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[Speech cannula for children with tracheotomy and oxygen inhalation therapy].

Because of various possible problems tracheotomy in children should be performed only in urgent cases and should be sewed up as soon as possible. Early language therapy and the use of cannulas with speaking device promote language development. We propose a special silver cannula with speaking device for children with oxygen dependence due to bronchopulmonary dysplasia.

Bronchopulmonary Dysplasia↗

Salbutamol in the treatment of asthmatic children. A comparison of oral and inhalation therapy alone and in combination.

In 10 children with asthma and reversible bronchial obstruction the effect on lung function (VC, FVC and FEV1) of salbutamol was tested comparing oral administration, inhalation or a combination of both. The oral treatment was carried out as a randomized double-blind salbutamol-placebo cross-over study followed by inhalation of salbutamol in all patients. In agreement with previous findings in adults, the study showed a significant increase of FEV1, FVC and VC (P less than 0.005) after oral salbutamol. Combined oral and inhalation medication of salbutamol gave a significantly higher increase of FEV1, VC (P less than 0.01) and FVC (P less than 0.05) when compared with oral therapy only. Compared with salbutamol inhalation only, the combined therapy gave a significantly higher FEV1 (P less than 0.01). The relatively high oral dose used produced no side effects.

Administration, Oral↗

Acute carbon dioxide narcosis during inhalational therapy with oxygen powered nebulizers in patients with chronic airflow limitation.

Six patients with acute carbon dioxide narcosis following nebulised salbutamol therapy were described. They had chronic obstructive airflow disease and were admitted in acute respiratory failure. The patients were treated with aerosolized salbutamol delivered from oxygen powered nebulizers. They developed severe acute hypercapnia. Five of the six patients died. The hazards of indiscriminate oxygen use in this clinical situation was discussed.

Aerosols↗

[Effects of oxygen inhalation therapy on blood and phonomechanography in patients with heart disease, lung disease and cardiorespiratory insufficiency].

Arterial PaO2 and some phonomechanographic indices were studied during and after a period of 40-60-100% oxygen breathing in fourteen patients (six with pulmonary insufficiency, four with cardiac disease and four with cardiorespiratory insufficiency). Arterial PaO2 was measured at the beginning, every five minutes during and many times after the ventilation. Myocardial performance was also measured by sistolic time: isovolumetric contraction time, left ventricular expulsive time, preejection pressure, deformation time. The authors discuss the modifications of these indices and the clinical involvement of O2 breathing.

Aged↗

[Medico-legal aspects of chronic respiratory insufficiency under long-term oxygen inhalation therapy].

Ninety-one subjects affected by severe pulmonary insufficiency necessitating continuous treatment with oxygen were studied. The social and professional realities and their status within the national health service were determined. The results of the research, obtained through the use of the questionnaires, showed that the lives of these subjects are very much influenced by their pathology. Among the factors considered were necessity for home assistance, scarce or absence of autonomy and contact with the outside world and extremely reduced work capacity. Elevated public spending for assistance was analyzed in reference to public health insurance as regards each single subject and the type of lung dysfunction from which the subject suffered.

Adult↗

[Physiological premises and mechanisms of normalizing effect of normobaric hypoxia and inhalation therapy].

Pathogenetic and physiological aspects of hypoxia problems have been considered. An opinion is stated that normalizing effect of intermittent normobaric hypoxia (INH) with short-term respiration of gaseous mixture containing at least 10% of oxygen in nitrogen is based on biorhythm inherent in all the living organisms with replacement of the high functional activity periods by the periods of rest and restoration with temporary physiological hypoxia as their typical companion. It is shown that for numerous diseases the course of INH or sessions of staying in the chamber of artificial mountain climate normalize the state of central nervous system, blood circulation, respiration, hemopoiesis and immunological reactivity, activate natural protective mechanisms and increase functional reserves of the organism. Allowing for anthropogenic pollution of the environment and its consequences for the health, it is advisable to widely adopt hypoxytherapy and orrhotherapy.

Cardiovascular Diseases↗

[Membrane technology as a basis for creation of treatment-and-prophylactic equipment for inhalation therapy and normobaric hypoxia].

The principles of membrane technology of gas distribution have been considered, that has a wider adoption in different branches of economy and in medicine. One of the promising trends of membrane technology employment is production of respiratory gas mixtures for hypoxytherapy, non-medicamental method to increase the human organism resistance to numerous pathogenetic environmental factors. Gas distributors and devices with different surface mass exchange and wide range of operating stress using hollow selectively permeable fibers of poly-4-methylpentene-1 are designed and produced under conditions of scientific productions. The technology of hollow fibers formation has been tried out on production spinning machinery of enterprises of chemical fibers in Ukraine. Design of gas distributors permits supplying them as a part of different devices of normobaric hypoxia from individual ones to devices of joint use allowing for customer's demands.

Equipment Design↗

Inhalation therapy: alternative systems--an overview.

Three possibilities exist, in principle, to apply medication by inhalation: (1) Inhalation from Pressurized Metered Dose Inhalers (2) Direct Inhalation of Dry Powder (3) Inhalation of Nebulized Aqueous Solutions. Chlorofluorocarbons that are necessary for pressurized metered dose inhalers have unwanted environmental properties. Therefore, alternative gases are being developed (HFA-134a and HFA 227) on the premise that pressurized metered dose aerosols in airways therapy have distinct advantages which are reflected in the high acceptance and application of these MDIs worldwide. Dry powder inhalation requires sophisticated devices to provide for exact dosing. For nebulizers the major problem was their size and consequently their restricted use. Multi-dose pocket-size systems are on the market for (1) and (2). For nebulization such a system is currently being introduced. A critical comparison of benefits and disadvantages of the existing drug delivery systems to the airways leads to the conclusion that all three modes will remain essential to cover the therapeutic needs for a wide variety of drugs and patient populations.

Administration, Inhalation↗

Case report: inhalation therapy of paromomycin is effective for respiratory infection and hypoxia by cryptosporidium with AIDS.

A 24-year-old man with AIDS and hemophilia A had intractable diarrhea and fever. Upon examination of stool and of a sigmoidal biopsy specimen, cryptosporidium was revealed. Approximately 2 months after admission, respiratory infection with hypoxia due to cryptosporidium developed. Paromomycin inhalation was effective therapy. To the authors' knowledge, this is the first case of respiratory cryptosporidiosis treated successfully by paromomycin inhalation.

AIDS-Related Opportunistic Infections↗

[Inhalation therapy in children younger than two years. I. From theory to practice].

Effective inhalation of drugs, even by small children under 2 years, is often faster, simpler, cheaper and better with metered dose inhalers with small antistatic (metal) inhalation chambers than with nebulisation. This is also true during considerable bronchial obstruction. It is mandatory that the inhalation chamber has a small dead space and well functioning valves opening at low flows. Effective dosing in small children is enhanced by more doses, given separately, while choosing the highest dose per spray available. Important factors determining bronchial deposition in small children are breathing frequency, tidal volume and the degree of bronchial obstruction and nasal obstruction, since inhalation goes primarily through the nose. If well-performed medication with a small inhalation chamber is clinically ineffective, it is better to start systemic medication, e.g. a corticosteroid, or even to consider artificial ventilation, rather than to try nebulisation. Better effective deposition is possible with inhalation of drugs in hydrofluoroalkane (HFA) aerosols, which will replace chlorofluorocarbon (CFC) aerosols in the near future.

Administration, Inhalation↗