Year 2002 - Volume 28 - Issue 1 (January/February)

Editorial

1 - A Maioridade do JP

Luiz Carlos Corrêa da Silva

J Bras Pneumol.2002;28(1):

2 - Admissão do Jornal de Pneumologia na SciELO Brasil: uma vitória com novos desafios

Thaís Helena Abrahão Thomaz Queluz

J Bras Pneumol.2002;28(1):

Original Article

3 - Respiratory morbidity among passive smoking children

Morbidade respiratória em crianças fumantes passivas

Luisa Maria Torres de Carvalho, Eanes Delgado Barros Pereira

J Bras Pneumol.2002;28(1):8-14

4 - Volume controlled ventilation versus pressure controlled ventilation in a canine acute lung injury model: effects on cardiorespiratory parameters and oxygen cost of breathing

Ventilação mecânica volume-controlada versus pressão controlada em modelo canino de lesão pulmonar aguda: efeitos cardiorrespiratórios e sobre o custo de oxigênio da respiração

Bruno do Valle Pinheiro, Marcelo Alcântara Holanda, Célia Mallart Larges, Oswaldo Shigueomi Beppu

J Bras Pneumol.2002;28(1):15-22

Background: It is questionable whether pressure-controlled ventilation (PCV) has advantages over volume-cycled ventilation (VCV). Objectives: To compare PCV to VCV with decelerating flow profile during assisted and controlled modes in an acute lung injury experimental model. Methods: Severe acute lung injury (PaO2/FIO2 < 100 mmHg) was induced by oleic acid IV infusion (0.05 mg/kg) in seven dogs. The animals were submitted to PCV and VCV in a randomized sequence. After 40 minutes in the assisted mode, ventilation was changed to the controlled mode after neuromuscular blockade. The tidal volume and the inspiratory time were kept constant throughout the experiment. Results: There were no differences in gas exchange (PaO2 and PaCO2), cardiac output or oxygen delivery (DO2) between VCV and PCV. The same was observed regarding maximum airway and plateau pressures, and also to the static compliance. Oxygen consumption (VO2) after neuromuscular blockade was 124 ± 48 in VCV versus 143 ± 50 ml/min in PCV, p = 0.42. In the assisted mode, there was a statistical trend of a higher VO2 in PCV (219 ± 72 versus 154 ± 67 ml/min in VCV, p = 0.06), that was associated with a statistical trend of a higher oxygen cost of breathing (OCB) during assisted PCV, although without statistical significance (31 ± 77 in VCV versus 75 ± 96 ml/min in PCV, p = 0.23), and also in a lower PvO2 (34 ± 7 in PCV versus 42 ± 6 ml/min in VCV, p = 0.02). These occurred despite a higher maximum inspiratory flow in the assisted mode in PCV (58 ± 9 versus 48 ± 4 L/min in VCV, p = 0.01). In both VCV and PCV the institution of controlled ventilation reduced cardiac debit and DO2 in as much as 20% relative to the assisted mode. Conclusions: The implementation of controlled ventilation improved the oxygen delivery/consumption relationship in this severe and with high OCB acute lung injury model. The PCV offered no additional benefits to VCV and it was associated with a higher OCB during the assisted mode.

Keywords: Artificial respiration. Pulmonary gas exchange. Tidal volume.

5 - Papain-induced experimental pulmonary emphysema model in rats

Modelo experimental de enfisema pulmonar em ratos induzido por papaína

Laerte Brasiliense Fusco, Paulo M. Pêgo-Fernandes, Alexandre Martins Xavier, Rogério Pazetti, Dolores Helena Rodriguez Ferreira Rivero, Vera Luiza Capelozzi, Fábio Biscegli Jatene

