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Abnormal control of ventilation in high-altitude pulmonary edema.

https://arctichealth.org/en/permalink/ahliterature3383
Source
J Appl Physiol. 1988 Mar;64(3):1268-72
Publication Type
Article
Date
Mar-1988
Author
P H Hackett
R C Roach
R B Schoene
G L Harrison
W J Mills
Author Affiliation
Denali Medical Research Project, Center for High Latitude Health Research, University of Alaska, Anchorage 99508.
Source
J Appl Physiol. 1988 Mar;64(3):1268-72
Date
Mar-1988
Language
English
Publication Type
Article
Keywords
Adult
Altitude
Anoxemia - physiopathology
Anoxia - physiopathology
Female
Humans
Male
Oxygen - metabolism
Oxygen Inhalation Therapy
Pulmonary Edema - physiopathology - therapy
Respiration
Abstract
We wished to determine the role of hypoxic chemosensitivity in high-altitude pulmonary edema (HAPE) by studying persons when ill and upon recovery. We studied seven males with HAPE and seventeen controls at 4,400 m on Mt. McKinley. We measured ventilatory responses to both O2 breathing and progressive poikilocapnic hypoxia. Hypoxic ventilatory response (HVR) was described by the slope relating minute ventilation to percent arterial O2 saturation (delta VE/delta SaO2%). HAPE subjects were quite hypoxemic (SaO2% 59 +/- 6 vs. 85 +/- 1, P less than 0.01) and showed a high-frequency, low-tidal-volume pattern of breathing. O2 decreased ventilation in controls (-20%, P less than 0.01) but not in HAPE subjects. The HAPE group had low HVR values (0.15 +/- 0.07 vs. 0.54 +/- 0.08, P less than 0.01), although six controls had values in the same range. The three HAPE subjects with the lowest HVR values were the most hypoxemic and had a paradoxical increase in ventilation when breathing O2. We conclude that a low HVR plays a permissive rather than causative role in the pathogenesis of HAPE and that the combination of extreme hypoxemia and low HVR may result in hypoxic depression of ventilation.
PubMed ID
3366741 View in PubMed
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Appropriateness of domiciliary oxygen delivery.

https://arctichealth.org/en/permalink/ahliterature196579
Source
Chest. 2000 Nov;118(5):1303-8
Publication Type
Article
Date
Nov-2000
Author
G H Guyatt
D A McKim
P. Austin
R. Bryan
J. Norgren
B. Weaver
R S Goldstein
Author Affiliation
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Source
Chest. 2000 Nov;118(5):1303-8
Date
Nov-2000
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Carbon Dioxide - blood
Confidence Intervals
Cross-Sectional Studies
Exercise Test
Female
Forced Expiratory Volume - physiology
Home Care Services, Hospital-Based
Humans
Logistic Models
Lung Diseases, Obstructive - physiopathology - therapy
Male
Ontario
Oxygen - administration & dosage - blood
Oxygen Consumption - physiology
Oxygen Inhalation Therapy
Patient Selection
Physical Exertion - physiology
Questionnaires
Referral and Consultation
Respiratory Therapy
Rest - physiology
Abstract
Almost every country in the developed world has a domiciliary oxygen program. Whether recipients meet program criteria has not been rigorously studied.
Cross-sectional survey.
Two hundred thirty-seven patients receiving domiciliary oxygen in the Ontario Ministry of Health Home Oxygen Program (HOP).
A respiratory therapist visited the patients' homes and administered questionnaires, obtained resting arterial blood gas measurements, and conducted a standardized home exercise test while monitoring oxygen saturation using an oximeter.
We evaluated the extent to which patients met HOP criteria that are based on the inclusion criteria of randomized trials showing the life-prolonging effects of domiciliary oxygen. We also assessed the extent to which the patients' oxygen prescription was consistent with the results of rest and exercise testing.
Ninety-six of 237 participants (40.5%; 95% confidence interval, 34.3 to 46.8) did not meet criteria for home oxygen. Patients aged 70 years old (70 of 132 patients; 53.0%). The proportion of patients meeting criteria was similar whether the referring physician was a specialist (71 of 112 patients; 62.5%) or a primary-care physician (69 of 123 patients; 56. 1%). A very important health benefit from oxygen was identified among 82% of those who met criteria and 88% of those who did not. Patients received higher flow rates than our criteria suggested were appropriate. Agreement between the independently assessed oxygen prescription at rest and the patients' report of oxygen use was extremely poor (chance-corrected agreement [kappa], 0.17), as was agreement concerning optimal exercise flow rates (kappa, 0.26).
Current procedures for administration and reimbursement of home oxygen result in a large proportion of recipients not meeting criteria, as well as the prescription of excessive oxygen flow rates. These results are likely to apply to many jurisdictions and suggest a large potential for more efficient resource allocation.
Notes
Comment In: Chest. 2001 Jul;120(1):318-911451861
PubMed ID
11083678 View in PubMed
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[Are there any cost-benefit limits in connection with neonatal care?]

