Background. We aimed to report our experience with bronchial artery embolization (BAE) in the management of moderate recurrent and/or life-threatening hemoptysis. Methods. We evaluated the demographics, clinical presentation, radiographic studies, short- and long-term efficacy, and complications in patients Who underwent BAE, at a tertiary university hospital, from 2003 to 2012. Results. Three hundred forty-one patients underwent BAE for the management of moderate recurrent or life-threatening hemoptysis. Pulmonary TB and bronchiectasis were the most common etiologies for hemoptysis in our locality. The most common angiographic signs for hemoptysis were hypervascularity and systemic-pulmonary artery shunt. BAE was successful in controlling hemoptysis immediately in 95% of patients and at 1 month in 90% of patients. Recurrence of hemoptysis was observed in 9.6% of patients, and reembolization was indicated in 85% of those cases. Complications of BAE were self-limited acute and subacute complications, while chronic complications were not recorded during this study. Conclusions. TB and bronchiectasis are the commonest etiologies for moderate recurrent or life-threatening hemoptysis in our locality. Hypervascular lesions from the bronchial arteries and nonbronchial systemic arteries represented the major vascular abnormalities. Bronchial and nonbronchial systemic artery embolizations were effective to control both acute and chronic hemoptyses, with no serious complications.

Background Automatic tube compensation (ATC) is one of the newer weaning modes that seem promising to improve the weaning process.Objective To evaluate the benefit of ATC in hastening and improving the weaning process. Patients and methodsIn a prospective randomizedcontrolled trial, all eligible patients of Assiut Chest Department who were mechanically ventilated were included during the period from April 2010 to March 2012. They were divided into two groups, 88 patients weaned by pressure support ventilation (PSV) and 78 patients weaned by ATC. The primary outcomes measure was the ability to maintain spontaneous breathing for more than 48 h after extubation and weaning duration.Results A total of 166 patients were included; the mean age was 58.6 ± 12.3 years; males represented 70%. The weaning duration was shorter in ATC than in PSV (19.7 vs. 29.9 h, respectively). Also, ATC had a higher trend toward successful extubation than PSV (88.5 vs. 78.4%). Patients who underwent weaning by ATC had a nonsignificant trend toward simple weaning. Moreover, hospital mortality was less in ATC (ATC 15.4% vs. PSV 22.7%). However, the difference did not reach significance in all primary and secondary outcomes. ConclusionIn respiratory ICU patients, the weaning process can be usefully performed by ATC (at least as effective as PSV) but without significant hastening of the weaning process. All primary and secondary outcomes were potentially improved (weaning duration, extubation outcome, predictive value of ATC-assisted ratio of respiratory rate and tidal volume, number of spontaneous breathing trials, weaning category, reintubation rate, complications, and hospital mortality).

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Spirometry is the most widely used lung function test both in the diagnosis and stratification of severity of lung disease. The Forced Expiratory Flow between 25 and 75% of the FVC (FEF25_75) is one of the most commonly cited measures of small airways pathology. This study aimed at evaluation of early effect of smoking on small airways. It included: 50 asymptomatic smokers (Group 1) and 50 non smokers (Group 2) as a control. The result revealed: The subjects age was ranged from 18 to 75 years with mean age 43.12 ± 13.231SD in smokers, and range from 15-62 with mean age 41.74 years with ± 14.512SD in nonsmokers. 62 % of the a symptomatic smokers were Manual workers which are the majority of the smokers, and 38 % for Mental worker while the majority of non-smokers were Mental worker 64 %, with 36 % for Manual worker. Smoking cigarette was most common (54 %), then marijuana (46 %). The mean values of all the pulmonary function tests are significantly reduced in smokers compared to non smokers, although, they are within the normal range. The association of impaired PFTs in smokers was found to be statistically highly significant to FEF 25-75 (small airway). Otherwise; there were no significance to other values applying unpaired T test. The most affected age group in significant FEF25-75 reduction was found in 36-55years old, females were more affected than males. The duration of smoking was the most independent risk factor that affects the small airways, than the type of smoking and number of cigarettes or stones per day.