Airways obstruction in survivors of thoracoplasty: Reversibility is greater in non‐smokers

O’Connor, Terence M.; O’Riordan, Deirdre; Stack, Maria; Bredin, C. P.

doi:10.1111/j.1440-1843.2003.00519.x

Cited by 5 publications

(2 citation statements)

References 19 publications

(20 reference statements)

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“…Furthermore, it is important to note that the M patients were mainly patients who experienced tuberculosis and therefore had an underlying intrinsic lung disease. [32][33][34][35] In the study of Jackson et al 6 patients who underwent a thoracoplasty had a 5-year survival rate of 64%, which is comparable to the survival of our M group.…”

Section: Article In Presssupporting

confidence: 67%

Home mechanical ventilatory support in patients with restrictive ventilatory disorders: A 48-year experience

Duiverman

Bladder

Meinesz

et al. 2006

Respiratory Medicine

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Section: Article In Presssupporting

confidence: 67%

Home mechanical ventilatory support in patients with restrictive ventilatory disorders: A 48-year experience

Duiverman

Bladder

Meinesz

et al. 2006

Respiratory Medicine

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“…120 On the other hand, a more recent study comparing total respiratory system compliance in patients after thoracoplasty with tuberculous patients who had no surgery, concluded that thoracoplasty reduced compliance less than anticipated because of compensation by the contralateral hemidiaphragm. 127 Interestingly, although some authors found that the size difference of the two lungs was reflected in greater restriction after right than left thoracoplasty, 122 others could not see such difference. 123…”

Section: Pulmonary Functionmentioning

confidence: 99%

Restrictive Chest Wall Disorders

Donath

Miller

2009

Semin Respir Crit Care Med

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Hypoventilation can be caused by diseases of the chest wall. Any anatomical or functional abnormality of the bony thorax increases dead space ventilation and the work of breathing, whether congenital or acquired, acute or chronic, and whether its cause is infectious, traumatic, environmental, iatrogenic, or unknown. In this article, we discuss these heterogeneous disorders from the viewpoint of the practicing nonpediatric pulmonary physician, only briefly touching on surgical, pediatric, rheumatologic, and other nonpulmonary ramifications. Emphasis is on the most common and the best researched forms of chest wall restriction, including kyphoscoliosis, fibrothorax, thoracoplasty, flail chest, and ankylosing spondylitis. Other diseases such as osteoporosis with its less well known pulmonary effects, and some rarely seen entities, are briefly discussed.

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Hypoventilation Syndromes

Piper

Yee

2014

Comprehensive Physiology

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In patients with impaired inspiratory muscle function or altered respiratory system mechanics, an imbalance between load and capacity can arise. The ventilatory control system normally compensates for this by increasing drive to maintain adequate alveolar ventilation levels, thereby keeping arterial CO2 within its normal range. To reduce work of breathing, a pattern of reduced tidal volume and increased respiratory rate occurs. This pattern itself may eventually reduce effective ventilation by increasing dead space ventilation. However, the impact of sleep on breathing and its role in the development of diurnal respiratory failure is often overlooked in this process. Sleep not only reduces respiratory drive, but also diminishes chemoresponsiveness to hypoxia and hypercapnia creating an environment where significant alterations in oxygenation and CO2 can occur. Acute increases in CO2 load especially during rapid eye movement sleep can initiate the process of bicarbonate retention which further depresses ventilatory responsiveness to CO2. Treatment of hypoventilation needs to be directed toward factors underlying its development. Nocturnal noninvasive positive pressure therapy is the most widely used and reliable strategy currently available to manage hypoventilation syndromes. Although this may not consistently alter respiratory muscle strength or the mechanical properties of the respiratory system, it does appear to reset chemosensitivity by reducing bicarbonate, resulting in a more appropriate ventilatory response to CO2 during wakefulness. Not only is diurnal hypoventilation reduced with noninvasive ventilation, but quality of life, functional capacity and survival are also improved. However, close attention to how therapy is set up and used are key factors in achieving clinical benefits.

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Airways obstruction in survivors of thoracoplasty: Reversibility is greater in non‐smokers

Abstract: Long-term survivors of TPL have an obstructive as well as a restrictive ventilatory defect. These patients have partial reversibility of the obstructive defect. The degree of reversibility found suggests that bronchodilator therapy may help these patients.

Cited by 5 publications

References 19 publications

Home mechanical ventilatory support in patients with restrictive ventilatory disorders: A 48-year experience

Home mechanical ventilatory support in patients with restrictive ventilatory disorders: A 48-year experience

Restrictive Chest Wall Disorders

Hypoventilation Syndromes

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