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Respiratory Care

Renan Maloni Augusto, André Luis Pereira Albuquerque, Thomas Jaeger, Carlos Roberto Ribeiro de Carvalho, Pedro Caruso
BACKGROUND: The use of esophageal catheters with microtransducer promises advantages over traditional catheters with air-filled balloons. However, performance comparisons between these 2 types of catheters are scarce and incomplete. METHODS: A catheter with a 9.5-cm air-filled balloon at the distal tip and a catheter with a microtransducer mounted within a flexible silicone rubber were tested in vitro and in vivo. In vitro, the response times of both catheters were compared, and the drift of the baseline pressure of the microtransducer catheter was evaluated over a 6-h period...
October 11, 2016: Respiratory Care
Freda Patterson, David S Zaslav, Diana Kolman-Taddeo, Hillary Cuesta, Mary Morrison, Frank T Leone, Aditi Satti
BACKGROUND: African-American smokers experience disproportionate COPD morbidity. As a front-line COPD behavioral management strategy, smoking cessation is less prevalent among African-American smokers. Identifying barriers and predictors to smoking cessation in this population is important to bridging this disparity. METHODS: In this study, the predictors of enrollment and attendance to a 3-session urban hospital smoking cessation program were examined. A retrospective chart review was conducted for all pulmonary clinic patients who smoked and were referred to the cessation program between June 2013 and May 2014...
October 11, 2016: Respiratory Care
Irene Torres-Sánchez, Irene Cabrera-Martos, Ana Díz-Pelegrina, Gerald Valenza-Demet, Maria Paz Moreno-Ramírez, Marie Carmen Valenza
BACKGROUND: COPD exacerbations are frequent events that have a negative impact on the lives of patients. The aims of this study were to analyze physical and functional impairment during hospital stay in subjects hospitalized due to COPD exacerbation and to assess the physical and functional impact of hospitalization at a 1-month follow-up in patients with severe COPD. METHODS: This was a prospective observational study on a sample of 52 subjects hospitalized due to COPD exacerbation...
October 4, 2016: Respiratory Care
Takeshi Kera, Ayako Edahiro, Hirohiko Hirano, Hisashi Kawai, Hideyo Yoshida, Motonaga Kojima, Yoshinori Fujiwara, Kazushige Ihara, Shuichi Obuchi
BACKGROUND: Under the hypothesis that elderly people in the community may have deficient oropharyngeal dysfunction, the purpose of this case-control study was to compare oral and physical characteristics in elderly people with and without a history of pneumonia and to identify factors distinguishing them. METHODS: In 2014, we examined 1,311 elderly people who agreed to participate in a longitudinal and intervention study for the community-dwelling elderly. We looked at such physical characteristics as body composition, grip power, gait, and balance and at oropharyngeal characteristics, such as alternating motion rate (AMR) in speech and the repetitive saliva-swallowing test (RSST)...
September 27, 2016: Respiratory Care
Laura Gochicoa-Rangel, Rogelio Pérez-Padilla, Juan Carlos Vázquez-García, Mónica Silva-Cerón, Silvia Cid-Juárez, David Martínez-Briseño, Paul L Enright, Robert Jensen, Luis Torre-Bouscoulet
BACKGROUND: The 2005 American Thoracic Society/European Respiratory Society guidelines for single-breath diffusing capacity of the lung for carbon monoxide (DLCO) recommend a weekly biological control test and/or DLCO simulator to detect instrument error drift. Very little has been published regarding the results of such a quality assurance program. Our aim was to analyze the long-term stability of a portable DLCO instrument. METHODS: We used a new EasyOne Pro system and checked its accuracy using a DLCO simulator with 2 reference gases (concentration A: carbon monoxide [CO] = 0...
September 27, 2016: Respiratory Care
Taiga Itagaki, Christopher T Chenelle, Desmond J Bennett, Daniel F Fisher, Robert M Kacmarek
BACKGROUND: During both nasal noninvasive ventilation (NIV) and invasive ventilation of neonates, the presence of air leaks causes triggering and cycling asynchrony. METHODS: Five ICU ventilators (PB840, PB980, Servo-i, V500, and Avea) were compared in available invasive ventilation and NIV ventilator modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV]). The V500 and Avea do not provide PC-CSV and PC-CMV in NIV...
September 20, 2016: Respiratory Care
Adriane B Cardim, Patrícia Em Marinho, Jasiel F Nascimento, Helen Kb Fuzari, Armèle Dornelas de Andrade
Whole-body vibration (WBV) is considered a type of physical activity based on the assumption that it results in an increase in muscle strength and performance and, therefore, may be a promising way to exercise patients with COPD. A comprehensive database search (PubMed/MEDLINE, LILACS, CINAHL, Web of Science, Scopus, and COCHRANE Library) for randomized trials, including original articles, that compared WBV groups versus control groups was conducted and studies were selected for comparison. The effect of WBV treatment was compared for minimum clinically important differences...
