Publications
235 results found
Browne HAK, Jones M, Simonds AK, et al., 1999, Variabilty of breathing pattern in the elderly during sleep, AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 159, Pages: A789-A789, ISSN: 1073-449X
Taylor AM, Jhooti P, Keegan J, et al., 1999, Magnetic resonance navigator echo diaphragm monitoring in patients with suspected diaphragm paralysis, JOURNAL OF MAGNETIC RESONANCE IMAGING, Vol: 9, Pages: 69-74, ISSN: 1053-1807
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- Citations: 15
Simonds AK, 1998, Introduction to the mechanism of obstructive sleep apnoea and snoring., Monaldi Arch Chest Dis, Vol: 53, Pages: 617-620, ISSN: 1122-0643
Simonds AK, Muntoni F, Heather S, et al., 1998, Impact of nasal ventilation on survival in hypercapnic Duchenne muscular dystrophy, THORAX, Vol: 53, Pages: 949-952, ISSN: 0040-6376
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- Citations: 262
Simonds AK, 1998, Nasal ventilation, POSTGRADUATE MEDICAL JOURNAL, Vol: 74, Pages: 343-346, ISSN: 0032-5473
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- Citations: 1
Simonds AK, 1998, Weaning difficulties., Monaldi Arch Chest Dis, Vol: 53, Pages: 70-73, ISSN: 1122-0643
All units providing ventilatory support will experience patients with weaning difficulties. The factors which contribute to weaning problems include the pathophysiology of the illness, the extent of underlying chronic disease, and equipment, physician-related and organisational issues. In this article ways to resolve these problems are outlined.
AlKattan K, Simonds A, Chung KF, et al., 1997, Kyphoscoliosis and bronchial torsion, CHEST, Vol: 111, Pages: 1134-1137, ISSN: 0012-3692
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- Citations: 26
Simonds AK, 1997, Non-invasive ventilation in neuromuscular disease, BRITISH JOURNAL OF HOSPITAL MEDICINE, Vol: 57, Pages: 87-90, ISSN: 0007-1064
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- Citations: 2
Simonds AK, 1996, Negative pressure ventilation in acute hypercapnic chronic obstructive pulmonary disease, THORAX, Vol: 51, Pages: 1069-1070, ISSN: 0040-6376
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- Citations: 3
SIMONDS AK, ELLIOTT MW, 1995, OUTCOME OF DOMICILIARY NASAL INTERMITTENT POSITIVE PRESSURE VENTILATION IN RESTRICTIVE AND OBSTRUCTIVE DISORDERS, THORAX, Vol: 50, Pages: 604-609, ISSN: 0040-6376
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- Citations: 277
Simonds AK, Elliott MW, 1995, Outcome of domiciliary nasal intermittent positive pressure ventilation in restrictive and obstructive disorders., Thorax, Vol: 50, Pages: 604-609, ISSN: 0040-6376
BACKGROUND: Nasal intermittent positive pressure ventilation (NIPPV) is a new technique which has rapidly supplanted other non-invasive methods of ventilation over the last 5-10 years. Data on its effectiveness are limited. METHODS: The outcome of long term domiciliary NIPPV has been analysed in 180 patients with hypercapnic respiratory failure predominantly due to chest wall restriction, neuromuscular disorders, or chronic obstructive lung disease. One hundred and thirty eight patients were started on NIPPV electively, and 42 following an acute hypercapnic exacerbation. Outcome measures were survival (five year probability of continuing NIPPV), pulmonary function, and health status. A crossover study from negative pressure ventilation to NIPPV was carried out in a subgroup of patients. RESULTS: Five year acturial probability of continuing NIPPV for individuals with early onset scoliosis (n = 47), previous poliomyelitis (n = 30), following tuberculous lung disease (n = 20), general neuromuscular disorders (n = 29), and chronic obstructive pulmonary disease (n = 33) was 79% (95% CI 66 to 92), 100%, 94% (95% CI 83 to 100), 81% (95% CI 61 to 100), 43% (95% CI 6 to 80), respectively. Most of the patients with bronchiectasis died within two years. One year after starting NIPPV electively the mean (SD) PaO2 compared with the pretreatment value was +1.8 (1.9) kPa, mean PaCO2 -1.4 (1.3) kPa in patients with extrapulmonary restrictive disorders, and PaO2 +0.8 (1.0) kPa, PaCO2 -0.9 (0.8) kPa in patients with obstructive lung disease. Arterial blood gas tensions improved in patients transferred from negative pressure ventilation to NIPPV. Health status was ranked highest in patients with early onset scoliosis, previous poliomyelitis, and following tuberculous lung disease. In the group as a whole health perception was comparable to outpatients with other chronic disorders. CONCLUSIONS: The long term outcome of domiciliary NIPPV in patients with chronic respiratory failure due
