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Unilateral Extrapul...
Unilateral Extrapulmonary Airway Bypass in Advanced Emphysema
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- Moore, Alastair J. (author)
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, United Kingdom
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- Cetti, Edward (author)
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, United Kingdom
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- Haj-Yahia, Saleem (author)
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Trust, London, United Kingdom
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- Carby, Martin (author)
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, United Kingdom
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- Björling, Gunilla, Docent (author)
- Karolinska Institutet,Sophiahemmet Högskola,Division of Anaesthesia and Intensive Care, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm
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- Karlsson, Sigbritt (author)
- KTH,Fiber- och polymerteknologi,Fibre and Polymer Technology, School of Chemical Science and Engineering, Royal Institute of Technology, Stockholm
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- Shah, Pallav (author)
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, United Kingdom
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- Goldstraw, Peter (author)
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Trust, London, United Kingdom
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- Moxham, John (author)
- Department of Respiratory Medicine, Kings College Hospital, London, United Kingdom
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- Jordan, Simon (author)
- Department of Thoracic Surgery, Royal Brompton and Harefield NHS Trust, London, United Kingdom
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- Polkey, Michael I. (author)
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, United Kingdom
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(creator_code:org_t)
- Elsevier BV, 2010
- 2010
- English.
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In: Annals of Thoracic Surgery. - : Elsevier BV. - 0003-4975 .- 1552-6259. ; 89:3, s. 899-906E2
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https://doi.org/10.1...
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Abstract
Subject headings
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- Background. Gas trapping in emphysema results in resting and dynamic hyperinflation. We tested the hypothesis that a direct connection between the lung parenchyma and the atmosphere could increase expiratory flow and thereby potentially improve dyspnea through the relief of gas trapping. Methods. Ex vivo we studied 7 emphysematous lungs and 3 fibrotic lungs (as controls) and measured expiratory flow before and after airway bypass insertion during a forced maneuver in an artificial thorax. Pilot studies were conducted in vivo in 6 patients with advanced emphysema using a size 9 endotracheal tube as a bypass surgically placed through the chest wall into the upper lobe. Results. In the ex vivo emphysematous lungs the volume expelled during a forced expiratory maneuver increased from 169 to 235 mL (p < 0.05). In the in vivo group 4 patients retained the bypass tube for 3 months or more; total lung capacity was reduced, and the forced expiratory volume in 1 second increased by 23% (mean percent predicted at baseline versus 3 months, 24.4% versus 29.5%). Conclusions. An extrapulmonary airway bypass increases expiratory flow in emphysema. This may be a useful approach in hyperinflated patients with homogeneous emphysema. (Ann Thorac Surg 2010;89:899-906)
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
Keyword
- lung-volume-reduction
- obstructive pulmonary-disease
- collateral
- ventilation
- dynamic hyperinflation
- expiratory flow
- exercise
- copd
- hospitalization
- exacerbation
- improves
- Surgical research
- Kirurgisk forskning
- Caring sciences
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Moore, Alastair ...
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Cetti, Edward
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Haj-Yahia, Salee ...
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Carby, Martin
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Björling, Gunill ...
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Karlsson, Sigbri ...
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show more...
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Shah, Pallav
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Goldstraw, Peter
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Moxham, John
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Jordan, Simon
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Polkey, Michael ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Nursing
- Articles in the publication
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Annals of Thorac ...
- By the university
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Royal Institute of Technology
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Sophiahemmet University College
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Karolinska Institutet
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Red Cross University College