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Respiratory Care

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https://www.readbyqxmd.com/read/28424226/objective-measurement-of-adherence-to-out-patient-airway-clearance-therapy-by-high-frequency-chest-wall-compression-in-cystic-fibrosis
#1
Christina L Mikesell, Robert R Kempainen, Theresa A Laguna, Jeremiah S Menk, Andrew R Wey, Philippe R Gaillard, Warren E Regelmann
BACKGROUND: Objective measures of adherence to high-frequency chest wall compression (HFCWC, also known as high frequency chest wall oscillation, HFCWO), a form of airway clearance therapy for patients with cystic fibrosis, are lacking. We used a novel electronic monitoring device integrated into an HFCWC vest to measure adherence compared with self-reported adherence. We determined factors that influenced adherence and how adherence correlated with baseline pulmonary function and pulmonary exacerbations...
April 19, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28424225/quantitative-assessment-of-airway-pathology-in-subjects-with-copd-using-low-dose-high-resolution-computed-tomography
#2
Huai Chen, Gai-Qun Chen, Qing-Si Zeng, Ting-Ting Xia, Jia-Xuan Zhou, Shi-Jun Qiu
BACKGROUND: The purpose of this study was to correlate airway parameters of COPD determined by low-dose high-resolution computed tomography (HRCT) with pulmonary function testing (PFT) results. METHODS: PFT data were collected for subjects with COPD and healthy controls. All subjects received inspiratory and expiratory phase low-dose HRCT. Bronchi in the apical segment of the right upper lobe (RB1), posterior segment of the right lower lobe (RB6), and lower lingual segment of the left upper lobe (LB5) were the target bronchi...
April 19, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28400408/incidence-and-risk-factors-for-cardiovascular-collapse-after-unplanned-extubations-in-the-pediatric-icu
#3
Paulo Sérgio Lucas da Silva, Marcelo Cunio Machado Fonseca
BACKGROUND: Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. METHODS: All children who had been mechanically ventilated for ≥12 h were prospectively tracked for UEs over an 8-y period. Subjects were included in the study if they were between ages 1 month and 16 y and had experienced UE...
April 11, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28377403/evaluation-of-the-safety-and-effectiveness-of-the-rapid-flow-expulsion-maneuver-to-clear-subglottic-secretions-in-vitro-and-in-vivo
#4
Jie Li, Yajuan Zong, Quan Zhou, Huaping Dai, Chen Wang
BACKGROUND: Clearing subglottic secretions has been proved to reduce ventilator-associated pneumonia. A manual method named the rapid flow expulsion maneuver was developed to clear subglottic secretions. This study evaluates its safety and effectiveness and analyzes the influential factors. METHODS: This study was composed of 2 parts. In an in vitro study, secretions were instilled directly to the area above the cuff in an intubated tracheal model. Secretions were expelled by the rapid flow expulsion maneuver with different volumes and peak flows in 3 tracheal positions (0, 15, and 30°)...
April 4, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28377402/assessing-initial-response-to-high-frequency-jet-ventilation-in-premature-infants-with-hypercapnic-respiratory-failure
#5
Craig R Wheeler, Craig D Smallwood, Iris O'Donnell, Daniel Gagner, Martha C Sola-Visner
BACKGROUND: High-frequency jet ventilation (HFJV) has been used in conjunction with conventional ventilation for infants with respiratory failure. We sought to identify parameters that were associated with successful application of HFJV in patients with hypercapnic respiratory failure. METHODS: A single-center, retrospective review of infants who received HFJV was conducted. Subjects were enrolled if birthweight was ≤2,000 g and capillary PCO2 was ≥55 mm Hg...
April 4, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28351905/comparison-of-cisatracurium-versus-atracurium-in-early-ards
#6
Leanne Moore, Charles Joseph Kramer, Sophie Delcoix-Lopes, Ariel M Modrykamien
BACKGROUND: Administration of cisatracurium in severe ARDS decreases in-hospital mortality. Whether clinical outcomes are cisatracurium-specific or related with all neuromuscular blockers is unknown. This study aimed to compare outcomes in severe ARDS patients treated with cisatracurium versus atracurium. METHODS: Patients admitted in ICUs with a diagnosis of severe ARDS and treated with neuromuscular blocking agents within 72 h of diagnosis were included. Subjects treated with cisatracurium versus atracurium were compared...
March 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28351904/evaluation-of-the-prevalence-and-effectiveness-of-education-on-metered-dose-inhaler-technique
#7
Kayce M Shealy, Victoria C Paradiso, Megan L Slimmer, Darien L Campbell, Tiffaney B Threatt
BACKGROUND: The objectives of this study were: (1) to assess the prevalence of and types of education methods provided to participants who use a metered-dose inhaler (MDI), (2) to determine the prevalence of MDI misuse in adults using objective and subjective assessments, and (3) to determine whether any associations exist between the education method and the participant's ability to properly use an MDI. METHODS: Adult participants who had a current or previous history of MDI use were recruited from retail pharmacies and physician offices in Laurens County, South Carolina...
