臨床呼吸器疾患とケアのジャーナル: オープンアクセス

NIV is a form of ventilation which provides ventilator support through the patient's upper airways using a mask or other appropriate device. NIV is an effective treatment for patients with severe COPD. The beneficial effects of NIV have been particularly apparent in patients with acute hypercapnic respiratory failure (AHRF). BiPAP (Figure 1) and CPAP are the most common types of ventilators used in NIV, along with nasal masks and full-face masks.

Post-infectious bronchiolitis obliterans (PIBO) is a respiratory disease characterised by obstruction of the small airways. This obstruction limits the exercise capacity and reduces the quality of life of affected children. Two children with PIBO who were 10 and 14 years of age and both oxygen-dependent are presented. Both children underwent heart rate variability (HRV) measurements, revealing an increase in the LFnu and the LF/HF ratio and demonstrating a predominant effect on the sympathetic system. The functional capacity was assessed by a six-minute walking test (6MWT), and the distance travelled was lower than the reference values. Spirometry revealed advanced obstructive ventilatory limitation in both cases. The HRV measurements are consistent with the decrease in physical fitness in these children and indicate the need for further studies on HRV in this pathology.

Bronchoscopy is an important technique and flexible bronchoscopy procedures are considered comparatively safe. Notwithstanding, we here describe a woman who died of asphyxia caused uncontrolled hemorrhage following transbronchial lung biopsy. A medico-legal autopsy disclosed a small wound with clotted blood at the point of the transbronchial lung biopsy. The right lung was filled with a large volume of blood. Other organs showed no significant findings. Thus, this woman died from asphyxia associated with uncontrolled hemorrhage from the site of a transbronchial lung biopsy. We believe that our case is very instructive for safety bronchoscopy procedures.