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Respiratory Care

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https://www.readbyqxmd.com/read/29042486/parameters-for-simulation-of-adult-patients-during-mechanical-ventilation
#1
Jean-Michel Arnal, Aude Garnero, Mathieu Saoli, Robert L Chatburn
BACKGROUND: Simulation studies are often used to examine ventilator performance. However, there are no standards for selecting simulation parameters. This study collected data in passively-ventilated adult human subjects and summarized the results as a set of parameters that can be used for simulation studies of intubated, passive, adult subjects with normal lungs, COPD, or ARDS. METHODS: Consecutive adult patients admitted to the ICU were included if they were deeply sedated and mechanically ventilated for <48 h without any spontaneous breathing activity...
October 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29042485/maternal-stress-during-pregnancy-and-allergic-diseases-in-children-during-the-first-year-of-life
#2
Katarzyna Smejda, Kinga Polanska, Dorota Merecz-Kot, Anna Krol, Wojciech Hanke, Joanna Jerzynska, Wlodzimierz Stelmach, Paweł Majak, Iwona Stelmach
BACKGROUND: Many recent studies indicate that prenatal maternal distress increases the risk of allergic diseases in children. The mechanisms that favor it are still unclear. OBJECTIVES: We aimed to assess the association between exposure to different kinds of prenatal stress and the occurrence of atopic dermatitis, food allergy, wheezing, and recurrent respiratory tract infections in children. METHODS: The study population consisted of 370 mother-child pairs from a Polish Mother and Child Cohort (REPRO_PL)...
October 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29042484/accuracy-of-oxygen-flow-delivered-by-compressed-gas-cylinders-in-hospital-and-prehospital-emergency-care
#3
Frédéric Duprez, Jean Bernard Michotte, Gregory Cuvelier, Alexandre Legrand, Sharam Mashayekhi, Gregory Reychler
BACKGROUND: Oxygen cylinders are widely used both in hospital and prehospital care. Excessive or inappropriate FIO2 may be critical for patients with hypercapnia or hypoxia. Moreover, over-oxygenation could be deleterious in ischemic disorders. Supplemental oxygen from oxygen cylinder should therefore be delivered accurately. The aim of this study was to assess the accuracy of oxygen flows for oxygen cylinder in hospital and prehospital care. METHODS: A prospective trial was conducted to evaluate accuracy of delivered oxygen flows (2, 4, 6, 9 and 12 L/min) for different oxygen cylinder ready for use in different hospital departments...
October 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29018041/spontaneous-breathing-trials-and-conservative-sedation-practices-reduce-mechanical-ventilation-duration-in-subjects-with-ards
#4
Richard H Kallet, Hanjing Zhuo, Vivian Yip, Antonio Gomez, Michael S Lipnick
BACKGROUND: Spontaneous breathing trials (SBTs) and daily sedation interruptions (DSIs) reduce both the duration of mechanical ventilation and ICU length of stay (LOS). The impact of these practices in patients with ARDS has not previously been reported. We examined whether implementation of SBT/DSI protocols reduce duration of mechanical ventilation and ICU LOS in a retrospective group of subjects with ARDS at a large, urban, level-1 trauma center. METHODS: All ARDS survivors from 2002 to 2016 (N = 1,053) were partitioned into 2 groups: 397 in the pre-SBT/DSI group (June 2002-December 2007) and 656 in the post-SBT/DSI group (January 2009-April 2016)...
October 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28974647/a-quality-improvement-project-to-improve-evidence-based-inhaled-nitric-oxide-use
#5
Colleen A Hughes Driscoll, Natalie L Davis, Megan Miles, Dina El-Metwally
BACKGROUND: Inhaled nitric oxide (INO) reduces extracorporeal membrane oxygenation (ECMO) use in term and near-term neonates with persistent pulmonary hypertension of the newborn; however, its overutilization is increasing. We hypothesized that implementing a shared baseline protocol would safely improve evidence-based INO use in a Level IV neonatal ICU. METHODS: Through several plan-do-study-act cycles, a shared baseline protocol for initiation and weaning of INO was developed and implemented starting in August 2014...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28974646/factors-associated-with-re-intubation-within-14-days-after-ventilator-liberation
#6
Chia-Chen Chu, Chin-Jung Liu, Suh-May Yen, Wen-Yu Chou, Pei-Tseng Kung, Yuh-Show Tsai, Wen-Chen Tsai
BACKGROUND: According to Taiwan's integrated delivery system policy, ventilator-dependent patients are successfully liberated from mechanical ventilation in accordance with step-down care. However, premature discharge affects the 14-d readmission quality index. Therefore, we explored the risk and related factors of subjects liberated from mechanical ventilation who were re-intubated within 14 d. METHODS: This retrospective study analyzed a cohort of ventilator-dependent subjects 17 y of age and older using a population-based database from the Taiwan National Health Research Institutes Database from 2006 to 2010...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28974645/noninvasive-ventilation-in-obese-subjects-after-acute-respiratory-failure
#7
Charlotte Bry, Sandrine Jaffré, Béatrice Guyomarc'h, Frédéric Corne, Sylvaine Chollet, Antoine Magnan, François-Xavier Blanc
