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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
Taiga Itagaki, Nobuto Nakanishi, Nao Okuda, Emiko Nakataki, Mutsuo Onodera, Jun Oto, Masaji Nishimura
BACKGROUND: We previously reported the effects of high-flow nasal cannula (HFNC) oxygen therapy on thoraco-abdominal synchrony. This study was designed to clarify the effect of HFNC on thoraco-abdominal synchrony in pediatric subjects after cardiac surgery and to investigate HFNC optimal flow in this population. METHODS: Thoraco-abdominal synchrony was evaluated with respiratory inductive plethysmography. After extubation, we delivered oxygen via face mask for 30 min to subjects with mild to moderate respiratory failure...
September 11, 2018: Respiratory Care
Annia F Schreiber, Piero Ceriana, Nicolino Ambrosino, Alberto Malovini, Stefano Nava
BACKGROUND: Patients undergoing prolonged mechanical ventilation represent up to 15% of all patients requiring weaning from mechanical ventilation. Although recent guidelines have recommended including physiotherapy early during mechanical ventilation to speed the process of weaning, only indirect evidence supporting the use of physiotherapy is available for patients receiving prolonged mechanical ventilation. The aim of our study was to evaluate the effects of a physiotherapy program in subjects requiring prolonged mechanical ventilation and the correlates of successful weaning...
September 11, 2018: Respiratory Care
Louise Rose, Douglas McKim, David Leasa, Mika Nonoyama, Anu Tandon, Marta Kaminska, Colleen O'Connell, Andrea Loewen, Bronwen Connolly, Patrick Murphy, Nicholas Hart, Jeremy Road
BACKGROUND: Regular monitoring combined with early and appropriate use of airway clearance can reduce unplanned hospital admissions for patients with neuromuscular disease (NMD) and spinal cord injury (SCI). We aimed to describe and compare knowledge of guidelines, monitoring of cough effectiveness, clinician prescription/provision of airway clearance strategies, and service provision constraints in the United Kingdom and Canada. METHODS: This was a cross-sectional survey of clinicians affiliated with NMD and SCI clinics in Canada, 2016 attendees at the Home Mechanical Ventilation Conference in the United Kingdom, and United Kingdom physiotherapist networks...
September 11, 2018: Respiratory Care
Renee M Bartle, Andrew G Miller, Anthony J Diez, P Brian Smith, Michael A Gentile, Mihai Puia-Dumitrescu
BACKGROUND: Endotracheal tube (ETT) depth in premature infants is of critical importance because potentially life-threatening adverse events can occur if the tube is malpositioned. Analysis of current data indicates that the accuracy of current resuscitation guidelines for infants <1 kg is poor. We hypothesized that a weight-based formula that is used clinically in our institution would accurately predict appropriate ETT placement in infants weighing < 1 kg. METHODS: The medical records, from July 2013 to November 2016, of all infants < 1 kg who were intubated were retrospectively reviewed and included...
September 11, 2018: Respiratory Care
Valliappan Muthu, Ritesh Agarwal, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal
BACKGROUND: The outcomes of patients with tuberculosis admitted to an ICU remain undetermined. Herein, we reviewed the literature to describe the mortality of subjects with tuberculosis who are critically ill, and explore the effect of glucocorticoids on survival. METHODS: A systematic review of medical literature databases was performed for studies that describe the outcome of subjects with tuberculosis who required ICU admission. We calculated the proportion of hospitalized subjects with tuberculosis who required ICU admission...
September 11, 2018: Respiratory Care
Kazuto Kikuchi, Masahiro Satake, Yusuke Kimoto, Satomi Iwasawa, Ryohei Suzuki, Michio Kobayashi, Chizu Wada, Takanobu Shioya
BACKGROUND: Manually-assisted coughing and mechanical insufflation-exsufflation (MI-E) are commonly used in patients with Duchenne muscular dystrophy (DMD). Few studies have compared cough peak flow (CPF) with manually-assisted coughing to other methods, such as MI-E + manually-assisted coughing. In addition, few studies have reported the reliability of the measured CPF values. This study aimed to compare CPF with different cough-assistance methods and to examine the reliability of CPF data...
September 11, 2018: Respiratory Care
Ting Luo, Hui Zhou, Jie Meng
BACKGROUND: Tracheobronchopathia osteochondroplastica (TO) consists of benign lesions of tracheal and bronchial mucosa with multiple nodular hyperplasia of bone or cartilage protruding into the lumen. METHODS: We diagnosed 73 subjects with TO with the use of bronchoscopy in the Department of Respiratory and Critical Care Medicine of Xiangya Hospital between January 2000 and April 2017. Clinical manifestations, radiographic characteristics, bronchoscopic manifestations, histopathological findings, and treatments were analyzed retrospectively...
