patients with phlegm-heat-blood stasis type AECOPD. To investigate the effect of acetylcysteine on microinflammation and lung ventilation in patients with phlegm-heat and blood-stasis-type AECOPD. One hundred patients with phlegm-heat and blood-stasis-type AECOPD were randomly assigned to two groups. The treatment group received acetylcysteine inhalation (10% solution, 5 mL, twice daily) along with conventional therapy, whereas the control group received only conventional therapy. The treatment duration was 14 d. Inflammatory markers (C-reactive protein, interleukin-6, and tumor necrosis factor-alpha) in the serum and sputum as well as lung function parameters (forced expiratory volume in one second, forced vital capacity, and peak expiratory flow) were assessed pre- and post-treatment. Acetylcysteine inhalation led to significant reductions in inflammatory markers and improvements in lung function parameters compared to those in the control group (P < 0.05). This suggests that acetylcysteine could serve as an effective adjunct therapy for patients with phlegm-heat and blood-stasis-type AECOPD. Acetylcysteine inhalation significantly reduced inflammatory markers in the serum and sputum and improved lung ventilation function parameters in patients with phlegm-heat and blood-stasis type AECOPD compared with the control group. These differences were statistically significant (P < 0.05). The study concluded that acetylcysteine inhalation had a positive effect on microinflammation and lung ventilation function in patients with this type of AECOPD, suggesting its potential as an adjuvant therapy for such cases. Acetylcysteine inhalation demonstrated significant improvements in reducing inflammatory markers in the serum and sputum, as well as enhancing lung ventilation function parameters in patients with phlegm-heat and blood-stasis type AECOPD. These findings suggest that acetylcysteine could serve as a valuable adjuvant therapy for individuals with this specific type of AECOPD, offering benefits for managing microinflammation and optimizing lung function.

Different positive end expiratory pressure and tidal volume controls on lung protection and inflammatory factors during surgical anesthesia.

Mechanical ventilation can lead to the severe impairment of the metabolic pathway of alveolar surfactants, inactivating alveolar surfactants and significantly reducing lung-chest compliance. The cardiopulmonary function of elderly patients usually reduced to a certain extent, and there are lung complications after surgical anesthesia, just like lung barotrauma caused by mechanical ventilation, atelectasis and postoperative hypoxemia. To investigate the effects of different positive end expiratory pressures (PEEPs) and tidal volumes (VTs) on respiratory function, the degree of the inflammatory response and hemodynamic indexes in patients undergoing surgery under general anesthesia. A total of 120 patients undergoing surgery for gastric or colon cancer under general anesthesia in Xinghua People's Hospital from January 2017 to January 2021 were randomly divided into Group A and Group B, with 60 cases in each group. The ventilation mode in Group A was VT (6.0 mL/kg) + PEEP (5.0 cmH2O), while that in Group B was VT (6.0 mL/kg) + PEEP (8.0 cmH2O). Blood gas parameters, respiratory mechanical parameters, inflammatory response indicators, hemodynamic indicators and related complications were compared between the two groups. There were no significant differences in PaCO2, PaO2, oxygen or the examined indexes at T0 between group A and group B (P > 0.05). The measured PaO2 value of patients in group A at T3 was higher than that in group B, and the difference was significant (P < 0.05). There were no significant differences in peak airway pressure (Ppeak), mean airway pressure or dynamic pulmonary compliance (Cdyn) at T0 between group A and group B (P > 0.05). The measured Ppeak value of patients in group A at T1 was higher than that in group B, and the difference was significant (P < 0.05). The measured Cdyn value at T1 and T2 was greater than that in group B (P < 0.05). Before surgery, there were no significant differences in tumor necrosis factor-α (TNF-α), interleukin (IL)-6 or IL-10 between group A and group B (P > 0.05). After 4 h, the measured values of TNF-α and IL-6 in group A were lower than those in group B, and the differences were significant (P < 0.05). The IL-10 Level in group A was higher than that in group B (P < 0.05). At T0, there were no significant differences in cardiac output, cardiac index (CI), stroke volume index (SVI) or mean arterial pressure between group A and group B (P > 0.05). The measured values of CI and SVI at T2 in patients in group A were higher than those in group B, and the differences were significant (P < 0.05). For patients undergoing surgery for gastric or colon cancer under general anesthesia, the VT (6.0 mL/kg) + PEEP (5.0 cmH2O) regimen was more effective than the VT (6.0 mL/kg) + PEEP (8.0 cmH2O) regimen in protecting the lung function and ventilatory function of patients, and it had better effects on maintaining hemodynamic stability and reducing inflammatory reactions.