September 20, 2016: Respiratory Care
David Ae Imber, Massimiliano Pirrone, Changsheng Zhang, Daniel F Fisher, Robert M Kacmarek, Lorenzo Berra
With a rising incidence of obesity in the United States, anesthesiologists are faced with a larger volume of obese patients coming to the operating room as well as obese patients with ever-larger body mass indices (BMIs). While there are many cardiovascular and endocrine issues that clinicians must take into account when caring for the obese patient, one of the most prominent concerns of the anesthesiologist in the perioperative setting should be the status of the lung. Because the pathophysiology of reduced lung volumes in the obese patient differs from that of the ARDS patient, the best approach to keeping the obese patient's lung open and adequately ventilated during mechanical ventilation is unique...
September 13, 2016: Respiratory Care
Denitza P Blagev, Dean Sorenson, Olinto Linares-Perdomo, Stacy Bamberg, Matthew Hegewald, Alan H Morris
BACKGROUND: Although the ratio of FEV1 to the vital capacity (VC) is universally accepted as the cornerstone of pulmonary function test (PFT) interpretation, FVC remains in common use. We sought to determine what the differences in PFT interpretation were when the largest measured vital capacity (VCmax) was used instead of the FVC. METHODS: We included 12,238 consecutive PFTs obtained for routine clinical care. We interpreted all PFTs first using FVC in the interpretation algorithm and then again using the VCmax, obtained either before or after administration of inhaled bronchodilator...
September 13, 2016: Respiratory Care
Fulsen Bozkus, Nursel Dikmen, Hatice Sahin, Anil Samur
BACKGROUND: Gamma-glutamyl transferase (gamma-GT) is an enzyme present in the cell membranes, which is used as a new biomarker in prediction of inflammation, myocardial infarction, stroke, and cardiac death. The objective of this study was to investigate the relationship between serum levels of gamma-GT and cardiovascular disease in subjects with COPD and the correlation between serum gamma-GT level and degree of the limitation of air flow in COPD. METHODS: A total of 70 subjects (46...
September 6, 2016: Respiratory Care
José Augusto S Pellegrini, Rafael B Moraes, Juçara G Maccari, Roselaine P de Oliveira, Augusto Savi, Rodrigo A Ribeiro, Karen Ea Burns, Cassiano Teixeira
Spontaneous breathing trials (SBTs) are among the most commonly employed techniques to facilitate weaning from mechanical ventilation. The preferred SBT technique, however, is still unclear. To clarify the preferable SBT (T-piece or pressure support ventilation [PSV]), we conducted this systematic review. We then searched the MEDLINE, EMBASE, SciELO, Google Scholar, CINAHL,, and Cochrane CENTRAL databases through June 2015, without language restrictions. We included randomized controlled trials involving adult subjects being weaned from mechanical ventilation comparing T-piece with PSV and reporting (1) weaning failure, (2) re-intubation rate, (3) ICU mortality, or (4) weaning duration...
September 6, 2016: Respiratory Care
Anja M Raab, Jörg Krebs, Claudio Perret, Franz Michel, Maria Te Hopman, Gabi Mueller
BACKGROUND: Respiratory complications remain a major cause of mortality among individuals with spinal-cord injury (SCI). The present study investigated whether respiratory function is a discriminator of pneumonia in individuals with SCI and is aimed to determine the best predictive parameter. METHODS: This was a retrospective cohort study. Individuals with traumatic SCI, level C3 to T12, complete and incomplete lesions, were included. Data on respiratory function were extracted from medical records...
August 30, 2016: Respiratory Care
Steffen Wirth, Luc Seywert, Johannes Spaeth, Stefan Schumann
BACKGROUND: Artificial airway resistance as provided by small-lumen tracheal tubes or catheters increases the risk of intrinsic PEEP (PEEPi). We hypothesized that by active expiration assistance, larger minute volumes could be generated without causing PEEPi compared with conventional mechanical ventilation when using small-lumen tracheal tubes or a cricothyrotomy catheter. METHODS: We investigated the active expiration assistance in a physical model of the respiratory system and estimated its hypothetical performance in terms of maximal flow generated with endotracheal tubes ranging from 3...
