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D Köhler

Publications and source records attributed to D Köhler.

204 records · Page 12Linked to original sources
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[Inhalation bronchial provocation tests in children: comparative measurements of oscillation, occlusion pressure and plethysmographic resistance].

Examination of the lung function and bronchial provocation tests are useful for confirmation of an airway obstruction. There is a need for measurements independent of child cooperation. The standard method is body plethysmography. Forced oscillation method and interrupted occlusion method were recently introduced. Measurements of airway resistance by body plethysmography (Raw), by forced oscillation (Ros) and by interrupted occlusion method (Rvd) were compared during 78 inhalative bronchial provocation tests. The correlation index between Raw and Ros total was 0,84 and between Raw and Rvd 0,89. There is a good sensitivity and specifity in allergen bronchial provocation testing in all three methods. A bronchial sensitivity is confirmed in body plethysmography by 100% increase of Raw. In the interrupted method a 50% increase of Rvd in children smaller than 165 cm and in forced oscillation method a relative increase of 25% (0,15 kPa/l/s) is sufficient to assess a bronchial sensitivity to tested allergen.

Adolescent↗
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Long-term oxygen therapy stops the natural decline of endurance in COPD patients with reversible hypercapnia.

BACKGROUND: Respiratory muscle weakness is one of the most important causes of hypercapnia in patients with COPD. There is evidence that stable hypercapnic patients will benefit from long-term oxygen therapy (LTOT). OBJECTIVES: The prognostic role of reversible hypercapnia in COPD is still unclear. Early implementation of LTOT in these patients may influence endurance time and mortality. METHODS: In this pilot study, we investigated 28 patients (26 males, 49-74 years) with COPD, advanced airflow limitation [forced expiratory volume in 1 s (percentage of predicted value) 40.8 +/- 10.2] and mild hypoxaemia (pO(2) 66.5 +/- 6.3 mm Hg). All patients had developed a moderate reversible hypercapnia during an acute exacerbation or during exercise testing (peak pCO(2) 48.0 +/- 2.5 mm Hg). Patients were allocated randomly to a control group (n = 14) or an LTOT group (n = 14). The two groups were well matched in terms of physiological data. Lung function, endurance time (cycle ergometer), dyspnoea score, blood gases and LTOT compliance were measured at baseline and every 6 months over a period of 3 years. RESULTS: Endurance time increased from 6.4 +/- 2.7 min at baseline to 7.1 +/- 2.7 min after 1 year in the LTOT group and decreased from 6.1 +/- 3.0 to 4.9 +/- 3.8 min in the controls (p < 0.05). After 1 year, the end-exercise dyspnoea score was significantly lower in the LTOT group (4.5 +/- 1.5) than in the controls (5.7 +/- 1.9). CONCLUSION: COPD patients with reversible hypercapnia and mild hypoxaemia benefit from LTOT in terms of endurance time and a reduction of exertional dyspnoea after 1 year.

Aged↗