Sleep related respiratory disorders in end-stage renal disease patients on peritoneal dialysis.

Study Objective: To assess the possible effects of peritoneal dialysis (PD) on sleep-related respiration, which might result from dialysate bulk load in the abdomen and/or alterations in metabolic control of respiration during sleep.

Design: Subjective and objective measures of sleep were prospectively compared on randomly assigned nights with PD fluid (2.0 L) and without PD fluid in the peritoneal cavity in 11 end-stage renal disease (ESRD) patients on PD.

Airway insufflation. Increasing flow rates progressively reduce dead space in respiratory failure.

We have previously shown that airway insufflation (AI) reduces dead space (VD) and minute ventilation (VL) in patients with respiratory failure, and when used chronically leads to lowered and more stable arterial PCO2. The present study was designed to measure the effect of increasing AI flow rate on VD and other aspects of gas exchange in respiratory failure in order to examine the hypothesis that AI exerts its main physiologic effect by progressive reductions of VD. Five patients with varying degrees of respiratory failure caused by either restrictive or obstructive lung disease were studied by means of the specialized techniques we developed to analyze gas exchange during AI.

The lung mucosa: a critical environmental battleground.

The entirety of the lung mucous membrane and epithelial surface are exposed to the environment; react to noxious environmental gases, vapors, and particles; and are under physiologic and humoral mediator control. In recent years much information has been gained regarding the mucous membrane of the tracheobronchial tree, its physiology, and its reaction to environmental hazards. The pharmacologic control of secretion, ciliary beat rate, and net mucus flow governs both the clearance of mucus and the clearance of particles.

Survival in patients with primary pulmonary hypertension. Results from a national prospective registry.

Objective: To characterize mortality in persons diagnosed with primary pulmonary hypertension and to investigate factors associated with survival.

Design: Registry with prospective follow-up.

Setting: Thirty-two clinical centers in the United States participating in the Patient Registry for the Characterization of Primary Pulmonary Hypertension supported by the National Heart, Lung, and Blood Institute.