We have shown that resistive breathing training did not improve the ability to breathe through higher resistances. Furthermore, we found no improvement in ventilatory muscular endurance as measured by the maximal sustained ventilatory capacity and no change in maximal respiratory pressures; however, we did find that an altered pattern of breathing with a longer Ti […]

We emphasize that combined LVRS and wedge resection of pulmonary nodules is not appropriate for all patients with severe COPD and an indeterminate pulmonary nodule. Our results are applicable only to a highly select group of patients who underwent surgery primarily for emphysema, not the lung nodule. Our patients were selected for LVRS on the […]

While much of the improvement in lung function expected after LVRS appears gradually over the first several months after surgery, there are recent data suggesting improved static elastic recoil pressure in the immediate postoperative period which could lead to early improvement in airflow characteristics and, therefore, could have simplified perioperative management. Preliminary reports have suggested […]

Based on years of experience with pulmonary resection, extensive criteria have been developed to select patients with minimal risk for perioperative complications and postoperative respiratory insufficiency. The exclusionary criteria are listed in Table 4. Using criteria based upon the FEVl7’ predicted postoperative FEV predicted postoperative Deo, or maximum oxygen uptake on exercise testing, our patients would […]

The postoperative mortality rate was 0% in the study and control groups. In addition, only two patients in the study group developed evidence of significant morbidity. Patient 1 developed right middle lobe pneumonia and patient 5 had a prolonged air leak requiring continued chest tube use. In the control group, three patients developed postoperative complications. […]

From January 1995 to June 1996, 467 patients were evaluated for LVRS at the University of Michigan Medical Center. Of these, 113 were deemed appropriate for surgery and 75 have undergone either unilateral (16 patients) or bilateral (59 patients) LVRS. Eleven patients were noted to have single pulmonary nodules, defined as a nodule measuring 2 […]

Surgical techniques for study patients included either median sternotomy with bilateral apical lung volume reduction utilizing a linear stapler buttressed with strips of bovine pericardium or unilateral lower lobe reduction via a muscle-sparing thoracotomy. The location and volume of resected tissue were guided by findings from HRCT and SPECT scanning that delineated those areas involved […]

All patients underwent a detailed history and physical examination. Breathlessness was measured using the baseline/transitional dyspnea indexes (BDI/TDI) of Mahler et al. Routine laboratory data included CBC count, electrolytes, and liver function studies. Pulmonary Function Testing: Spirometry and lung volumes were performed on a calibrated pneumotachograph (Medical Graphics Co.; St. Paul, Minn) and values were […]

Pulmonary malignancy is the single most common cause of cancer death in both men and women in the United States. Most patients with bronchogenic carcinoma also have coexisting obstructive lung disease. In these individuals, the goal of management is to resect the malignancy without compromising respiratory function. Many investigators have sought to define the risks […]

The study by Turner et al of 985 patients using home nebulizers reported that 50.6% of patients were adherent and 49.4% were nonadherent with their prescribed regimen. They also reported that adherence was not related to the effects of illness on daily functioning. This finding may contrast with the present one as these patients were […]