[Clinico-functional effect of a course of interval normobaric hypoxic therapy in patients with chronic obstructive bronchitis and bronchial asthma]. / Kliniko-funktsional'nyi éffekt kursa interval'noi normobaricheskoi gipoksiterapii u bol'nykh khronicheskim obstruktivnym bronkhitom i bronkhial'noi astmoi.

AIM: To study short- and long-term clinicofunctional effects of primary and secondary courses of interval normobaric hypoxia (INH) in patients with chronic obstructive bronchitis (COB) and bronchial asthma (BA). MATERIALS AND METHODS: The study group of 45 COB and BA patients were exposed to INH. The control group of 20 COB and BA patients received conventional drugs. The INH patients were examined using the acute hypoxia test, return respiration test, peak-flowmetry, assessment of external respiration function (ERF), immune status, heart rate, blood pressure. Stange test ERF and the disease course within the last 2-3 years were analyzed. RESULTS: INH proved more beneficial for COB and BA patients than the standard drugs. Bronchial obstruction reduced by 10-15%, exercise tolerance, general condition, ventilation, hemodynamic and immunological parameters improved, frequency of bronchopulmonary infection exacerbations dropped 2-fold. CONCLUSION: An INH course is effective in the majority of COB and BA patients. It is recommended for treatment and rehabilitation once or twice a year.

[Effect of oxygen in different concentrations and free radical-anti-radical activity system in patients with chronic pulmonary insufficiency]. / Vozdeistvie kisloroda raznoi kontsentratsii na sistemu svobodnoradikal'naia-antiradikal'naia aktivnost' u bol'nykh khronicheskoi legochnoi nedostatochnost'iu.

The study of free-radical processes elucidated concentrations of O2 producing a negative effect in chronic obstructive bronchitis sufferers with respiratory insufficiency (RI). In RI of the second and third degree concentration of inhaled O2 should not exceed 50%. In this concentration O2 toxicity is not evident, unbalance of the system free radical-antiradical activity is less pronounced, O2 transport from the lungs to the tissue reaches optimal level. A course of oxygen therapy (20 daily sessions lasting 30 min., 50% O2) is not toxic, promoted activation of SOD and alleviation of arterial hypoxemia.

[Possibilities of normobaric hypoxic training in rehabilitation of patients with chronic bronchitis]. / Vozmozhnosti normobaricheskoi gipoksicheskoi trenirovki v reabilitatsii bol'nykh khronicheskim bronkhitom.

To provide evidence for the potentialities of normobaric hypoxic training (NHT), oxygen cascades from the lung to tissues and responses to hypoxic and hypercapnic stimuli were analyzed in chronic bronchitis patients with Stages 1, 2, and respiratory failure. Since at Stages 2 and 3, compensatory responses are substantially decreased, there is arterial, and occasionally, venous hypoxemia, NHT is contraindicated in these patients. Compensatory responses are preserved only during early stages 0 and 1 respiratory failure, showing it expedient to employ NHT. NHT regimens (as many as 20 sessions) used in these patients improved the patients' condition and physical activity, normalized ventilation function. However, the concurrent diseases exacerbated in some cases. Medical monitoring is needed when the NHT regimen is used.

[The functional characteristics of an additional dead space and a respirator for preparing hypoxic-hypercapnic mixtures intended for respiration training]. / Funktsional'nye kharakteristiki dopolnitel'nogo "mertvogo" prostranstva i respiratora dlia prigotovleniia gipoksichesko-giperkapnicheskoi smesi, primeniaemykh dlia trenirovki dykhaniia.

A study was made of the characteristics of respiration recorded during the use of a respirator for preparing hypoxic hypercapnic mixtures as compared to the use of an additional "dead" space. In both cases, there was a significant increase of total ventilation, largely at the expense of respiration deepening. However, during respiration via a respiratory mask, the increase of the minute respiratory volume was accompanied by a rise of alveolar ventilation whereas during respiration via the ADS, alveolar ventilation dropped. Hyperventilation did not entail CO2 washing out from the blood and hypocapnia development during respiration via the mask and ADS. The differences revealed may appear helpful for respiration training at the hospital. In this case, an appropriate outfit should be sorted out for each patient on an individual basis.

[The hospital stage of the long-term oxygen therapy of chronic lung failure in patients with chronic obstructive bronchitis]. / Statsionarnyi étap dlitel'noi kislorodoterapii khronicheskoi legochnoi nedostatochnosti u bol'nykh s khronicheskim obstruktivnym bronkhitom.

