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296 Disturbances of Respiratory Function lung volumes, and a low DLCO should prompt further evaluation for pulmonary vascular disease. Arterial blood gas testing is often helpful in assessing respiratory disease. Hypoxemia, while usually apparent with pulse ox...

297 Diagnostic Procedures in Respiratory Disease In the second approach, FRC is determined by measuring the compressibility of gas within the chest, which is proportional to the volume of gas being compressed. The patient sits in a body plethys­ mograph (a cha...

SECTION 2 Diseases of the Respiratory System review and meta-analysis to help differentiate asthma/chronic obstruc­ tive pulmonary disease overlap syndrome, and has been shown in some studies to correlate with the presence of eosinophils in the sputum and bloo...

298 Asthma review and meta-analysis to help differentiate asthma/chronic obstruc­ tive pulmonary disease overlap syndrome, and has been shown in some studies to correlate with the presence of eosinophils in the sputum and blood and with response to inhaled cor...

300 Occupational and Environmental Lung Disease over a 4-month course reduce the antigenic stimulus in ABPA and may therefore modulate disease activity in selected patients. Newer azole agents may be used as well. The use of monoclonal antibody against IgE (om...

301 Bronchiectasis Rebecca M. Baron, Beverly W. Baron, Miriam Baron Barshak Bronchiectasis Bronchiectasis refers to an irreversible airway dilation that involves the lung in either a focal or a diffuse manner and that classically has been categorized as cylind...

302 Cystic Fibrosis Eric J. Sorscher Cystic Fibrosis ■ ■CLINICAL FEATURES Cystic fibrosis (CF) is an autosomal recessive exocrinopathy affect­ ing multiple epithelial tissues. The gene product responsible for CF (the cystic fibrosis transmembrane conductance r...

303 Chronic Obstructive Pulmonary Disease Grasemann H, Ratjen F: Cystic fibrosis. N Engl J Med 389:1693, 2023. Keating D et al: VX-445-tezacaftor-ivacator in patients with cystic fibrosis and one or two Phe508del alleles. N Engl J Med 379:1612, 2018. Manfredi ...

304 Interstitial Lung Disease gases. However, this schema may have more utility in the emer­ gency department than in the outpatient setting. TREATMENT OF ACUTE EXACERBATIONS Bronchodilators  Typically, patients are treated with inhaled beta agonists and musca...

305 Disorders of the Pleura ■ ■FURTHER READING American Thoracic Society/European Respiratory Society: Consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 165:277, 2002. Raghu G et al; ATS/ERS/JRS/ALAT Committee on Idi...

306 Disorders of the Mediastinum patients. Nearly all patients with secondary pneumothorax should be treated with tube drainage. Many will need thoracoscopy or thora­ cotomy with stapling of blebs and surgical pleurodesis. If the patient is not a good operativ...

307 Disorders of Ventilation can delineate the extent of fibrosis. Tissue biopsy may be necessary to rule out malignancy. Treatment in chronic fibrosing mediastinitis is focused on relieving symptoms and preventing further complications. Therapy often includes...

308 Sleep Apnea ■ ■DIAGNOSIS Respiratory symptoms associated with acute hyperventilation can be the initial manifestation of systemic illnesses such as diabetic ketoaci­ dosis. Causes of acute hyperventilation need to be excluded before a diagnosis of chronic ...

309 Lung Transplantation Hilary J. Goldberg, Hari R. Mallidi Lung Transplantation ■ ■END-STAGE LUNG DISEASE AND INDICATIONS FOR LUNG TRANSPLANTATION The Lung Allocation Score (LAS) was implemented in 2005 for the purpose of prioritizing organ allocation. In th...

310 Interventional Pulmonary Medicine during the first year after transplant. However, as infections can also occur late after transplant, most centers recommend prophylactic therapy be continued for life. ■ ■LONG-TERM MANAGEMENT OF LUNG TRANSPLANT RECIPIENTS ...

SECTION 1 Respiratory Critical Care Section 1 Respiratory Critical Care Rebecca M. Baron, Anthony F. Massaro Approach to the Patient with Critical Illness The care of critically ill patients requires a thorough understand­ ing of pathophysiology and centers i...

311 Approach to the Patient with Critical Illness Section 1 Respiratory Critical Care Rebecca M. Baron, Anthony F. Massaro Approach to the Patient with Critical Illness The care of critically ill patients requires a thorough understand­ ing of pathophysiology...

312 Acute Respiratory Distress Syndrome hypoxemia, neuromuscular paralysis, and severe hypotension must be ruled out. If there is uncertainty about the cause of coma, studies of cerebral blood flow and electroencephalography should be performed. ■ ■WITHHOLDING...