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Respiratory Care

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https://www.readbyqxmd.com/read/29233852/inhalation-sedation-in-subjects-with-ards-undergoing-continuous-lateral-rotational-therapy
#1
Andreas Meiser, Heinrich V Groesdonk, Sarah Bonnekessel, Thomas Volk, Hagen Bomberg
INTRODUCTION: Isoflurane has shown better sedation control and potential benefits in patients with ARDS compared to propofol or midazolam, but the practical use during continuous lateral rotational therapy remains unknown. We therefore compared isoflurane with propofol and midazolam regarding sedation depth (per the Richmond Agitation-Sedation Scale), opioid consumption, lung function, and hemodynamics in patients treated with continuous lateral rotational therapy. METHODS: 38 consecutive critically ill surgical subjects were retrospectively studied using a hospital database...
December 12, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29233851/incremental-shuttle-walk-test-to-assess-and-prescribe-exercise-for-subjects-with-bronchiectasis-hallway-versus-treadmill
#2
Cristiane S Oliveira, Anderson José, Crislaine O Santos, Cristiane H Y de Oliveira, Thiago C O Carvalho, Rejane A S de Castro, Jessyca P R Selman, Anderson A de Camargo, Simone Dal Corso
INTRODUCTION: The incremental shuttle walk test was initially developed to be carried out in a hallway (ISWT-H) but has been modified to be performed on a treadmill (ISWT-T). However, it is still unknown whether performance on ISWT-H and ISWT-T are similar in patients with bronchiectasis. In this study, we compared the performance, physiological responses, and perception of effort between the ISWT-T with a handrail and ISWT-H for subjects with bronchiectasis. We also sought to estimate and compare the prescription for training intensity with both tests...
December 12, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29208759/the-role-of-multidetector-computed-tomography-and-the-forced-oscillation-technique-in-assessing-lung-damage-in-adults-with-cystic-fibrosis
#3
Letícia S Lacerda, Agnaldo J Lopes, Alysson R S Carvalho, Alan R M Guimarães, Mônica C Firmida, Marcos C S Castro, Roberto Mogami, Pedro L Melo
BACKGROUND: With increased survival rates and the consequent emergence of an adult population with cystic fibrosis (CF), developing novel tools for periodic evaluations of these patients has become a new challenge. Thus, we sought to determine the contribution of lung-volume quantification using multidetector computed tomography (CT) in adults with CF and to investigate the association between structural changes and functional abnormalities. METHODS: This was a cross-sectional study in which 21 adults with CF and 22 control subjects underwent lung-volume quantification using multidetector CT...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29208758/respiratory-volume-monitoring-reduces-hypoventilation-and-apnea-in-subjects-undergoing-procedural-sedation
#4
Robert H Nichols, Justin A Blinn, Thuan M Ho, Robert A McQuitty, Michael P Kinsky
INTRODUCTION: The use of monitored anesthesia care for endoscopic procedures increases the risk of respiratory depression, necessitating careful monitoring of patient ventilation. We examined the effectiveness of an impedance-based respiratory volume monitor (RVM) in improving the safety of patients undergoing upper and lower gastrointestinal endoscopies under total intravenous anesthesia. We hypothesized that feedback from the RVM would allow anesthesiologists to maintain adequate ventilation, which would reduce the duration of respiratory depression (ie, hypoventilation and apnea) compared to a blinded control group...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29208757/critical-velocity-determined-by-a-non-exhaustive-method-in-subjects-with-copd
#5
Marceli Rocha Leite, Juliana Souza Uzeloto, Bruna Spolador de Alencar Silva, Ana Paula Coelho Figueira Freire, Fabiano Francisco de Lima, Eduardo Zapaterra Campos, Diego Giulliano Destro Christofaro, Carlos Augusto Kalva-Filho, Dionei Ramos, Ercy Mara Cipulo Ramos