https://arctichealth.org/en/permalink/ahliterature58555
Source
Lakartidningen. 2002 Jan 17;99(3):208
Publication Type
Article
Date
Jan-17-2002

Asthma. Assessment and management in a pediatric hospital.

https://arctichealth.org/en/permalink/ahliterature221319
Source
Can Fam Physician. 1993 Apr;39:793-8
Publication Type
Article
Date
Apr-1993
Author
B D Lyttle
A M Hollestelle
Author Affiliation
Department of Paediatric Pulmonary, Children's Hospital of Western Ontario, University of Western Ontario, London.
Source
Can Fam Physician. 1993 Apr;39:793-8
Date
Apr-1993
Language
English
Publication Type
Article
Keywords
Acute Disease
Albuterol - therapeutic use
Asthma - diagnosis - therapy
Canada
Child
Child, Preschool
Emergency Medicine - methods - statistics & numerical data
Emergency Service, Hospital - statistics & numerical data - utilization
Female
Hospitals, Pediatric
Humans
Length of Stay - statistics & numerical data
Male
Medical Audit
Medical History Taking
Oxygen Inhalation Therapy - utilization
Patient Admission - statistics & numerical data
Patient Readmission - statistics & numerical data
Pediatrics - methods - statistics & numerical data
Physical Examination
Physician's Practice Patterns
Prednisone - therapeutic use
Random Allocation
Recurrence
Retrospective Studies
Abstract
To evaluate the method used to assess and subsequently manage children with asthma, a retrospective chart review was carried out at the Children's Hospital of Western Ontario in London. Charts of 78 children diagnosed with asthma were randomly selected from emergency room daily records and inpatient files. Pharmacologic management of acute asthma proved adequate, but children with daily asthma symptoms likely would not have been identified or treated.
Notes
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PubMed ID
8495137 View in PubMed
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Asthma, lung function and allergy in 12-year-old children with very low birth weight: a prospective study.