High-flow nasal cannula versus conventional oxygen therapy in acute COPD exacerbation with mild hypercapnia: a multicenter randomized controlled trial

BackgroundHigh-flow nasal cannula (HFNC) can improve ventilatory function in patients with acute COPD exacerbation. However, its effect on clinical outcomes remains uncertain.MethodsThis randomized controlled trial was conducted from July 2017 to December 2020 in 16 tertiary hospitals in China. Patients with acute COPD exacerbation with mild hypercapnia (pH ≥ 7.35 and arterial partial pressure of carbon dioxide > 45 mmHg) were randomly assigned to either HFNC or conventional oxygen therapy. The primary outcome was the proportion of patients who met the criteria for intubation during hospitalization. Secondary outcomes included treatment failure (intolerance and need for non-invasive or invasive ventilation), length of hospital stay, hospital cost, mortality, and readmission at day 90.ResultsAmong 337 randomized patients (median age, 70.0 years; 280 men [83.1%]; median pH 7.399; arterial partial pressure of carbon dioxide 51 mmHg), 330 completed the trial. 4/158 patients on HFNC and 1/172 patient on conventional oxygen therapy met the criteria for intubation (P = 0.198). Patients progressed to NPPV in both groups were comparable (15 [9.5%] in the HFNC group vs. 22 [12.8%] in the conventional oxygen therapy group; P = 0.343). Compared with conventional oxygen therapy, HFNC yielded a significantly longer median length of hospital stay (9.0 [interquartile range, 7.0–13.0] vs. 8.0 [interquartile range, 7.0–11.0] days) and a higher median hospital cost (approximately $2298 [interquartile range, $1613–$3782] vs. $2005 [interquartile range, $1439–$2968]). There were no significant differences in other secondary outcomes between groups.ConclusionsIn this multi-center randomized controlled study, HFNC compared to conventional oxygen therapy did not reduce need for intubation among acute COPD exacerbation patients with mild hypercapnia. The future studies should focus on patients with acute COPD exacerbation with respiratory acidosis (pH < 7.35). However, because the primary outcome rate was well below expected, the study was underpowered to show a meaningful difference between the two treatment groups.Trial registration: NCT03003559. Registered on December 28, 2016.

Thumb-tack needles based on "Biaoben acupoint compatibility" for sequela of COVID-19 during recovery period

To observe the effect of thumb-tack needles based on "Biaoben acupoint compatibility" on sequela symptoms, mental state and pulmonary ventilation function in patients with coronavirus disease 2019 (COVID-19) during recovery period. Fifty cases of COVID-19 during recovery period were randomly divided into an observation group and a control group, 25 cases in each group. The patients in the observation group were treated with thumb-tack needles at Guanyuan (CV 4), Zusanli (ST 36) and Taiyuan (LU 9). The patients in the control group were treated with sham thumb-tack needles at identical acupoints as the observation group. The treatment in the two groups was given once a day, 7-day treatment was taken as a course of treatment, and totally two courses of treatment were given. The TCM symptom score, Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, pulmonary function (forced vital capacity [FVC], forced expiratory volume in the first second [FEV1], peak expiratory flow [PEF]), the severity of pulmonary ventilation dysfunction and pulmonary imaging changes in the two groups were compared before and after treatment. Compared before treatment, the total scores and each item scores of TCM symptom scale, HAMA scores and HAMD scores in the two groups were reduced after treatment (P<0.05). Except for the symptom scores of dry throat and dry stool, the total score and each item score of TCM symptom scale, HAMA score and HAMD score in the observation group were lower than those in the control group (P<0.05). Compared before treatment, FVC, FEV1 and PEF in the two groups were increased after treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The severity of pulmonary ventilation dysfunction in the two groups was reduced after treatment (P<0.05), and the severity in the observation group was better than that in the control group (P<0.05). After treatment, the lung shadow area in the two groups was decreased (P<0.05), and that in the observation group was smaller than the control group (P<0.05). The improvement of imaging change in the observation group was better than that in the control group (P<0.05). The thumb-tack needles based on "Biaoben acupoint compatibility" could significantly reduce the sequela symptoms, anxiety and depression in patients with COVID-19 during recovery stage, and improve the pulmonary ventilation function.