March 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28351903/diaphragm-muscle-thinning-in-subjects-receiving-mechanical-ventilation-and-its-effect-on-extubation
#8
Horiana B Grosu, David E Ost, Young Im Lee, Juhee Song, Liang Li, Edward Eden, Keith Rose
BACKGROUND: Diaphragm muscle weakness and atrophy are consequences of prolonged mechanical ventilation. Our purpose was to determine whether thickness of the diaphragm (TDI) changes over time after intubation and whether the degree of change affects clinical outcome. METHODS: For this prospective, longitudinal observational study, we identified subjects who required mechanical ventilation and measured their TDI by ultrasonography. TDI was measured at baseline and repeated 72 h later and then weekly until the subject was either liberated from mechanical ventilation, was referred for tracheostomy, or died...
March 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28325778/extracorporeal-life-support-as-a-bridge-to-lung-transplantation-a-single-center-experience-with-an-emphasis-on-health-related-quality-of-life
#9
Annemieke Oude Lansink-Hartgring, Wim van der Bij, Erik A Verschuuren, Michiel E Erasmus, Adrianus J de Vries, Karin M Vermeulen, Walter M van den Bergh
BACKGROUND: Extracorporeal life support (ECLS) as a bridge to lung transplantation is increasingly used, but information on long-term outcome is scarce. We aim to summarize our experience with an emphasis on health-related quality of life. Secondary outcomes include ICU and hospital stay and pre- and post-transplant mortality. METHODS: A retrospective cohort study of all adult subjects receiving ECLS as a bridge to lung transplantation from 2010 to 2014 was reviewed and compared with all adult subjects who underwent bilateral lung transplantation in the same period...
March 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28325777/intratracheal-seal-disc-a-novel-tracheostoma-closure-device
#10
Karen J Christiansen, Niels Moeslund, Henrik Lauridsen, Louise Devantier, Marianne C Rohde, Benedict Kjœrgaard, Michael Pedersen
BACKGROUND: Tracheostomy decannulation is accompanied by several clinical concerns due to air leakage. In this study, we introduced a novel tracheostoma closure device that facilitates the use of noninvasive ventilation, improvement of pulmonary function, and vocalization in the newly decannulated patient. The biosafety and feasibility of the device were evaluated in an animal model. METHODS: Five Danish Landrace pigs were subjected to tracheostomy followed by decannulation and insertion of the tracheostoma closure device...
March 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28325776/noninvasive-respiratory-support-during-pediatric-ground-transport-implementation-of-a-safe-and-feasible-procedure
#11
Nuria Millán, Carme Alejandre, Aina Martinez-Planas, Josep Caritg, Elisabeth Esteban, Martí Pons-Òdena
BACKGROUND: The purpose of this work was to determine the safety and feasibility of noninvasive support in children with acute respiratory failure (ARF) during interhospital ground transport. METHODS: This was a prospective, single-center observational clinical study in the pediatric transport unit of a tertiary-care pediatric hospital. We included all subjects with ARF transported from November 2010 to March 2013. A specific noninvasive support protocol was used for all cases...
March 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28292973/evaluation-of-functional-characteristics-of-4-oscillatory-positive-pressure-devices-in-a-simulated-cystic-fibrosis-model
#12
Hillary Van Fleet, Diane K Dunn, Neil L McNinch, Teresa A Volsko
BACKGROUND: Oscillatory positive expiratory pressure (OPEP) is an airway clearance therapy that delivers positive pressure and air-flow oscillations during exhalation. This study described functional characteristic differences of 4 OPEP devices during an active exhalation in a simulated model. We hypothesized peak pressure (Ppeak), positive expiratory pressure (PEP), oscillatory frequency (f), and pressure amplitude will differ, depending upon the device used, device resistance setting, and time (repeated consecutive active exhalations through the device)...
March 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28292972/respiratory-therapy-faculty-knowledge-of-and-attitudes-toward-interprofessional-education
#13
Marlo M Vernon, Nicole M Moore, Lisa-Anne Cummins, Stephanie E Reyes, Andrew J Mazzoli, Vahe Heboyan, Gianluca De Leo
BACKGROUND: Interprofessional education (IPE) improves collaboration and patient care through joint education between health professions. Respiratory therapy (RT) faculty were surveyed to evaluate their knowledge and attitudes toward IPE. We report current opportunities for IPE from faculty and compare responses from associate's, bachelor's, and master's degree programs and profit versus nonprofit institutions. METHODS: We developed an online survey based on IPE literature and questions modified for the RT discipline...
March 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28270544/sedentary-behavior-is-an-independent-predictor-of-mortality-in-subjects-with-copd
#14
Karina C Furlanetto, Leila Donária, Lorena P Schneider, José R Lopes, Marcos Ribeiro, Karen B P Fernandes, Nidia A Hernandes, Fabio Pitta
BACKGROUND: The terms sedentary behavior and physical inactivity have been confusingly mixed. Although the association between physical inactivity and mortality has been shown previously in subjects with COPD, this association had not yet been investigated with regard to sedentarism. The aim of this work was to investigate the impact of sedentary behavior on mortality of subjects with COPD and to propose a cutoff point of sedentarism with prognostic value. METHODS: In this retrospective cohort study, sedentary behavior was assessed with 2 activity monitors (DynaPort and Sensewear armband) in 101 subjects with COPD from 2006 to 2011...