https://arctichealth.org/en/permalink/ahliterature15260
Source
Pediatr Allergy Immunol. 2003 Jun;14(3):184-92
Publication Type
Article
Date
Jun-2003
Author
Xiao-Mei Mai
Per-Olof Gäddlin
Lennart Nilsson
Orvar Finnström
Bengt Björkstén
Maria C Jenmalm
Ingemar Leijon
Author Affiliation
Department of Molecular and Clinical Medicine, Division of Paediatrics, Linköping University, Linköping, Sweden. xiama@imk.liu.se
Source
Pediatr Allergy Immunol. 2003 Jun;14(3):184-92
Date
Jun-2003
Language
English
Publication Type
Article
Keywords
Asthma - etiology - physiopathology
Bronchopulmonary Dysplasia - complications - physiopathology
Child
Dermatitis, Atopic - etiology - physiopathology
Humans
Infant, Newborn
Infant, Very Low Birth Weight
Oxygen Inhalation Therapy
Prevalence
Prospective Studies
Questionnaires
Research Support, Non-U.S. Gov't
Risk factors
Skin Tests
Spirometry
Sweden
Abstract
We assessed the relationship between very low birth weight (VLBW) (or= 9 days was the only remaining significant risk factor for a history of asthma (adjusted OR 6.7, 95%CI 1.0-44). The VLBW children who required mechanical ventilation during the neonatal period were more likely to have bronchial hyperresponsiveness than those not requiring mechanical ventilation (60% vs. 28%, p = 0.050). The spirometric values were similar among the VLBW and the term children at 12 years. Very low birth weight was not significantly related to allergic rhinoconjunctivitis, eczema or positive skin prick tests. Furthermore, the levels of IL-4, IL-5 and IFN-gamma in stimulated cell cultures were similar in the VLBW and the term children. A history of asthma by 12 years of age was twice as common among the VLBW as the term children, and neonatal oxygen supplementation seemed to be associated with the increased risk. Furthermore, mechanical ventilation during the neonatal period was associated with bronchial hyperresponsiveness at age 12. Very low birth weight per se was not, however, related to atopy.
PubMed ID
12787297 View in PubMed
Less detail
Source
Duodecim. 2012;128(24):2556-61
Publication Type
Article
Date
2012
Author
Vesa Eskola
Matti Korppi
Author Affiliation
Tampereen yliopistosairaala, lastenklinikka.
Source
Duodecim. 2012;128(24):2556-61
Date
2012
Language
Finnish
Publication Type
Article
Keywords
Bronchiolitis - diagnosis - epidemiology - therapy
Bronchopulmonary Dysplasia - complications - epidemiology
Finland - epidemiology
Humans
Infant
Infant, Newborn
Infant, Premature
Intensive Care
Oxygen Inhalation Therapy
Risk factors
Abstract
Bronchiolitis is the most common disease leading to hospitalization of infants of less than one year of age in Finland. Among each age group, the disease needs hospitalization in approx. 3% of the cases. Patients of less than one month of age and formerly premature infants, especially those having bronchopulmonary dysplasia, require intensive care. Monitoring of oxygenation and administration of supplemental oxygen are the cornerstones of the treatment. When required, inhalations of racemic epinephrine are given for severe symptoms. The authors' treatment practice for bronchiolitis is presented in this article.
PubMed ID
23393929 View in PubMed
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Burn injury during long-term oxygen therapy in Denmark and Sweden: the potential role of smoking.

https://arctichealth.org/en/permalink/ahliterature286298
Source
Int J Chron Obstruct Pulmon Dis. 2017;12:193-197
Publication Type
Article
Date
2017
Author
Hanan A Tanash
Thomas Ringbaek
Fredrik Huss
Magnus Ekström
Source
Int J Chron Obstruct Pulmon Dis. 2017;12:193-197
Date
2017
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Burns - diagnosis - epidemiology - mortality
Denmark - epidemiology
Female
Humans
Hypoxia - diagnosis - mortality - physiopathology - therapy
Incidence
Male
Middle Aged
Multivariate Analysis
Oxygen Inhalation Therapy - adverse effects - contraindications - mortality
Proportional Hazards Models
Prospective Studies
Pulmonary Disease, Chronic Obstructive - diagnosis - mortality - physiopathology - therapy
Registries
Risk assessment
Risk factors
Severity of Illness Index
Smoking - adverse effects - epidemiology - mortality
Sweden - epidemiology
Young Adult
Abstract
Long-term oxygen therapy (LTOT) increases life expectancy in patients with COPD and severe hypoxemia. Smoking is the main cause of burn injury during LTOT. Policy regarding smoking while on LTOT varies between countries. In this study, we compare the incidence of burn injury that required contact with a health care specialist, between Sweden (a country with a strict policy regarding smoking while on LTOT) and Denmark (a country with less strict smoking policy).
This was a population-based, cohort study of patients initiating LTOT due to any cause in Sweden and Denmark. Data on diagnoses, external causes, and procedures were obtained from the Swedish and Danish National Patient Registers for inpatient and outpatient care. Patients were followed from January 1, 2000, until the first of the following: LTOT withdrawal, death, or study end (December 31, 2009). The primary end point was burn injury during LTOT.
A total of 23,741 patients received LTOT in Denmark and 7,754 patients in Sweden. Most patients started LTOT due to COPD, both in Sweden (74%) and in Denmark (62%). The rate of burn injury while on LTOT was higher in Denmark than in Sweden; 170 (95% confidence interval [CI], 126-225) vs 85 (95% CI, 44-148) per 100,000 person-years; rate ratio 2.0 (95% CI, 1.0-4.1). The risk remained higher after adjustment for gender, age, and diagnosis in multivariate Cox regression, hazard ratio 1.8 (95% CI, 1.0-3.5). Thirty-day mortality after burn injury was 8% in both countries.
Compared to Sweden, the rate of burn injury was twice as high in Denmark where smoking is not a contraindication for prescribing LTOT.
Notes
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PubMed ID
28123292 View in PubMed
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Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease - 2007 update.