Observation on Effect of Seretide on Pulmonary Ventilation Function in Patients with Chronic Obstructive Pulmonary Disease (COPD) Complicated with Respiratory Failure

Observation on Effect of Seretide on Pulmonary Ventilation Function in Patients with Chronic Obstructive Pulmonary Disease (COPD) Complicated with Respiratory Failure

Assessment of ventilatory function in patients with spinocerebellar ataxia type 2.

Subclinical ventilatory dysfunction is observed in individuals with spinocerebellar ataxias (SCA). No studies have correlated ventilatory dysfunction to clinical and functional decline in SCA2. To evaluate the relationship between the values of peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and presence of respiratory complaints with age, disease duration, age at onset of symptoms, balance scores, independence in basic (ADL) and instrumental (IADL) Activities of Daily Living (ADLs), and severity of ataxia (SARA) in individuals with SCA2. Cross-sectional study evaluating age, disease duration, age at onset of symptoms, scores in the Berg Balance Scale and in the SARA, Functional Independence Measure and Lawton's scale, values of PEF and MIP, and the presence of respiratory complaints. The study included 36 individuals with SCA2, with a mean age of 42.5±2.4 years, disease duration of 7.6±8.2 years, age 33.7±11.5 years at onset of symptoms, and 9.9±10.3 points in the SARA scale. The lowest PEF values correlated with the longer disease duration (p=0.021). The lowest values of PEF and MIP correlated with greater balance impairment (p=0.019 and p=0.045, respectively), increased degree of dependence in the ADL (p=0.006 and p=0.050, respectively) and IADL (p=0.003 and p=0.001, respectively) scales, and highest severity of ataxia (p=0.00 and p=0.017, respectively). Respiratory complaints were observed in 12 (33.3%) individuals and were not related to age, disease duration, age at onset of symptoms, balance, independence, ataxia severity, or PEF and MIP values. Ventilatory dysfunction, even when asymptomatic, is related to balance impairment, independence, and ataxia severity in individuals with SCA2.

Application of extracorporeal membrane oxygenation technique in patients with acute respiratory failure caused by ammonia poisoning

Acute severe ammonia inhalation can seriously affect oxygenation and ventilation function of patients, and even cause acute respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) technology is increasingly used in treating patients with ARDS caused by infection, cardiogenic shock, trauma, and drowning with achieved certain effects, but its usage for ARDS caused by ammonia is rarely reported. On July 7, 2018, a case of ARDS caused by ammonia inhalation was admitted to the emergency ICU of the First Affiliated Hospital of Zhengzhou University. After admission, the patient was treated with ECMO immediately on the basis of anti-infection, anti-oxidation, suctioning and nebulization treatments. After 8 days, he was weaned from ECMO and transferred to a general ward for continued rehabilitation. After 23 days, his condition improved and was discharged without complaining of any discomfort during the follow-up till March 2019. The successful experience was summarized in order to provide reference for the treatment of such patients in the future.

