Egyptian Journal of Bronchology最新文献

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Comparing frequencies of asthma-chronic obstructive pulmonary disease overlap in patients with stable chronic obstructive pulmonary disease 稳定期慢性阻塞性肺病患者哮喘-慢性阻塞性肺疾病重叠频率的比较
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-07-01 DOI: 10.4103/ejb.ejb_1_19
Nezar R. Mohamed, M. Abd El Hakim, Z. Saeed, R. Helmy
{"title":"Comparing frequencies of asthma-chronic obstructive pulmonary disease overlap in patients with stable chronic obstructive pulmonary disease","authors":"Nezar R. Mohamed, M. Abd El Hakim, Z. Saeed, R. Helmy","doi":"10.4103/ejb.ejb_1_19","DOIUrl":"https://doi.org/10.4103/ejb.ejb_1_19","url":null,"abstract":"Context Asthma and chronic obstructive pulmonary disease (COPD) may share some physiological features and coexist as asthma-chronic obstructive pulmonary disease overlap (ACO). The prevalence of ACO differs according to the diagnostic criteria and study design. In patients with COPD, the prevalence of ACO varies from 5 to 55%. This study aims to examine the effect of using different diagnostic criteria on the resulting frequency of ACO in patients with COPD. Settings and design This cross-sectional observational study enrolled 60 patients with COPD randomly selected from outpatient clinics of Chest Department of Minia Cardio-Thoracic University Hospital during the period from September 2015 to September 2016. Patients and methods History, clinical examination, spirometry, and sputum cytology were done. The frequency of ACO among the 60 patients with stable COPD was separately studied based on five different diagnostic criteria (Hardin’s, Menezes, combined Hardin and Menezes, Spanish consensus, and Global Initiative for Asthma-Global Initiative for Chronic Obstructive Lung Disease criteria). Statistical analysis Statistical analysis was performed using statistical package for social science software (χ2 test and independent sample t test). Results The frequency of ACO in COPD was 40, 23.3, 16.7, 13.3, and 10% on applying combined Hardin and Menezes, Hardin’s alone, Menezes alone, the Spanish consensus, and Global Initiative for Asthma-Global Initiative for Chronic Obstructive Lung Disease criteria, respectively. Conclusion The frequency of ACO in patients with COPD decreases when using more restrictive diagnostic criteria.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44620464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endoscopic transbronchial needle aspiration in sampling mediastinal lesions 内镜下经支气管针抽吸纵隔病变
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-07-01 DOI: 10.4103/ejb.ejb_96_18
M. Ibrahim, Aida M. Yousef, M. Hantera, Magda Ahmed, S. A. Abd-Elhafez
{"title":"Endoscopic transbronchial needle aspiration in sampling mediastinal lesions","authors":"M. Ibrahim, Aida M. Yousef, M. Hantera, Magda Ahmed, S. A. Abd-Elhafez","doi":"10.4103/ejb.ejb_96_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_96_18","url":null,"abstract":"Context Endoscopy plays an integral part in the evaluation of mediastinum. Transbronchial sampling can be done conventionally or guided with endobronchial ultrasonography (EBUS), which is a new tool that allows seeing beyond the airway. Following its invention, the use of conventional sampling has declined. Aims To evaluate the efficacy of EBUS-transbronchial needle aspiration (TBNA) in sampling mediastinal lesions after conventionally negative TBNA result and to compare EBUS-TBNA sampling in subcarinal and hilar sites versus paratracheal sites regarding diagnostic yield. Settings and design A prospective evaluation study was done. Patients and methods The study enrolled 52 patients with undiagnosed mediastinal lymphadenopathy or lesions. Subcarinal lesions were sampled by both conventional TBNA and EBUS-TBNA sampling (after negative conventional sampling results), and paratracheal lesions were sampled only with EBUS. Statistical analysis used Data were analyzed to test statistical significant difference between groups. Quantitative data were presented as mean±SD, and Student t test was used to compare between two groups. Results No complications were reported. Conventional subcarinal TBNA sampling was done in 37 cases, where sufficient sampling was seen in 67.6% of cases, was diagnostic in 16.2% and had sensitivity of 20%. EBUS-TBNA was done in 22 cases after negative conventional sampling result, and in additional 15 cases as an initial procedure during the study. EBUS diagnosed 89.2% of cases, with sensitivity of 97.1%. Diagnostic percent in EBUS targeting subcarinal/hilar sites was 81.8% whereas was 100% in paratracheal EBUS sampling. Conclusion Both modalities of sampling are safe. Diagnostic value of EBUS-TBNA exceeded much more than conventional sampling.