J Bras Pneumol.2002;28(1):1-7

Objective: The reproduction of an experimental emphysema model in rats by intratracheal instillation of papain was proposed for the evaluation of lung volume reduction surgeries. Method: The study used orotracheal instillation of papain (20 mg/kg) dissolved in 0.9% saline solution. Forty days after instillation, animals underwent mechanical ventilation. Elastance and resistance of the respiratory system were measured, and the rats were sacrificed by having their lungs removed. The pulmonary tissue of the animals was qualitatively analyzed with hematoxylineosin staining and submitted to morphometric analysis for the measurement of the mean alveolar diameter. The pulmonary tissue was also subjected to resorcin-fuchsin staining for the identification of elastic fibers, which were quantified in alveolar septa by digital imaging. Results: In the animals instilled with papain, the histological analysis of the lungs showed pan-acinar emphysema, with rupture of alveolar septa and hyperdistention. Morphometric analysis showed higher mean values for mean alveolar diameter in the lungs of the animals submitted to papain (149.08 μm and 100.56 μm) as compared to the group receiving saline solution (64.08 μm and 75.90 μm). The quantification of elastic fibers of alveolar septa of papain-treated animals was 70% lower than in the animals receiving saline solution. Mechanic ventilation did not show differences in respiratory system resistance of animals receiving papain or saline solution. Respiratory system elastance was lower in the group receiving papain than in the group receiving saline solution, showing a functional status compatible with pulmonary emphysema, with decreased elasticity of the pulmonary tissue. Conclusion: The reproduction of an experimental model of pan-acinar pulmonary emphysema in rats was achieved by papain instillation through the respiratory tree with functional and morphologic evidences.

Keywords: Pulmonary emphysema. Experimental model. Papain. Rats. Drug instillations.

6 - Pulmonary tuberculosis: findings on high resolution computerized tomography of active disease on patients with bacteriological confirmation

Tuberculose pulmonar: achados na tomografia computadorizada de alta resolução do tórax em pacientes com doença em atividade comprovada bacteriologicamente

Cristiane Aló Campos, Edson Marchiori, Rosana Rodrigues

J Bras Pneumol.2002;28(1):23-29

7 - Role of the open lung biopsy in the evaluation of undiagnosed acute lung disease in a pediatric intensive care unit

Contribuição da biópsia pulmonar a céu aberto na avaliação de pneumopatias difusas e agudas em unidade de terapia intensiva pediátrica

Albert Bousso, Evandro Roberto Baldacci, José Carlos Fernandes, Iracema de Cássia Oliveira Fernandes, Andréa Maria Gomes Cordeiro, José Pinhata Otoch, Bernardo Ejzenberg, Yassuhiko Okay

J Bras Pneumol.2002;28(1):30-40

Introduction: The diagnosis of diffuse lung disease is still a challenge for the pediatric intensive care physician. Routine clinical examinations and laboratory tests are frequently negative. The objective of this study was to evaluate the diagnostic potential, the impact on therapy and the rate of complications of open lung biopsy in children with undiagnosed diffuse lung disease, respiratory failure and inappropriate response to initial therapy. Methods: From January 1987 to January 1997, 29 children with diffuse pulmonary disease of unknown etiology, respiratory failure (PaO2 /FiO2 < 300) and no response to previous treatments were considered for open lung biopsy. Newborns, children with known chronic pulmonary disease and children with untreatable shock or coagulopathy were excluded. All biopsies were performed by a thoracic surgeon by a microthoracotomy in the lung shown to be the most affected by X-ray examination. Tissue samples were analyzed in terms of cultures, light microscopy, electron microscopy and immunofluorescence microscopy, according to the pathologist's decision. Results: All biopsies (100%) resulted in at least one histological diagnosis and in 20 patients (68.9%) it was obtained a specific diagnosis. The most frequent histological patterns found were: non-specific interstitial pneumonitis with variable degrees of fibrosis in 18 cases; bronchiolitis in eight cases and pulmonary hypertension in three cases. Regarding the most frequent specific diagnosis, six children were found with cytomegalovirus infection, three with Pneumocystis carinii, three with adenovirus and three with respiratory syncytial virus infection. These data induced a change in therapy in 20 children (68.9%). The most frequent changes in therapy were the use of corticosteroids in 14 children and a review of the antibiotic regimen in six patients. Seven patients (24.1%) presented with complications that were easily resolved. There were 13 deaths, probably due to the critical conditions of these patients, all unrelated to the procedure. Conclusions: Open lung biopsy, though an invasive procedure, should be considered in the evaluation of selected children with undiagnosed diffuse lung disease, respiratory failure and with no satisfactory response to previous therapies.