Acute Effect of Combined Manual Therapy and Therapeutic Exercise versus Short-Acting Bronchodilator on Ventilatory Function in Patients with COPD

Acute Effect of Combined Manual Therapy and Therapeutic Exercise versus Short-Acting Bronchodilator on Ventilatory Function in Patients with COPD

Effect of ulinastatin on perioperative glycocalyx and lung function in patients undergoing mitral valve replacement surgery

To explore the effect of ulinastatin on perioperative glycocalyx and lung function in patients undergoing mitral valve replacement surgery. Methods: Fourty patients, undergoing mitral valve replacement, were randomly allocated into a control group and an ulinastatin group, which were administrated 50 mL normal saline or 2×104 U/kg ulinastatin at the beginning of cardiopulmonary bypass (CPB), respectively. The radical artery blood was collected at 4 time points: After induction of anesthesia (T0), at 10 min after the start of CPB (T1), 1 h after the end of CPB (T2), and 8 h after operation. The concentration of syndecan-1 and TNF-α in blood was measured. Moreover, the blood gas analysis was preformed and the oxygen index (OI) and difference in alveolar arterial oxygen partial pressure (PA-aO2) were calculated at T0, T2, and T3. Results: There were no significant difference between the 2 groups in OI, PA-aO2, and the concentration of syndecan-1 and TNF-α at T0 (P>0.05). The concentration of syndecan-1 and TNF-α was significantly increased at T1 and T2 in the 2 groups, and reached peak at T2. Compared with the control group, the concentration of syndecan-1 and TNF-α was decreased in the ulinastatin group at T1, T2, and T3 (P<0.05). Compared with T0, OI was lower and PA-aO2 was higher at T2 and T3 in both groups, but the 2 indexes were improved in the ulinastatin group compared with those in the control group (P<0.05). Conclusion: Ulinastatin can improve the post-operative pulmonary ventilation function in patients with mitral valve replacement. The mechanism may be associated with the inhibition of TNF-α release and the reduction of glycocalyx shedding induced by ulinastatin.

Nanoconjugate-bound adenosine A1 receptor antagonist enhances recovery of breathing following acute cervical spinal cord injury

Respiratory complications in patients with spinal cord injury (SCI) are common and can have a negative impact on the quality of patients' lives. Previously, we found that intradiaphragmatic administration of the nanoconjugate-bound A1 adenosine receptor antagonist, 1,3-dipropyl-8-cyclopentylxanthine (DPCPX) induced recovery of diaphragm function following SCI in rats. When administered immediately following the injury, recovery was observed as early as 3days following SCI and it persisted until the end of the study, 28days after the drug delivery. The recovery was observed using diaphragmatic electromyography (EMG) as well as phrenic nerve recordings; both of which were conducted under anesthetized conditions. Confounding effects of anesthetic may make data interpretation complex in terms of the impact on overall ventilatory function and clinical relevance. The objective of the present study was to test the hypothesis that intradiaphragmatic administration of nanoconjugate-bound DPCPX, enhances recovery of ventilation following SCI in the unanesthetized rat. To that end, Sprague-Dawley rats underwent C2 spinal cord hemisection (C2Hx) on day 0 and received either: (i) 0.15μg/kg of nanoconjugate-bound DPCPX or (ii) vehicle control (50μl distilled water). To assess ventilation, unrestrained whole body plethysmography (WBP) was performed on day 0 (immediately before the surgery) and 3, 7, 14, 21 and 28days following the SCI. Frequency, tidal volume, and minute ventilation data were analyzed in two minute bins while the animal was calm and awake. We found that a single administration of the nanoconjugate-bound A1 adenosine receptor antagonist facilitated recovery of tidal volume and minute ventilation following SCI. Furthermore, the treatment attenuated SCI-associated increases in respiratory frequency. Taken together, this study suggests that the previously observed DPCPX nanoconjugate-induced recovery in diaphragmatic and phrenic motor outputs may translate to a clinically meaningful improvement in ventilatory function in patients with SCI.

