Independently of well known pulmonary risk factors, an intact diaphragm during thoracoabdominal aortic repair results in a higher probability of early ventilator weaning.

Restrictive pulmonary function after heart-lung transplantation (HLT) has been attributed to the use of smaller donor lungs and/or an inability to generate normal negative pleural pressures. Pleural pressure generation depends on both the size of the recipient thoracic cage and its neuromuscular integrity. To determine whether lung volumes after heart-lung transplantation are more dependent on donor lung size or on recipient chest wall characteristics, seven HLT recipients were evaluated before and after transplantation. Postoperative values initially (average, 2 months), 6, and 12 months after transplantation were compared with predicted lung volumes for the recipient and donor organs. TLC dropped from a mean of 5.2 +/- 0.5 L preoperatively to 3.7 +/- 0.3 L (p less than 0.05) 2 months after HLT, but it improved with time and ultimately was not different from preoperative values. The predicted TLC of the HLT donor organs were significantly larger than those of the recipient's predicted TLC, with a mean of 6.9 +/- 0.4 versus 5.3 +/- 0.3 L (p less than 0.05). DLCO, arterial PO2, and PCO2 did not change after surgery. Within limits, larger donor lungs appear to adapt to the constraints of the recipient chest and may be used with clinical success, without apparent adverse effects.

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Introduction: Hyper-lucent lung syndrome or Swyer-James-Macleod syndrome is a rare, often an incidental finding, primarily showing unilateral hyper-lucency as a consequence of bronchiolitis obliterans. Often diagnosed in early childhood; though in some cases it may only be discovered in adulthood or on account of recurrent chest infections. Case Presentation: A patient presented to our outpatient center with complaints of shortness of breath with mild to moderate exertional dyspnea & exacerbations of symptoms classically associated with chronic obstructive pulmonary disease. Complaints have persisted for several years with waxing & waning intensity. There is a history of migraine, atrial fibrillation, hypothyroidism, and colon & breast cancer without recurrence. Computed tomography of the chest with intravenous contrast showed asymmetric emphysematous changes with marked hyperinflation & attenuated vasculatures confined to the middle lobe of the right lung. The patient was started on a combination of inhaled long-acting beta-agonists, corticosteroids & long-acting muscarinic antagonists and is almost asymptomatic. Conclusion: Geriatric patients are at increased risk of various age-related diseases, respiratory disorders being among them. Knowledge of this rare condition allows for its appropriate management as it often coexists with bronchiectasis & results in frequent respiratory infections, which may be preventable.