Respiratory Mechanics in Lung Disease and Surgery

肺部疾病和外科手术中的呼吸力学

基本信息

  • 批准号:
    6765148
  • 负责人:
  • 金额:
    $ 27.79万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    1996
  • 资助国家:
    美国
  • 起止时间:
    1996-08-01 至 2006-06-30
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Chronic obstructive pulmonary disease (COPD) is a life-threatening, debilitating disease affecting more than 2 million Americans. New surgical therapies such as lung transplantation and lung volume reduction surgery (LVRS) can improve quality of life and pulmonary function in COPD. However, questions remain as to which patients are most likely to benefit from these therapies and why surgery is effective in some patients and not in others. We will continue an observational study of respiratory mechanics in a large cohort of patients with COPD before and after lung transplantation and LVRS. Our rationale is that our coordinated program of respiratory mechanical investigation will continue to provide insights and suggest useful measures of respiratory function that will reveal mechanisms of disease. Specific aims are: 1) To measure the maximal inspiratory pressure-volume characteristic of the chest wall in patients before and after lung transplantation or LVRS to assess changes in inspiratory function of the chest wall. We will test the hypothesis that inspiratory function of the chest wall is often compromised after operation, and that chest wall restriction is an important cause of failure to improve after LVRS or single lung transplantation for emphysema. If true, this finding would lead to studies of the origins and remedies of chest wall restriction after surgery. 2) To explore the differences between lung volumes measured by multiple breath helium dilution, plethysmography, and computed tomography (CT). Accurate measurements of lung volume are essential for diagnosis, for documentation of hyperinflation, for evaluation of patients before surgery, and for assessment of the effects of LVRS and transplantation. We will test the hypothesis that, contrary to current belief, helium dilution is more accurate than plethysmography in patients with COPD. If true, this finding would change clinical practice in this important group. 3) To develop methods to measure the pressure-area characteristics of the trachea in patients undergoing bronchoscopy and to determine whether the site of expiratory flow limitation in these patients is in the lungs or trachea. Acquired tracheomalacia is reportedly common in patients with COPD, and can cause severe expiratory obstruction that may be relieved by stenting or surgical reinforcement of the airway. We will test the hypothesis that many patients with demonstrated tracheomalacia and central airway collapse have obstruction caused by collapse of intrapulmonary airways, which is not amenable to surgical correction. Our findings will provide normative data on tracheal collapsibility not currently available, explore the association between tracheomalacia and COPD, and test a method for predicting the effect of stenting on expiratory obstruction in these patients.
描述(申请人提供):慢性阻塞性肺病 慢性阻塞性肺病(COPD)是一种危及生命、使人虚弱的疾病,影响着超过2 百万美国人。肺移植和肺等新的外科治疗方法 肺减容手术(LVRS)可改善患者的生活质量和肺功能 在慢性阻塞性肺疾病中的作用。然而,关于哪些患者最多的问题仍然存在。 可能从这些疗法中受益,以及为什么手术对某些人有效 而不是在其他人身上。我们将继续进行观测研究 大量COPD患者治疗前后的呼吸力学研究 肺移植和左肺减容术。我们的理论基础是我们的协调计划 呼吸机械调查将继续提供洞察力和 建议有用的呼吸功能测量方法,以揭示 疾病。具体目标是:1)测量最大吸气量 患者手术前后胸壁压力-容量特征的研究 肺移植或左肺减容术评估患者吸气功能的变化 胸壁。我们将检验这个假设,即胸部的吸气功能 手术后胸壁经常受损,胸壁限制是 肺减容术后或单肺功能改善失败的重要原因 移植治疗肺气肿。如果这是真的,这一发现将导致对 手术后胸壁受限的原因及处理方法。2)探索 多次呼气氦气测量肺体积的差异 稀释、体积描记和计算机断层扫描(CT)。精确测量 肺体积对于诊断、记录 恶性充气,用于术前患者评估和评估 左肺反搏和移植的效果。我们将检验这一假设, 与目前的看法相反,氦的稀释比 慢性阻塞性肺疾病患者的体积描记。如果是真的,这一发现将会改变 临床实践中的这一重要群体。3)开发方法来测量 急性呼吸窘迫综合征患者气管压力-面积特征 支气管镜检查并确定呼气流速受限的部位 这些患者位于肺部或气管内。获得性气管软化是 据报道,这在COPD患者中很常见,可能会导致严重的呼气 梗阻可通过支架植入或外科手术加强来缓解 气道口。我们将检验这样一种假设,即许多患者都证明了 气管软化和中央气道塌陷有塌陷引起的阻塞 肺内呼吸道,这是不能手术矫正的。我们的 这些发现将提供目前尚未提供的关于气管塌陷的标准化数据 探索气管软化与慢性阻塞性肺疾病之间的联系,并测试a 预测支架置入术对这些患者呼气性阻塞影响的方法 病人。

项目成果

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STEPHEN H LORING其他文献

STEPHEN H LORING的其他文献

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{{ truncateString('STEPHEN H LORING', 18)}}的其他基金

EPVent 2-A Phase II Trial Esophageal Pressure Guided Ventilation
EPVent 2-A II 期试验食管压力引导通气
  • 批准号:
    8700476
  • 财政年份:
    2012
  • 资助金额:
    $ 27.79万
  • 项目类别:
EPVent 2-A Phase II Trial Esophageal Pressure Guided Ventilation
EPVent 2-A II 期试验食管压力引导通气
  • 批准号:
    8536932
  • 财政年份:
    2012
  • 资助金额:
    $ 27.79万
  • 项目类别:
Ancillary Study
辅助研究
  • 批准号:
    8309670
  • 财政年份:
    2012
  • 资助金额:
    $ 27.79万
  • 项目类别:
EPVent 2-A Phase II Trial Esophageal Pressure Guided Ventilation
EPVent 2-A II 期试验食管压力引导通气
  • 批准号:
    8283454
  • 财政年份:
    2012
  • 资助金额:
    $ 27.79万
  • 项目类别:
MESOTHELIAL LUBRICATION AND PLEURAL HOMEOSTASIS
间皮润滑和胸膜稳态
  • 批准号:
    6351582
  • 财政年份:
    2000
  • 资助金额:
    $ 27.79万
  • 项目类别:
MESOTHELIAL LUBRICATION AND PLEURAL HOMEOSTASIS
间皮润滑和胸膜稳态
  • 批准号:
    6027276
  • 财政年份:
    2000
  • 资助金额:
    $ 27.79万
  • 项目类别:
Mesothelial Lubrication and Pleural Homeostatsis
间皮润滑和胸膜稳态
  • 批准号:
    7446064
  • 财政年份:
    2000
  • 资助金额:
    $ 27.79万
  • 项目类别:
Mesothelial Lubrication and Pleural Homeostatsis
间皮润滑和胸膜稳态
  • 批准号:
    7253935
  • 财政年份:
    2000
  • 资助金额:
    $ 27.79万
  • 项目类别:
Mesothelial Lubrication and Pleural Homeostatsis
间皮润滑和胸膜稳态
  • 批准号:
    6917022
  • 财政年份:
    2000
  • 资助金额:
    $ 27.79万
  • 项目类别:
Mesothelial Lubrication and Pleural Homeostatsis
间皮润滑和胸膜稳态
  • 批准号:
    6827663
  • 财政年份:
    2000
  • 资助金额:
    $ 27.79万
  • 项目类别:

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慢性阻塞性肺疾病精准治疗优化:动态治疗方案分析
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HIV 感染者慢性阻塞性肺病恶化的危险因素、护理质量和结果
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