Effects of moxibustion in improving the ventilatory function of patients with lung distension caused by deficiency of lung-spleen qi

Objective To explore the effects of moxibustion in improving the ventilatory function of patients with lung distension caused by deficiency of lung-spleen qi. Methods Totally 60 patients with lung distension caused by deficiency of lung-spleen qi were selected and divided into the observation group and the control group, with 30 cases in each group. Patients in the control group were given combined traditional Chinese medicine and western medicine treatment plus routine care, while patients in the observation group were treated with moxibustion with moxa sticks on the basis of treatment in the control group. The therapeutic effect between two groups were compared. Results After two continuous courses of treatment, in the pulmonary function test, the ratio of the forced expiratory volume in one second and forced vital capacity (FEV1/FVC) in the observation group was (73.13±1.23) %, and in the control group, it was (67.83±1.04) % (t=18.03, P<0.05) . The total effective rate in the observation group was 93.3%, and it was 83.3% in the control group (χ2=10.92, P<0.05) . Conclusions Moxibustion with moxa sticks could effectively improve the ventilation function of patients with lung distension caused by deficiency of lung-spleen qi. Key words: Moxibustion; Deficiency of lung-spleen qi; Lung distension; Ventilatory function

Effects of Early Continuous Venovenous Hemofiltration on E-Selectin, Hemodynamic Stability, and Ventilatory Function in Patients with Septic-Shock-Induced Acute Respiratory Distress Syndrome.

Objective. To investigate the effects of 72-hour early-initiated continuous venovenous hemofiltration (ECVVH) treatment in patients with septic-shock-induced acute respiratory distress syndrome (ARDS) (not acute kidney injury, AKI) with regard to serum E-selectin and measurements of lung function and hemodynamic stability. Methods. This prospective nonblinded single institutional randomized study involved 51 patients who were randomly assigned to receive or not receive ECVVH, an ECVVH group (n = 24) and a non-ECVVH group (n = 27). Besides standard therapies, patients in ECVVH group underwent CVVH for 72 h. Results. At 0 and 24 h after initiation of treatment, arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) ratio, extravascular lung water index (EVLWI), and E-selectin level were not significantly different between groups (all P > 0.05). Compared to non-ECVVH group, PaO2/FiO2 is significantly higher and EVLWI and E-selectin level are significantly lower in ECVVH group (all P < 0.05) at 48 h and 72 h after initiation of treatment. The lengths of mechanical ventilation and stay in intensive care unit (ICU) were shorter in ECVVH group (all P < 0.05), but there was no difference in 28-day mortality between two groups. Conclusions. In patients with septic-shock-induced ARDS (not AKI), treatment with ECVVH in addition to standard therapies improves endothelial function, lung function, and hemodynamic stability and reduces the lengths of mechanical ventilation and stay in ICU.

Ventilation function disorder of flail arm syndrome

To study the features of ventilation function in patients with flail arm syndrome (FAS). The clinical data of 351 patients with sporadic amyotrophic lateral sclerosis (ALS) from 2009 to 2013 were retrospectively reviewed. Among them, 329 were classical ALS and 22 were FAS. The differences of forced vital capacity (FVC) between FAS and classical ALS were analyzed. The percent predicted FVC (FVC% pred) values were (88.0 ± 9.5)% in FAS and (84.3 ± 16.8)% in classical ALS including 4 and 128 patients with abnormal FVC% pred (< 80%) in FAS and classical ALS, respectively. The FVC% pred levels were significantly higher in FAS subjects [(88.0 ± 9.5)%] than in classical ALS subjects of bulb [(80.0 ± 14.8)%] or those of upper limb [(80.8 ± 16.0)%] onset with duration over 12 months (All P < 0.05). The proportion of subjects with FVC% pred < 80% was statistically lower in FAS [18.2% (4/22)] than in both classical ALS of upper limb onset [42.8% (80/187); P = 0.037] and classical ALS with duration over one year [48.5% (48/99); P = 0.009]. Impaired ventilation function occurs less and later in FAS than that in classical ALS of upper limb onset with duration over one year, suggesting later and less requirement for non-invasive positive pressure ventilation treatment for FAS patients. Differentiation of FAS subjects from ALS helps assess prognosis and make treatment plan for these patients.