BACKGROUND: Exercise training is an effective and low-cost tool for COPD rehabilitation. Thus, validating a non-exhaustive method to determine a patient's anaerobic threshold would be a very interesting tool in practical settings. We aimed to test the reproducibility of critical velocity values determined in a non-exhaustive manner (CVNE) and tolerance for exercise performed at this physiological marker in subjects with COPD. METHODS: Twelve subjects with COPD were evaluated in this cross-sectional study...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29208756/neurally-adjusted-ventilatory-assist-after-pediatric-cardiac-surgery-clinical-experience-and-impact-on-ventilation-pressures
#6
Benjamin Crulli, Mariam Khebir, Baruch Toledano, Suzanne Vobecky, Nancy Poirier, Guillaume Emeriaud
INTRODUCTION: After pediatric cardiac surgery, ventilation with high airway pressures can be detrimental to right ventricular function and pulmonary blood flow. Neurally adjusted ventilatory assist (NAVA) improves patient-ventilator interactions, helping maintain spontaneous ventilation. This study reports our experience with the use of NAVA in children after a cardiac surgery. We hypothesize that using NAVA in this population is feasible and allows for lower ventilation pressures. METHODS: We retrospectively studied all children ventilated with NAVA (invasively or noninvasively) after undergoing cardiac surgery between January 2013 and May 2015 in our pediatric intensive care unit...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29208755/home-mechanical-ventilation-a-12-year-population-based-retrospective-cohort-study
#7
Marcus Povitz, Louise Rose, Salimah Z Shariff, Sean Leonard, Blayne Welk, Krista Bray Jenkyn, David J Leasa, Andrea S Gershon
BACKGROUND: Increasing numbers of individuals are being initiated on home mechanical ventilation, including noninvasive (bi-level) and invasive mechanical ventilation delivered via tracheostomy due to chronic respiratory failure to enable symptom management and promote quality of life. Given the high care needs of these individuals, a better understanding of the indications for home mechanical ventilation, and health-care utilization is needed. METHODS: We performed a retrospective cohort study using provincial health administrative data from Ontario, Canada (population ∼13,000,000)...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29208754/proactive-use-of-high-flow-nasal-cannula-with-critically-ill-subjects
#8
Keith D Lamb, Sarah K Spilman, Trevor W Oetting, Julie A Jackson, Matthew W Trump, Sheryl M Sahr
INTRODUCTION: It has been suggested that use of a high-flow nasal cannula (HFNC) could be a first-line therapy for patients with acute hypoxic respiratory failure. The purpose of this study was to determine if protocolized use of HFNC decreases unplanned intubation and adverse outcomes in an ICU population. METHODS: The study was a prospective evaluation of 2 cohorts who received HFNC per protocol. Control groups were retrospective selections of subjects who received HFNC in the pre-protocol period...
December 5, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29184049/does-diaphragmatic-electrical-activity-in-preterm-infants-predict-extubation-success
#9
Neetu Singh, Matthew J McNally, Robert A Darnall
BACKGROUND: Despite many advances in respiratory care and mechanical ventilation, neonatologists lack an objective tool to aid in decision making for timely extubation. Electrical activity of the diaphragm (EAdi), a measure of neural respiratory drive and inspiratory load, may be a useful predictor of extubation success in preterm neonates. The objective of this work was to investigate whether peak EAdi could distinguish successful versus failed extubation in mechanically ventilated preterm infants...
November 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29184048/utilizing-respiratory-therapists-to-reduce-costs-of-care
#10
Ellen A Becker, Cheryl A Hoerr, Kimberly S Wiles, Debra L Skees, Corinne H Miller, Douglas S Laher
INTRODUCTION: Changes to the reimbursement of respiratory care services over the past 26 years make it imperative that respiratory therapists (RTs) demonstrate cost savings to establish their value. Therefore, this systematic review evaluated the cost-related impacts from utilizing RTs to deliver care when compared to other care providers. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to guide the search process...
