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Respiratory Care

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https://www.readbyqxmd.com/read/28096477/the-future-of-respiratory-care-results-of-a-new-york-state-survey-of-respiratory-therapists
#1
Stephen G Smith, Lisa M Endee, Lisa A Benz Scott, Pamela L Linden
BACKGROUND: In the current health-care environment, respiratory care may need to make significant changes to academic preparation and clinical practice. The purpose of this research was to assess current needs of respiratory therapists (RTs) in New York State and to understand how RTs perceive their future clinical and academic roles. METHODS: This study employed a descriptive, cross-sectional non-experimental design. Between October and December 2014, a 32-item online survey was distributed via e-mail to the 2,170 members of the New York State Society of Respiratory Care...
January 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28096476/accuracy-of-oxygen-consumption-and-carbon-dioxide-elimination-measurements-in-2-breath-by-breath-devices
#2
Craig D Smallwood, John N Kheir, Brian K Walsh, Nilesh M Mehta
BACKGROUND: Although accurate quantification of oxygen consumption (V̇O2 ) and carbon dioxide elimination (V̇CO2 ) provides important insights into a patient's nutritional and hemodynamic status, few devices exist to accurately measure these parameters in children. Therefore, we assessed the accuracy and agreement of 2 devices currently on the market using a pediatric in vitro model of gas exchange. METHODS: We utilized a Huszczuk simulation model, which simulates oxygen consumption and carbon dioxide production using gas dilution, to examine the accuracy of two FDA-cleared respiratory modules (E-COVX and E-sCAiOVX-00)...
January 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28073994/vibrating-mesh-nebulizer-compared-with-metered-dose-inhaler-in-mechanically-ventilated-subjects
#3
Meagan N Dubosky, Yi-Fan Chen, Mary E Henriksen, David L Vines
BACKGROUND: The impact of various aerosol delivery devices on patient outcomes during mechanical ventilation is unknown. If one method of delivery results in a higher ventilator-associated pneumonia (VAP) rate than another, multiple patient outcomes may be affected. This study aimed to determine whether there was a difference in VAP occurrence and patient outcomes (days receiving ventilation and in-hospital mortality) between the vibrating mesh nebulizer (AeroNeb Solo) and the metered-dose inhaler (MDI)...
January 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28073993/daily-goals-formulation-and-enhanced-visualization-of-mechanical-ventilation-variance-improves-mechanical-ventilation-score
#4
Brian K Walsh, Craig Smallwood, Jordan Rettig, Robert Kacmarek, John Thompson, John H Arnold
BACKGROUND: The systematic implementation of evidence-based practice through the use of guidelines, checklists, and protocols mitigates the risks associated with mechanical ventilation, yet variation in practice remains prevalent. Recent advances in software and hardware have allowed for the development and deployment of an enhanced visualization tool that identifies mechanical ventilation goal variance. Our aim was to assess the utility of daily goal establishment and a computer-aided visualization of variance...
January 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28049743/alternative-indexes-to-estimate-the-functional-capacity-from-the-6-minute-walk-test-in-children-and-adolescents-with-cystic-fibrosis
#5
Renata Tiemi Okuro, Maria Angela Gonçalves de Oliveira Ribeiro, José Dirceu Ribeiro, Rafaela Coelho Minsky, Camila Isabel Santos Schivinski
BACKGROUND: Cystic fibrosis is a multi-systemic disease related to reduced functional capacity. The distance covered in the 6-min walk test (6MWT) has been known to assess functional capacity, but little is known about other indexes that can be derived. We sought to compare the performance during the 6MWT and the estimated indexes of functional capacity from the 6MWT between subjects with cystic fibrosis (CF) and healthy individuals as well as to assess the relationship among these indexes and disease severity, pulmonary function, and nutritional status in CF...
January 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28049742/feasibility-of-mid-frequency-ventilation-among-infants-with-respiratory-distress-syndrome
#6
Ramachandra Bhat, John Kelleher, Namasivayam Ambalavanan, Robert L Chatburn, Eduardo Mireles-Cabodevila, Waldemar A Carlo
BACKGROUND: Mid-frequency ventilation, a strategy of using conventional ventilators at high frequencies, may reduce lung injury but has had limited evaluation in neonates. Hence, a randomized crossover study was designed to assess the feasibility of using mid-frequency ventilation in preterm infants with respiratory distress syndrome. METHODS: Twelve preterm infants (≥500 g and ≥24 weeks gestational age) who were receiving pressure-limited conventional ventilation with frequencies ≤60 breaths/min for respiratory distress syndrome were randomized to periods of mid-frequency ventilation (conventional ventilation with the fastest frequency up to 150 breaths/min that gave complete inspiration and expiration) or conventional ventilation (frequency ≤60 breaths/min), each lasting 2 h using a crossover design...
