27 patients diagnosed as chronic obstructive pulmonary disease (COPD) came with acute hypercapnic respiratory failure due to COPD and met the inclusion and exclusion criteria. They were managed by non invasive positive pressure ventilation (NIPPV). 21 cases showed success and 6 cases showed failure and were put on invasive mechanical ventilation within the first 24 h. It was shown that before initiation of NIPPV, the failed cases had significantly higher Body Mass Index (BMI) 34.7 compared to 28.1 in successful cases and significantly lower pH 7.20 ± 0.05 compared with 7.27 ± 0.04. After 1 h of initiation of NIPPV, the successful group showed improvement regarding pH and PaCO 2 , while the failed group showed worsening of the same parameters, with a significant difference (p value <0.001, 0.005), respectively. After 4 h, there was improvement in both groups regarding pH which reached normalization in the successful group, PaCO 2 , and PO 2 , with no statistical significant difference. There were significant differences in the respiratory rate (p value < 0.001), and the expiratory positive airway pressure (EPAP) (p value 0.024) between the two groups. Thus we can conclude that the use of NIPPV in such patients can be successful in around 78% of cases, however failure can be predicted by high BMI, initial lower pH and higher PaCO 2 , insignificant response to NIPPV after 1 h. They also show increased respiratory rate and need for higher expiratory positive airway pressure.

No abstract

Background Chronic obstructive pulmonary disease (COPD) is a common disease that can be prevented and even treated. It leads to high morbidity and mortality rates. Proinflammatory cytokines and oxidative radicals were found to be implicated in COPD pathogenesis. Objectives To measure serum level of interleukin 6 (IL-6) in patients with stable COPD and also to detect the relationship of IL-6 levels with COPD severity. Patients and methods A total of 50 patients having stable COPD, in addition to 20 healthy control individuals, were included in the study. History taking and clinical examination, BMI calculation, spirometry (postbronchodilator spirometry in COPD group), and 6-min walk test were done for all patients. Measurement of serum level of IL-6 was done by using the enzyme-linked immunosorbent assay. Results Serum level of IL-6 showed significantly higher concentrations among patients with COPD compared with healthy individuals [359.87±106.99 and 188.92±77.97 pg/ml, respectively; P<0.001]. An inverse nonsignificant correlation was found between serum level of IL-6 and 6-min walk test distance, forced expiratory volume in the 1 s, forced vital capacity, and maximum expiratory flow 25-75% predicted values. Mean IL-6 level was higher in the patients with severe and very severe COPD (371.75±103.12 pg/ml) compared with those with mild and moderate COPD (336.82±113.72 pg/ ml) (P=0.291). Conclusion Serum level of IL-6 showed significant higher concentrations in patients with COPD when compared with control ones, but IL-6 level did not show significant correlation with the disease severity.

No abstract

Background and objective Pulmonary hypertension is an assorted state that encompasses a spectrum of diseases and is categorized into five groups. The registries are necessary for the identification of risk factors, progression of the disease, outcomes, and effect of treatment strategies on the progression of the disease. The aim of this work was to identify different groups of PH identified at an Egyptian referral center and to compare the demographic and clinical characteristics of each group. Patients and methods This study included 132 patients who were diagnosed with a right heart catheter in the Chest Department, Kasr El-Aini Hospital, Faculty of Medicine, Cairo University, in the period from January 2017 to January 2019. Patients were classified into different groups, then received medical treatment accordingly. Demographic and clinical data were documented. Arterial blood gases, spirometry, and 6-minute walk test (6MWT) were performed. Results The mean age of cases was (43.9±13.69) years; the majority of them were females (72.7%). More than half of the patients (57.5%) had pulmonary artery hypertension (PAH), while 22.7% and 18.3% had pulmonary hypertension due to chronic thrombo-embolic cause and lung cause respectively. The 1-year survival rate was 81.8%. Conclusions The results of the study showed female predominance, the PAH type was the commonest, and the overall 1-year survival rate was 81.8%.