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Respiratory Care

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https://www.readbyqxmd.com/read/29463692/prophylactic-antibiotic-use-in-copd-and-the-potential-anti-inflammatory-activities-of-antibiotics
#1
REVIEW
Anthony W Huckle, Lucy C Fairclough, Ian Todd
Antibiotics have previously demonstrated anti-inflammatory properties, and they have been linked to therapeutic benefit in several pulmonary conditions that feature inflammation. Previous research suggests that these anti-inflammatory properties may be beneficial in the treatment of COPD. This review assesses the potential benefit of prophylactic, long-term, and low-dose antibiotic therapy in COPD, and whether any effects seen are anti-inflammatory in nature. Randomized, controlled trials comparing antibiotic therapy with placebo in subjects with stable COPD were evaluated...
February 20, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29432140/noise-exposure-from-high-flow-nasal-cannula-oxygen-therapy-a-bench-study-on-noise-reduction
#2
Takamitsu Kubo, Hiroaki Nakajima, Ryo Shimoda, Tatsuya Seo, Yurie Kanno, Toshikazu Kondo, Sunao Tamai
BACKGROUND: High-flow nasal cannula (HFNC) oxygen therapy produces noise at a level such that patients often complain. However, the noise level has not been measured digitally. METHODS: We evaluated 3 types of HFNCs without filters and 2 types with filters attached for noise reduction. Optiflow (with and without a filter), MaxVenturi (with and without a filter) and AIRVO2 (without a filter only) were positioned at the center of a hospital room. We measured the noise levels at the distance of 1 m from the equipment at various total flows (30, 40, 50, 60 L/min) and F IO 2 (0...
February 6, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29432139/crossover-evaluation-of-compressors-and-nebulizers-typically-used-by-cystic-fibrosis-patients
#3
Samah M Awad, Ariel Berlinski
BACKGROUND: Compressor/nebulizer units are used to deliver inhaled medications to patients with cystic fibrosis. Practitioners and parents frequently replace either the compressor or the nebulizer with a similar component from a different brand. We hypothesized that these changes could affect the compressor/nebulizer flow-pressure and aerosol characteristics. METHODS: The following compressors were studied: Pari Vios, Pulmo-Aide model 5650D, and Inspiration Elite model HS456...
February 6, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29432138/characteristics-of-subjects-who-failed-a-120-minute-spontaneous-breathing-trial
#4
Guopeng Liang, Tingting Liu, Yihua Zeng, Yunfeng Shi, Wei Yang, Yunqin Yang, Yan Kang
BACKGROUND: The objective of this work was to identify the unique characteristics of patients who experienced success in a 30-min spontaneous breathing trial (SBT) but failed at 120 min. METHODS: Patients who had received mechanical ventilation for >24 h were eligible for inclusion in this study. The SBT was performed by 7 cm H 2 O of pressure support with zero PEEP. After a successful 120-min SBT, weaning from mechanical ventilation was performed. Data were collected at 30 and 120 min or at the failure of the SBT...
February 6, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29432137/air-travel-for-subjects-receiving-long-term-oxygen-therapy
#5
Christina D Campbell, Matthew W Smyth, Lindsay Brown, Emer Kelly
BACKGROUND: Ambulatory oxygen (O2) is the recommended treatment for hypoxemia at rest or induced by exercise. Commercial aircraft often fly at altitudes of 30,000 feet; their cabins are pressurized to altitudes of 6,000-8,000 feet, with an equivalent FIO2 of 0.15.O2 supplementation, for those receiving baseline ambulatory O2, is paramount. METHODS: We gathered information on subjects' experience traveling with supplementary oxygen and reasons individuals receiving O2 do not travel...
February 6, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29382795/evaluation-of-a-low-cost-bubble-cpap-system-designed-for-resource-limited-settings
#6
Desmond J Bennett, Ryan W Carroll, Robert M Kacmarek
BACKGROUND: Respiratory compromise is a leading contributor to global neonatal death. CPAP is a method of treatment that helps maintain lung volume during expiration, promotes comfortable breathing, and improves oxygenation. Bubble CPAP is an effective alternative to standard CPAP. We sought to determine the reliability and functionality of a low-cost bubble CPAP device designed for low-resource settings. METHODS: The low-cost bubble CPAP device was compared to a commercially available bubble CPAP system...
