ABSTRACT
Introduction：Respiratory failures are categorized into types I and II. To our knowledge, we report the first case of pulmonary rehabilitation in a patient with systemic sclerosis/polymyositis overlap syndrome who developed type II respiratory failure.Methods：The patient was a 77-year-old woman who had received treatment for systemic sclerosis and polymyositis at another hospital. When she visited our hospital to obtain a second opinion, she suddenly lost consciousness and underwent trachea intubation because of typeⅡrespiratory failure. She received physical therapy on the third day of hospitalization and underwent a tracheotomy on the 16th day. As her thoracic movement was markedly restricted, we started physical training. After she was weaned off from the ventilator on the 43rd day, we performed muscular strength training and aerobic exercise. No exacerbation of CO2 storage was observed even if chest motion training was performed. She was discharged on the 72nd day and advised to wear retina®．Administration of therapeutic drugs such as steroids was maintained at the same dose.Conclusion：Physical therapy, such as chest mobilization, was effective for marked restriction of chest movement in a patient who had both polymyositis and systemic sclerosis.
ABSTRACT
Introduction：Respiratory failures are categorized into types I and II. To our knowledge, we report the first case of pulmonary rehabilitation in a patient with systemic sclerosis/polymyositis overlap syndrome who developed type II respiratory failure.Methods：The patient was a 77-year-old woman who had received treatment for systemic sclerosis and polymyositis at another hospital. When she visited our hospital to obtain a second opinion, she suddenly lost consciousness and underwent trachea intubation because of typeⅡrespiratory failure. She received physical therapy on the third day of hospitalization and underwent a tracheotomy on the 16th day. As her thoracic movement was markedly restricted, we started physical training. After she was weaned off from the ventilator on the 43rd day, we performed muscular strength training and aerobic exercise. No exacerbation of CO2 storage was observed even if chest motion training was performed. She was discharged on the 72nd day and advised to wear retina®．Administration of therapeutic drugs such as steroids was maintained at the same dose.Conclusion：Physical therapy, such as chest mobilization, was effective for marked restriction of chest movement in a patient who had both polymyositis and systemic sclerosis.
ABSTRACT
Objective: To analyze the application value of heated humidifier and water humidifier of BiPAP ventilator in the treatment of type II respiratory failure. Methods: The clinical data of 50 patients with type II respiratory failure were statistically analyzed, and these patients were divided into heated humidifier group (adopted heated humidifier, n=25) and water humidifier group (adopted water humidifier, n=25) according to the difference of humidifying device of BiPAP ventilator. The PaO2, PaCO2, pH and the effect of humidifier for upper respiratory tract with dry sensation between pre-and post treatment were analyzed by statistical method. Results: The values of PaO2and pH of heated humidifier group were significantly higher than that of water humidifier group (t=4.303, t=3.182, P<0.05), respectively. While the PaCO2of heated humidifier group was significantly lower than that of water humidifier group (t=6.965, P<0.05). In the contrast of dry sensation of upper respiratory tract, the ratio of non-dry sensation in heated humidifier group was 84.0% (21/25) and it was 32.0% (8/25) in water humidification group, and the difference between the two groups was significant (x2=12.83, P<0.05). And the ratio of general dry sensation in heated humidifier group was 16.0% (4/25) and it was 40.0% (10/25) in water humidification group, and the ratio of heated humidifier group was significantly lower than that of water humidifier group (x2=5.02, P<0.05). Besides, the ratio of worst dry sensation in heated humidifier group was 0 and it was 28.0% (7/25) in water humidifier group, and the ratio of heated humidifier group was significantly lower than that of water humidifier group (x2=7.38, P<0.05). Conclusion: In the treatment of type II respiratory failure by using BiPAP ventilator, the application value and effect of heated humidifier is higher than that of water humidifier, so it is worthy to promote and use the heated humidifier in clinical practice.
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Objective To investigate the immune protective effect of recombinant growth hormone on chronic obstructive pulmonary disease ( COPD) patients with typeⅡin respiratory failure during the application of ventilator.Methods 52 patients with COPD with respiratory failure in Taizhou City Hospital from July 2014 to November 2015 in this study who were treated with ventilator therapy were divided into two groups.The control group received routine treatment, and the treatment group received more with recombinant growth hormone 8 U/d subcutaneous injected.Before and after treatment 14 days,determination of nutritional indicators,immune function,inflammatory markers and indicators of oxidative stress.Results Compared with before treatment,levels of total protein,albumin,transferrin and fibronectin in 2 groups after treatment increased,levels of IgM,IgG,CD4 +,CD8 +and CD4 +/CD8 +increased,levels of TNF-α,IL-8 and CRP decreased,levels of MDA,GSH and TAO decreased,levels of SOD increased(P<0.05), compared with the control group,levels of total protein,albumin,transferrin and fibronectin in the treatment group were higher,levels of IgM,IgG,CD4 +, CD8 +and CD4 +/CD8 +were higher,levels of TNF-α,IL-8 and CRP were lower,levels of MDA,GSH and TAO were lower,levels of SOD were higher (P<0.05).Conclusion Recombinant growth hormone has immune function protective effect on the COPD patients with type II respiratory failure in the process of breathing machine, which can improve the nutritional index and reduce the inflammatory reaction.