BACKGROUND Most patients with amyotrophic lateral sclerosis (ALS) are treated with mechanical insufflation-exsufflation (MI-E) in order to improve cough. This method often fails in ALS with bulbar involvement, allegedly due to upper-airway malfunction. We have studied this phenomenon in detail with laryngoscopy to unravel information that could lead to better treatment. METHODS We conducted a...

HYPOTHESIS Patients undergoing warmed, humidified carbon dioxide (CO2) insufflation for laparoscopic cholecystectomy will (1) maintain a warmer intraoperative core temperature, (2) have their surgeon experience less fogging of the camera lens, and (3) have less postoperative pain than patients undergoing laparoscopic cholecystectomy with standard CO2 insufflation. DESIGN A double-blind, prosp...

BACKGROUND AND STUDY AIMS Insufflation of the intestinal tract, usually with room air, is necessary to improve visualization during colonoscopy. However, most patients complain of bowel distension and abdominal pain afterwards. Recently, carbon dioxide (CO2) rather than air insufflation has been used. We aimed to evaluate the efficiency, safety, and comfort of colonoscopy CO2 insufflation, with...

Since the first article introducing doubleballoon endoscopy (DBE) was published in 2001 [1], the technique has proven effective for deep intubation of the small bowel and is used in clinical practice worldwide. However, the intubation depth is sometimes limited by the distension of the small bowel due to air insufflation during the procedure. In a recent report [2], the total success rate using...

Although symptomatic carbon dioxide (CO(2)) embolism is rare, it recognized as a potentially fatal complication of laparoscopic surgery. Sudden hemodynamic instability could be a CO(2) embolism especially during insufflation. A 65-year-old man received laparoscopic prostatectomy for 5 hours under CO(2) pneumoperitoneum without any problem. After resection of prostate, it was stopped following d...

[Purpose] In Duchenne muscular dystrophy, it increases risks of difficulties of expectoration of secretion, asphyxia, aspiration pneumonia because of decreased cough function. The aim of this study is to prove that manually assisted coughing or mechanical insufflation-exsufflation prevents pulmonary complication and contribute to continue oral intake safely and continue rate of oral intake in D...

PURPOSE For patients with neuromuscular disease, air stacking, which inflates the lungs to deep volumes, is important for many reasons. However, neuromuscular patients with severe glottic dysfunction or indwelling tracheostomy tubes cannot air stack effectively. For these patients, we developed a device that permits deep lung insufflations substituting for glottic function. MATERIALS AND METH...