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Vitální kapacita plic po operaci srdce v Institutu klinické a experimentální medicíny Praha / Vital capacity of lungs after operation hearts IKEM PragueCHVOJKOVÁ, Lenka January 2011 (has links)
Cardiovascular diseases in the Czech Republic represent the main cause of death and significantly contribute to the sickness rate and premature disability. Possibilities of treatment of cardiovascular diseases keep developing increasingly these days. An important part is the follow up spa treatment as well as sufficiently performed effective cardio rehabilitation. The theoretical part characterizes functional examination of the lungs and stress tests in cardiology. Simultaneously it describes early spa treatment and defines quality of life. The aim of the diploma thesis, which deals with the vital capacity of the lungs, was to prove positive effect of early spa treatment on the vital capacity of the lungs and on improvement of quality of life, specifically with respect to positive perception of one´s overall physical health. Hypotheses - H1: An early spa therapy positively affects spirometry values. H2: Patients with an early spa therapy better perceive their overall physical health. A form of quantitative research was chosen, in order to verify the determined aims and hypotheses of the diploma thesis. A standardized international Short Form SF - 36 questionnaires on quality of life was used for the data collection. Spirometry was utilized for ascertaining objective functional parameters. Values of spirometry examination were used for comparison. 32 patients after cardiovascular surgery were included in the research, who were transferred to Lázně Poděbrady on the 6th - 8th day after the surgery, 22 of them being men (69%) and 10 women (31 %). The average age of patients under research was 66,06 + 11,48 years. The check group consisted of 10 healthy volunteers. 8 women (80 %) and 2 men (20 %) at the average age of 37,1 + 13,3 years were included in the research. It follows from the spirometry results measured before the heart surgery at IKEM cardio center that a difference in results between the second and third spirometry occurred. The second and third spirometrical examination is the period of time, when the respondent undergoes the early spa treatment. After the heart surgery spirometry values worsen and improve in the course of the spa therapy. The research showed that the perception of overall physical health after the heart surgery is subject to perception of pain, which negatively affected sense of overall perception of physical health. H1 was confirmed and H2 was not confirmed. In order to improve current situation, it would be suitable to devote not only to cardio rehabilitation but also to improvement of perception of pain, e.g. by means of psychotherapy (art therapy, music therapy?). It is also important to widen a possibility of outpatient cardio rehabilitation in each cardio center for patients after heart surgery.
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Comprehensive Integrated Spirometry Using Raised Volume Passive and Forced Expirations and Multiple-Breath Nitrogen Washout in InfantsMorris, Mohy G. 28 February 2010 (has links)
With the rapid somatic growth and development in infants, simultaneous accurate measurements of lung volume and airway function are essential. Raised volume rapid thoracoabdominal compression (RTC) is widely used to generate forced expiration from an airway opening pressure of 30 cmH2O (V30). The (dynamic) functional residual capacity (FRCdyn) remains the lung volume most routinely measured. The aim of this study was to develop comprehensive integrated spirometry that included all subdivisions of lung volume at V30 or total lung capacity (TLC30). Measurements were performed on 17 healthy infants aged 8.6-119.7 weeks. A commercial system for multiple-breath nitrogen washout (MBNW) to measure lung volumes and a custom made system to perform RTC were used in unison. A refined automated raised volume RTC and the following two novel single maneuvers with dual volume measurements were performed from V30 during a brief post-hyperventilation apneic pause: (1) the passive expiratory flow was integrated to produce the inspiratory capacity (IC) and the static (passive) FRC (FRCst) was estimated by initiating MBNW after end-passive expiration; (2) RTC was initiated late during passive expiration, flow was integrated to produce the slow vital capacity (jSVC) and the residual volume (RV) was measured by initiating MBNW after end-expiration while the jacket (j) was inflated. Intrasubject FRCdyn and FRCst measurements overlapped (p = 0.6420) but neither did with the RV (p < 0.0001). Means (95% confidence interval) of FRCdyn, IC, FRCst, jSVC, RV, forced vital capacity and tidal volume were 21.2 (19.7-22.7), 36.7 (33.0-40.4), 21.2 (19.6-22.8), 40.7 (37.2-44.2), 18.1 (16.6-19.7), 40.7 (37.1-44.2) and 10.2 (9.6-10.7) ml/kg, respectively. Static lung volumes and capacities at V30 and variables from the best forced expiratory flow-volume curve were dependent on age, body length and weight. In conclusion, we developed a comprehensive physiologically integrated approach for in-depth investigation of lung function at V30 in infants.
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