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43300323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effects of sedation on clinical, gasometric, and respiratory muscle parameters in critically ill chronic obstructive pulmonary disease patients 镇静对慢性阻塞性肺疾病危重症患者临床、胃肠测量和呼吸肌参数的影响
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-07-01 DOI: 10.4103/ejb.ejb_79_18
A. Alkarn, M. Abdelghany, Mohammad Khalaf, E. Kamel, Wafaa Gadalla
{"title":"Effects of sedation on clinical, gasometric, and respiratory muscle parameters in critically ill chronic obstructive pulmonary disease patients","authors":"A. Alkarn, M. Abdelghany, Mohammad Khalaf, E. Kamel, Wafaa Gadalla","doi":"10.4103/ejb.ejb_79_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_79_18","url":null,"abstract":"Background Severe chronic obstructive pulmonary disease (COPD) exacerbation requiring mechanical ventilation is commonly encountered in the ICU. Sedation is necessary to facilitate mechanical ventilation. The effect of no-sedation strategy on different patient parameters on the ventilator has not yet been well studied. The aim of this study was to test the efficacy of no-sedation protocol in controlling COPD patient’s gasometric and clinical parameters during mechanical ventilation. Patients and methods Patients with COPD who required mechanical ventilation were randomized to either: sedated with daily interruption (control group) (n=50) or nonsedated group (n=47). The change in the partial pressure of arterial CO2 (PaCO2) was the primary outcome measure. Secondary outcome measures included: changes in pH, heart rate (HR), mean arterial blood pressure (MAP), respiratory rate, airway occlusion pressure (P0.1), and negative inspiratory force (NIF). Recordings for arterial blood gases, HR, MAP, and respiratory rate were performed as baseline at intubation, 1, 2, 12, 24, and 48 h after intubation. NIF and P0.1 were recorded 48 h after intubation. Results No significant difference was found in baseline recordings of PaCO2, pH, HR, MAP, and respiratory rate between the sedated and nonsedated groups. Further recordings of PaCO2 (P_1, P_2, P_3, and P_4<0.001, P_5=0.005), HR (P<0.001), and respiratory rate (P<0.001) were significantly higher in the nonsedated group. The rate of correction of pH from acidosis was faster among the sedated patients. MAP was significantly higher in nonsedated patients in recordings 2, 12, and 48 h after intubation (P_1=0.9, P_2<0.001, P_3<0.001, P_4=0.87, P_5<0.001). No significant difference was found in NIF or P0.1 between the two groups (P=0.8 and 0.1, respectively). Conclusion COPD patients managed by no-sedation strategy had higher PaCO2, HR, MAP, and respiratory rate. No-sedation had no significant effect on respiratory muscle function when compared with daily interruption of sedation.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46085599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Comparison of methods to quantitate spontaneous pneumothorax - A study from a tertiary care hospital 三级甲等医院自发性肺气肿定量方法的比较研究
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-07-01 DOI: 10.4103/ejb.ejb_93_18
U. Devaraj, P. Ramachandran, U. Krishnaswamy, N. Sinha, G. D'Souza
