Microbiologic contamination study of nebulizers after aerosol therapy in patients with cystic fibrosis.

Background: To evaluate the contamination of delivery systems after an aerosol therapy session in patients with cystic fibrosis who have chronic Pseudomonas aeruginosa infection.

Methods: Fifty-three patients with cystic fibrosis were enrolled in the study from March 1996 to June 1997. All patients were age 7 years or older and had P aeruginosa infection.

French multicenter randomized double-blind placebo-controlled trial on nebulized amiloride in cystic fibrosis patients. The Amiloride-AFLM Collaborative Study Group.

The effect of amiloride, a sodium channel blocker, has been evaluated in a multicenter randomized double-blind placebo-controlled trial in cystic fibrosis patients more than 5-years-old (n = 137) whose forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV(1)), and forced mid-expiratory flow (FEF(25-75)) were not below 50%, 50%, and 30% of reference values, respectively. Patients were randomly allocated to two parallel groups. Sixty-four patients were chronically colonized with Pseudomonas aeruginosa; they received either amiloride or placebo as a nebulized solution three times daily for 6 months.

[Comparative study of the performance and ergonomics of nebulizers in cystic fibrosis].

This study had, as its aim, to test twelve nebulizers (6 jet, 6 ultrasonic) which are used in the treatment of cystic fibrosis. Devices were connected to a respirator in order to mimic the ventilation of a child and of an adult suffering from cystis fibrosis. Three medications: tobramycine, colistine and amiloride were nebulised.

Nebulizer performance: AFLM study. Association Française de Lutte contre la Mucoviscidose.

This study was conducted by the AFLM order to determine the performance characteristics of 12 commercially available nebulizers (6 ultrasonic and 6 jet) used in the treatment of cystic fibrosis (CF). The nebulizers were connected to a circuit which simulated the ventilation of a CF child and CF adult, and were tested using three drug solutions: tobramycin (T), colistin (C), and amiloride (A). Nebulizer performance was evaluated according to the volume of drug solution delivered in 10 min during the simulated inspiratory phase (VI), drug granulometry (G%), drug concentration modification in the nebulizer reservoir (delta C), and percentage of efficiently aerosolized drug EA%).

[The quality of oxygen therapy delivery systems using oxygen-saving valves. A multicenter study. The ANTADIR Medico-Technical Commission].

The saturation of oxygen (SaO2) using oxygen therapy with an oxygen saving system, Optimox (CFPO) or COS 5 (Puritan, Bennett) has been compared to the SaO2 using continuous oxygen therapy. The oxygen output using the oxygen saving system was regulated in such a way as to be equivalent to the oxygen flow without the economiser. Three situations were studied: the day, the night and during effort.

Preserved CO2 response in cerebral and muscular blood vessels during cimetidine treatment.

It is known that cimetidine inhibits the hypoxia-induced increase in cerebral blood flow (CFB) in dogs, but the mechanism of this inhibition is not fully understood. Since the accepted mechanisms explaining the increase in CBF during hypercapnia are very different from those active during hypoxia, acute hypercapnia was induced in 12 conscious dogs in order to study the cimetidine effect in this condition. Six dogs were given i.

The inotropic effect of digoxin on an isolated rat heart in hypercapnia and (or) hypoxia.

The explanation for the increased frequency of troubles with digoxin therapy in patients with chronic pulmonary diseases is debated. The reported effects of hypoxia in vivo on myocardial levels of digoxin are contradictory, and there have been few studies on the effects of hypercapnia. In the past, it has been shown in rat myocardial tissue at rest in vitro that hypoxia decreased and hypercapnic acidosis increased the digoxin uptake.

Theophylline disposition in patients with COLD with and without hypoxemia.

This study aimed to assess the effect of hypoxemia on theophylline disposition. Ten patients with a mean (+/- SEM) of 58 +/- 3 years with COLD (PaO2 55 +/- 1 mm Hg, PaCO2 46 +/- 2 mm Hg, and pH of 7.39 +/- 0.

Effect of moderate hypoxemia on atrial natriuretic factor and arginine vasopressin in normal man.

The object of this study was to assess the effect of moderate acute hypoxemia on plasma concentrations of atrial natriuretic factor (ANF), arginine vasopressin (AVP), plasma renin activity (PRA) and urinary excretion of prostaglandin E2 (UPGE2V). Eight volunteers were exposed for 2 hours to a gas mixture containing 10% O2, 4.5% CO2 and 85.

Theophylline disposition during acute and chronic hypoxia in the conscious dog.

It has been reported in experimental models that acute hypoxia reduced the activity of the hepatic cytochrome P-450. The objective of the present study was to investigate in conscious dogs whether acute and chronic hypoxia will influence the disposition of theophylline. To this purpose 6 beagle dogs received 8 mg/kg i.

Role of the mechanical impairment on the ventilatory response to CO2 in chronic airway obstruction.