January 30, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29382794/helmet-versus-nasal-prong-cpap-in-infants-with-acute-bronchiolitis
#7
Juan Mayordomo-Colunga, Corsino Rey, Alberto Medina, Pablo Martínez-Camblor, Ana Vivanco-Allende, Andrés Concha
BACKGROUND: Nasal prongs are frequently used to deliver noninvasive CPAP in bronchiolitis, especially in the youngest children. A helmet interface is an alternative that might be comparable to nasal prongs. We sought to compare these interfaces. METHODS: We performed a prospective, randomized, crossover, single-center study in an 8-bed multidisciplinary pediatric ICU in a university hospital. Infants age <3 months who were consecutively admitted to the pediatric ICU during a bronchiolitis epidemic season and fulfilled inclusion criteria were recruited...
January 30, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29382793/frequent-versus-infrequent-monitoring-of-endotracheal-tube-cuff-pressures
#8
Adam Letvin, Pamala Kremer, Patty C Silver, Nizama Samih, Peggy Reed-Watts, Marin H Kollef
BACKGROUND: Currently there is no accepted standard of practice for the optimal frequency of endotracheal tube cuff pressure monitoring in mechanically ventilated patients. Therefore, we conducted a study to compare infrequent endotracheal tube cuff pressure monitoring (immediately after intubation and when clinically indicated for an observed air leak or due to tube migration) with frequent endotracheal tube cuff pressure monitoring (immediately after intubation, every 8 h, and when clinically indicated)...
January 30, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29382792/prolonged-mechanical-ventilation-as-a-predictor-of-mortality-after-cardiac-surgery
#9
Maria Dolores Fernandez-Zamora, Antonio Gordillo-Brenes, Esther Banderas-Bravo, José Andrés Arboleda-Sánchez, Rafael Hinojosa-Pérez, Eduardo Aguilar-Alonso, Ángel Herruzo-Aviles, Emilio Curiel-Balsera, Ángel Sánchez-Rodríguez, Ricardo Rivera-Fernández
BACKGROUND: Mortality among the small percentage of cardiac surgery patients receiving prolonged mechanical ventilation is high, but this issue appears to be inadequately addressed in guidelines. METHODS: This study is a retrospective analysis of prospective, multi-center, and observational study in Spain including all adults undergoing cardiac surgery in 3 Andalusian hospitals between June 2008 and December 2012. RESULTS: The study included 3,588 adults with mean ± SD age of 63...
January 30, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29362219/incentive-spirometry-adherence-a-national-survey-of-provider-perspectives
#10
Adam E M Eltorai, Grayson L Baird, Ashley Szabo Eltorai, Joshua Pangborn, Valentin Antoci, H Allethaire Cullen, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
BACKGROUND: Patient adherence is a critical factor for success of patient-administered therapies, including incentive spirometry (IS). Patient adherence with IS is not known, so we sought to evaluate providers'perspectives on the current state of IS adherence and elucidate possible factors hindering patient adherence. METHODS: Respiratory therapists (RTs) and nurses across the United States were surveyed via social media and online newsletters. Surveys were distributed to the relevant national RT and nursing societies: the American Association for Respiratory Care, the Academy of Medical-Surgical Nurses, the American Society of Peri-Anesthesia Nurses, and the American Association of Critical-Care Nurses...