{"title":"Comparison of methods to quantitate spontaneous pneumothorax - A study from a tertiary care hospital","authors":"U. Devaraj, P. Ramachandran, U. Krishnaswamy, N. Sinha, G. D'Souza","doi":"10.4103/ejb.ejb_93_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_93_18","url":null,"abstract":"Background Pneumothorax can present as a respiratory emergency and has varied etiology. However, literature available on assessment and management of primary spontaneous pneumothorax (PSP) based on radiological quantitation is scarce. This study was undertaken to compare two different methods of quantitating pneumothorax size with that recommended in American Thoracic Society (ATS) guideline on chest radiogram with respect to possible change in management practices. Patients and methods A prospective cohort of adults presenting with spontaneous pneumothorax (SP) over 3 years to Emergency and Pulmonology Department, St John’s Medical College Hospital, Bangalore, was included. Demographic characteristics and clinical presentation were compiled. Management of SP was based on ATS guidelines. PSP size on chest radiogram was requantitated in the included patients using Light’s index and Collin’s method and was compared with that proposed by the ATS guideline. Results Seventy-six participants with SP were studied; their mean age was 43.7 years, with a preponderance of male patients (84.2%). Twenty-four (31.6%) patients had PSP and 52 (68.4%) patients had secondary spontaneous pneumothorax. In PSP, there was poor agreement between various methods of estimating size of pneumothorax on chest radiogram (Kappa statistic=0.23; ICC of 0.263). Three (12.5%) of the 24 incidences of PSP, which were treated conservatively as per ATS guidelines, would have required invasive intervention if Light’s index or the Collin’s formula were taken into consideration. Conclusion There was poor agreement of radiological pneumothorax size estimation by Collin’s, Light’s, and that proposed in the ATS guidelines. Thus, a unified, standardized method of radiological assessment of PSP is required.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47633694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predictors of spontaneous breathing outcome in mechanically ventilated chronic obstructive pulmonary disease patients 机械通气慢性阻塞性肺病患者自主呼吸结果的预测因素
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-07-01 DOI: 10.4103/ejb.ejb_81_18
S. Sayed, Aliae Mohammed Hussein, Waleed Elddin Khaleel
{"title":"Predictors of spontaneous breathing outcome in mechanically ventilated chronic obstructive pulmonary disease patients","authors":"S. Sayed, Aliae Mohammed Hussein, Waleed Elddin Khaleel","doi":"10.4103/ejb.ejb_81_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_81_18","url":null,"abstract":"Background Morbidity and mortality due to chronic obstructive pulmonary disease (COPD) represents a worldwide pandemic, with exacerbations necessitating mechanical ventilation representing important aspects of disease management. Attempts to search for better weaning indices (WIs) is a continuous process. This study seeks for best index predicting weaning outcome in COPD patients. Patients and methods 2One hundred and fifty COPD patients (110 men, 40 women) receiving mechanical ventilation were included in this study. Weaning process as early as possible was considered. Patients who were receiving mechanical ventilation of more than 24 h underwent daily screen of subjective and objective indices for weaning readiness. Measurements done on admission and through weaning process included: acute physiology and chronic health evaluation II score, simplified acute physiology score II, CORE (compliance, oxygenation, respiration, and effort) index, rapid shallow breathing index (RSBI), WI, integrative weaning index (IWI), compliance, rate, oxygenation, and pressure (CROP) index and P0.1/negative inspiratory force index. Results There is a highly significant difference between weaning success and failure groups regarding the CORE index, RSBI, WI, IWI, CROP index, and P0.1/negative inspiratory force. CORE index had the highest area under the curve (0.929) which was significantly higher than other indices included in the study. Conclusion RSBI, WI, IWI, and CROP index displayed moderate accuracy in predicting spontaneous breathing trial success in COPD patients. CORE index showed better diagnostic performance in predicting successful weaning and had the highest accuracy.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41406135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
B-type natriuretic peptide as a predictor of severity in admitted patients with acute exacerbation of COPD b型利钠肽作为住院COPD急性加重患者严重程度的预测因子
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-07-01 DOI: 10.4103/ejb.ejb_90_18
