am Main, Medizinische Klinik H des Städtischen Krankenhauses Frankfurt am Main-Höchst, Medizinische Klinik des St.-Markus-Krankenhauses Frankfurt am Main, Medizinische Abteilungen des Bürgerhospitals und des Katharinen-Krankenhauses Frankfurt am Main, des Städtischen Krankenhauses in Hanau amMain, des Kreiskrankenhauses in Grofl-Umstadt und des Stadtkrankerihauses Neuwied

Ergometric body plethysmography has been made possible through the connection of a normal bicycle ergometer with the slightly modified box of a whole-body plethysmograph. The expected difficulties – the warming-up of , the air inside the box and the artefacts caused by the cycling movements – proved to be of little importance. Special measures had to be taken regarding the rebreathing from the BTPS bag. Already during an exercise period of 2–3 min, important aspects can be recognized: healthy subjects did not reveal a uniform pattern of their resistance behaviour. In patients with chronic bronchial obstruction, several causes of their dyspnoe during exercise could be found: in most cases, an increase in poorly ventilated alveolar spaces with a phase-shift during in- and expiration; in some cases, an increase in intrathoracic pressure during expiration causing bronchial collapse and in several patients a check valve mechanism with overinflation of the lungs. Patients with a predominantly broncholytic exercise reaction have also been observed. Thus, ergometric body plethysmography opens new aspects for the examination of the mechanics of breathing during exercise and thereby it completes function tests using only high respiratory frequencies or forced expiration, however, without exercise.

No abstract

Wirksamkeit und Organisation der assistierenden Oberdruckbeatmung mit Aerosolinhalation bei chronischen obstruktiven Lungenkrankheiten* Notwendigkeit und Erfolge der Beatmungstherapie bei Patienten, die wegen einer schweren respiratorischen Insuffizienz intubiert oder tracheotomiert werden mußten, stehen außer Zweifel. Sie wird im allgemeinen auf einer Intensivpflegestation durchgeführt (6, 17, 18, 23). Kann die Respiratorbehandlung aber auch in Form einer regelmäßig angewandten assistierenden intermittierenden Uberdruckbeatmung mit gleichzeitiger Aerosoizufuhr auf einer Normalstation in größerem Umfang eingesetzt werden und insbesondere bei den zahlreichen Fällen von chronischer Bronchialobstruktion unterschiedlicher Genese als gesicherte Therapie die bewährten Maßnahmen der medikamentösen, physikalischen und antiallergischen Behandlung sinnvoll ergänzen? anläglich des zehnjährigen Bestehens der Klinik

Changes in O₂ concentration in the gas mixture supplied by assistive respirators of the Bird and Bennett type were monitored continuously with a new fast registering O₂ analyzer in conjunction with a pneumotachogram. When using 100 % O₂ to drive the respirators unfavourably high O₂ concentrations were registered even with a single breath, and could be traced as to their origin: The admixture of atmosphere room air via Ventury tube remains rather constant even with high back pressure and low flow adjustment. The air-oxygen flow rate from the Venturi tube to the patient is slowed down or stopped completely by closure of the valve at the end of the tube. Meanwhile the unimpaired flow of the pure oxygen through the nebulizer leads to high inspiratory O₂ concentrations. However, eventual toxicity could result only in a case of a low compliance, high inspiratory positive pressure and long term ventilation. In some patients suffering from alveolar hypoventilation the hypoxemic drive of respiration may be retarded even by slight elevation of inspiratory oxygen concentration. In these cases we could confirm previous experience that driving the respirators with compressed air and adding O₂ at controlled low flow rates to the atmospheric compartment of the respirators represents a very adequate form of treatment.