ELLIOTT MW, SIMONDS AK, 1995, NOCTURNAL ASSISTED VENTILATION USING BILEVEL POSITIVE AIRWAY PRESSURE - THE EFFECT OF EXPIRATORY POSITIVE AIRWAY PRESSURE, EUROPEAN RESPIRATORY JOURNAL, Vol: 8, Pages: 436-440, ISSN: 0903-1936
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- Citations: 27
Elliott MW, Simonds AK, 1995, Nocturnal assisted ventilation using bilevel positive airway pressure: the effect of expiratory positive airway pressure., Eur Respir J, Vol: 8, Pages: 436-440, ISSN: 0903-1936
Increasing expiratory positive airway pressure (EPAP) has theoretical advantages during overnight nasal ventilation. We wanted to evaluate the effect of the addition of EPAP upon the control of nocturnal hypoventilation. Seven patients with neuromuscular/skeletal (NMS) disorder (mean +/- SD forced vital capacity (FVC) 1.06 +/- 0.28 l, arterial oxygen tension (PaO2) 9.1 +/- 0.6 kPa, and arterial carbon dioxide tension (PaCO2) 6.9 +/- 0.9 kPa), and seven patients with chronic obstructive pulmonary disease (COPD) (FEV1 0.46 +/- 0.14 l, PaO2 6.2 +/- 0.6 kPa, and PaCO2 8.4 +/- 1.1 kPa) all underwent full polysomnography on two nights during bilevel positive airway pressure (BiPAP) ventilation, with and without the addition of expiratory positive airway pressure, which was matched to the level of dynamic positive end-expiratory pressure (PEEP) or set at a minimum value of 5 cmH2O. In the group with neuromuscular/skeletal disorders the maximum transcutaneous carbon dioxide tension (PtcCO2) overnight was lower (inspiratory positive airway pressure (IPAP) 8.1 +/- 1.4 kPa, IPAP/EPAP 7.3 +/- 0.9 kPa) and the minimum level of arterial oxygen saturation (SaO2 min) increased (IPAP 77.1 +/- 6.7%, IPAP/EPAP 83.6 +/- 4.2%) when expiratory positive airway pressure was added. There were no differences in mean PtcCO2 or mean oxygen saturation, but sleep quality was worse (non-rapid eye movement (non-REM) sleep IPAP 266 +/- 44 min, IPAP/EPAP 226 +/- 32 min). In the patients with COPD, expiratory positive airway pressure conferred no advantage.(ABSTRACT TRUNCATED AT 250 WORDS)
MUNTONI F, HIRD M, SIMONDS AK, 1994, PREVENTIVE NASAL VENTILATION IN DUCHENNE MUSCULAR-DYSTROPHY, LANCET, Vol: 344, Pages: 340-340, ISSN: 0140-6736
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- Citations: 4
Simonds AK, 1994, Sleep studies of respiratory function and home respiratory support., BMJ, Vol: 309, Pages: 35-40, ISSN: 0959-8138
SIMONDS AK, 1994, FORTNIGHTLY REVIEW - SLEEP STUDIES OF RESPIRATORY-FUNCTION AND HOME RESPIRATORY SUPPORT, BRITISH MEDICAL JOURNAL, Vol: 309, Pages: 35-40, ISSN: 0959-8138
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- Citations: 13
ELLIOTT MW, AQUILINA R, GREEN M, et al., 1994, A COMPARISON OF DIFFERENT MODES OF NONINVASIVE VENTILATORY SUPPORT - EFFECTS ON VENTILATION AND INSPIRATORY MUSCLE EFFORT, ANAESTHESIA, Vol: 49, Pages: 279-283, ISSN: 0003-2409
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- Citations: 40
Simonds AK, 1993, Nasal intermittent positive pressure ventilation in neuromuscular and chest wall disease., Monaldi Arch Chest Dis, Vol: 48, Pages: 165-168, ISSN: 1122-0643
The short- and long-term physiological, functional and economic benefits of NIPPV in patients with chronic chest wall and stable neuromuscular disease have been confirmed and its advantages over non-invasive negative pressure ventilation outlined. Current research should help provide guidelines for patient selection and the most appropriate use of NIPPV in progressive neuromuscular disorders.
