Eletrocardiographic monitoring in COPD patients receiving tiotropium.

Tiotropium is a once-daily, inhaled anticholinergic for the treatment of chronic obstructive pulmonary disease that acts as a prolonged antagonist of the M3-receptor. To ascertain whether electrophysiologic effects can be detected following tiotropium treatment in patients with chronic obstructive pulmonary disease, serial electrocardiograms were incorporated into multiple placebo-controlled clinical trials including long-term (6 and 12-month) trials with tiotropium 18 mcg daily (n=2,128) and a 4-week dose-ranging study with tiotropium up to 36 mcg daily (n= 169). In addition, 24-hour electrocardiographic (Holter) monitoring was performed as part of a 6-week, placebo-controlled trial with tiotropium 18 mcg daily (n= 121).

Influence of different release times on spontaneous breathing pattern during airway pressure release ventilation.

Objective: Airway pressure release ventilation (APRV) is a ventilatory mode with a time cycled change between an upper (P(high)) and lower (P(low)) airway pressure level. APRV is unique because it allows unrestricted spontaneous breathing throughout the ventilatory cycle. We studied the influence of different release times (time of P(low)) on breathing pattern and gas exchange in patients during partial mechanical ventilation.

Proportional assist versus pressure support ventilation: effects on breathing pattern and respiratory work of patients with chronic obstructive pulmonary disease.

Objective: To investigate the breathing pattern and the inspiratory work of breathing (WOB(I)) in patients with chronic obstructive pulmonary disease (COPD) assisted with proportional assist ventilation (PAV) and conventional pressure support ventilation (PSV).

Design: Prospective controlled study.

Setting: Intensive care unit of a university hospital.

Monitoring perioperative changes in distribution of pulmonary ventilation by functional electrical impedance tomography.

Background: Electrical impedance tomography (EIT) is a noninvasive technique providing cross-sectional images of the thorax. We have tested an extended evaluation procedure, the functional EIT (f-EIT), to identify the local shifts of ventilation known to occur during the transition between spontaneous, controlled and assisted ventilation modes.

Methods: Ten patients scheduled for elective laparotomy were studied in the surgical ward, operating theatre and ICU during spontaneous and different modes of mechanical ventilation.