Pulmonary function improvement in patients with ankylosing spondylitis kyphosis after pedicle subtraction osteotomy.

A prospective clinical study. To observe postoperative change in pulmonary function in patients with ankylosing spondylitis (AS) kyphosis after pedicle subtraction osteotomy (PSO). The preoperative pulmonary dysfunction in patients with AS has been reported in several literatures, whereas few research about postoperative changes in pulmonary function with AS kyphosis was published. A total of 32 (27 males and 5 females) patients with AS were eligibly involved. Twenty-nine (25 males and 4 females) patients completed the follow-up and 3 (2 males and 1 females) patients were lost. Pulmonary function tests, breath-holding time (BHT), and full-length spine radiographs in natural standing position were followed postoperatively. The global kyphosis significantly decreased from 63.0°± 20.3° preoperatively to 15.3°± 10.3° postoperatively and 17.1°± 10.9° at the 2-year follow-up. The BHT before surgery was 32.5 ± 10.1 s, whereas the postoperative BHT had increased to 43.1 ± 8.6 s (P < 0.05). Two patients with AS underwent normal pulmonary function test before operation, whereas there were 19 patients at 2-year follow-up. The clinical improvement rate was 85.2% (23/27). The percent-predicted vital capacity had increased from 68.4% ± 9.5% to 79.4% ± 6.1% at 2-year follow-up (P < 0.05). The percent-predicted forced vital capacity before PSO was 75.5% ± 6.4% and it was 81.0% ± 6.9% at 2-year follow-up (P < 0.05). The improved percent-predicted vital capacity and predicted forced vital capacity had a positive correlation with the correction of global kyphosis (r = 0.6328 and 0.8612, respectively). The postoperative pulmonary function including pulmonary volume and ventilatory function in patients with AS with kyphosis had significantly improved at 2-year follow-up. And, the improved pulmonary function had a positive correlation with the kyphosis correction. 3.

Application of intensive care fulltime nursing team on the assist ventilation in the patients with respiratory failure

Objective To explore the effect of intensive care fulltime nursing team on the treatment compliance of ventilator assisted ventilation in the patients with respiratory failure .Methods Two hundred respiratory failure patients from January 2010 to January 2013 were chosen and divided into the control group and the observation group , each with 100 cases.The control group received the routine nursing , and the observation group received the nursing intervention through the intensive care fulltime nursing team . The treatment compliance and nursing satisfaction were compared between two groups .Results The cases of complete , reluctant, refuse treatment compliance were respectively 99,1,0 cases in the observation group , and were 68, 20,12 cases in the control group, and the difference was statistically significant （Z=-4.41,P〈0.01）.The satisfaction of patients in observation group was higher than the control group , the difference was statistically significant（Z=-2.67,P〈0.01）.The indexes of arterial blood gas including pH , PaO2, PaCO2, SaO2 were （7.47 ±0.05）, （79.33 ±7.21） mmHg, （57.17 ±7.41） mmHg, （96.62 ±6.53） % in the observation group, and were better than those of the control group , and the differences were statistically significant （ t=2.447,2.326,4.032,4.773, respectively;P〈0.05）.The incidence rate of ventilator associated pneumonia was 8% in the observation group , and was 21% in the control group , and the difference was statistically significant （χ2 =16.937,P〈0.05）.The hospitalization in the observation group was less than that of control group, and the difference was statistically significant （t=9.246,P〈0.01）.Conclusions The intensive care fulltime nursing team can increase the treatment compliance of ventilator assisted ventilation in the patients with respiratory failure , and improve the ventilation function of patients with respiratory failure , and improve the quality of nursing and the success rate of treatment , and promote the early rehabilitation of patients , and is worthy of clinical application . Key words: Respiratory failure; Intensive care fulltime nursing team; Ventilator assisted ventilation; Compliance

Ventilatory Function in Patients Who Underwent Abdominoplasty with Plication of the Aponeurosis of the External Oblique

