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A Augustynen

Publications and source records attributed to A Augustynen.

4 recordsLinked to original sources
PubMed2001

Physiologic effects of negative pressure ventilation in acute exacerbation of chronic obstructive pulmonary disease.

To assess the physiologic effects of continuous negative extrathoracic pressure (CNEP), negative pressure ventilation (NPV), and negative extrathoracic end-expiratory pressure (NEEP) added to NPV in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD), we measured in seven patients ventilatory pattern, arterial blood gases, respiratory mechanics, and pressure- time product of the diaphragm (PTPdi) under four conditions: (1) spontaneous breathing (SB); (2) CNEP (-5 cm H(2)O); (3) NPV; (4) NPV plus NEEP. CNEP and NPV were provided by a microprocessor-based iron lung capable of thermistor-triggering. Compared with SB, CNEP improved slightly but significantly Pa(CO(2 ))and pH, and decreased PTPdi (388 +/- 59 versus 302 +/- 43 cm H(2)O. s, respectively, p < 0.05) and dynamic intrinsic positive end-expiratory pressure (PEEPi) (4.6 +/- 0.5 versus 2.1 +/- 0.3 cm H(2)O, respectively, p < 0.001). NPV increased minute ventilation (V E), improved arterial blood gases, and decreased PTPdi to 34% of value during SB (p < 0.001). NEEP added to NPV further slightly decreased PTPdi and improved patient-ventilator interaction by reducing dynamic PEEPi and nontriggering inspiratory efforts. We conclude that CNEP and NPV, provided by microprocessor-based iron lung, are able to improve ventilatory pattern and arterial blood gases, and to unload inspiratory muscles in patients with acute exacerbation of COPD.

Acute Disease↗
PubMed1997

Negative pressure ventilation in COPD patients with acute on chronic respiratory failure.

Negative pressure ventilators act by exposing the surface of the chest wall to subatmospheric pressure during inspiration. During negative pressure ventilation (NPV), tidal volume is related to the peak of the inspiratory negative pressure and the pressure waveform generated by the ventilator pump; for the same peak of negative pressure a square wave produces a greater tidal volume than a half sine wave. Several uncontrolled studies suggest that NPV may have a potential therapeutic role in the treatment of acute on chronic respiratory failure in patients with chronic obstructive pulmonary disease (COPD), reducing the need for endotracheal intubation. Recently, NPV has been used with a good outcome as a first-line treatment in COPD patients with severe acute respiratory failure and hypoxic hypercapnic coma. The positive results of these reports need to be confirmed by further controlled studies before recommending the generalized use of NPV in COPD patients with acute respiratory failure as standard care.

Acute Disease↗
PubMed1994

Iron lung treatment of acute on chronic respiratory failure: 16 yrs of experience.

Noninvasive ventilatory supports are gaining a prominent position among ventilatory techniques aimed to improve ventilation in patients with acute-on-chronic respiratory failure (ACRF). It has not yet been established whether these techniques can be considered as a preventive measure to avoid the need for endotracheal intubation, or are really another means to provide full ventilatory support. At our respiratory intensive care unit (RICU), the ventilatory treatment of ACRF has, for many years, been based on a conservative method, which relies on the use of a body ventilator (iron lung) providing intermittent negative pressure ventilation (INPV). From 1975 to 1991, we treated ACRF in 2,116 patients with chronic obstructive pulmonary disease (COPD) and 604 patients with restrictive thoracopulmonary disease (RTD). Two thousand and eleven patients (95%) underwent INPV. The mortality rate during hospitalization was 9.9% for the patients as a whole (10% and 8.9% for COPD and RTD patients, respectively). The mean length of stay in the RICU was 10.5 +/- 9.5 days. Furthermore, we report the results of our previous studies which investigated how the iron lung works, and how it affected the short- and long-term prognosis of COPD patients in ACRF. Finally, in 180 patients, we report the effects of INPV provided by iron lung on the treatment of ACRF with hypoxic hypercapnic coma (HHC). INPV resulted in a significant improvement of arterial blood gas values and pH, associated with a progressive recovery of the level of consciousness. Only 13 patients needed intubation and 41 (23%) died during hospitalization.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