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Respiratory Care

Theodore Dassios, Paul Dixon, Anne Greenough
BACKGROUND: CPAP improves respiratory function in prematurely born infants by establishing and maintaining functional residual capacity, but the level of CPAP that optimizes respiratory function has not been adequately described. We compared ventilation efficiency and respiratory muscle function at different levels of CPAP. METHODS: We studied spontaneously breathing, intubated convalescent premature infants at King's College Hospital NHS Foundation Trust and calculated the ventilation efficiency index and the respiratory muscle time constant of relaxation (τ) at the end of 3 consecutive 5-min periods at 4, 6, and 8 cm H2 O of CPAP delivered in random order...
November 6, 2018: Respiratory Care
Adam Em Eltorai, Ariel R Choi, Ashley Szabo Eltorai
The electronic cigarette (e-cigarette) has been regarded by many as a healthier alternative to the combustible cigarette, yet there is a lack of consensus concerning the health consequences and the health benefits associated with e-cigarette use. We review the research on the effects of e-cigarettes on multiple physiological systems, examine the association between e-cigarette use and combustible cigarette uptake and cessation, and highlight research necessary to build consensus. Although the levels of known toxicants and carcinogens tend to be significantly lower in e-cigarettes than in combustible cigarette smoke, toxicants in e-cigarette e-liquid and those that form as part of the vaporization process may produce adverse health consequences in their own right...
November 6, 2018: Respiratory Care
Ismail Ozsoy, Buse Ozcan Kahraman, Serap Acar, Sevgi Ozalevli, Atila Akkoclu, Sema Savci
BACKGROUND: Activities of daily living (ADL) are important for an independent life. As COPD progresses, the ability to complete ADL is usually reduced. Knowing the possible factors that influence the ability to perform ADL may allow better targeting of appropriate rehabilitation programs to increase the independence levels and/or to prevent further decreases in patients with COPD. Therefore, the aim of this study was to investigate ADL performance as measured by the London Chest Activity of Daily Living scale, which is a commonly used measure in patients with COPD...
November 6, 2018: Respiratory Care
Agathe Kudela, Maude Millereux, Corentin Gouezel, Dominique Prat, Frédéric Jacobs, Olfa Hamzaoui, Nadège Demars, Guy Moneger, Anne Sylvie Dumenil, Pierre Trouiller, Benjamin Sztrymf
BACKGROUND: Our study set out to test the effect of noninvasive ventilation (NIV) performed after unplanned extubation. METHODS: Retrospective analysis of prospectively collected data in a university-affiliated mixed ICU of 12 beds during a 5-y period (January 2013 to December 2017). Unplanned extubation was defined as the occurrence of an unplanned removal of the endotracheal tube, whether deliberate or accidental. NIV after an unplanned extubation was not protocolized and was decided by the physician in charge on an individual basis...
November 6, 2018: Respiratory Care
Yet Hong Khor, Raymond Wong, Christine F McDonald
BACKGROUND: Home oxygen therapy is commonly prescribed for patients who remain hypoxemic at hospital discharge, although evidence supporting this practice is lacking. This study aimed to evaluate oxygen prescription and follow-up for patients who were prescribed post-discharge short-term oxygen therapy (STOT) and to assess their long-term outcome. METHODS: A retrospective audit was undertaken of subjects prescribed STOT following hospitalization at a single site in Melbourne, Australia, between January 2011 and December 2015...
November 6, 2018: Respiratory Care
Michael Insel, Bhupinder Natt, Jarrod Mosier, Joshua Malo, Christian Bime
BACKGROUND: The 2009 H1N1 influenza epidemic saw a rise in the use of extracorporeal membrane oxygenation (ECMO) as a supportive therapy for refractory ARDS. We sought to determine whether ECMO utilization follows a seasonal pattern that matches the influenza season, and whether it can further be explained by the incidence of each influenza subtype. METHODS: We performed a longitudinal analysis of non-cardiac and cardiac-associated ECMO cases from the National In-patient Sample from 2005 to 2014, using overdispersed Poisson regression to evaluate associations with influenza incidence categorized by influenza-like illness and total positive influenza tests divided by subtype from the Centers for Disease Control and Prevention...
October 30, 2018: Respiratory Care
Yet Hong Khor, Nicole Sl Goh, Ian Glaspole, Anne E Holland, Christine F McDonald
BACKGROUND: Exertional desaturation is an important predictor of mortality in patients with interstitial lung disease. We evaluated the prevalence of exertional desaturation in subjects with interstitial lung disease and determined its relationship with the prescription of ambulatory oxygen therapy. METHODS: Our retrospective analysis examined prospectively collected data from interstitial lung disease registries of 2 Melbourne hospitals: Alfred Health and Austin Health...