INTRODUCTION: Noninvasive ventilation (NIV) has been widely used to treat acute respiratory failure in obese patients. Criteria that could help clinicians to decide whether they should continue to use NIV after such an initial episode remain unclear. Our retrospective study aims to analyze characteristics of subjects receiving long-term NIV after an initial hospitalization for acute respiratory failure. METHODS: From January 2011 to December 2012, 77 obese adults were admitted in the ICU of the respiratory disease department in Nantes University Hospital in France...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28974644/respiratory-therapist-managed-arterial-catheter-insertion-and-maintenance-program-experience-in-a-non-teaching-community-hospital
#8
Sasheen Pack, Peter Y Hahn, James K Stoller, Srinivas R Mummadi
BACKGROUND: Usual practice in community health-care settings indicates that arterial catheters are inserted by physicians. In the context of a respiratory therapist (RT)-managed arterial catheter placement protocol being implemented in our community hospital, the current study describes the implementation and outcomes of this RT-managed arterial catheter insertion and maintenance program. METHODS: Tuality Healthcare is a 215-bed community health-care system (10-bed ICU) in Hillsboro, Oregon...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28974643/perceived-satisfaction-with-long-term-oxygen-delivery-devices-affects-perceived-mobility-and-quality-of-life-of-oxygen-dependent-individuals-with-copd
#9
Constance C Mussa, Laura Tonyan, Yi-Fan Chen, David Vines
BACKGROUND: Although routine physical activity for individuals with COPD is recommended, there are inherent limitations of available oxygen delivery devices that may result in hypoxemia during activity. Changes in Medicare laws have resulted in an increased use of oxygen cylinders and a reduction in the use of liquid oxygen devices. The aim of this survey was to assess the impact of perceived satisfaction with various oxygen delivery devices on perceived mobility and quality of life (QOL) of oxygen-dependent subjects with COPD...
October 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28951469/inspiratory-muscle-performance-of-former-smokers-and-nonsmokers-using-the-test-of-incremental-respiratory-endurance
#10
Magno F Formiga, Michael A Campos, Lawrence P Cahalin
BACKGROUND: Smoking has potential deleterious effects on respiratory muscle function. Smokers may present with reduced inspiratory muscle strength and endurance. We compared inspiratory muscle performance of nonsmokers with that of former smokers without overt respiratory problems via the Test of Incremental Respiratory Endurance. METHODS: This study was performed on 42 healthy subjects between the ages of 30 and 79 y (mean ± SD of 56.5 ± 14.4 y). Fourteen male and 7 female former smokers were matched to nonsmokers based on sex, age, height, and weight...
September 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28951468/impact-of-a-noninvasive-ventilation-protocol-in-hospitalized-children-with-acute-respiratory-failure
#11
Yorschua Jalil, Felipe Damiani, Claudia Astudillo, Gregory Villarroel, Patricio Barañao, Edson Bustos, Alejandra Silva, Mireya Mendez
BACKGROUND: Noninvasive ventilation (NIV) has proven to be useful in the management of children with acute respiratory failure as a result of acute lower respiratory infection. Despite this, evidence addressing the initiation and/or discontinuation criteria of NIV in children remains limited. The objective of this study was to evaluate the usefulness and clinical impact of an NIV protocol in hospitalized children with acute respiratory failure because of acute lower respiratory infection...
September 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28951467/a-low-pressure-oxygen-storage-system-for-oxygen-supply-in-low-resource-settings
#12
Roger P Rassool, Bryn A Sobott, David J Peake, Bagayana S Mutetire, Peter P Moschovis, Jim Fp Black
BACKGROUND: Widespread access to medical oxygen would reduce global pneumonia mortality. Oxygen concentrators are one proposed solution, but they have limitations, in particular vulnerability to electricity fluctuations and failure during blackouts. The low-pressure oxygen storage system addresses these limitations in low-resource settings. This study reports testing of the system in Melbourne, Australia, and nonclinical field testing in Mbarara, Uganda. METHODS: The system included a power-conditioning unit, a standard oxygen concentrator, and an oxygen store...
September 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28951466/emergency-department-blood-gas-utilization-and-changes-in-ventilator-settings
#13
Haitham S Al Ashry, Jeremy B Richards, Daniel F Fisher, Jeffrey Sankoff, Todd A Seigel, Lauren B Angotti, Susan R Wilcox
BACKGROUND: Mechanically ventilated patients increasingly spend hours in emergency department beds before ICU admission. This study evaluated the performance of blood gases in mechanically ventilated subjects in the emergency department and subsequent changes to mechanical ventilation settings. METHODS: This was a multi-center, prospective, observational study of subjects ventilated in the emergency department, conducted at 3 academic emergency departments from July 2011 to March 2013...
