Journal of Clinical Respiratory Diseases & Care: Open Access

Background: Long-term oxygen therapy, including ambulatory oxygen, has been widely used for patients with COPD having chronic respiratory failure. However, factors important for selecting suitable carriers of ambulatory oxygen, such as a cylinder cart or backpack, remain unclear for patients with moderate-to-severe COPD. Methods: Twelve patients with moderate-to-severe COPD (mean age, 69.6 ± 7.3 years) performed a six-minute walk test (6MWT) with a cylinder cart and backpack in random order. The parameters of 6MWT with each carrier, pulmonary function test results, and a questionnaire about the preference of each carrier after 6MWTs were analyzed. Results: The Δ distance (distance walked with a backpack - that waked with a cylinder cart) positively correlated with FEV1 (r=0.678, P=0.02) and lung diffusing capacity for carbon monoxide (DLCO) (r=0.606, P=0.048). Patients who could walk longer with a backpack were significantly higher in FEV1 (1.3 ± 0.8 vs. 0.8 ± 0.1 L, P=0.040) and DLCO (13.6 ± 2.1 vs. 8.2 ± 3.3 ml/min/mmHg, P=0.02) than those who walked longer with a cylinder cart. Additionally, patients who could walk longer with a backpack showed a lower maximum pulse rate and pulse rate after 6MWT than those who walked longer with a cylinder cart. Further, patients who preferred a backpack were significantly higher in percentage of predicted FVC (%FVC; 94.4 ± 17.2 vs. 65.5 ± 11.6% P=0.02) and lower in residual volume (2.7 ± 0.8 vs. 4.0 ± 0.6 L, P=0.042) than those who preferred a cylinder cart. Conclusions: FEV1, DLCO, and pulse rate during and/or after 6MWT can be important factors in the selection of proper ambulatory oxygen transport carriers for greater exercise capacity in patients with COPD having chronic respiratory failure.

NIV is a form of ventilation which provides ventilator support through the patient's upper airways using a mask or other appropriate device. NIV is an effective treatment for patients with severe COPD. The beneficial effects of NIV have been particularly apparent in patients with acute hypercapnic respiratory failure (AHRF). BiPAP (Figure 1) and CPAP are the most common types of ventilators used in NIV, along with nasal masks and full-face masks.

Objective: To determine the presence of acute myocardial dysfunction in status asthmaticus. Methodology: Prospective studies were included acute severe asthma patients admitted to intensive care from January 2008 to September 2013. We included a control group with healthy athletes subjected to stress by "bench press n=20-" and "combat karate for 15 minutes, n=14-", SC2000-2013 Siemens Echocardiography was available in the gym. Cardiac stress response of asthmatic patients and athletes was evaluated by echocardiography. An off-line analysis by 3D Image and hybrid speckle tracking was performed. We performed analysis by means of using ANOVA test. Results: 32 asthmatic patients (11 males) were included, with a median age of 31 (17-40 years). The age of the controls was 33.45 ± 0.9 years. The left ventricular ejection fraction was similar although septum and anterolateral segment presented segmental alterations in all acute asthmatics patients evidenced by strain and strain rate. Acute asthmatics patients had lower strain, lower velocities, less displacements, and more asynchrony versus controls. Conclusions: Acute asthmatics patients were complicated with a myocardial dysfunction detected by speckle tracking. This tool could be useful for the proper diagnosis of critically ill patients.

A 34-year-old lady presented with history suggestive of bronchial asthma & allergic rhinosinusitis. Computerized tomogram (CT) of thorax showed nodular calcification of trachea with sparing of the posterior wall. CT paranasal sinus revealed sinusitis with bone destruction. Bronchoscopy and bronchial biopsy was consistent with the diagnosis of tracheobronchopathia osteochondroplastica (TPO). Diagnosis of atrophic rhino sinusitis was established based on the diagnostic criteria. Sinobronchial symptoms have been described in TPO, but destruction of sinus due to atrophic rhinosinusitis has not been reported.