October 30, 2018: Respiratory Care
Shogo Misu, Masahiro Kaneko, Hideki Sakai, Yutaro Oki, Yukari Fujimoto, Akira Ishikawa, Rei Ono
BACKGROUND: There are limited longitudinal studies reporting predictive factors for decline in 6-min walk distance (6MWD) in patients with COPD. While previous studies have confirmed the association between air-flow limitation and decline in 6MWD, other factors have not been clarified. The objective of this study was to investigate whether exercise-induced oxygen desaturation (EID) could be a predictive factor for decline in 6MWD in patients with COPD. The interactive effect of air-flow limitation on the association between EID and decline in 6MWD was also investigated...
October 16, 2018: Respiratory Care
Saeed M Alghamdi, Rayan A Siraj, Arzu Ari
BACKGROUND: Clinical facilities are essential components not only of health care delivery systems, but also of health care education programs. The clinical learning environment (CLE) is important in training the future health care workforce. Because respiratory therapy (RT) is a practice-based profession, it is essential to integrate clinical education into RT education. RT education programs face several issues with respect to the need for preparing a proper CLE in various clinical settings...
October 16, 2018: Respiratory Care
Mohammed M Alqahtani, Lynda T Goodfellow, Ralph D Zimmerman, Gerald S Zavorsky
BACKGROUND: Waterpipe (hookah) smoking is a form of tobacco smoking that is noticeably increasing worldwide, particularly among young adults. A growing body of literature indicates that college students may not be as knowledgeable as they should be in making decisions about waterpipe smoking. PURPOSE: This study evaluated the prevalence, knowledge, and attitudes regarding waterpipe smoking use among college-based health-care students. METHODS: Two instruments were found to be appropriate to the study, and permission was obtained to modify usage in this specific study...
October 16, 2018: Respiratory Care
Michelle L Jones, Shasha Bai, Tracy L Thurman, Shirley J Holt, Mark J Heulitt, Sherry E Courtney
BACKGROUND: Noninvasive ventilation (NIV) is commonly used in neonates. A mode of NIV called neurally adjusted ventilatory assist (NAVA) offers patient-ventilator interactions by using electrical activity of the diaphragm to control mechanical breaths. We hypothesized that the work of breathing (WOB) would decrease with NIV-NAVA. Secondary objectives evaluated the impact of NIV-NAVA on arterial blood gases and respiratory parameters. METHODS: We compared WOB between synchronized breaths in NIV-NAVA and NIV in piglets with healthy lungs and then with surfactant-depleted lungs...
September 25, 2018: Respiratory Care
Rajeev Bhatia, Emma Schwendeman
BACKGROUND: A simple exercise test to evaluate for exercise-induced bronchoconstriction (EIB) is routinely ordered in pediatric patients with exercise-induced dyspnea. However, the utility of this test in establishing the cause of exercise-induced dyspnea is not thoroughly examined in the pediatric population. We sought to assess the efficiency of a simple EIB challenge test in finding the cause of exercise-induced dyspnea in pediatric patients referred to our tertiary center in the last 5 y...
September 25, 2018: Respiratory Care
Emily Sheppard, Kerrie Chang, Jackie Cotton, Sonia Gashgarian, Danny Slack, Kenneth Wu, Anna Michalski, Pat Fox, Anne L Stephenson, Sunita Mathur
BACKGROUND: Muscle weakness is an important systemic consequence in adults with cystic fibrosis, but it can be challenging to evaluate clinically. This study examined the validity of lower-extremity functional tests to assess quadriceps muscle strength and muscle power. METHODS: The subjects underwent 4 functional tests: 30-s sit-to-stand test, stair-climb power test, vertical jump height, and triple hop distance. Quadriceps muscle strength and power were tested by using a dynamometer (the accepted standard)...
September 25, 2018: Respiratory Care
Amelia F Kan, Jane M Butler, Meghan Hutchence, Kristi Jones, John Widger, Michael A Doumit
BACKGROUND: Cough augmentation techniques are taught by health-care providers to improve secretion clearance and to help prevent respiratory infections in children with neuromuscular disease. There is some evidence of the effectiveness of a manually assisted cough when applied by health-care providers. However, it is unknown whether parents and caregivers may also be effective in applying manually assisted cough. The aim of this study was to evaluate whether parents and caregivers are effective at applying a manually assisted cough to a child with neuromuscular disease after being taught by a health-care provider...
