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Respiratory Care

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https://www.readbyqxmd.com/read/27899533/the-integrative-weaning-index-in-elderly-icu-subjects
#1
Leandro M Azeredo, Sérgio N Nemer, Carmen Sv Barbas, Jefferson B Caldeira, Rosângela Noé, Bruno L Guimarães, Célia P Caldas
BACKGROUND: With increasing life expectancy and ICU admission of elderly patients, mechanical ventilation, and weaning trials have increased worldwide. METHODS: We evaluated a cohort with 479 subjects in the ICU. Patients younger than 18 y, tracheostomized, or with neurologic diseases were excluded, resulting in 331 subjects. Subjects ≥70 y old were considered elderly, whereas those <70 y old were considered non-elderly. Besides the conventional weaning indexes, we evaluated the performance of the integrative weaning index (IWI)...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27899532/long-term-management-for-ventilator-assisted-children-in-hong-kong-2-decades-experience
#2
Shuk-Kuen Chau, Ada Wing-Yan Yung, So-Lun Lee
BACKGROUND: The population of children receiving long-term mechanical ventilation is growing worldwide, but only limited data exist in Asian regions. The objective of the study was to review the management of these children in Hong Kong over the past 2 decades. METHODS: This was a retrospective cohort study. Hospital records from subjects receiving mechanical ventilation for >3 months were retrieved. Demographic characteristics and medical information of subjects (≤21 y old) under the care of the ventilator program at the Duchess of Kent Children's Hospital between 1997 and 2015 were reviewed...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27899531/a-respiratory-therapist-disease-management-program-for-patients-hospitalized-with-copd
#3
Patty C Silver, Marin H Kollef, Darnetta Clinkscale, Peggy Watts, Robin Kidder, Brittany Eads, Debbie Bennett, Carolyn Lora, Michael Quartaro
BACKGROUND: Patients with COPD often require repeated emergency department visits and hospitalizations for COPD exacerbations. Such readmissions increase health-care costs and expose COPD patients to the added risks of nosocomial infections and increased mortality. METHODS: To determine whether a respiratory therapist (RT) disease management program could reduce re-hospitalization and emergency department visits, a prospective, single-center, unblinded, randomized trial was performed...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27899530/deep-breathing-improves-end-tidal-carbon-dioxide-monitoring-of-an-oxygen-nasal-cannula-based-capnometry-device-in-subjects-extubated-after-abdominal-surgery
#4
Shunsuke Takaki, Kenji Mizutani, Moeka Fukuchi, Tasuku Yoshida, Masahumi Idei, Yuko Matsuda, Yoshikazu Yamaguchi, Tetsuya Miyashita, Takeshi Nomura, Osamu Yamaguchi, Takahisa Goto
BACKGROUND: Capnometry detects hypoventilation earlier than pulse oximetry while supplemental oxygen is being administered. We compared the end-tidal CO2 (PETCO2 ) measured using a newly developed oxygen nasal cannula with a CO2-sampling port and the PaCO2 in extubated subjects after abdominal surgery. We also investigated whether the difference between PaCO2 and PETCO2 is affected by resting, by spontaneous breathing with the mouth consciously closed, and by deep breathing with the mouth closed...
November 29, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879385/fio2-in-an-adult-model-simulating-high-flow-nasal-cannula-therapy
#5
Yusuke Chikata, Mutsuo Onodera, Jun Oto, Masaji Nishimura
BACKGROUND: High-flow nasal cannula therapy (HFNC) is widely used for patients with acute respiratory failure. HFNC has a number of physiological effects. Although FIO2 is considered to be constant, because HFNC is an open system, FIO2 varies according to inspiratory flow, tidal volume (VT), and HFNC gas flow. We investigated the influence of HFNC gas flow and other respiratory parameters on FIO2 during HFNC. METHODS: We evaluated an HFNC system and, for comparison, a conventional oxygen therapy system...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879384/videolaryngoscopy-with-noninvasive-ventilation-in-subjects-with-upper-airway-obstruction
#6
Javier Sayas Catalán, Ignacio Jiménez Huerta, Pedro Benavides Mañas, Manel Luján, Daniel López-Padilla, Eva Arias Arias, Ana Hernández Voth, Claudio Rabec
BACKGROUND: Noninvasive ventilation (NIV) titration may be difficult when dynamic airway obstruction episodes persist, even with high expiratory positive airway pressure (EPAP). We aimed to determine the usefulness of videolaryngoscopy during NIV for identifying mechanisms and sites of obstruction and for providing a guide for their resolution in difficult-to-titrate subjects. METHODS: When obstructions during NIV were present in the built-in software, EPAP was raised to 12cm H2O...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879383/high-flow-nasal-cannula-in-critically-ill-subjects-with-or-at-risk-for-respiratory-failure-a-systematic-review-and-meta-analysis
#7
REVIEW
Wagner Luis Nedel, Caroline Deutschendorf, Edison Moraes Rodrigues Filho
High-flow nasal cannula (HFNC) oxygen delivery has been gaining attention as an alternative means of respiratory support for critically ill patients, with recent studies suggesting equivalent outcomes when compared with other forms of oxygen therapy delivery. The main objective of this review was to extract current data about the efficacy of HFNC in critically ill subjects with or at risk for respiratory failure. We performed a systematic review of publications (from database inception to October 2015) that evaluated HFNC in critically ill subjects with or at risk for acute respiratory failure and performed a meta-analysis comparing HFNC with noninvasive ventilation (NIV) and with standard oxygen therapy regarding major outcomes: incidence of invasive mechanical ventilation and ICU mortality...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879382/veteran-preferences-regarding-wireless-management-of-positive-airway-pressure-for-obstructive-sleep-apnea-at-a-tertiary-health-care-system