Nasser Abdelnaby, H. Shabana, Waleed R. Arafat
{"title":"B-type natriuretic peptide as a predictor of severity in admitted patients with acute exacerbation of COPD","authors":"Nasser Abdelnaby, H. Shabana, Waleed R. Arafat","doi":"10.4103/ejb.ejb_90_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_90_18","url":null,"abstract":"Background patients with acute AECOPD show an abrupt worsening of baseline ventricular function and pulmonary hypertension, using clear predictors or markers for severity in such patients is critical to be early stratified and properly managed. Aim Assess the value of BNP as A predictor for severity in patients with AECOPD represented by need for intensive care admission, invasive and non-invasive mechanical ventilation, pulmonary hypertension, hospital and 3 months mortality. Study design Prospective study Methods A prospective Cohort study in tertiary level hospital conducted on 88 patients with AECOPD and 88 healthy control subjects, patients were divided into 2 subgroups: ICU admitted and ward admitted Patient were subjected to clinical, electrocardiographic, radiological and laboratory evaluation and observation of the clinical course during admission and 3 months following hospital discharge. Results The study revealed higher BNP in AECOPD patients compared with healthy control subjects and in ICU admitted compared with ward patients (P, 0.001). positive correlation with age, smoking index, Paco2, SPAP, RVD, need for ICU ,IMV, hospital stay and overall Mortality (r.coefficient: 0.398, 0.533, 0.605, 0.635, 0.732, -0.617, 0.577, 0.728 0.030, respectivly) ,we revealed negative correlation with ABGs parameters (Pao2, PH and o2 saturation), with r. coefficient of (-0.616, -0.609, -0.630, respectively), linear regression revelled that BNP is significant predictors for ICU admission ,ROC curve revealed that BNP more than 425pg/ml had sensitivity , specificity of (70.8% and, 100%) to predict need for ICU admission. Conclusion BNP may be considered as an accessible, useful, non-invasive and low-cost marker of severity COPD exacerbations.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42628226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Role of telomerase expression in interstitial lung diseases 端粒酶表达在肺间质性疾病中的作用
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-07-01 DOI: 10.4103/ejb.ejb_71_18
M. Shaban, R. Elhefny, S. Hussein, A. Badr, Zeinab A. Nour
{"title":"Role of telomerase expression in interstitial lung diseases","authors":"M. Shaban, R. Elhefny, S. Hussein, A. Badr, Zeinab A. Nour","doi":"10.4103/ejb.ejb_71_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_71_18","url":null,"abstract":"Background Telomeres are hexameric nucleotide sequences. The biological role of telomeres is to prevent shortening of DNA to preserve integrity of the genome. Length of telomeres is determined by age, sex, and environmental exposures. Telomeres are vulnerable to injury by oxidative stress. Telomere length is sustained by telomerase, a ribonucleoprotein telomerase reverse transcriptase (TERT). Telomerase may help cell growth and secure against cell death. ‘Telomeropathy’ is associated with genetic mutations. The most common phenotype related to telomerase mutation is pulmonary fibrosis. Objective To investigate the associations of both TERT and telomerase RNA component C with disease progression in patients with interstitial lung diseases (ILDs), which include idiopathic pulmonary fibrosis (IPF), and to compare results between patients with ILD and control. Patients and methods A total of 46 patients with different types of ILDs were enrolled as well as 15 healthy persons as control. Whole blood sample was obtained from both patients and healthy control for detection of expression of telomerase gene by quantitative real-time PCR. Results There was a significant negative correlation between telomerase reverse transcriptase (h-TERT) and partial pressure of oxygen (r=−23, P=0.03). Both h-TERT and telomerase reverse transcriptaseRNA component (h-TERC) were relatively more expressed in patients with IPF with pulmonary hypertension, whereas there was a significant elevation of h-TERT relative expression in patients with IPF with honeycombing high-resolution computed tomography pattern in comparison with those with reticulonodular pattern, with median of 0.85 versus 0.29, respectively. Conclusion Hypoxia may affect DNA damage in the telomere region. Expression of telomerase may take part in pulmonary fibrosis. Exposure to hypoxia or growth factors can stimulate the expression of telomerase on cells of vascular smooth muscle.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48686463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Implementation of bronchoscopic conventional transbronchial needle aspiration service in a tertiary care chest hospital 支气管镜常规经支气管针吸服务在某三级胸科医院的实施