September 25, 2018: Respiratory Care
Jennifer A Cronly, Alistair J Duff, Kristin A Riekert, Anthony P Fitzgerald, Ivan J Perry, Elaine A Lehane, Aine Horgan, Barbara A Howe, Muireann Ni Chroinin, Eileen Savage
BACKGROUND: People with cystic fibrosis face substantial physical, psychological, and social challenges as they move into adolescence and adulthood, which are likely to impact on their health-related quality of life. This study sought to examine the relative importance of physical and mental health variables associated with health-related quality of life in this group. METHODS: Adults and adolescents ( N = 174; ≥14 y old) from across 11 adult or pediatric cystic fibrosis clinics in the Republic of Ireland, completed a background questionnaire that contained self-reported physical health variables, pulmonary function (ie, FEV1 %) and body mass index...
September 25, 2018: Respiratory Care
Anderson José, Tamires Machado Ramos, Rejane Agnelo Silva de Castro, Cristiane Santos de Oliveira, Anderson Alves de Camargo, Rodrigo Abensur Athanazio, Samia Zahi Rached, Rafael Stelmach, Simone Dal Corso
BACKGROUND: Bronchiectasis leads to reduced functional capacity, which might have implications for physical activity. The impact of dyspnea and long-term oxygen therapy on physical activity has never been investigated in subjects with bronchiectasis. Based on these findings, specific strategies could be applied to allow individuals to be more active in their daily life. In this study we aimed to evaluate physical activity, the impact of dyspnea and long-term oxygen therapy on physical activity, and the determinants of physical activity in subjects with bronchiectasis...
September 25, 2018: Respiratory Care
Anoopindar K Bhalla, Robinder G Khemani, Justin C Hotz, Rica P Morzov, Christopher Jl Newth
BACKGROUND: Widespread use of transcutaneous P CO2 ( P tcCO2 ) monitoring is currently limited by concerns many practitioners have regarding accuracy. We compared the accuracy of P tcCO2 with that of P aCO2 measurements in critically ill children, and we investigated whether clinical conditions associated with low cardiac output or increased subcutaneous tissue affect this accuracy. METHODS: We performed a single-center prospective study of critically ill children placed on transcutaneous monitoring...
September 25, 2018: Respiratory Care
Daniel C Schmitz, Rebecca A Ivancie, Kyung E Rhee, Heather C Pierce, Alicia O Cantu, Erin S Fisher
BACKGROUND: Reports show that many patients do not use their pressurized metered-dose inhalers (pMDIs) effectively. The National Heart, Lung, and Blood Institute recommends that health-care providers educate and assess patients' pMDI technique at each opportunity. However, limited data exist regarding how often pediatric primary care providers perform assessments and which methods they use. We sought to (1) identify instructional methods used to teach pMDI use, (2) describe how pMDI use is reassessed at follow-up visits, and (3) describe primary care provider attitudes and barriers to in-office pMDI instruction...
September 25, 2018: Respiratory Care
Nobuto Nakanishi, Jun Oto, Taiga Itagaki, Emiko Nakataki, Mutsuo Onodera, Masaji Nishimura
BACKGROUND: Most heat-and-moisture exchangers (HMEs) for patients with tracheostomy and spontaneously breathing are small and have suction ports that allow some expiratory gas to escape, which loses vapor held in the expired gas. Recently, a heated-and-humidified high-flow system for spontaneously breathing patients with tracheostomy was developed. Little is known, however, about the humidifying performance of HMEs or heated-and-humidified high-flow systems for spontaneous breathing patients with a tracheostomy...
September 25, 2018: Respiratory Care
Fernanda Maria Vendrusculo, João Paulo Heinzmann-Filho, Juliana Severo da Silva, Margarita Perez Ruiz, Márcio Vinícius Fagundes Donadio
BACKGROUND: Aerobic fitness, as measured by peak oxygen uptake (V̇O2 peak), correlates with survival in children and adults with cystic fibrosis (CF). We sought to evaluate the effects of V̇O2 peak on mortality rates in subjects with CF. METHODS: An online search in PubMed, Embase, LILACS, and SciELO databases was conducted, and cohort studies that assessed mortality rates after oxygen absorption measurements during a maximal exercise test were included. Data were extracted independently by 2 reviewers...
September 11, 2018: Respiratory Care
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