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Effect of upper-airway stimulation for obstructive sleep apnoea on airway dimensions.

This study evaluated stimulation effects on retropalatal and retrolingual dimensions during drug-induced sedation compared with wakefulness to assess mechanistic relationships in response to UAS. Patients with an implanted stimulator underwent nasal video endoscopy while awake and/or during drug-induced sedation in the supine position. The cross-sectional area, anterior-posterior and lateral dimensions of the retropalatal and retrolingual regions were measured during baseline and stimulation.

15 patients underwent endoscopy while awake and 12 underwent drug-induced sedation endoscopy. Increased levels of stimulation were associated with increased area of both the retropalatal and retrolingual regions. During wakefulness, a therapeutic level of stimulation increased the retropalatal area by...

E-Cigarette Vapor May Be Less Toxic Than Tobacco Smoke: Study

Secondhand vapor created by one brand of electronic cigarette harbors fewer hazardous chemicals than regular cigarette smoke, although the researchers report the finding doesn't leave e-cigarettes in the clear.

The study has caveats. For one, it doesn't examine which hazardous chemicals in e-cig vapor actually make it into the lungs of people nearby. And the scientists only looked at indoor smoking, which is often banned in the United States.

Still, the findings indicate that "generally speaking, e-cigarettes are safer than traditional cigarettes," said study author Arian Saffari, a graduate student and fellow with the department of civil and environmental engineering at the University of Southern California. However, "we can still find some hazardous material in e-cigarette smoke," Saffari noted. "And therefore we cannot leave e-cigarettes unregulated." ...

Can non‐invasive positive pressure ventilation prevent endotracheal intubation in acute lung injury/acute respiratory distress syndrome? A meta‐analysis

The role of non-invasive positive pressure ventilation (NIPPV) in acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) is controversial. The aim of this study was to investigate whether NIPPV could prevent endotracheal intubation and decrease mortality rate in patients with ALI/ARDS.

Randomized controlled trials (RCT) which reported endotracheal intubation and mortality rate in patients with ALI/ARDS treated by NIPPV were identified in Pubmed, Medline, Embase, Central Cochrane Controlled Trials Register, Chinese National Knowledge Infrastructure, reference lists and by manual searches. Fixed- and random-effects models were used to calculate pooled relative risks. This meta-analysis included six RCT involving 227 patients. The results showed that endotracheal intubation rate was lower in NIPPV (95% confidence interval (CI): 0.44–0.80, z = 3.44, P = 0.0006), but no significant difference was found either in intensive care unit (ICU) mortality (95% CI: 0.45–1.07, z = 1.65, P = 0.10) or in hospital mortality (95% CI: 0.17–1.58, z = 1.16, P = 0.25). Only two studies discussed the aetiology of ALI/ARDS as pulmonary or extra-pulmonary, and neither showed statistical heterogeneity (I2 = 0%, χ2 = 0.31, P = 0.58), nor a significant difference in endotracheal intubation rate (95% CI: 0.35–9.08, z = 0.69, P = 0.49).

In conclusion, the early use of NIPPV can decrease the endotracheal intubation rate in patients with ALI/ARDS, but does not change the mortality of these patients.

E-cigarettes: Studies presented at the ERS Congress

(European Lung Foundation) The latest evidence on the potential benefits and risks of e-cigarettes has been presented this week at the European Respiratory Society's International Congress in Munich. (Source: EurekAlert! - Medicine and Health)

Associations and outcomes of septic pulmonary embolism.

CONCLUSION: The epidemiology of septic pulmonary embolism has broadened over the past decade with an increase in identified extrapulmonary, non-cardiac sources. In the context of an extrapulmonary infection, clinical features of persistent fever, bacteremia and pulmonary complaints should raise suspicion for this syndrome, and typical findings on the chest CT scans confirm the diagnosis. Antibiotics, local drainage procedures and increasingly, anticoagulation are keys to successful outcomes. PMID: 25184008 [PubMed] (Source: Respiratory Care)

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