The authors analyze the role of the initial inpatient stage of long-term oxygen therapy (LOT) in combined treatment of chronic pulmonary failure in patients with chronic obstructive bronchitis, lung emphysema, and pneumosclerosis. The treatment lasted 30 days both in the main and in the control groups. In addition to basic therapy, the main group patients received 38% O2 for 15 h a day. To decrease the risk of PaCO2 elevation with a possible respiratory disorder, particularly in patients with initial hypercapnia, it is suggested that a special oxygen test with simultaneous control of acid-base balance and gas composition of the arterial blood may be carried out. In contrast to the control group, the main group patients demonstrated an improvement of gas composition of the arterial blood and of the parameters such as the alveolar-arterial gradient according to O2, the physiological pulmonary shunt. The combined use of oxygen therapy and resistance at expiration made it possible to ameliorate a number of external respiration function parameters, diffusion lung capacity, and enhanced the effect of oxygen therapy. It is shown that patients with PaO2 may be given LOT within the range of 60-69 mm Hg, provided the pulmonary physiological shunt exceeds 20%.

[The role of sleep apnea in the pathogenesis of cardio-pulmonary insufficiency in patients with chronic obstructive bronchitis]. / O roli nochnogo apnoé v patogeneze legochno-serdechnoi nedosta- tochnosti u bol'nykh khronicheskim obstruktivnym bronkhitom.

Continuous registration of breath, ECG, O2 tension was carried out in sleeping chronic obstructive bronchitis (COB) patients (n-46). Sleep apnea was detected in 19 of them. It was found that signs of pulmonary insufficiency in association of COB and sleep apnea occur significantly earlier. No correlation was observed between the severity of bronchial obstruction and pathological sleep apnea. The discussion covers mechanisms of pulmonary and cardiac insufficiency onset in COB patients with sleep apnea, therapeutic responses to long-term oxygen treatment and introduction of artificial respiratory control.

[Use of normobaric hypoxia in the combined modality therapy of patients with chronic bronchitis]. / Primenenie normobaricheskoi gipoksii v kompleksnom lechenii bol'nykh khronicheskim bronkhitom.

The authors review the main physiological alterations occurring in the body under the influence of hypoxia. Provide the data on successful use of the method in the treatment of a number of diseases with a purpose of increasing nonspecific resistance of the body. Based on the review of literature provide evidence for the use of normobaric hypoxic stimulation (NHOS) in multimodality treatment and prophylaxis of patients suffering from chronic bronchitis (CB). A study was made of the reactions of the cardiorespiratory system towards normobaric hypoxia and of the clinical effect of the continuous treatment with NHOS. The increase of nonspecific resistance of the body was noted, which manifested itself by the deceleration of CB exacerbations, optimization of the work of the cardiorespiratory system and rise of exercise tolerance after a course of NHOS. Recommendations are given for the use of the given method in multimodality treatment and rehabilitation of CB patients.

[The use of a respiratory regulator in the combined therapy of obstructive lung diseases]. / Ispol'zovanie reguliatora dykhaniia v kompleksnoi terapii obstruktivnykh zabolevanii legkikh.

The authors review a method for the treatment of patients suffering from nonspecific pulmonary diseases associated with the obstructive syndrome by means of a respiratory regulator which permits the building of positive pressure of 2-4 cm H2O throughout expiration. External respiration, gas exchange and hemodynamics were explored in 30 patients with chronic obstructive bronchitis and in 30 patients with bronchial asthma treated by the respiratory regulator. There were clinical and functional data indicating the lowering of bronchial obstruction: an increase of the lung capacities, improvement of the velocity indicators, and improvement of the ventilation-perfusion correlations in the lungs.

[A method of determining respiratory resistance by interrupting the air flow]. / Metodika opredeleniia soprotivleniia dykhaniia metodom preryvaniia vozdushnogo potoka.

Air flow interruption was employed to check up the correctness of respiratory resistance measurements. The least scatter and minimum influence of muscle efforts perverting the alveolar pressure are obtained with pressure gained in the mouth after oscillations. Provided the resistance is computed in such a manner, the rate of the flow is measured before the interruption. It has been established that air flow interruption should be best performed during quiet respiration, at a rate approximating the maximum one, i.e. at about 0.5 l/s. To obtain sufficiently stable data, it is necessary to derive the mean value from several (at least 5) respiratory cycles.