#8
Ken He, Brian N Palen, Elizabeth A Mattox, Elizabeth C Parsons
BACKGROUND: Timely monitoring of obstructive sleep apnea (OSA) therapy can be a challenge amid conflicting pressures of rising patient volume and shortage of sleep medicine providers. Positive airway pressure (PAP) devices with wireless modem technology have the potential to improve patient access to care and streamline work load, yet little is known about patient attitudes toward telehealth integration among veterans with sleep apnea. As part of a larger quality improvement initiative at the Veterans Affairs (VA) Puget Sound Health Care System, we elicited veterans' preferences toward modem versus traditional PAP data download, including patient attitudes and factors affecting those preferences...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879381/pediatric-prolonged-mechanical-ventilation-considerations-for-definitional-criteria
#9
REVIEW
Michaël Sauthier, Louise Rose, Philippe Jouvet
A 2005 consensus conference led by the National Association for Medical Direction of Respiratory Care (NAMDRC) defined prolonged mechanical ventilation (PMV) for adults as invasive and/or noninvasive mechanical ventilation (NIV) for ≥21 consecutive days for ≥6 h/d. In children, no such consensus definition exists. This results in substantial variability in definitional criteria, making study of the impact and outcomes of PMV across and within settings problematic. The objective of this work was to identify how PMV for children and neonates is described in the literature and to outline pediatric/neonatal considerations related to PMV, with the goal of proposing a pediatric/neonatal adaptation to the NAMDRC definition...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879380/performance-of-leak-compensation-in-all-age-icu-ventilators-during-volume-targeted-neonatal-ventilation-a-lung-model-study
#10
Taiga Itagaki, Desmond J Bennett, Christopher T Chenelle, Daniel F Fisher, Robert M Kacmarek
BACKGROUND: Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. METHODS: Four ICU ventilators (Servo-i, PB980, V500, and Avea) were compared in available invasive volume-targeted ventilation modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV])...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27879379/performance-of-the-pneux-system-a-bench-study-comparison-with-4-other-endotracheal-tube-cuffs
#11
Christopher T Chenelle, Taiga Itagaki, Daniel F Fisher, Lorenzo Berra, Robert M Kacmarek
BACKGROUND: Cuff design affects microaspiration, a risk factor for pneumonia. We questioned whether the PneuX low-volume fold-free cuff design would prevent cuff leakage and maintain the same tracheal wall pressure as high-volume, low-pressure (HVLP) cuffs. METHODS: We evaluated 4 HVLP-cuffed endotracheal tubes (ETTs), Hi-Lo (polyvinyl chloride [PVC]), Microcuff (polyurethane [PU]), SealGuard (PU+tapered), and TaperGuard (PVC+tapered), and the PneuX with its dedicated tracheal seal monitor...
November 22, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27803355/past-and-present-ards-mortality-rates-a-systematic-review
#12
Jan Máca, Ondřej Jor, Michal Holub, Peter Sklienka, Filip Burša, Michal Burda, Vladimír Janout, Pavel Ševčík
ARDS is severe form of respiratory failure with significant impact on the morbidity and mortality of critical care patients. Epidemiological data are crucial for evaluating the efficacy of therapeutic interventions, designing studies, and optimizing resource distribution. The goal of this review is to present general aspects of mortality data published over the past decades. A systematic search of the MEDLINE/PubMed was performed. The articles were divided according to their methodology, type of reported mortality, and time...
November 1, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27729399/stability-and-agreement-of-a-microtransducer-and-an-air-filled-balloon-esophageal-catheter-in-the-monitoring-of-esophageal-pressure
#13
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
https://www.readbyqxmd.com/read/27729398/smoking-cessation-in-pulmonary-care-subjects-a-mixed-methods-analysis-of-treatment-seeking-participation-and-preferences
#14
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
https://www.readbyqxmd.com/read/27703064/physical-and-functional-impairment-during-and-after-hospitalization-in-subjects-with-severe-copd-exacerbation
#15
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
https://www.readbyqxmd.com/read/27677305/long-term-stability-of-a-portable-carbon-monoxide-single-breath-diffusing-capacity-instrument
#16
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
https://www.readbyqxmd.com/read/27651525/effects-of-leak-compensation-on-patient-ventilator-synchrony-during-premature-neonatal-invasive-and-noninvasive-ventilation-a-lung-model-study
#17
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
https://www.readbyqxmd.com/read/27651524/does-whole-body-vibration-improve-the-functional-exercise-capacity-of-subjects-with-copd-a-meta-analysis
#18
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
https://www.readbyqxmd.com/read/27624631/evaluating-how-post-bronchodilator-vital-capacities-affect-the-diagnosis-of-obstruction-in-pulmonary-function-tests
#19
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
https://www.readbyqxmd.com/read/27899548/editor-s-commentary
#20
(no author information available yet)
No abstract text is available yet for this article.
December 2016: Respiratory Care
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