0000000000000144
AUTHOR
John R. Bach
showing 5 related works from this author
Neuromuscular and Chest Wall Diseases in Pregnancy
2009
Patients with severe respiratory muscle impairment, in particular when vital capa-city is below 60% of the predicted normal values, are often discouraged frombecoming pregnant for fear of respiratory complications and the need for tra-cheostomy and invasive mechanical ventilation (1). A growing fetus can impairthe functioning of weak diaphragms resulting in lower vital capacity and respira-tory reserve and impair cough function. In addition, there is increased oxygenconsumption and ventilation requirement. Complications in pregnancy and theneed for analgesics and anesthesia during labor and delivery can also cause orexacerbate ventilatory failure.Neuromuscular DiseasesNeuromuscular diseases…
Kyphoscoliosis ventilatory insufficiency: noninvasive management outcomes.
2000
Objective: To determine the effects on symptoms, pulmonary function, sleep, and other clinical variables of treating kyphoscoliosis-associated chronic alveolar hypoventilation with nocturnal nasal ventilation. Design: Sixteen patients with kyphoscoliosis were treated with nocturnal nasal ventilation delivered by volume-cycled (seven patients) and pressure-cycled (nine patients) ventilators. Dyspnea, morning headaches, fatigue, hypersomnolence, and perceived sleep quality were assessed. Results: All pretreatment symptoms improved significantly with nasal ventilation. Likewise, Pao 2 (mm Hg), Pao 2 /Fio 2 , Paco 2 (mm Hg), pH, and forced vital capacity (in milliliters and as a percentage of p…
Endurance training in patients with chronic obstructive pulmonary disease: a comparison of high versus moderate intensity.
2000
Abstract Gimenez M, Servera E, Vergara P, Bach JR, Polu J-M. Endurance training in patients with chronic obstructive pulmonary disease: a comparison of high versus moderate intensity. Arch Phys Med Rehabil 2000;81:102-9. Purpose: To create a maximum tolerated 45-minute aerobic training program for patients with chronic obstructive pulmonary disease (COPD) and to compare its outcomes with those of commonly prescribed moderate exercise. Design: Prospective, randomized trial. Setting: A work physiology laboratory. Patients and Methods: The maximum exercise intensities that 7 COPD patients could sustain for 45 minutes were determined on a bilevel exercise ergometer. The patients then exercised …
Effect of lung mechanics on mechanically assisted flows and volumes.
2004
To correlate the air flows generated by mechanical insufflation-exsufflation as a function of pressure delivery in a lung model at two pulmonary compliance and three airway resistance settings.With each combination of pulmonary compliances of 25 and 50 ml/cm H2O and airway resistances of 6, 11, and 17 cm H2O/liter/sec, ten cycles of mechanical insufflation-exsufflation were applied using pressure deliveries of 40 to -40, 50 to -50, 60 to -60, and 70 to -70 cm H2O. The resulting peak exsufflation flows and volumes were recorded.In a multivariate analysis, the pulmonary compliance, airway resistance, and pressure delivery were all found to significantly affect exsufflation flows and volumes s…
Noninvasive Ventilatory Assistance During Exercise for Patients with Kyphoscoliosis
2007
The goal was to determine whether noninvasive ventilatory assistance (NIV) could facilitate exercise performance and benefit physiologic parameters for eight hypercapnic kyphoscoliosis patients using a cycloergometer for 6-min periods at a constant power (20 W). The exercise protocols were performed in random order while breathing unaided (spontaneous breathing test or SBT) and also while receiving NIV (NIV test or NIVT). The NIV was pressure support (15 cm H2O) plus positive end expiratory pressure (PEEP) (4 cm H2O) via a nasal mask. Of the compared parameters, heart rate was not significantly different, but acidosis (pH = 7.32 +/- 0.04 vs. 7.36 +/- 0.04), hypoxia (PaO2 = 61.5 +/- 15.9 vs.…