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Biomedical subjects

I Hawryłkiewicz

Publications and source records attributed to I Hawryłkiewicz.

41 records · Page 3Linked to original sources
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Effects of prolonged oxygen therapy on pulmonary hypertension and blood viscosity in patients with advanced cor pulmonale.

In 16 patients with chronic bronchitis and advanced cor pulmonale admitted to hospital due to heart failure, a controlled 6-weeks oxygen therapy, 17 h a day, was performed. The trial was started when patients were out of the exacerbation of the disease in a respiratory and circulatory steady state. Pulmonary hemodynamics, blood viscosity, packed cell volume and basic lung function data before and after oxygen therapy were compared. A significant fall of mean pulmonary arterial pressure from 42 to 30 mm Hg without a change in the cardiac output was found. Blood viscosity and packed cell volume-significantly decreased. Arterial oxygen tension did not significantly change. It seems that 17-hours per day oxygen therapy is sufficient to induce regression of anatomic changes in pulmonary arteries, a main cause of pulmonary hypertension in hypoxic cor pulmonale.

Adult↗
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Pulmonary haemodynamics in patients with OSAS or an overlap syndrome.

BACKGROUND: Alveolar hypoxia is the most important mechanism leading to pulmonary arterial vasoconstriction, remodelling and pulmonary hypertension. Patients with Obstructive Sleep Apnoea Syndrome (OSAS) experience multiple short periods of alveolar hypoxia during apnoeic episodes. However, the question as to whether these hypoxic episodes are responsible for the development of permanent pulmonary hypertension is still debatable. We aimed to investigate the relationship between the episodes of nocturnal desaturation and pulmonary haemodynamics in two distinct group patients: with pure OSAS or an overlap syndrome. METHODS: We studied 67 patients with severe OSAS (means: age 45+/-8 years, AHI 62+/-22, FEV1 3.6+/-0.8 L = 97+/-16% of predicted PaO2 72+/-10 mmHg, PaCO2 40+/-4 mmHg) and 17 patients with an overlap syndrome (OS), means: age 51+/-5 years, AHI 64+/-19, FEV1 1.5+/-0.7 = 43+/-16% of predicted PaO2 57+/-9 mmHg). All subjects underwent pulmonary artery catheterisation with pressure and flow recordings and an overnight full sleep study. RESULTS: On average patients with OSAS had nocturnal desaturation (mean overnight SaO2 = 87+/-5%) and normal PPA (15.8+/-4.6 mmHg). Only 11 out of 67 subjects (16%) presented with pulmonary hypertension. Patients with OS had nocturnal desaturation (mean overnight SaO2 = 80.2+/-8.5%) and mild pulmonary hypertension (PPA 24.2+/-7.4 mmHg). Only three out of 17 patients had normal pulmonary arterial pressure. CONCLUSIONS: In patients with severe OSAS, pulmonary hypertension is rare (16%) and is related best to the severity of the disease and to obesity. In OS patients diurnal pulmonary hypertension is frequent but does not correlate with the severity of nocturnal desaturation.

Adult↗
PubMedDate not supplied

[Value of additional qualifying tests for home oxygen therapy in patients with chronic obstructive diseases and moderate hypoxemia].

A value of pulmonary artery catheterization, exercise test and blood oxygenation at sleep was assessed. Such tests are considered as the additional possibility for classifying the patients with chronic obstructive disease, with moderate hypoxia, to the treatment with oxygen at home. Hemodynamic tests have shown pulmonary hypertension in 73% of patients. Clinical evaluation of the cor pulmonale seemed satisfactory. A decrease in arterial blood oxygenation during exercise below 88%, being a border value classifying to the treatment with oxygen at home, was found in 82% of patients. Marked decrease in blood oxygenation at sleep has been characteristic feature of all patients. Exercise test and oximetry at night may also valuable for classifying the patients to the treatment with oxygen under home conditions.

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