September 4, 2018: Respiratory Care
Massimiliano Pirrone, David Ae Imber, Francesco Marrazzo, Riccardo Pinciroli, Changsheng Zhang, Lynn Bry, Mary L Delaney, Andrea M Dubois, John G Thomas, Laura Nistico, Rachael Melton-Kreft, Edward A Bittner, Robert M Kacmarek, Lorenzo Berra
BACKGROUND: Biofilm on the surface of endotracheal tubes (ETTs) is associated with ventilator-associated pneumonia. The use of silver-coated ETTs has been suggested to reduce the occurrence of ventilator-associated pneumonia by preventing biofilm formation. However, mucus accumulation can reduce the antibacterial activity of silver-coated ETTs by isolating bacterial colonies from the silver surface. We hypothesized that, in mechanically ventilated subjects, periodical removal of secretions through the use of a cleaning device would enhance the antimicrobial properties of silver-coated ETTs and thus reduce bacterial colonization...
September 4, 2018: Respiratory Care
Pooja M Kanth, Caesar Alaienia, Gerald C Smaldone
BACKGROUND: Inhaled interferon, a potential treatment for idiopathic pulmonary fibrosis, must be formulated with mannitol, which can cause bronchospasm and cough. Coughing during drug inhalation can be affected by many factors, but some factors are fixed by the needs of the formulation and inflammatory disease in the airways. A component of the cough response may be related to sites of deposition, particularly upper and central airways. If deposition sites are important, then manipulating the particle distribution of the aerosol may mitigate coughing...
August 28, 2018: Respiratory Care
Ivana Gonçalves Labadessa, Audrey Borghi-Silva, Adriana Sanches Garcia de Araujo, Fabiola Paula Galhardo Rizzatti, Valéria Amorim P Di Lorenzo
BACKGROUND: The incremental shuttle walk test (ISWT) has been widely used to assess exercise capacity of subjects with COPD. However, to date, no studies have assessed its reliability in the asthmatic population. This study aimed to assess the test-retest reliability of ISWT for the distance walked (ISWD) and cardiorespiratory and metabolic responses in adult subjects with asthma. METHODS: This was a cross-sectional observational study. Thirty-four subjects of both genders, 18-45 y old, with a diagnosis of controlled asthma, were recruited from March 2012 to December 2015...
August 28, 2018: Respiratory Care
Liliane Ps Mendes, Karoline S Moraes, Mariana Hoffman, Danielle Sr Vieira, Giane A Ribeiro-Samora, Susan M Lage, Raquel R Britto, Verônica F Parreira
BACKGROUND: Breathing exercises, such as diaphragmatic breathing and pursed-lips breathing, play a role in some individuals with COPD and might be considered for those patients who are unable to exercise. However, in the literature are reports of some adverse effects of diaphragmatic breathing in patients with COPD. Thus, the purpose of this study was to assess the effects of diaphragmatic breathing and diaphragmatic breathing combined with pursed-lips on chest wall kinematics, breathlessness, and chest wall asynchrony in subjects with COPD, and also to assess whether the combination of both exercises reduces the adverse effects of diaphragmatic breathing while maintaining its benefits...
August 28, 2018: Respiratory Care
Hideyuki Mouri, Taisuke Jo, Nobuaki Michihata, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
BACKGROUND: Exacerbation of idiopathic interstitial pneumonias (IIPs) requiring mechanical ventilation is associated with high mortality. However, evidence for the optimal management strategy in patients on mechanical ventilation for exacerbation of IIPs is scarce. This study aimed to evaluate the association between continuous rocuronium infusion and in-hospital mortality in patients with exacerbation of IIPs requiring mechanical ventilation. METHODS: The effect of continuous rocuronium infusion was retrospectively analyzed using data in the Japanese Diagnosis Procedure Combination in-patient database from July 2010 to March 2016...
