Showing papers in "Clinics in Chest Medicine in 1996"

TL;DR: Advances in the management of this disorder, especially liver transplantation, finally have allowed us to offer some hope to patients with this disease, and further knowledge of the interaction of the liver and the lung is helped.

TL;DR: Treatment of patients with portal and pulmonary hypertension is limited, and mean survival following diagnosis is approximately 15 months, and the effect of liver transplantation on the natural history of disease is discussed.

TL;DR: If sepsis is not diagnosed and treated early, it can become self-perpetuating, and elderly persons, in particular, are at a greater risk of death from sepsIs, the systemic response to severe infection in critically ill patients.

TL;DR: A description of the underlying pathophysiology is followed by a review of physiologic data explaining the mechanisms of action of noninvasive ventilation, and a critical review of clinical studies is presented with specific suggestions.

TL;DR: Two recent clinical trials suggest that ventilatory management has a major influence on the outcome of weaning from mechanical ventilation in difficult-to-wean patients.

TL;DR: The hepatopulmonary syndrome results from erythrocytes bypassing the lung without oxygenation, and the hypoxemia may result from portapulmonary shunting, passage around alveoli through pleural and hilar blood vessels, and intrapulmonary vascular dilatations.

TL;DR: The role of liver transplantation as a treatment for the hepatopulmonary syndrome (HPS) has had an evolving and controversial history as discussed by the authors, and many basic questions still remain.

TL;DR: The authors discusses the pathogenic events that lead to sepsis syndrome and reviews critical steps in regulating inflammatory mediators to allow the host to recover from gram-negative bacteremia.

TL;DR: The basic pathophysiologic mechanisms underlying the abnormal pulmonary gas exchange often seen in patients with cirrhosis are reviewed, and available evidence suggests that both the liver and the endothelial cells may play a pivotal role in the regulation of the pulmonary vascular tone in these patients.

TL;DR: The authors reviewed the basis for concern about traditional ventilatory support in acute respiratory distress syndrome (ARDS) and developed an approach based on current evidence and newer options for management, which may retard the healing of the injured lung.

TL;DR: Several cytokines and mediators may be involved in the pathogenesis of the hepatopulmonary syndrome and in the cytokine cascades that are activated in systemic inflammatory states such as acute respiratory distress syndrome.

TL;DR: New developments in arterial blood gas monitoring, pulse oximetry, capnometry, and monitoring of neuromuscular function and pulmonary mechanics are dealt with, emphasizing issues most relevant to mechanical ventilation.

TL;DR: The current state of knowledge, with reference to acute lung injury and current efforts, are examined to arrive at effective pharmacologic approaches to treat acute respiratory distress syndrome.

TL;DR: As immunosuppression begins to have an effect, the LTx recipient becomes susceptible to the same opportunistic infectious organisms that cause significant morbidity and mortality in recipients of other solid organ transplants.

TL;DR: Situations in which independent lung ventilation may be of use include massive hemoptysis, pulmonary alveolar proteinosis, risk of interbronchial aspiration, unilateral lung injury, single lung transplant, and BPF.

TL;DR: Patient-ventilator synchrony is important in the management of the ventilator-dependent patient and may require monitoring of airway pressure and flow waveforms.

TL;DR: To determine selectively whether macrophages can cause lung injury and what mediators they may contribute to the complex interactions among inflammatory cells, cytokines, proteases, oxygen radicals, and lipid mediators that participate in early sepsis-induced lung injury, two experimental approaches are described.

TL;DR: The different manipulations of NO pathway during sepsis are described (transcription and post-transcription of iNOS, enzymatic function, substrate availability, NO concentration, and NO effector molecules), although their clinical benefit remains controversial.

TL;DR: To assess the presence of expiratory flow limitation correctly, to measure auto-PEEP correctly, and to identify the maximal PEEP level to be used, measurements of flow and opening pressure must be obtained during a brief period of suspended respiratory muscle activity with the patient's own breathing pattern reproduced accurately.

TL;DR: Bacterial pneumonia remains an important cause of treatable morbidity among HIV-1-infected persons andBronchopneumonia should be considered particularly in the setting of segmental or lobar consolidation associated with productive cough and fever.

TL;DR: This article examines interactions between the lungs and the liver during microbial sepsis from four interrelated elements of host defense: control of systemic endotoxemia, bacteremia, and vasoactive by-products of seps is controlled via hepatic mononuclear phagocytic (Kupffer's) cell clearance.

TL;DR: Isoniazid preventive therapy substantially reduces the risk of tuberculosis in persons with HIV infection and newer agents, such as the macrolides and rifabutin, form the nucleus of treatment regimens and also are effective in preventing the disease.

TL;DR: The role of granulocyte colony-stimulating factor as a proinflammatory mediator and a potential adjuvant treatment in patients with severe infection are examined.

TL;DR: Many new approaches to mechanical ventilation have been developed, including lung protection conventional ventilation strategies, long inspiratory time strategies, pressure-targeted breath enhancements, airway pressure-related release ventilation, and proportional-assist ventilation.

TL;DR: In this paper, iCa2+ accumulation may play an important role in the progression from early sepsis to MODS, the most common cause of mortality in the ICU.

TL;DR: The clinical presentation, diagnosis, and treatment of the pulmonary complications of the malignancies associated with HIV infection are discussed.

TL;DR: Pulmonary diseases continue to be important causes of illness and death in patients with HIV infection, but changes in therapy and demographics of HIV-infected populations are changing their manifestations.

TL;DR: The approach to the HIV-infected patient with pulmonary disease is summarized by the algorithms in Figures 3 and 4, and should avoid unnecessary procedures in patients with simple bacterial infections, without missing opportunistic infections and tumors.

TL;DR: The characteristics of volume-cycled and pressure-controlled ventilation are reviewed and in detail conversion from one mode to the other is discussed.

TL;DR: There is no clinical evidence that augmenting DO2 to supernormal levels decreases organ dysfunction or mortality in sepsis, and improved techniques to assess tissue hypoxia at the organ level are needed and therapies directed at correcting the maldistribution of blood flow and O2 use defects of seps is needed.