KOPELMAN PG, ELLIOTT MW, SIMONDS A, et al., 1992, SHORT-TERM USE OF FLUOXETINE IN ASYMPTOMATIC OBESE SUBJECTS WITH SLEEP-RELATED HYPOVENTILATION, INTERNATIONAL JOURNAL OF OBESITY, Vol: 16, Pages: 825-830, ISSN: 0307-0565
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- Citations: 13
Udwadia ZF, Santis GK, Steven MH, et al., 1992, Nasal ventilation to facilitate weaning in patients with chronic respiratory insufficiency., Thorax, Vol: 47, Pages: 715-718, ISSN: 0040-6376
BACKGROUND: The non-invasive technique of nasal intermittent positive pressure ventilation (NIPPV) has an established role in providing domiciliary nocturnal ventilatory support in patients with chest wall disorders, neuromuscular disease, and chronic obstructive lung disease. NIPPV was used to simplify ventilatory management and assist the return of spontaneous breathing in patients with chronic respiratory insufficiency who had failed to wean from conventional intermittent positive pressure ventilation (IPPV). METHODS: A trial of NIPPV was carried out in 22 patients with weaning difficulties. Nine patients had chest wall disorders or primary lung disease, six had neuromuscular conditions, and seven had cardiac disorders with additional pulmonary disease. Conventional IPPV via an endotracheal tube or tracheostomy had been continued postoperatively in nine patients and 13 had been ventilated after acute cardiorespiratory decompensation. RESULTS: Conventional IPPV had been continued for a median of 31 days (range 2-219). Eighteen patients were successfully transferred to NIPPV and discharged home a median of 11 days (range 8-13) after starting this type of ventilation. Sixteen patients remain well 1-50 months after hospital discharge and 10 of these continue on domiciliary nocturnal NIPPV. Seven patients have returned to work. CONCLUSION: NIPPV can be used to facilitate the return of spontaneous breathing and to reduce the need for intensive care accommodation in patients with an acute exacerbation of chronic respiratory insufficiency that requires intubation and IPPV.
UDWADIA ZF, SANTIS GK, STEVEN MH, et al., 1992, NASAL VENTILATION TO FACILITATE WEANING IN PATIENTS WITH CHRONIC RESPIRATORY INSUFFICIENCY, THORAX, Vol: 47, Pages: 715-718, ISSN: 0040-6376
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- Citations: 103
Elliott MW, Simonds AK, Carroll MP, et al., 1992, Domiciliary nocturnal nasal intermittent positive pressure ventilation in hypercapnic respiratory failure due to chronic obstructive lung disease: effects on sleep and quality of life., Thorax, Vol: 47, Pages: 342-348, ISSN: 0040-6376
BACKGROUND: Domiciliary assisted ventilation, using negative or positive pressure devices, is an effective treatment for respiratory failure due to chest wall deformity and neuromuscular disease. Negative pressure ventilators have been used with some success in patients with chronic obstructive lung disease in hospital, but attempts to continue treatment at home have been disappointing. This study evaluates the practicalities of nasal intermittent positive pressure ventilation at home in patients with chronic obstructive lung disease and the effect on sleep and quality of life. METHODS AND RESULTS: Twelve patients with chronic obstructive lung disease and hypercapnic respiratory failure received nasal intermittent positive pressure ventilation at home during sleep. At six months eight were continuing with the ventilation. One patient had died and three had withdrawn because they were unable to sleep with the equipment. Full polysomnography performed during ventilation in patients continuing treatment at six months showed an increase in mean PaO2 of 11% (+2% to +23%) and lower mean transcutaneous carbon dioxide tensions (by -2.7 (-1.3 to -5.1) kPa) overnight compared with spontaneous breathing before the start of nasal intermittent positive pressure ventilation. Total sleep time and sleep efficiency changed during ventilation by +72.5 (+21 to +204) minutes and +5% (-3% to +30%) respectively; sleep architecture and the number of arousals were unchanged. Quality of life did not change but was no worse during ventilation. At one year seven patients were still using the ventilator and PaCO2 and bicarbonate ion concentration during the day had improved further by comparison with the values at six months (change from baseline -1.7 (-2.1 to -0.6) kPa, p less than 0.05, and -6.3 (-11.9 to -4) mmol/l, p less than 0.05). CONCLUSIONS: Nasal intermittent positive pressure ventilation can be used effectively at home during sleep in selected patients with chronic obstructive lung
ELLIOTT MW, SIMONDS AK, CARROLL MP, et al., 1992, DOMICILIARY NOCTURNAL NASAL INTERMITTENT POSITIVE PRESSURE VENTILATION IN HYPERCAPNIC RESPIRATORY-FAILURE DUE TO CHRONIC OBSTRUCTIVE LUNG-DISEASE - EFFECTS ON SLEEP AND QUALITY-OF-LIFE, THORAX, Vol: 47, Pages: 342-348, ISSN: 0040-6376
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- Citations: 110
ELLIOTT MW, SIMONDS AK, CRAMER D, et al., 1992, DOUBLE-BLIND, PLACEBO CONTROLLED-STUDY OF THE ACUTE EFFECTS OF FLUOXETINE ON SLEEP AND BREATHING IN ASYMPTOMATIC PATIENTS WITH OBESITY, THORAX, Vol: 47, Pages: P235-P236, ISSN: 0040-6376
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- Citations: 2
STEVEN MH, CRAMER D, SIMONDS AK, 1992, HOME SLEEP STUDIES WITH MESAM-4 - FEASIBILITY, ACCURACY AND DIAGNOSTIC-VALUE, THORAX, Vol: 47, Pages: P234-P235, ISSN: 0040-6376
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