November 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29184047/the-impact-of-using-non-birth-sex-on-the-interpretation-of-spirometry-data-in-subjects-with-air-flow-obstruction
#11
Jeffrey M Haynes, Ralph W Stumbo
BACKGROUND: Sex is an important determinant of lung capacity and function. This study examined the impact of using non-birth sex on the interpretation of spirometry data in transgender subjects with air-flow obstruction. METHODS: This study was a retrospective analysis of anonymous spirometry data. Eighty adult male and 80 adult female subjects were chosen from the database via random sampling. FVC, FEV1, and FEV1/FVC were collected and analyzed. Differences in percent of predicted, Z scores, classification of disease severity, and the incidence of a value migrating above or below the lower limit of normal between sex assignments were examined...
November 28, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29162719/limiting-factors-in-walking-performance-of-subjects-with-copd
#12
Marcela Alves Sanseverino, Matteo Pecchiari, Renata Luisa Bona, Danilo Cortozi Berton, Francisco Busolli de Queiroz, Mathieu Gruet, Leonardo A Peyré-Tartaruga
INTRODUCTION: Exercise intolerance is the most predominant symptom in patients with COPD. Nevertheless, it is unclear whether walking economy and gait variability are altered in these patients. Thus, our main objective was to compare the cost of transport and gait variability as a function of speed, including the self-selected walking speed, in subjects with COPD relative to healthy subjects. METHODS: 22 subjects, 11 with COPD (FEV1 = 45 ± 17% of predicted) and 11 age- and sex-matched healthy subjects undertook an evaluation that involved walking on a treadmill at 6 speeds (at 3...
November 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29162718/delay-between-actuation-and-shaking-of-a-hydrofluoroalkane-fluticasone-pressurized-metered-dose-inhaler
#13
Ariel Berlinski, Dirk von Hollen, John N Pritchard, Ross Hm Hatley
BACKGROUND: Inhaled corticosteroids are used to treat pediatric asthma. The shaking of a pressurized metered-dose inhaler (pMDI) is required to ensure consistency of emitted dose. Delays between shaking and actuating the pMDI are frequent during administration of aerosols to children where a valved holding chamber is used. METHODS: In a recent clinical trial, we used a monitoring device to record shaking and actuation of the pMDI and the inhalation profiles of children with asthma while they were inhaling fluticasone hydrofluoroalkane from a valved holding chamber onto an external filter...
November 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29162717/reference-values-for-the-6-min-walk-distance-6mwt-in-healthy-children-aged-7-to-12-years-in-brazil-main-results-of-the-tc6minbrasil-multi-center-study
#14
Lucas de Assis Pereira Cacau, Vitor Oliveira Carvalho, Alessandro Dos Santos Pin, Carlos Raphael Araujo Daniel, Daisy Satomi Ykeda, Eliane Maria de Carvalho, Juliana Valente Francica, Luíza Martins Faria, Mansueto Gomes-Neto, Marcelo Fernandes, Marcelo Velloso, Marlus Karsten, Patrícia de Sá Barros, Valter Joviniano de Santana-Filho
INTRODUCTION: Brazil is a country with great climatic, socioeconomic, and cultural differences that does not yet have a reference value for the 6-min walk test (6MWT) in healthy children. To avoid misinterpretation, the use of equations to predict the maximum walking distance should be established in each country. OBJECTIVES: We sought to establish reference values and to develop an equation to predict the 6-min walk distance (6MWT) for healthy children in Brazil...
November 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29114011/albuterol-delivery-efficiency-in-a-pediatric-model-of-noninvasive-ventilation-with-double-limb-circuit
#15
Jeanne Velasco, Ariel Berlinski
BACKGROUND: Noninvasive ventilation (NIV) is used to treat respiratory failure in patients with concomitant need for aerosol delivery. Limited pediatric data are available on aerosol delivery efficiency, and none at all regarding aerosol delivery efficiency with a double-limb circuit. We compared the effect of position in the double-limb ventilator circuit, types of nebulizer, and ventilator settings on aerosol delivery efficiency in a pediatric model of NIV. We hypothesized that placing a vibrating mesh nebulizer at the ventilator and using the highest inspiratory pressures would increase aerosol delivery efficiency...
