Late-onset post-lesional paroxysmal hypothermia: a case series and literature review.

Background: Paroxysmal hypothermia (PH) is a rare condition characterized by recurrent episodes of spontaneous hypothermia, bradycardia, disorders of consciousness and, in some cases, hyperhidrosis. When associated with a detectable hypothalamic lesion, PH episodes usually occur shortly after the brain insult.

Methods: We performed a retrospective study to identify patients who had demonstrated at least one episode of symptomatic spontaneous PH as defined by (i) tympanic temperature < 35 °C; (ii) drowsiness and/or confusion state and/or coma; (iii) duration of the episode ≥ 24 h; (iv) absence of other condition resulting in hypothermia RESULTS: Among 8824 patients, we identified four patients with recurrent late-onset PH episodes of 1-26-day duration that occurred 6-46 years after the brain insult.

Reliability of Tidal Volume in Average Volume Assured Pressure Support Mode.

Background: Remote monitoring is increasingly used in patients who receive home mechanical ventilation. The average volume assured pressure support mode is a target volume pressure preset mode that delivers a given tidal volume (V) within a range of controlled inspiratory pressures. In a mode such as this, it is important to verify that the V value retrieved from the ventilator SD card is accurate.

Mechanisms of Orthopnea in Stable Obese Subjects.

Background: The present study explored the role of closing volume as a determinant of orthopnea in stable obese subjects. We hypothesized that: (1) increase in closing volume in supine position would be greater in orthopneic than in non-orthopneic subjects, and (2) the relationship of change in closing volume to change in dyspnea with position would be dependent on expiratory flow limitation in the sitting position.

Methods: In stable obese subjects, in sitting and supine positions, we measured the Borg dyspnea score, static lung volumes, expiratory flow limitation during tidal breathing, and single-breath nitrogen expiration test.

Quantitative analysis of acid-base disorders in patients with chronic respiratory failure in stable or unstable respiratory condition.

Background: The Stewart approach theorizes that plasma pH depends on P(aCO₂), the strong ion difference, and the plasma total concentration of non-volatile weak acids (A(tot)). The conventional approach measures standardized base excess, bicarbonate (HCO₃⁻), and the anion gap.

Objective: To describe acid-base disorders with the Stewart approach and the conventional approach in patients with chronic respiratory failure.

Sleep apnea in patients with heart failure: could cardiac resynchronization therapy be the first line treatment?

Adaptive servo-ventilation as well as continuous and bi-level positive airway pressure seems to effectively treat sleep apnea syndrome (SAS) in patients with chronic heart failure (CHF), and to improve left ventricular function. However, no randomized data show a significant impact of ventilation on survival in patients with CHF. By contrast, there is overwhelming evidence that cardiac resynchronization therapy (CRT) improves outcomes in patients with CHF.

Effect of a noninvasive ventilatory support during exercise of a program in pulmonary rehabilitation in patients with COPD.

Background: Breathlessness is the most common symptom limiting exercise in patients with chronic obstructive pulmonary disease (COPD). Exercise training can improve both exercise tolerance and health status in these patients, intensity of exercise being of key importance. Nevertheless, in these patients extreme breathlessness and/or peripheral muscle fatigue may prevent patients from reaching higher levels of intensity.