Pneumothorax as a complication of lung volume recruitment.

Lung volume recruitment involves deep inflation techniques to achieve maximum insufflation capacity in patients with respiratory muscle weakness, in order to increase peak cough flow, thus helping to maintain airway patency and improve ventilation. One of these techniques is air stacking, in which a manual resuscitator is used in order to inflate the lungs. Although intrathoracic pressures can rise considerably, there have been no reports of respiratory complications due to air stacking.

[Lung volume recruitment in impending respiratory failure].

Lung volume recruitment can improve peak cough flows and respiratory compliance in patients who either do or do not require mechanical ventilation. There are several lung volume recruitment techniques: air stacking, glossopharyngeal breathing and mechanical insufflation-exsufflation with cough assist devices. The principle of lung volume recruitment is based on the insufflation of air in the lungs after maximal inspiration.

[Obesity hypoventilation syndrome--serious but reversible providing weight is lost].

Obesity hypoventilation syndrome (OHS) is a condition in which obesity and chronic hypoventilation during waking hours are combined. Patients with OHS are more likely to be hospitalized and to require intensive-care monitoring compared with patients with similar degrees of obesity without hypoventilation. Treatment with chronic non-invasive positive pressure ventilation (NPPV) is associated with a lower morbidity and mortality.

Vocal cord dysfunction in amyotrophic lateral sclerosis: four cases and a review of the literature.

We describe 4 patients with amyotrophic lateral sclerosis (ALS) and glottic narrowing due to vocal cord dysfunction, and review the literature found using the following search terms: amyotrophic lateral sclerosis, motor neuron disease, stridor, laryngospasm, vocal cord abductor paresis, and hoarseness. Neurological literature rarely reports vocal cord dysfunction in ALS, in contrast to otolaryngology literature (4%-30% of patients with ALS). Both infranuclear and supranuclear mechanisms may play a role.