August 28, 2018: Respiratory Care
Haitham Saeed, Marwa Mohsen, Abeer Salah Eldin, Ahmed A Elberry, Raghda Rs Hussein, Hoda Rabea, Mohamed Ea Abdelrahim
BACKGROUND: The aim of this work was to determine the effect of fill volume and humidification change on aerosol delivery during single-limb noninvasive ventilation (NIV). METHODS: Four groups were recruited, each consisting of 12 subjects (6 females) with COPD receiving NIV. Groups 1 and 3 received inhaled salbutamol with a vibrating mesh nebulizer, and Groups 2 and 4 received inhaled salbutamol with a jet nebulizer. The in vivo study was carried out on days 1 and 3...
August 14, 2018: Respiratory Care
Yves de Souza, Kenia Maynard da Silva, Diego Condesso, Bianca Figueira, Arnaldo J Noronha Filho, Rogério Rufino, Rik Gosselink, Cláudia H da Costa
BACKGROUND: Pulmonary rehabilitation programs improve exercise capacity and quality of life in patients with COPD. Domiciliary strategies to maintain these benefits have been proposed. OBJECTIVE: This study aimed to determine whether a rehabilitation manual would facilitate the maintenance of the benefits acquired during out-patient pulmonary rehabilitation. METHODS: Fifty subjects with stable COPD were included (26 women and 24 men). All the subjects were evaluated during screening and after 12 wk of out-patient rehabilitation, and then were randomly divided into 2 groups, with one group that received the rehabilitation manual for home use (manual group) and the other group only received verbal recommendations (control group)...
August 7, 2018: Respiratory Care
Cristina Jácome, Juan Carlos Aviles-Solis, Åshild Myrnes Uhre, Hans Pasterkamp, Hasse Melbye
BACKGROUND: For clinical practice and research, it would be easier to auscultate lung sounds without simultaneously measuring air flow. This study evaluated whether the presence of adventitious lung sounds and the characteristics of normal lung sounds differ between spontaneous and standardized breathing in a general population. METHODS: A cross-sectional study was conducted with 116 subjects (53.4% female, mean age 59.2 ± 11.6 y). The subjects reported heart/lung diseases and the degree of dyspnea, and spirometry was carried out...
August 7, 2018: Respiratory Care
Stine Hangaard, Thomas Kronborg, Ole K Hejlesen
BACKGROUND: COPD is largely underdiagnosed. Patients with undiagnosed COPD need to be diagnosed to ensure early treatment institution. It is therefore relevant to obtain a more profound understanding of the characteristics of patients with undiagnosed COPD to improve COPD case finding. This study aimed to explore the characteristics of subjects with undiagnosed COPD from the United States National Health and Nutrition Examination Survey (NHANES) dataset (2007-2012) based on post-bronchodilator spirometry...
August 7, 2018: Respiratory Care
Hadeer S Harb, Ahmed A Elberry, Hoda Rabea, Maha Fathy, Mohamed Ea Abdelrahim
BACKGROUND: Predosing patients with COPD with salbutamol by using a pressurized metered-dose-inhaler (pMDI) as a bronchodilator was hypothesized to improve the distribution of the subsequent nebulized dose. This study determined the effect of a pMDI preliminary bronchodilator dose on the aerosol delivered by a mesh nebulizer during single-limb noninvasive ventilation. METHODS: Twelve subjects with COPD who received noninvasive ventilation were enrolled in a randomized, open-label, urinary pharmacokinetic study...
August 7, 2018: Respiratory Care
Wen-Cheng Chao, Wei-Lun Chang, Chieh-Liang Wu, Ming-Cheng Chan
BACKGROUND: A ventilator-associated events (VAEs) algorithm was developed to detect events in mechanically ventilated subjects using objective parameters, and we aimed to use objective data of fluid balance to identify pulmonary edema-associated VAEs. METHODS: This single-center retrospective cohort study was conducted in a medical ICU and enrolled all mechanically ventilated patients between July 2016 and June 2017. Electronic medical records were reviewed to obtain data regarding ventilator-associated conditions (VACs), infection-related ventilator-associated complications (IVACs), possible ventilator-associated pneumonia (VAP), and traditionally defined VAP...
August 7, 2018: Respiratory Care
Stephane Bourassa, Pierre-Alexandre Bouchard, François Lellouche
BACKGROUND: The gas mask is used to protect military and non-military personnel exposed to respiratory hazards (chemical, biologic, radiologic, and nuclear agents). The objective was to evaluate the impact of the gas mask on indexes of respiratory effort and breathing patterns in a human model because no data exist. METHODS: The design of the study was a crossover evaluation with four 10-min conditions in a randomized order: with and without wearing the gas mask when at rest and when exerting a standardized effort...
July 31, 2018: Respiratory Care
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