March 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28270543/clinical-and-functional-lung-parameters-associated-with-frequent-exacerbator-phenotype-in-subjects-with-severe-copd
#15
Alberto Capozzolo, Pierluigi Carratù, Silvano Dragonieri, Vito Antonio Falcone, Vitaliano Nicola Quaranta, Vito Liotino, Giuseppina D'Alba, Giorgio Castellana, Onofrio Resta
BACKGROUND: COPD is currently recognized as a syndrome associated with a high prevalence of comorbidities and various phenotypes. Exacerbations are very important events in the clinical history of COPD because they drive the decline in lung function. In the present study, we aim to identify whether there are any clinical and functional specific features of frequent exacerbators in a population of patients with severe COPD. METHODS: We conducted a cross-sectional, case control study...
March 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28270542/effects-of-heat-and-moisture-exchangers-and-exhaled-humidity-on-aerosol-deposition-in-a-simulated-ventilator-dependent-adult-lung-model
#16
Arzu Ari, Khalid S Alwadeai, James B Fink
BACKGROUND: Many in vitro models report higher inhaled dose with dry versus heated humidity. Heat-and-moisture exchangers (HMEs) provide passive humidity in ventilator-dependent patients but act as a barrier to aerosol. The HMEs designed to allow aerosol delivery (HME-ADs) have not been well described. The purpose of this study is to determine the impact on aerosol deposition of HME-ADs with and without active exhaled humidity in a simulated ventilator-dependent adult model. METHODS: We used an in vitro lung model consisting of an intubated teaching mannequin with an endotracheal tube of 8...
March 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28246308/use-of-cough-peak-flow-measured-by-a-ventilator-to-predict-re-intubation-when-a-spirometer-is-unavailable
#17
Bai Linfu, Jun Duan
BACKGROUND: A ventilator includes the function to measure flow velocity. We aimed to compare the predictive accuracy for re-intubation diagnosed by cough peak flow (CPF) measured by a spirometer and a ventilator. METHODS: Endotracheally intubated subjects who passed a spontaneous breathing trial were enrolled. Before extubation, CPF was measured by a spirometer and a ventilator, respectively. Re-intubation was recorded at 72 h after extubation. RESULTS: A total of 126 subjects were enrolled...
February 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28246307/pulmonary-function-and-retrobulbar-hemodynamics-in-subjects-with-type-2-diabetes-mellitus
#18
He Tai, Ming-Yue Wang, Yue-Ping Zhao, Ling-Bing Li, Xiao-Lin Jiang, Zheng Dong, Xiao-Nan Lv, Jing Liu, Qian-Yan Dong, Xin-Guang Liu, Jin-Song Kuang
BACKGROUND: The primary goals of this study were to evaluate early changes in pulmonary function and retrobulbar hemodynamics and to examine the correlation between these parameters in patients with type 2 diabetes during the preclinical stages of diabetic retinopathy. METHODS: For the single-time point measurements, 63 subjects with type 2 diabetes without diabetic retinopathy (diabetes group) and 32 healthy subjects (control group) were selected to evaluate any early changes in pulmonary function and retrobulbar hemodynamics and to examine the correlation between these parameters...
February 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28246306/a-novel-method-of-measuring-fractional-exhaled-nitric-oxide-in-tracheostomized-ventilator-dependent-children
#19
Vydehi R Murthy, Hugo Escobar, Mike Norberg, Charisse I Lachica, Linda L Gratny, Ashley K Sherman, William E Truog, Winston M Manimtim
BACKGROUND: The lower airway concentration of fractional exhaled nitric oxide (FENO) is unknown in children with chronic lung disease of infancy who have tracheostomy for long-term mechanical ventilation. We aimed to evaluate an online method of measuring FENO in a cohort of ventilator-dependent children with a tracheostomy and to explore the relationship between the peak FENO concentration (FENO peak) and the degree of respiratory support using the respiratory severity score. METHODS: We conducted a prospective cross-sectional study in 31 subjects who were receiving long-term respiratory support through a tracheostomy...
February 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28223466/short-term-effect-of-autogenic-drainage-on-ventilation-inhomogeneity-in-adult-subjects-with-stable-non-cystic-fibrosis-bronchiectasis
#20
William Poncin, Grégory Reychler, Noémie Leeuwerck, Nathalie Bauwens, Anne-Sophie Aubriot, Candice Nader, Giuseppe Liistro, Sophie Gohy
BACKGROUND: Lung clearance index (LCI), a measure of ventilation inhomogeneity derived from a multiple-breath washout test, is a promising tool for assessing airway function in patients with non-cystic fibrosis bronchiectasis. However, it is unknown whether ventilation inhomogeneity could improve after successful elimination of excessive secretions within bronchiectasis. The objective of this work was to assess the short-term effects of lung secretion clearance using the autogenic drainage technique on standard lung function tests and LCI in subjects with non-cystic fibrosis bronchiectasis...
February 21, 2017: Respiratory Care
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