January 23, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29362218/increasing-awareness-of-the-roles-knowledge-and-skills-of-respiratory-therapists-through-an-interprofessional-education-experience
#11
John B Zamjahn, Ellen O Beyer, Kelly L Alig, Donald E Mercante, Katherine L Carter, Tina P Gunaldo
BACKGROUND: The objectives of this study were: (1) to assess the use of interprofessional education (IPE) to improve the knowledge and skill levels of nursing and occupational therapy students regarding respiratory therapy (RT) medical devices and techniques, nursing and RT students regarding safe patient transfers, and RT and occupational therapy students regarding safe handling of a patient's medical lines during transfers and (2) to promote collaborative behaviors. METHODS: A prospective mixed methods approach was used for data collection of an IPE high-fidelity simulation experience involving 73 nursing, occupational therapy, and RT students at an academic medical institution...
January 23, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29362217/outcomes-of-tracheostomized-subjects-undergoing-prolonged-mechanical-ventilation-in-an-intermediate-care-facility
#12
Bertrand Herer
BACKGROUND: The incidence of chronically ill subjects with prolonged mechanical ventilation (PMV) has significantly increased over the last decade because of improvements in acute critical care. The aim of this study was to describe the outcomes and care pathways of subjects receiving PMV through a tracheostomy tube in an intermediate-care facility. METHODS: Sixty-six subjects with chronic respiratory failure who experienced 109 hospitalizations between December 2010 and December 2012 in a 34-bed post-care unit were retrospectively included and followed for at least 1 y...
January 23, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29362216/perspectives-on-incentive-spirometry-utility-and-patient-protocols
#13
Adam E M Eltorai, Grayson L Baird, Ashley Szabo Eltorai, Joshua Pangborn, Valentin Antoci, H Allethaire Cullen, Katherine Paquette, Kevin Connors, Jacqueline Barbaria, Kimberly J Smeals, Saurabh Agarwal, Terrance T Healey, Corey E Ventetuolo, Frank W Sellke, Alan H Daniels
BACKGROUND: Incentive spirometry (IS) is widely used to prevent postoperative pulmonary complications, despite limited clinical effectiveness data and a lack of standardized use protocols. We sought to evaluate health care professionals' perspectives on IS effectiveness and use procedures. METHODS: An online survey was distributed via social media and newsletters to relevant national nursing and respiratory care societies. Attitudes concerning IS were compared between the American Association for Respiratory Care (AARC) and the nursing societies...
January 23, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29339545/perioperative-implementation-of-noninvasive-positive-airway-pressure-therapies
#14
REVIEW
David R Hillman, Carla R Jungquist, Dennis Auckley
Noninvasively applied positive airway pressure therapy (PAP) is available in 3 basic modes: continuous positive airway pressure (CPAP), bi-level positive airway pressure (BPAP), and adaptive servo-ventilation. These are in widespread use in home and hospital settings to treat a variety of disorders of ventilation or gas exchange, including obstructive sleep apnea, sleep-related hypoventilation, periodic breathing, acute and chronic hypercapnic respiratory failure, and acute respiratory failure. They are increasingly being used perioperatively to prevent or treat upper airway obstruction, hypoventilation, and periodic breathing, and they have been found to improve postoperative outcomes in the case of obstructive sleep apnea...
January 16, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29317460/patient-reported-outcome-measures-for-symptom-perception-during-a-cystic-fibrosis-exacerbation
#15
Gabriela Schmid-Mohler, Ann-Louise Caress, Rebecca Spirig, Christian Benden, Janelle Yorke
BACKGROUND: Symptom burden increases during pulmonary exacerbations of cystic fibrosis (CF), and patient-reported outcome measures (PROMs) are often used to evaluate symptoms as either primary or secondary outcomes. However, there is currently no guidance on the use of PROMs to assess symptom burden during pulmonary exacerbations. METHODS: A systematic literature search was conducted to identify PROMs measuring symptom experience, management, or influencing factors, which were developed for CF patients and had been used at least once during pulmonary exacerbations...