https://arctichealth.org/en/permalink/ahliterature160182
Source
Can Respir J. 2007 Sep;14 Suppl B:5B-32B
Publication Type
Article
Date
Sep-2007
Author
Denis E O'Donnell
Shaw Aaron
Jean Bourbeau
Paul Hernandez
Darcy D Marciniuk
Meyer Balter
Gordon Ford
Andre Gervais
Rogers Goldstein
Rick Hodder
Alan Kaplan
Sean Keenan
Yves Lacasse
Francois Maltais
Jeremy Road
Graeme Rocker
Don Sin
Tasmin Sinuff
Nha Voduc
Author Affiliation
Queen's University, Kingston, Canada.
Source
Can Respir J. 2007 Sep;14 Suppl B:5B-32B
Date
Sep-2007
Language
English
Publication Type
Article
Keywords
Adrenal Cortex Hormones - therapeutic use
Aged
Bronchodilator Agents - therapeutic use
Canada
Female
Humans
Male
Middle Aged
Oxygen Inhalation Therapy
Pulmonary Disease, Chronic Obstructive - drug therapy - rehabilitation - surgery
Smoking Cessation
Abstract
Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Canada that is both preventable and treatable. Our understanding of the pathophysiology of this complex condition continues to grow and our ability to offer effective treatment to those who suffer from it has improved considerably. The purpose of the present educational initiative of the Canadian Thoracic Society (CTS) is to provide up to date information on new developments in the field so that patients with this condition will receive optimal care that is firmly based on scientific evidence. Since the previous CTS management recommendations were published in 2003, a wealth of new scientific information has become available. The implications of this new knowledge with respect to optimal clinical care have been carefully considered by the CTS Panel and the conclusions are presented in the current document. Highlights of this update include new epidemiological information on mortality and prevalence of COPD, which charts its emergence as a major health problem for women; a new section on common comorbidities in COPD; an increased emphasis on the meaningful benefits of combined pharmacological and nonpharmacological therapies; and a new discussion on the prevention of acute exacerbations. A revised stratification system for severity of airway obstruction is proposed, together with other suggestions on how best to clinically evaluate individual patients with this complex disease. The results of the largest randomized clinical trial ever undertaken in COPD have recently been published, enabling the Panel to make evidence-based recommendations on the role of modern pharmacotherapy. The Panel hopes that these new practice guidelines, which reflect a rigorous analysis of the recent literature, will assist caregivers in the diagnosis and management of this common condition.
Notes
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PubMed ID
17885691 View in PubMed
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Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease - 2008 update - highlights for primary care.