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-07-01 DOI: 10.4103/ejb.ejb_95_18
M. Farrag, Gehan El Assal, Ashraf Madkour, N. Osman, Manar H. Taha
{"title":"Implementation of bronchoscopic conventional transbronchial needle aspiration service in a tertiary care chest hospital","authors":"M. Farrag, Gehan El Assal, Ashraf Madkour, N. Osman, Manar H. Taha","doi":"10.4103/ejb.ejb_95_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_95_18","url":null,"abstract":"Background Conventional transbronchial needle aspiration (C-TBNA) is a unique technique that allows the sampling tissue from beyond the endobronchial tree, such as enlarged lymph nodes, peribronchial, or submucosal lesions. However, it remains underutilized and even unavailable in many countries and centers around the world including Egypt. Objective This study aimed to implement bronchoscopic C-TBNA service in a tertiary care chest hospital with special emphasis on the diagnostic yield, complications encountered, and learning experience. Patients and methods This cohort study was conducted on 60 patients with bronchoscopic nonvisible extraluminal lesions who have sought bronchoscopic C-TBNA service at the Bronchoscopy Unit of both Ain Shams University Hospital and Giza Chest Hospital during the period from June 2016 to February 2018. Results The overall C-TBNA had a diagnostic yield of 88.3% in which 68.3% were malignant and 20% had sarcoidosis without serious complications recorded except for minor non-life-threatening bleeding in 21.7% of cases. After 6 months of C-TBNA learning experience, the diagnostic yield showed improvement in physicians without previous C-TBNA experience, but without reaching a statistical significance. Also, there were significant reduction in both duration and complications of C-TBNA. Conclusion Implementing C-TBNA service in a tertiary care chest hospital in bronchoscopically nonvisible extraluminal lesions seems to be a safe, easy technique with high diagnostic yield and its learning performance was able to be improved over time.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45582575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Assessment of diaphragmatic mobility by chest ultrasound in patients with chronic obstructive pulmonary disease on different modes of mechanical ventilation 不同机械通气模式下慢性阻塞性肺疾病患者膈肌活动度的胸部超声评价
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-06-01 DOI: 10.4103/ejb.ejb_99_18
Adel A. M. Saeed, Ashraf El Maraghy, R. Raafat, Ahmed Abd Elsamad
{"title":"Assessment of diaphragmatic mobility by chest ultrasound in patients with chronic obstructive pulmonary disease on different modes of mechanical ventilation","authors":"Adel A. M. Saeed, Ashraf El Maraghy, R. Raafat, Ahmed Abd Elsamad","doi":"10.4103/ejb.ejb_99_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_99_18","url":null,"abstract":"Background Chronic obstructive pulmonary disease (COPD) is a disease characterized by airway obstruction and air trapping that is not fully reversible. The diaphragm is the principal respiratory muscle, and its dysfunction can prolong the duration of mechanical ventilation. Ultrasonography is a fast, easy, and accurate method of bedside evaluation for diaphragmatic function. In the ICU population, it can quantify normal and abnormal movements in a variety of clinical conditions. Patients and methods A prospective observational study was carried on 32 patients with COPD admitted to the respiratory ICU. Diaphragmatic excursion had been assessed by chest ultrasonography in every mode of mechanical ventilation and was correlated with weaning off mechanical