January 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28028190/beliefs-and-attitudes-associated-with-hookah-smoking-among-a-united-states-college-population
#7
Mary P Martinasek, Linda G Haddad, Christopher W Wheldon, Tracey E Barnett
BACKGROUND: This study explores the differences among smokers of waterpipe tobacco in a college population to better inform campaigns to curb waterpipe use. METHODS: Participants included undergraduate and graduate students attending a liberal arts university in Florida. E-mail-based, cross-sectional surveys were collected in 2 sequential years. RESULTS: The majority of respondents (64%) reported having ever smoked a hookah, even if just 1-2 puffs...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28028189/implementation-of-a-%C3%AE-agonist-airway-clearance-protocol-in-a-pediatric-icu
#8
Gary R Lowe, J Randy Willis, Shasha Bai, Mark J Heulitt
BACKGROUND: Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children's Hospital for β-agonist and airway clearance interventions where one did not exist. METHODS: This project was composed of 2 parts: a survey administered to RTs and licensed independent practitioners and a retrospective review of outcome data comparing a therapist-driven β-agonist/airway clearance protocol with physician-directed respiratory care ordering in a patient population admitted for acute respiratory failure...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28028188/feasibility-of-a-respiratory-movement-evaluation-tool-to-quantify-thoracoabdominal-movement-for-neuromuscular-diseases
#9
Fumio Liu, Michiyuki Kawakami, Kimimasa Tamura, Yoshihito Taki, Katsumi Shimizu, Tomoyoshi Otsuka, Tetsuya Tsuji, Chieko Miyata, Syoichi Tashiro, Ayako Wada, Katsuhiro Mizuno, Yoshimitsu Aoki, Meigen Liu
BACKGROUND: An objective method to evaluate thoracoabdominal movement is needed in daily clinical practice to detect patients at risk of hypoventilation and to allow for timely interventions in neuromuscular diseases. The clinical feasibility, reliability, and validity of a newly developed method for quantifying respiratory movement using fiber grating sensors, called the Respiratory Movement Evaluation Tool (RMET), was evaluated. METHODS: The time needed to measure respiratory movement and the usability of the measurement were determined by 5 clinicians using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28028187/evaluating-the-effectiveness-of-written-dry-powder-inhaler-instructions-and-health-literacy-in-subjects-diagnosed-with-copd
#10
Hana J Alsomali, David L Vines, Brian D Stein, Ellen A Becker
BACKGROUND: Improper inhaler use results in decreased drug deposition in the lungs. The impact of health literacy and poor vision on the patient's ability to learn inhaler technique by reading instructions has not been confirmed. This study evaluated the effectiveness of learning inhaler technique from written instructions and the impact of health literacy for patients diagnosed with COPD who used a dry powder inhaler (DPI). METHODS: This pilot study recruited subjects diagnosed with COPD...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27999152/optimizing-peep-by-electrical-impedance-tomography-in-a-porcine-animal-model-of-ards
#11
Nadine Hochhausen, Ingeborg Biener, Rolf Rossaint, Andreas Follmann, Christian Bleilevens, Till Braunschweig, Steffen Leonhardt, Michael Czaplik
BACKGROUND: Mechanical ventilation is necessary in diverse clinical circumstances. Especially in the context of ARDS, so-called protective ventilation strategies must be followed. It is already known that PEEP might enhance oxygenation in ARDS. However, determining the optimal PEEP settings in clinical routines is challenging. Electrical impedance tomography (EIT) is a promising technique with which to adjust ventilator settings. We investigated whether the combination of different EIT parameters, namely the global inhomogeneity and hyperdistension indices, may lead to a feasible and safe PEEP setting...
December 20, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27999151/endotracheal-intubation-training-and-skill-maintenance-for-respiratory-therapists
#12
Andrew G Miller
BACKGROUND: Endotracheal intubation is commonly performed outside the operating room (OR). Although respiratory therapists (RTs) performing endotracheal intubation is a well-established practice, the optimum way for RTs to be trained and maintain their skills is unspecified. The purpose of this study was to describe training methods and skills maintenance methods and to identify barriers that prevent RTs from intubating in some institutions. METHODS: A survey instrument was developed by the author...
December 20, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27999150/the-concave-shape-of-the-forced-expiratory-flow-volume-curve-in-3-seconds-is-a-practical-surrogate-of-fev1-fvc-for-the-diagnosis-of-airway-limitation-in-inadequate-spirometry
#13
Hao Li, Chunhong Liu, Yi Zhang, Wei Xiao
BACKGROUND: Spirometry is important for the differential diagnosis of dyspnea. However, some patients cannot exhale for ≥6 s to achieve the American Thoracic Society/European Respiratory Society criteria. The aim of this study was to demonstrate the reliability of a new parameter that quantifies the degree of concavity in the first 3 s to define airway limitation as a surrogate for the FEV1/FVC. METHODS: Four hundred spirometry test results were selected through complete random sampling...
