RESUMEN
Prerequisites for success in domiciliary assisted respiration for chronic respiratory insufficiency are the understanding of the patient and his active participation in the treatment as well as adjustment and attitude of his environment. The authors report their experience in 89 patients. Spirographic data were obtained in 72 patients which permitted subdivision into a group with restrictive disturbances and one with obstructive changes. The differences in prognosis in these two groups of patients were surprising. The survival rates in the obstructive diseases after 3, 5 and 10 years were 54%, 38% and 33% respectively; the corresponding values for the restrictive diseases were 84%, 84% and 69%. These differences are statistically significant. The restrictive changes are therefore considerably more favorable to assess, also with respect to a better quality of life.
Asunto(s)
Respiración Artificial/métodos , Dispositivos de Autoayuda , Traqueotomía/métodos , Cuidados Posteriores/métodos , Anciano , Enfermedad Crónica , Francia , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/fisiopatología , Insuficiencia Respiratoria/fisiopatología , Insuficiencia Respiratoria/cirugía , Espirometría/métodosRESUMEN
It deals with a new formula which gives the estimation of lean body mass (LBM) by the electric impedance measure at 1 MHz. According to the authors the weight of LBM is set up in two parts: the total water (TBW) conductive of electricity and an inert part (ILBM) which is a bad conductive one: the weight is an individual constant at the grown up. ILBM is calculated from simple morphological datums (H = height and C = wrist circonference). From which one concludes the formula: LBM = TBW + ILBM.
Asunto(s)
Peso Corporal , Pletismografía de Impedancia , Tejido Adiposo , Adulto , Composición Corporal , Agua Corporal , Humanos , MétodosRESUMEN
The role of the skeleton in electrolyte equilibrium, well known for various diseases, remains difficult to understand during chronic hypercapnia. An experimental study of normoxic (O2:21%) hypercapnia (CO2:8 +/- 1%) was carried out for two, four and six weeks, followed by a systematic quantitative determination, in thigh-bone samples of Na+, K+, Ca++, PO4--, N2 and CO2 in 72 rats, and of total H2O and extracellular H2O (H2Oe) in 129 rats. Considering the mean values of groups (from 16 to 42 subjects for each group), at various times of hypercapnia, bone K+ was increased during hypercapnia (+3 to 4 X 10(-3) mEq/g fresh tissue), Ca++ diminished (--12.5 to 15.4 mEq). PO4-- and Na+ temporarily decreased at two and four weeks of hypercapnia. On account of the scatter of individual results, only the variation of K+ was statistically significant (at two weeks). This increase in bone K+, accompanying a partially compensated acidaemia, is to compare with the significant hyperkaliemia observed at two and four weeks, whereas this period is characterized by a decrease in K+ in skeletal muscle, as shown in a previous work. In a group of 72 rats, the analysis of correspondances and correlations points out the bone CO2 as a very significant variable, opposite to the variable H2Oe. PO4--is positively correlated to Na+. The complexity of the results does not permit a decisive interpretation of the phenomenon. On the other hand, this study corroborates the bone calcium loss and reveals the gain in bone potassium during hypercapnia.
Asunto(s)
Huesos/metabolismo , Electrólitos/metabolismo , Hipercapnia/metabolismo , Animales , Bicarbonatos/sangre , Agua Corporal/metabolismo , Calcio/metabolismo , Fémur/metabolismo , Masculino , Oxígeno/sangre , Fosfatos/metabolismo , Potasio/metabolismo , Ratas , Sodio/metabolismoRESUMEN
After briefly recalling the action of corticosteroids on the normal and pathological lung, the authors review the different etiologies where they can be used in respiratory pathology.
Asunto(s)
Corticoesteroides/uso terapéutico , Enfermedades Pulmonares/tratamiento farmacológico , Corticoesteroides/metabolismo , Adulto , Enfermedades Bronquiales/tratamiento farmacológico , Disnea/tratamiento farmacológico , Humanos , Recién Nacido , Pulmón/efectos de los fármacos , Enfermedades Pleurales/tratamiento farmacológico , Edema Pulmonar/tratamiento farmacológicoRESUMEN
During courses of haemodialysis or treatment with powerful diuretics, the clinician at the present time bases his actions on blood pressure levels which reflects blood volume and on weight variation which is dependent on water loss. The authors show, in studying variations in total body impedance at 5kHz and 1kHz and their ratio R, that there exists another method of observation which complements the basic notions provided by blood pressure levels and baseline weight. They were thus able to detect the possible formation of cellular oedema due to excessively rapid osmotic depletion. The method makes possible the evaluation of these sectorial fluid transfers when they occur, even though they are not evident clinically. This easy to use method is perhaps less rapid than the usual means of observation but is nevertheless more rational and provides information on electrolyte balance.