ventilation and other physiological parameters. Results Of 32 patients with COPD included in the study, 24 patients were successfully weaned versus eight patients failed to be weaned off mechanical ventilation. Diaphragmatic excursions in every mode of mechanical ventilation (noninvasive, volume control, bilevel positive airway pressure, and pressure support) were higher in weaned patients with best cutoff values of 1.4, 1.3, 1.5, and 1.6 cm, respectively. Moreover, the diaphragmatic excursions were directly correlated with tidal volumes and inversely correlated with days of mechanical ventilation and rapid shallow breathing index. Conclusion Diaphragmatic displacement assessed by ultrasound is a good predictor for weaning off mechanical ventilation in patients with COPD, as it is sensitive, specific, and accurate. Diaphragmatic excursions are directly related to tidal volumes and inversely related with rapid shallow breathing index and days of mechanical ventilation.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48915404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Fayoum experience in the ultrasonographic evaluation of diffuse parenchymal lung disease 法尤姆在弥漫性肺实质疾病超声诊断中的经验
IF 1.3
Egyptian Journal of Bronchology Pub Date : 2019-05-17 DOI: 10.4103/ejb.ejb_54_18
Sherif Refaat El Fatah, R. Elhefny, R. Ahmed, Doaa Mohamed El Tawab
{"title":"Fayoum experience in the ultrasonographic evaluation of diffuse parenchymal lung disease","authors":"Sherif Refaat El Fatah, R. Elhefny, R. Ahmed, Doaa Mohamed El Tawab","doi":"10.4103/ejb.ejb_54_18","DOIUrl":"https://doi.org/10.4103/ejb.ejb_54_18","url":null,"abstract":"Objective Chest ultrasound has many uses, both diagnostic and interventional. It may be used for the diagnosis of multiple pleural diseases (pleural effusion, pleural masses, and pneumothorax). It is also used in the diagnosis of diseases caused by lung parenchymal lesions, such as neoplasms, pulmonary embolism, pneumonia, and lung abscesses. Aim This study aimed to evaluate the sonographic features of diffuse parenchymal lung disease (DPLD). Design This was a prospective study. Setting The study was carried out at Fayoum University Hospital in Egypt during the period spanning from January 2017 to June 2017. Patients and methods This study included 120 participants. Sixty of them were diagnosed as having DPLD. For the diagnosis of these cases, we need a full medical history, a detailed clinical examination, spirometry, 6 min walk test, arterial blood gases’ analysis, high-resolution computed tomography, and chest ultrasound. The other 60 were studied as controls. Statistical analysis The data were collected and coded to facilitate data manipulation, and they were double entered into Microsoft Access; the data analysis was performed by using SPSS software, version 18 in Windows 7. The simple descriptive analysis was carried out in the form of numbers and percentages for qualitative data and arithmetic means as central tendency measurement, SDs as measure of dispersion for the quantitative parametric data and the inferential statistic test. Results There was a female predominance with a wide range of age. Most of the cases were nonsmokers, breeding birds, and exposed to biomass. All cases had diffuse bilateral B-lines. There was a negative relation between the Warrick score on the one hand and the B-line number, PaO2, 6 min walk test, and forced vital capacity on the other hand. In contrast, a positive relation was demonstrated between the Warrick score and B-line distance and pleural thickness. Most of the studied patients (71.6%) had irregular and thickened pleura and (51.6%) had an abolished lung sliding. Conclusion Chest ultrasound has a significant role in the diagnosis of DPLD and also in estimating the severity of the disease according to the number and the distance between B-lines. Multiple B-lines in the combination of thickened and irregular pleural line are highly suggestive of DPLD.","PeriodicalId":34128,"journal":{"name":"Egyptian Journal of Bronchology","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2019-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45721243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
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