Understanding the structure of the bronchial tree and the lung and its gas exchange units will help to clarify the determinants of ventilation, blood flow, and gas exchange within the lung and how we measure them. The authors discuss pulmonary physiology, methods of measuring respiratory function, and what happens to that function when abdominal surgery is performed

Agreement between arterial and venous pH and pCO2 in patients undergoing non‐invasive ventilation in the emergency department

Blood gas analysis is an important part of the assessment of ventilatory function in patients with respiratory distress. Traditionally, analysis of arterial blood has been used, but recently, there has been a move towards venous blood gas analysis for selected conditions. Arteriovenous agreement for pH and pCO2 in adult patients undergoing non-invasive ventilation (NIV) has not been explored to date. The aim of this study was to address this question. This was a prospective study of adult patients undergoing NIV for acute respiratory compromise in an ED. When arterial blood gas analysis was required for clinical purposes, staff also drew a venous sample as close to simultaneously as possible. Data collected included demographics, clinical diagnosis and results of blood gas analyses. Primary outcome of interest was arteriovenous agreement for pH and pCO2 . Bland-Altman bias plot analysis was used. Eighty-nine sample pairs in 53 patients were studied. Median age was 74, and 64% of patients were male. The principal diagnoses were chronic obstructive pulmonary disease (43%) and acute pulmonary oedema (40%). Mean difference for pH (a-v) was 0.04 pH units (95% limits of agreement -0.02, 0.11). Mean difference for pCO2 (a-v) was -8.02 mmHg (95% limits of agreement -22.63, 6.58) CONCLUSION: For adult patients undergoing NIV in an ED, arteriovenous agreement for pH was close with narrow limits of agreement making venous pH clinically interchangeable with arterial pH. Agreement for pCO2 was poor with unacceptably wide limits of agreement.

Middle ear ventilation function in patients with myringoplasty alone and myringoplasty plus mastoidectomy

In this study we investigated the correlation between middle ear pressure changes in patients with myringoplasty alone and together with intact canal wall mastoidectomy. The tympanometric values of 102 patients with myringoplasty alone and 78 patients with myringoplasty plus intact canal wall mastoidectomy were examined by tympanometric analysis in this retro-prospective study. The study population consisted of 130 male and 50 female patients (mean age 25.3±7.7). All patients underwent myringoplasty with or without mastoidectomy due to chronic otitis without cholesteatoma. Patients with a value of less than -100 daPa during the postoperative follow-up were considered having normal middle ear ventilation. Independent-samples t-test was used for comparison of the analyses results of groups. Sixty patients with myringoplasty (58.8%) and 55 patients with intact canal wall mastoidectomy (70.5%) had middle ear pressures less than -100 daPa at three months after surgery. The percentage of recovery over the first three years was 70.5% and 76.9% in the myringoplasty and intact canal wall mastoidectomy groups, respectively. The rate of persistent negative pressure is 21.6% and 14.1% in the myringoplasty and intact canal wall mastoidectomy groups, respectively. The number of patients who had negative middle ear pressure in myringoplasty group was higher than the number of those in intact canal wall mastoidectomy group at all intervals. However, when the rate of normalization over time was compared between two groups, no significant difference was found (p>0.05). In first three months, the significantly higher number of patients achieving normal middle ear ventilation in mastoidectomy group compared to the patients without mastoidectomy is a finding which supports the additional effect of mastoidectomy on the pressure normalization function. However, the rate of normalization over time is not different between two groups. Middle ear pressure normalization is a continuous dynamic process and improvements may be seen for up to one year.

P101 Surface parasternal intercostal electromyogram (sEMGpara) as a monitoring tool in cystic fibrosis

Lung function has been traditionally accepted as the primary monitoring tool in cystic fibrosis. The rate of change in lung function however, is slowing and is now as low as...

Chronological observation of ventilatory function in patients with chronic respiratory diseases (author's transl)

Chronological observation of ventilatory function in patients with chronic respiratory diseases (author's transl)