December 20, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27999149/time-required-to-rectify-inhaler-errors-among-experienced-subjects-with-a-faulty-technique
#14
Andrea S Melani, Marco Bonavia, Eliuccia Mastropasqua, Alessandro Zanforlin, Marco Lodi, Paola Martucci, Nicola Scichilone, Maria Aliani, Margherita Neri, Piersante Sestini
BACKGROUND: Regardless of the device used, many patients have difficulty maintaining proper inhaler technique over time. Repeated education from caregivers is required to ensure persistence of correct inhaler technique, but no information is available to evaluate the time required to rectify inhaler errors in experienced users with a baseline faulty technique and whether this time of re-education to restore inhaler mastery can differ between devices. METHODS: This was a multi-center, single-visit, open-label, cross-sectional study in a large group of 981 experienced adult subjects (mean ± SD age 64 ± 15 y), mainly suffering from COPD and asthma, who showed faulty inhaler technique at a follow-up visit in chest clinics...
December 20, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27965421/icu-clinicians-underestimate-breathing-discomfort-in-ventilated-subjects
#15
Andrew P Binks, Steven Desjardin, Richard Riker
BACKGROUND: Breathing discomfort (dyspnea) during mechanical ventilation in the ICU may contribute to patient distress and complicate care. Assessment of nonverbal cues may allow caregivers to estimate patient breathing discomfort. This study assesses the accuracy of those caregiver estimates. METHODS: Thirty subjects were identified from ventilated, hemodynamically stable patients in the special care unit of Maine Medical Center. Those with impaired neurological function or too unstable to waken were excluded...
December 13, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27965420/microalbuminuria-in-subjects-with-copd-relationship-to-the-new-version-of-global-initiative-for-chronic-obstructive-lung-disease-staging
#16
Fulsen Bozkus, Nursel Dikmen, Anil Samur
BACKGROUND: Microalbuminuria, used as a marker of endothelial dysfunction, is a predictor of mortality for any reason and of cardiovascular events. Recent research on the management of COPD has focused more on comorbidities, including cardiovascular events. The objective of this study was to investigate the incidence of microalbuminuria and whether it is associated with physiological and clinical features in a subject group that was classified in line with the new version of the Global Initiative for Chronic Obstructive Lung Disease stages...
December 13, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27923938/computerized-respiratory-sounds-novel-outcomes-for-pulmonary-rehabilitation-in-copd
#17
Cristina Jácome, Alda Marques
BACKGROUND: Computerized respiratory sounds are a simple and noninvasive measure to assess lung function. Nevertheless, their potential to detect changes after pulmonary rehabilitation (PR) is unknown and needs clarification if respiratory acoustics are to be used in clinical practice. Thus, this study investigated the short- and mid-term effects of PR on computerized respiratory sounds in subjects with COPD. METHODS: Forty-one subjects with COPD completed a 12-week PR program and a 3-month follow-up...
December 6, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27923937/low-volume-whole-body-vibration-training-improves-exercise-capacity-in-subjects-with-mild-to-severe-copd
#18
Marc Spielmanns, Tobias Boeselt, Rainer Gloeckl, Anja Klutsch, Henrike Fischer, Henryk Polanski, Christoph Nell, Jan H Storre, Wolfram Windisch, Andreas R Koczulla
BACKGROUND: The objective of this study was to investigate the benefits of a low-volume out-patient whole-body vibration training (WBVT) program on exercise capacity in comparison with a calisthenics training program in subjects with COPD. METHODS: In this single-center randomized controlled trial, 29 subjects with mild to severe COPD were randomized to WBVT or to calisthenics training, including relaxation and breathing retraining in combination with calisthenics exercises...
December 6, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27923936/enteral-nutrition-is-a-risk-factor-for-airway-complications-in-subjects-undergoing-noninvasive-ventilation-for-acute-respiratory-failure
#19
Mariko Kogo, Nagata Kazuma, Takeshi Morimoto, Jiro Ito, Yuki Sato, Shunsuke Teraoka, Daichi Fujimoto, Atsushi Nakagawa, Kojiro Otsuka, Keisuke Tomii
BACKGROUND: Early enteral nutrition is recommended for mechanically ventilated patients in several studies and guidelines. In contrast, the effects of early enteral nutrition on noninvasive ventilation (NIV) have not been investigated extensively. The lack of an established method of airway protection suggests that enteral nutrition administration to these patients could increase airway complications and worsen outcomes. METHODS: Between January 2007 and January 2015, 150 patients were admitted to our respiratory department for acute respiratory failure and received NIV for >48 h...
December 6, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27923935/radiographic-mastoid-and-middle-ear-effusions-in-intensive-care-unit-subjects
#20
Phillip Huyett, Yael Raz, Barry E Hirsch, Andrew A McCall
BACKGROUND: This study was conducted to determine the incidence of and risk factors associated with the development of radiographic mastoid and middle ear effusions (ME/MEE) in ICU patients. METHODS: Head computed tomography or magnetic resonance images of 300 subjects admitted to the University of Pittsburgh Medical Center neurologic ICU from April 2013 through April 2014 were retrospectively reviewed. Images were reviewed for absent, partial, or complete opacification of the mastoid air cells and middle ear space...
December 6, 2016: Respiratory Care
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