https://arctichealth.org/en/permalink/ahliterature157884
Source
Can Respir J. 2008 Jan-Feb;15 Suppl A:1A-8A
Publication Type
Article
Author
Denis E O'Donnell
Paul Hernandez
Alan Kaplan
Shawn Aaron
Jean Bourbeau
Darcy Marciniuk
Meyer Balter
Gordon Ford
Andre Gervais
Yves Lacasse
Francois Maltais
Jeremy Road
Graeme Rocker
Don Sin
Tasmin Sinuff
Nha Voduc
Author Affiliation
Queen's University, Kingston, Canada. odonnell@queensu.ca
Source
Can Respir J. 2008 Jan-Feb;15 Suppl A:1A-8A
Language
English
Publication Type
Article
Keywords
Bronchodilator Agents - therapeutic use
Canada - epidemiology
Diagnosis, Differential
Humans
Oxygen Inhalation Therapy
Primary Health Care
Pulmonary Disease, Chronic Obstructive - diagnosis - epidemiology - physiopathology - therapy
Respiratory Function Tests
Smoking Cessation
Abstract
Chronic obstructive pulmonary disease (COPD) is a major respiratory illness in Canada that is preventable and treatable but unfortunately remains underdiagnosed. The purpose of the present article from the Canadian Thoracic Society is to provide up-to-date information so that patients with this condition receive optimal care that is firmly based on scientific evidence. Important summary messages for clinicians are derived from the more detailed Update publication and are highlighted throughout the document. Three key messages contained in the update are: use targeted screening spirometry to establish a diagnosis and initiate prompt management (including smoking cessation) of mild COPD; improve dyspnea and activity limitation in stable COPD using new evidence-based treatment algorithms; and understand the importance of preventing and managing acute exacerbations, particularly in moderate to severe disease.
Notes
Comment In: Can Respir J. 2008 May-Jun;15(4):219; author reply 21918666343
PubMed ID
18292855 View in PubMed
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Cardiovascular and antacid treatment and mortality in oxygen-dependent pulmonary fibrosis: A population-based longitudinal study.

https://arctichealth.org/en/permalink/ahliterature278251
Source
Respirology. 2016 May;21(4):705-11
Publication Type
Article
Date
May-2016
Author
Magnus Ekström
Anna Bornefalk-Hermansson
Source
Respirology. 2016 May;21(4):705-11
Date
May-2016
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Aged, 80 and over
Angiotensin Receptor Antagonists - therapeutic use
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Antacids - therapeutic use
Cardiovascular Diseases - drug therapy - epidemiology
Comorbidity
Diuretics - therapeutic use
Female
Gastroesophageal Reflux - drug therapy - epidemiology
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Longitudinal Studies
Male
Oxygen Inhalation Therapy
Platelet Aggregation Inhibitors - therapeutic use
Prognosis
Prospective Studies
Pulmonary Fibrosis - complications - mortality - therapy
Survival Rate
Sweden - epidemiology
Abstract
Severe idiopathic pulmonary fibrosis is associated with an increased risk of cardiovascular disease and gastro-oesophageal reflux, which may influence prognosis. We evaluated associations between cardiovascular and antacid medications, and mortality, in oxygen-dependent pulmonary fibrosis (PF) of unknown cause.
Prospective population-based study of adults starting long-term oxygen therapy (LTOT) for PF in Sweden 2005-2009. PF of unknown cause was defined by excluding patients with known or probable secondary PF. Time-dependent associations between medications and all-cause mortality were analysed using extended Cox regression, adjusting for potential confounders including age, sex, vital capacity, blood gases, body mass index, performance status, comorbidity and concurrent medications.
Of 462 included patients, 329 (71%) died under observation. No patient was lost to follow-up. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB) were associated with reduced adjusted mortality (HR 0.63; 0.47-0.85) and antiplatelet drugs with increased mortality (HR 1.49; 1.11-2.00), largely driven by higher mortality in women. There were no associations with mortality for antacid treatments, ß-blockers, diuretics or statins.
In oxygen-dependent PF, treatment with ACEI/ARB was associated with improved survival, antiplatelet drugs with decreased survival, whereas there was no association between antacid, ß-blocker, diuretic or statin treatment and survival.
PubMed ID
27009834 View in PubMed
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