November 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29089461/physical-function-in-subjects-requiring-extracorporeal-membrane-oxygenation-before-or-after-lung-transplantation
#16
Kate Hayes, Carol L Hodgson, Vincent A Pellegrino, Greg Snell, Benjamin Tarrant, Louise M Fuller, Anne E Holland
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) is used as a rescue therapy before and after lung transplantation, but little is known about functional recovery or complications after ECMO in this cohort. This study aimed to describe early physical function and leg complications in subjects who received ECMO before or after lung transplantation, and to compare functional outcomes to a matched cohort of subjects who did not require ECMO. METHODS: A retrospective study was conducted over 2 years...
October 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29089460/measurements-obtained-from-esophageal-balloon-catheters-are-affected-by-the-esophageal-balloon-filling-volume-in-children-with-ards
#17
Justin C Hotz, Cary T Sodetani, Jeffrey Van Steenbergen, Robinder G Khemani, Timothy W Deakers, Christopher J Newth
INTRODUCTION: Esophageal balloon inflation volume may affect the accuracy of transpulmonary pressure estimates in adults, but the effect is unknown in pediatrics. Using a combination bench and human study, we sought to determine a range of optimal filling volumes for esophageal balloon catheters and to derive a technique to inflate catheters to yield the most accurate estimates of pleural pressure. METHODS: In the laboratory study, we evaluated 4 pediatric and adult esophageal balloon catheters, a liquid-filled catheter, and a micro-tip catheter, both with and without a model esophagus...
October 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29089459/choosing-the-proper-interface-for-positive-airway-pressure-therapy-in-subjects-with-acute-respiratory-failure
#18
REVIEW
Ahmed S BaHammam, Tripat Deep Singh, Ravi Gupta, Seithikurippu R Pandi-Perumal
Noninvasive ventilation is an effective treatment for a significant proportion of patients with acute respiratory failure. The success of noninvasive ventilation, however, depends on several factors, a major one being the selection of the proper interface. The choice and application of the interface in patients with acute respiratory failure is a considerable challenge for any treatment team. This review discusses the different types of interfaces that can be used in patients with acute respiratory failure, the differences between nasal, oro-nasal, and total face masks and the helmet, as well as the effect of interface type on treatment success and upper airway patency, mask fitting, problems related to the interface, and the relationship between ventilator type and interface choice...
October 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29066591/the-role-of-rescue-therapies-in-the-treatment-of-severe-ards
#19
REVIEW
Francesco Alessandri, Francesco Pugliese, V Marco Ranieri
ARDS is characterized by a non-cardiogenic pulmonary edema with bilateral chest radiograph opacities and hypoxemia refractory to oxygen therapy. It is a common cause of admission to the ICU due to hypoxemic respiratory failure requiring mechanical ventilation. Corticosteroids are not recommended in ARDS patients. Rescue therapies alleviate hypoxemia in patients unable to maintain reasonable oxygenation: recruitment maneuvers, prone positioning, inhaled nitric oxide, high-frequency oscillatory ventilation, and extracorporeal membrane oxygenation improve oxygenation, but their impact on mortality remains unproven...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29066590/development-and-feasibility-of-a-home-pulmonary-rehabilitation-program-with-health-coaching
#20
Roberto P Benzo, Kevin M Kramer, Johanna P Hoult, Paige M Anderson, Ivonne M Begue, Sara J Seifert
BACKGROUND: Pulmonary rehabilitation (PR) is an effective intervention for COPD. However, traditional center-based PR programs suffer from low uptake. Home-based PR is a viable solution, but few studies have shown the effectiveness of remote PR, as there is a scarcity of systems that can be easily adopted in clinical practice. The aim of this report is to communicate the development and feasibility of a home PR program that includes commercially available technology that allows the PR health coach to follow the patient through his or her PR process and to present the design of a prospective clinical trial...
October 24, 2017: Respiratory Care
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