Postlaryngectomy Respiratory System and Speech Breathing

Aim. To study the prognostic value of the results of dynamic capnography in the complex assessment of parameters of the respiratory system in 6-minute walk test in patients with chronic heart failure (CHF). Materials and Methods. 73 Patients were examined: the group of study included 48 patients with IIA or IIB stage CHF (mean age 57.94.6 years, 23 men), the control group included 25 practically healthy volunteers (mean age 47.63.5 years, 9 men). The patients were conducted complex determination of parameters of the respiratory system: clinical scaling before and after 6-minute walk test (6MWT), instrumental examinations including spirometry, capnography and pulse oximetry before, during and after physical activity. The analysis of survival was conducted on the basis of the dynamic follow-up of patients within 5 years (60 months). Results. In the analysis of parameters of dyspnea at rest, all the parameters were higher in the group of patients with CHF (р0.05). The distance walked by the patients with CHF in 6 minutes was 488.2390.84 m, which was significantly less than in the control group (815.6053.89 m, р=0.009). Dyspnea as the cause of stoppage/slowing down of walking in 6MWT, was also more often recorded in patients with CHF (93.83.0% and 48.05.1%, р=0.049). Besides, in 6MWT the patients noted: weakness in legs (50.15.0% in the group of CHF and 40.05.0% in the control group, р=0.014), palpitation (29.04.6% and 20.04.1%, respectively, р=0.004). Worsening of dyspnea parameters in 6MWT was more evident in patients with CHF than in the control group (р0.01). In the CHF group, hypocapnic type of ventilation was revealed in 6MWT, analysis of РЕТСО2 trend graphs revealed a wave-like increase in the parameters, the so called periodic breathing (PB). CO2 trend was recorded in CHF group in 58.31.0% of cases (the difference with the control group with р=0.046), the trend of heart rate in 18.80.3% of cases (р=0.027). Cox proportional hazards regression analysis of mortality in patients with CHF showed a prognostic significance of a complex model comprising the following parameters of a patient: body mass index (р=0.005), left ventricular end-diastolic dimension (р=0.034), left ventricular end-systolic dimension (р=0.002), left ventricular ejection fraction (р=0.041), 6MWT distance (р=0.004), desaturation (р=0.009), and the presence of signs of PB during 6MWT (р=0.005). Model coefficients were statistically significant at р0.0001. Conclusions. Dynamic capnography and pulse oximetry allow to identify signs of PB in patients with CHF during 6MWT which may deepen a complex assessment of parameters of the cardio-respiratory system in patients with CHF in order to determine tolerance to physical exercise as well as the effectiveness of the conducted treatment. Complex assessment of survival of patients with CHF showed prognostic significance of the following parameters of a patient: body mass index, left ventricular end-diastolic dimension, left ventricular end-systolic dimension, left ventricular ejection fraction, 6MWT distance, desaturation, PB during 6MWT.

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A Review on Functions of Rakt Dhatu and Prana Vayu to Establish Lung Function Capacity

International Journal of Innovative Research in Medical Science ◽

10.23958/ijirms/vol03-i01/13 ◽

2018 ◽

Vol 3 (01) ◽

Author(s):

Dr. Vishal Shamrao Patil ◽

Dr. (Mrs.) Manisha V. Bhalsing

Keyword(s):

Lung Function ◽

Functional Status ◽

Respiratory System ◽

Lung Function Tests ◽

Lung Volumes ◽

Happy Life ◽

Pathological Conditions ◽

Function Tests ◽

Forced Breathing

Lung function tests are useful in assessing the functional status of Respiratory system in both in physiological as well as pathological conditions. These are based on the measurement of volume of air breathed in and out in quite breathing & forced breathing. Air in lungs is classified in to two divisions’ lung volumes & lung capacities. Lung Capacities are the combination of two or more lung volumes. The concept of Rakt Dhatu & Vayu is important in case of respiration because Charaka says that pure blood provides the person with strength, luster & happy life because vital breath follows blood. It represents mechanism of oxygenated & deoxygenated blood & its relation with functioning capacity of Lungs. So In this article attempt has been made to review concepts regarding functions of Rakt Dhatu & Vayu to Establish Lung Function Capacity.

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