August 23, 2016: Respiratory Care
Gabriela R Gomes, Fernanda Pg Calvete, Gabriela F Rosito, Márcio Vf Donadio
BACKGROUND: Acute viral bronchiolitis is an inflammatory disease of the lower respiratory tract. This study aimed to compare the immediate effects of retrograde rhinopharyngeal clearance with nasopharyngeal aspiration in children admitted with acute viral bronchiolitis. METHODS: This was a randomized controlled clinical trial with children admitted for acute viral bronchiolitis up to 12 months old. Subjects were divided into a nasopharyngeal aspiration group and a clearance group, submitted to retrograde rhinopharyngeal clearance with physiological solution (0...
August 23, 2016: Respiratory Care
Conor T McCartney, Melissa N Weis, Gregg L Ruppel, Ravi P Nayak
BACKGROUND: Reversibility of obstructive lung disease is traditionally defined by changes in FEV1 or FVC in response to bronchodilators. These may not fully reflect changes due to a reduction in hyperinflation or air-trapping, which have important clinical implications. To date, only a handful of studies have examined bronchodilators' effect on lung volumes. The authors sought to better characterize the response of residual volume and total lung capacity to bronchodilators. METHODS: Responsiveness of residual volume and total lung capacity to bronchodilators was assessed with a retrospective analysis of pulmonary function tests of 965 subjects with obstructive lung disease as defined by the lower limit of normal based on National Health and Nutritional Examination Survey III prediction equations...
August 23, 2016: Respiratory Care
Jie-Feng Huang, Gong-Ping Chen, Bi-Ying Wang, Han-Sheng Xie, Jian-Ming Zhao, Li-Hua Wu, Li-Da Chen, Qi-Chang Lin
BACKGROUND: The purpose of this observational study was to investigate the relationship between upper-airway configuration assessed by CT imaging during the Müller maneuver state and the severity of obstructive sleep apnea syndrome (OSAS). METHODS: A total of 358 snoring subjects who underwent standard polysomnography and upper-airway configuration by using CT imaging were enrolled. According to the apnea-hypopnea index (AHI), subjects were classified into 4 groups: snoring group (simple snoring), AHI < 5; mild OSAS, 5 ≤ AHI < 15; moderate OSAS, 15 ≤ AHI < 30; and severe OSAS, AHI ≥ 30...
August 16, 2016: Respiratory Care
Stephen Morgan, Christoph P Hornik, Niyati Patel, Walter L Williford, David A Turner, Ira M Cheifetz
BACKGROUND: Continuous high-frequency oscillation (CHFO) creates a pressure gradient in the small airways that accelerates expiratory flow. The intended use of CHFO therapy is to facilitate secretion removal and treat atelectasis. Our objective was to assess the feasibility, safety, and efficacy of CHFO in the mechanically ventilated pediatric population. METHODS: After institutional review board approval, we retrospectively reviewed medical records of mechanically ventilated children treated with CHFO (the MetaNeb system) at our institution from July 1, 2007 through August 31, 2012...
August 16, 2016: Respiratory Care
Sibel Gunay, Muzaffer Sariaydin, Akif Acay
BACKGROUND: We aimed to investigate the predictor role of the plasma levels of lipid parameters and atherogenic indices on development of atherosclerosis in subjects with COPD. METHODS: We retrospectively analyzed 104 male subjects diagnosed with stable COPD in hospital records. We excluded subjects with exacerbation, with known cardiovascular diseases and other chronic diseases, receiving anti-hyperlipidemic treatment, without sufficient past medical history, and lacking needed laboratory data...
August 9, 2016: Respiratory Care
Louanne M Carabini, Jacob Nouriel, Ricardo Diaz Milian, Erin R Glogovsky, Robert J McCarthy, Thomas G Handler, Michael L Ault
INTRODUCTION: A pneumatic tube system (PTS) is a cost-effective, rapid transport modality that utilizes induced pressure changes. We evaluated the clinical importance of 2 transport modalities, human courier and PTS, for blood gas specimens. METHODS: Following open heart surgery, 35 simultaneous pairs of arterial and venous blood gas specimens were analyzed from 20 subjects. Of each pair, one specimen was transported to the blood gas laboratory via a human courier and the other via a SwissLog PTS...
August 9, 2016: Respiratory Care
Mary P Martinasek, Jamie B McGrogan, Alisha Maysonet
This systematic review focuses on respiratory effects of inhalational marijuana. The systematic review of the literature was conducted using a comparative method between 2 researchers. Abstracts were reviewed for inclusion of respiratory effects related to inhalational marijuana. Relevant abstracts were collected, and full text articles were retrieved for review. Articles were removed if they did not contain burning marijuana; were animal studies; or were editorials, systematic reviews, commentaries, non-English language, or non-respiratory-related articles...
August 9, 2016: Respiratory Care
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