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18.15 Chronic respiratory failure 4282 Michael I. Polkey and P.M.A. Calverley ESSENTIALS Chronic respiratory failure describes a clinical state when the ar- terial Po2 breathing air is less than 8.0 kPa, which may or may not be associated with hypercapnia (def...

18.16 Lung transplantation 4292 P. Hopkins and A.J. Fisher ESSENTIALS Lung transplantation offers the only therapeutic option for many pa- tients with end-​stage pulmonary and cardiopulmonary diseases, but donors are scarce and the major challenge facing lung ...

18.17 Pleural diseases 4305 D. de Fonseka, Y.C. Gary Lee, and N.A. Maskell ESSENTIALS Pleural effusion—​general considerations This is a common clinical problem which can complicate a range of lung and systemic diseases. Most cases can be diagnosed by pleural ...

18.18 Disorders of the thoracic cage and diaphragm 4328 John M. Shneerson and Michael I. Polkey ESSENTIALS Disorders of the thoracic skeleton can lead to a severe restrictive ventilatory defect, the risk of respiratory failure being highest with (1) scoliosis—...

18.19 Malignant diseases 4338 18.19.1 Lung cancer 4338 S.G. Spiro and N. Navani CONTENTS 18.19.1 Lung cancer  4338 S.G. Spiro and N. Navani 18.19.2 Pulmonary metastases  4360 S.G. Spiro 18.19.3 Pleural tumours  4361 Y.C. Gary Lee 18.19.4 Mediastinal tumour...

18.19.2 Pulmonary metastases 4360 S.G. Spiro section 18  Respiratory disorders 4360 18.19.2  Pulmonary metastases S.G. Spiro ESSENTIALS Malignant metastasis to the lung is common. It may present as a soli- tary enlarging nodule, as multiple nodules ranging eno...

18.19.3 Pleural tumours 4361 Y.C. Gary Lee 18.19.3  Pleural tumours 4361 Suzuki H, et al. (2015). Long-term outcomes after surgical resection of pulmonary metastases from colorectal cancer. Ann Thorac Surg, 99, 435–40. Van Geel AN, et al. (1996). Surgical trea...

18.19.4 Mediastinal tumours and cysts 4368 Y.C. Gary Lee and Helen E. Davies section 18  Respiratory disorders 4368 Future developments Current treatments for malignant pleural effusion are crude. Compounds such as iodine and silver nitrate have been used in s...

18.3 Clinical investigation of respiratory disorders 3956

18.3.1 Respiratory function tests 3956 G.J. Gibson 18.3 Clinical investigation of respiratory disorders CONTENTS 18.3.1 Respiratory function tests  3956 G. J. Gibson 18.3.2 Thoracic imaging  3970 Susan J. Copley and David M. Hansell 18.3.3 Bronchoscopy, tho...

18.3.2 Thoracic imaging 3970 Susan J. Copley and David M. Hansell section 18  Respiratory disorders 3970 Miscellaneous tests Analysis of expired air has traditionally been limited to oxygen and carbon dioxide, but recently attention has turned to other gases w...

18.3.3 Bronchoscopy, thoracoscopy, and tissue biopsy 3992 Pallav L. Shah section 18  Respiratory disorders 3992 further refined by assimilating other radiographic abnormalities, such as the presence of pleural disease in the case of asbestosis, or enlarged hil...

18.4 Respiratory infection 4004 18.4.1 Upper respiratory tract infections 4004 P. Little CONTENTS 18.4.1 Upper respiratory tract infections  4004 P. Little 18.4.2 Pneumonia in the normal host  4008 Wei Shen Lim 18.4.3 Nosocomial pneumonia  4022 Wei Shen Lim...

18.4.2 Pneumonia in the normal host 4008 Wei Shen Lim section 18  Respiratory disorders 4008 randomised controlled trial with nested qualitative study and cost-​ effectiveness study. Health Technol Assess, 18, vii–​xxv, 1–​101. Mehta N, et al. (2017). Antibiot...

18.4.3 Nosocomial pneumonia 4022 Wei Shen Lim section 18  Respiratory disorders 4022 FURTHER READING Briel M, et al. (2018). Corticosteroids in patients hospitalized with community-acquired pneumonia: Systematic review and indi- vidual patient data meta analys...

18.4.4 Mycobacteria 4026 Hannah Jarvis and Onn Min Kon section 18  Respiratory disorders 4026 Colonization and aspiration Secretions in the upper airways of intubated patients often pool above the endotracheal tube. Efforts to reduce the aspiration of these se...

18.4.5 Pulmonary complications of HIV infection 4031 Julia Choy and Anton Pozniak 18.4.5  Pulmonary complications of HIV infection 4031 Prevention The World Health Organization has prioritized the eradication of tu- berculosis and set the goal of reducing the ...

18.5 The upper respiratory tract 4040 18.5.1 Upper airway obstruction 4040 James H. Hull and Matthew Hind CONTENTS 18.5.1  Upper airway obstruction  4040 James H. Hull and Matthew Hind 18.5.2  Sleep-​related breathing disorders  4048 Mary J. Morrell, Julia Kel...