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Biomedical subjects

D E Westerman

Publications and source records attributed to D E Westerman.

6 recordsLinked to original sources
PubMed1983

Ventilatory responses to carbon dioxide in asthmatics with previous carbon dioxide retention during severe asthma.

Ventilatory responses to carbon dioxide (Sco2) were measured in 15 asymptomatic asthmatic patients in whom CO2 retention had been documented during a previous attack of acute asthma. At the time when Sco2 was measured, the patients had normal or only mildly impaired ventilatory function (vital capacity (VC) 3,5 +/- 0,19 I, 98,7 +/- 4% of predicted (mean +/- SE); forced expiratory volume in 1 second (FEV1) 2,37 +/- 0,161, 83,8 +/- 5,2% of predicted; and FEV1/VC 68 +/- 2,5%). Fifteen control subjects without lung disease were also studied (VC 4,38 +/- 0,28 I, 103 +/- 2,6% of predicted; FEV1 3,76 +/- 0,23 I, 112 +/- 4,4% of predicted; FEV1/VC 86 +/- 7,8%). Sco2 in the patients (1,21 +/- 0,14 l/min/mmHg, range 0,62 - 2,81) was significantly different (P less than 0,001) from that in controls (2,13 +/- 0,17 l/min/mmHg, range 1,13 - 3,17). Sco2 in a subgroup of 5 patients with normal pulmonary function was also significantly different from that in controls. Correction for lung size (Sco2/VC) did not detract from the significance of the difference between patients and controls, suggesting that inherently low respiratory centre sensitivities to CO2 may have played a role in the development of hypercapnia during severe asthma in these patients.

Acute Disease↗
PubMed1980

Metastatic endotracheal tumor from ovarian carcinoma.

This report describes a patient with acute airways obstruction and respiratory failure secondary to a large endotracheal metastasis from a primary ovarian carcinoma first detected seven years previously. Associated airflow obstruction due to mucus impaction contributed significantly to the development of respiratory failure. The tumor responded to radiotherapy, and radiologic evidence for tracheal obstruction was no longer present five months after irradiation.

Cystadenoma↗
PubMed1979

Identification of the high-risk asthmatic patient. Experience with 39 patients undergoing ventilation for status asthmaticus.

Thirty-nine asthmatic patients required mechanical ventilation (IPPV) for status asthamticus over a seven and a half year period. We reviewed their clinical records with particular emphasis on the events leading to intermittent positive pressure ventilation (IPPV) and the long-term courses of those patients who survived IPPV. Long delays by patients before seeking medical attention, incomplete assessment of acute attacks, underuse of corticosteroids prior to admission and overuse of sedation were important factors often influencing the necessity for IPPV. Four patients died during IPPV. Of the 35 who survived, 32 were regularly followed in our Respiratory Clinic. Nine patients subsequently died, eight undoubtedly from asthma. Serial measurements of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) were retrospectively analyzed to determine patterns of asthma. Of the 23 patients still alive, 14 have well controlled asthma, five have a pattern of persistent airflow obstruction, two have markedly labile asthma, and two have gradually deteriorating airflow obstruction. By contrast, seven patients who died sufficiently long after IPPV to enable categorization of their patterns showed either markedly labile asthma or gradually deteriorating airflow obstruction. None had relatively constant ventilatory function at either normal or suboptimal levels. We suggest that patterns of asthma are useful guides in detecting patients at high-risk. Patterns characterized by markedly labile asthma or gradually deteriorating airflow obstruction appear to be associated with an increased risk of sudden death from asthma.

Adolescent↗
PubMed1978

The magnitude of the asthma problem in Cape Town.

The magnitude of the asthma problem in Cape Town, as reflected by cases presenting to a large hospital, is described. The need for better facilities to treat acute asthma and to provide supervised interval therapy is discussed. A plea is made for the more widespread use of well-established simple beside aids in the assessment of the severity of asthma and the response to therapy.

Acute Disease↗