The purpose of this study was to assess the relationship between the breathing pattern response to CO2 and the severity of mechanical impairment in twenty patients with COLD. The CO2 response was compared to that of a control group of twelve normal subjects. All patients had airway obstruction (FEV1 = 40 +/- 14% of predicted; means +/- SD) and hyperinflation (FRC = 154 +/- 23% of predicted).

Cimetidine inhibits cerebral and hepatic mitochondrial respiration in rat.

The presence of cimetidine in the incubation medium of rat brain mitochondria caused decreased oxygen uptake, especially during oxidative phosphorylation (state 3). This inhibition of the respiratory control and of ATP synthesis was dose-dependent. The same observations were made for hepatic mitochondria.

Comparison between ventilatory and mouth occlusion pressure responses to hypoxia and hypercapnia in healthy sleeping man.

Ventilatory and mouth occlusion pressure (P0.1) responses to progressive isocapnic-hypoxia and hyperoxic-hypercapnia were compared in eleven healthy sleeping men during the same night. Hypoxic and hypercapnic responses were determined during wakefulness, non-rapid and rapid-eye-movement sleep.

[A multicenter trial of a device for treating obstructive sleep apnea by continuous positive pressure].

The efficacy and tolerance of a nasal CPAP device marketed in France (Pression +, Sefam) for the treatment of obstructive sleep apnoea syndromes have been evaluated in a co-operative trial including 12 patients. This study confirmed the efficacy of nasal CPAP on sleep parameters: total sleep time was increased; light non-REM sleep was diminished; slow-wave sleep and REM sleep were augmented; sleep apnoeas were eliminated completely or almost completely; oxygen saturation was markedly improved. At one month follow-up, most clinical features were improved; daytime blood gases showed little change but the number of red cells was decreased.

In vitro effects of hypoxia and (or) hypercapnic acidosis on the myocardial uptake of digoxin.

A recent study has shown in the conscious dog that hypoxia associated with respiratory acidosis could increase the in vivo distribution of digoxin in the myocardium. The aim of the present study was to evaluate in vitro the effects of hypoxia and (or) hypercapnic acidosis on the digoxin uptake. For this purpose, rat myocardium was incubated for 180 min with radiolabelled [3H]digoxin.

Long-term oxygen therapy can reverse the progression of pulmonary hypertension in patients with chronic obstructive pulmonary disease.

Sixteen patients with severe chronic obstructive pulmonary disease (COPD) (average values at the onset of O2 therapy: FEV1, 891 +/- 284 ml; PaO2, 50.2 +/- 6.6 mmHg; PaCO2, 51.

[Continuous positive pressure in the treatment of sleep apnea syndromes].

Continuous positive airway pressure as a long-term home treatment for sleep apnea syndromes would seem to present irreconcilable requirements; it must be simple and comfortable to use during sleep and it must be relatively inexpensive. The device described in this paper includes a compressor, an individually molded nose-mask and a water column. Improvements are still in progress, but, as it stands, it enables sleep apnea patients to be successfully treated at home.

Long-term course of pulmonary arterial pressure in chronic obstructive pulmonary disease.

Ninety-three patients with severe chronic obstructive pulmonary disease (COPD) of the bronchitic (n = 74) or emphysematous type (n = 19), who all had arterial hypoxemia, underwent 2 right cardiac catheterizations in a clinical steady state, with a delay of 5 yr or more between the first and the last catheterization. No patients received long-term O2 therapy or pulmonary vasodilator drugs. Patients were divided into 2 groups according to the initial level of mean pulmonary artery pressure (Pap).

[Sleep apnea syndromes. Treatment with continuous positive pressure by the nasal route].

Nine patients with severe, predominantly obstructive sleep apnoea syndromes were treated during one night by continuous positive pressure under polygraphic monitoring. Three patients did not tolerate the treatment for either mechanical reasons (2 cases) or ventilatory reasons (1 case). In the remaining 6 patients, continuous positive pressure resulted in reorganization of sleep and disappearance of obstructive and central apnoeic episodes.

[Diurnal basal pulmonary arterial pressure and nocturnal levels of oxygenation in patients with chronic bronchitis].

The relationship between diurnal pulmonary arterial pressure (Ppa) measured in steady state and nocturnal level of oxyhaemoglobin saturation (Sao2) measured continuously was studied in fourteen patients with chronic obstructive lung disease. A right heart catheterization was carried out in the morning in each patient. The nocturnal polygraphic study included a continuous recording of transcutaneous Sao2.

[Nocturnal changes in blood gases and pulmonary arterial pressure in chronic bronchitis patients with respiratory insufficiency (author's transl)].

Fourteen male patients with chronic bronchitis and respiratory insufficiency were monitored during nocturnal sleep by conventional polygraphy (EEG, EOG and EMG of the chin) associated with continuous recording of the mean pulmonary arterial pressure (PAP) and, in 50% of the cases, continuous measurement of O2 saturation. Six subjects were able to sleep long enough for oxygen saturation, blood gases and PAP values to be correlated with the various phases of sleep. Frequent, significant and sometimes abrupt peaks of hypoxaemia were observed; they usually, though not necessarily, occurred during paradoxical sleep.