September 26, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28928262/the-use-of-speaking-valves-in-children-with-tracheostomy-tubes-what-is-the-scope-of-the-literature
#14
Weeda Zabih, Theresa Holler, Faiza Syed, Laurie Russell, Jennifer Allegro, Reshma Amin
One-way speaking valves have been successfully used to restore audible meaningful speech in adult patients after tracheostomy tube placement. One-way speaking valves have also been used in pediatric patients after tracheostomy tube placement with promising results. We conducted a scoping review to synthesize and summarize the current evidence on the use of one-way tracheostomy tube speaking valves in the pediatric population to identify knowledge gaps that could inform future research programs and facilitate evidence-based clinical decision making...
September 19, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28900041/predicting-extubation-outcome-by-cough-peak-flow-measured-using-a-built-in-ventilator-flow-meter
#15
Florent Gobert, Hodane Yonis, Romain Tapponnier, Raul Fernandez, Marie-Aude Labaune, Jean-François Burle, Jack Barbier, Bernard Vincent, Maria Cleyet, Jean-Christophe Richard, Claude Guérin
BACKGROUND: Successful weaning from mechanical ventilation depends on the patient's ability to cough efficiently. Cough peak flow (CPF) could predict extubation success using a dedicated flow meter but required patient disconnection. We aimed to predict extubation outcome using an overall model, including cough performance assessed by a ventilator flow meter. METHODS: This was a prospective observational study conducted from November 2014 to October 2015. Before and after a spontaneous breathing trial, subjects were encouraged to cough as strongly as possible before freezing the ventilator screen to assess CPF and tidal volume (VT) in the preceding inspiration...
September 12, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28900040/reduced-diaphragm-excursion-during-reflexive-citric-acid-cough-test-in-subjects-with-subacute-stroke
#16
Yong-Min Choi, Geun-Young Park, Yeonji Yoo, Donggyun Sohn, YongJun Jang, Sun Im
BACKGROUND: Diaphragm excursion is limited during respiratory maneuvers after a stroke. How the diaphragm is limited during reflexive coughs and affects the effectiveness of cough in stroke patients is unclear. This study aimed to measure reflexive cough strength by cough peak flow (CPF) induced by citric acid nebulization (2.8 mol/L), record diaphragm excursions during reflexive coughs in stroke subjects at risk of silent aspiration, and compare these values with those of stroke subjects without risk of aspiration or dysphagia...
September 12, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28900039/the-contributing-risk-of-tobacco-use-for-ards-development-in-burn-injured-adults-with-inhalation-injury
#17
Majid Afshar, Giora Netzer, Michael J Mosier, Richard S Cooper, William Adams, Ellen L Burnham, Elizabeth J Kovacs, Ramon Durazo-Arvizu, Stephanie Kliethermes
BACKGROUND: This study aims to determine the relationship between tobacco use, inhalation injury, and ARDS in burn-injured adults. METHODS: This study was an observational cohort of 2,485 primary burn admissions to a referral burn center between January 1, 2008 and March 15, 2015. Subjects were evaluated by methods used to account for mediation and traditional approaches (multivariable logistic regression and propensity score analysis). Mediation analysis examined both the (1) indirect effect of tobacco use via inhalation injury as the mediator on ARDS development and (2) the direct effect of tobacco use alone on ARDS development...
September 12, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28874613/diaphragmatic-thickness-fraction-in-subjects-at-high-risk-for-copd-exacerbations
#18
Emel Eryüksel, Canan Cimşit, Melahat Bekir, Çagatay Cimsit, Sait Karakurt
BACKGROUND: Ultrasound-based diaphragmatic thickness fraction is a reflection of the size and function of the diaphragm. This study aimed to examine the value of this measurement in identifying patients with COPD who are at high risk for the development of symptoms and exacerbations. METHODS: This cross-sectional study included 53 subjects with COPD. Respiratory function test results, ultrasonography-based diaphragmatic thickness, symptom scores (modified Medical Research Council dyspnea scale); COPD Assessment Test results, and number of previous exacerbations and admissions were recorded...
September 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28874612/role-of-integrated-pulmonary-index-in-identifying-extubation-failure
#19
Ramandeep Kaur, David L Vines, Li Liu, Robert A Balk
BACKGROUND: The integrated pulmonary index (IPI) utilizes an algorithm based on the measurement of end-tidal carbon dioxide, breathing frequency, heart rate, and oxygen saturation to provide an assessment of the patient's ventilatory status. This clinical trial was designed to determine whether lower IPI values were associated with extubation failure. METHODS: This prospective observational trial was conducted in an academic medical center. After institutional review board approval, 100 mechanically ventilated subjects were enrolled...
September 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28874610/the-2017-global-initiative-for-chronic-obstructive-lung-disease-report-and-practice-implications-for-the-respiratory-therapist
#20
Michael W Hess
Since 1998, the Global Initiative for Obstructive Lung Disease (GOLD) has worked with health care professionals, medical researchers, and public health officials around the world to optimize the prevention, treatment, and management of COPD. GOLD has continually worked to ensure COPD management strategy recommendations are aligned with current published research. The 2017 GOLD report represents a major revision to GOLD strategy guidelines, the first such major revision in the last 5 years. As such, the 2017 report has significant implications for the diagnosis of COPD, the management of stable disease, and the treatment of exacerbations...
September 5, 2017: Respiratory Care
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