Case Report

8 - Endobronchial granular cell tumor: report of a case diagnosed by endoscopic biopsy

Tumor de células granulares endobrônquico: relato de um caso diagnosticado por biópsia endoscópica

Ayrton Schneider Filho, Carlos Renato Almeida Melo, Alessandra Naimaier Bertolazi, Carlos Eurico da Luz Pereira

J Bras Pneumol.2002;28(1):51-54

9 - Recurrent pneumothorax secondary to agenesis of the diaphragm

Pneumotórax recidivante secundário à agenesia do diafragma

Camila Baracat Mendina, Paulo Manuel Pêgo-Fernandes, Fábio Biscegli Jatene

J Bras Pneumol.2002;28(1):48-50

Review Article

10 - Lung cancer epidemiology

Epidemiologia do câncer do pulmão

Mauro Zamboni

J Bras Pneumol.2002;28(1):41-47

Case Report

11 - Cerebral tuberculoma

Tuberculoma cerebral

Elizabeth Clara Barroso, Tânia Regina Brígico de Oliveira, Ana Maria Dantas do Amaral, Valéria Góes Ferreira Pinheiro, Ana Lúcia de Oliveira Sousa

J Bras Pneumol.2002;28(1):55-58

Letters to the Editor

12 - Zémaria, a tosse e a fé no tratamento da tuberculose

Fernando Augusto Fiuza de Melo

J Bras Pneumol.2002;28(1):60-

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Year 2002 - Volume 28 - Issue 1 (January/February)

Editorial

1 - A Maioridade do JP

2 - Admissão do Jornal de Pneumologia na SciELO Brasil: uma vitória com novos desafios

Original Article

3 - Respiratory morbidity among passive smoking children

Morbidade respiratória em crianças fumantes passivas

4 - Volume controlled ventilation versus pressure controlled ventilation in a canine acute lung injury model: effects on cardiorespiratory parameters and oxygen cost of breathing

Ventilação mecânica volume-controlada versus pressão controlada em modelo canino de lesão pulmonar aguda: efeitos cardiorrespiratórios e sobre o custo de oxigênio da respiração

5 - Papain-induced experimental pulmonary emphysema model in rats

Modelo experimental de enfisema pulmonar em ratos induzido por papaína

6 - Pulmonary tuberculosis: findings on high resolution computerized tomography of active disease on patients with bacteriological confirmation

Tuberculose pulmonar: achados na tomografia computadorizada de alta resolução do tórax em pacientes com doença em atividade comprovada bacteriologicamente

7 - Role of the open lung biopsy in the evaluation of undiagnosed acute lung disease in a pediatric intensive care unit

Contribuição da biópsia pulmonar a céu aberto na avaliação de pneumopatias difusas e agudas em unidade de terapia intensiva pediátrica

Case Report

8 - Endobronchial granular cell tumor: report of a case diagnosed by endoscopic biopsy

Tumor de células granulares endobrônquico: relato de um caso diagnosticado por biópsia endoscópica

9 - Recurrent pneumothorax secondary to agenesis of the diaphragm

Pneumotórax recidivante secundário à agenesia do diafragma

Review Article

10 - Lung cancer epidemiology

Epidemiologia do câncer do pulmão

Case Report

11 - Cerebral tuberculoma

Tuberculoma cerebral

Letters to the Editor

12 - Zémaria, a tosse e a fé no tratamento da tuberculose

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