January 9, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29298901/five-year-follow-up-and-outcomes-of-noninvasive-ventilation-in-subjects-with-neuromuscular-diseases
#16
Mi Ri Suh, Won Ah Choi, Dong Hyun Kim, Jang Woo Lee, Eun Young Kim, Seong-Woong Kang
INTRODUCTION: The purpose of this study was to investigate the 5-year outcomes of noninvasive ventilation (NIV) application in different neuromuscular disease (NMD) groups. METHODS: We categorized 180 subjects who had initiated NIV between March 2001 and August 2009 into 4 groups and followed them for > 5 y. The NIV maintenance rate and average duration, applying time, and forced vital capacity (FVC) were investigated at the time NIV was initiated and 5 y after NIV initiation in each group...
January 3, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29279366/evaluation-of-safety-and-cost-of-an-open-design-oxygen-mask-in-a-large-community-hospital
#17
Patricia A DeJuilio, Maya B Jenkins, Jeffrey P Huml
BACKGROUND: In our large community hospital, we observed that traditional oxygen masks were sometimes set at an inappropriately low flow. We hoped to eliminate this safety concern through adoption of an open-design oxygen mask. We also hoped that more immediate flow changes would lead to a decrease in medical gas consumption. Finally, by standardizing to one mask, goals were to reduce the cost of oxygen delivery. METHODS: We conducted a retrospective analysis, 12 months before and 12 months after implementation of the open-design oxygen mask...
December 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29279365/clinical-effectiveness-of-incentive-spirometry-for-the-prevention-of-postoperative-pulmonary-complications
#18
REVIEW
Adam E M Eltorai, Ashley L Szabo, Valentin Antoci, Corey E Ventetuolo, Jack A Elias, Alan H Daniels, Dean R Hess
Incentive spirometry (IS) is commonly prescribed to reduce pulmonary complications, despite limited evidence to support its benefits and a lack of consensus on optimal protocols for its use. Although numerous studies and meta-analyses have examined the effects of IS on patient outcomes, there is no clear evidence establishing its benefit to prevent postoperative pulmonary complications. Clinical practice guidelines advise against the routine use of IS in postoperative care. Until evidence of benefit from well-designed clinical trials becomes available, the routine use of IS in postoperative care is not supported by high levels of evidence...
December 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29279364/heart-rate-and-oxygen-saturation-change-patterns-during-6-min-walk-test-in-subjects-with-chronic-thromboembolic-pulmonary-hypertension
#19
Takeshi Inagaki, Jiro Terada, Misuzu Yahaba, Naoko Kawata, Takayuki Jujo, Kengo Nagashima, Seiichiro Sakao, Nobuhiro Tanabe, Koichiro Tatsumi
INTRODUCTION: The 6-min walk test (6MWT) is commonly performed to assess functional status in patients with chronic thromboembolic pulmonary hypertension. However, changes in heart rate and oxygen saturation (SpO2 ) patterns during 6MWT in patients with chronic thromboembolic pulmonary hypertension remain unclear. METHODS: Thirty-one subjects with chronic thromboembolic pulmonary hypertension were retrospectively evaluated to examine the relationships between the change in heart rate (Δheart rate), heart rate acceleration time, slope of heart rate acceleration, heart rate recovery during the first minute after 6MWT (HRR1), change in SpO2 (ΔSpO2 ), SpO2 reduction time, and SpO2 recovery time during 6MWT, and the severity of pulmonary hemodynamics assessed by right heart catheterization and echocardiography...
December 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29279363/lack-of-benefit-of-heliox-during-mechanical-ventilation-of-subjects-with-severe-air-flow-obstruction
#20
James W Leatherman, Ramiro Saavedra Romero, Robert S Shapiro
BACKGROUND: The value of heliox (helium-oxygen mixture) for patients with severe air-flow obstruction is uncertain. The purpose of this study was to determine whether heliox could reduce the degree of hyperinflation and hypercapnia in mechanically ventilated patients with severe air-flow obstruction. METHODS: This was a single-center, prospective observational study conducted in a medical ICU of an academic medical center. We assessed the impact of heliox (65-70% helium, 30-35% oxygen) on airway pressures and arterial blood gases of 13 subjects undergoing mechanical ventilation for severe asthma (n = 8) or exacerbation of COPD (n = 5)...
December 26, 2017: Respiratory Care
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