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Respiratory Care

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https://www.readbyqxmd.com/read/28196936/influences-of-duration-of-inspiratory-effort-respiratory-mechanics-and-ventilator-type-on-asynchrony-with-pressure-support-and-proportional-assist-ventilation
#1
Renata S Vasconcelos, Raquel P Sales, Luíz H de P Melo, Liégina S Marinho, Vasco Pd Bastos, Andréa da Nc Nogueira, Juliana C Ferreira, Marcelo A Holanda
BACKGROUND: Pressure support ventilation (PSV) is often associated with patient-ventilator asynchrony. Proportional assist ventilation (PAV) offers inspiratory assistance proportional to patient effort, minimizing patient-ventilator asynchrony. The objective of this study was to evaluate the influence of respiratory mechanics and patient effort on patient-ventilator asynchrony during PSV and PAV plus (PAV+). METHODS: We used a mechanical lung simulator and studied 3 respiratory mechanics profiles (normal, obstructive, and restrictive), with variations in the duration of inspiratory effort: 0...
February 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28196935/air-stacking-a-detailed-look-into-physiological-acute-effects-on-cough-peak-flow-and-chest-wall-volumes-of-healthy-subjects
#2
Antonio Sarmento, Armèle F Dornelas de Andrade, Íllia Nadinne Df Lima, Andrea Aliverti, Guilherme Augusto de Freitas Fregonezi, Vanessa R Resqueti
BACKGROUND: Air stacking (AS) is a lung insufflation method that requires the use of a manual insufflator to provide air volumes higher than inspiratory capacity. Neuromuscular patients benefit the most from the maneuver; however, the acute effects of AS in healthy subjects are still unclear. METHODS: Twenty healthy subjects (8 males) were studied by optoelectronic plethysmography to investigate the immediate effects of AS on cough peak flow, operational volume variations, distribution of these volumes in the chest wall compartments (pulmonary rib cage, abdominal rib cage, and abdominal), breathing pattern, and shortening velocity of the respiratory muscles during a protocol that included vital capacity maneuvers and spontaneous coughs before and after AS...
February 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28196934/mortality-of-adult-critically-ill-subjects-with-cancer
#3
Regis Goulart Rosa, Tulio Frederico Tonietto, Bruno Achutti Duso, Juçara Gasparetto Maccari, Roselaine Pinheiro de Oliveira, William Rutzen, Laura Madeira, Aline Ascoli, Rachel Hessler, Paola Morandi, Ricardo Viegas Cremonese, Felippe Leopoldo Dexheimer Neto, Luciana Tagliari, Patrícia de Campos Balzano, José Hervê Diel Barth, Cassiano Teixeira
BACKGROUND: Cancer patients may require intensive care support for postoperative care, complications associated with underlying malignancy, or toxicities related to cancer therapy. The higher mortality rates found in this population than in the population of ICU patients without cancer may be attributable to confounding due to a higher prevalence of multiple organic dysfunctions at ICU admission in patients with malignancy; however, data regarding this hypothesis are scarce. Accordingly, we performed the present study to compare the crude and propensity score-matched mortality rates between adult subjects with and without cancer admitted to a mixed medical-surgical ICU...
February 14, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28174332/spiritual-well-being-and-correlated-factors-in-subjects-with-advanced-copd-or-lung-cancer
#4
Takaaki Hasegawa, Momoko Kawai, Nanori Kuzuya, Yohei Futamura, Akane Horiba, Takashi Ishiguro, Tsutomu Yoshida, Toshiyuki Sawa, Yasuyuki Sugiyama
BACKGROUND: Spiritual care for patients with COPD has rarely been discussed, and thus much remains unknown about their needs. The aims of this study were to identify the factors associated with spiritual well-being and to compare the levels of spiritual well-being between subjects with advanced COPD and those with inoperable lung cancer. METHODS: A total of 96 subjects with COPD or lung cancer participated in this study, which was conducted between December 2014 and April 2016...
February 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28174331/humidity-and-inspired-oxygen-concentration-during-high-flow-nasal-cannula-therapy-in-neonatal-and-infant-lung-models
#5
Yusuke Chikata, Saki Ohnishi, Masaji Nishimura
BACKGROUND: High-flow nasal cannula therapy (HFNC) for neonate/infants can deliver up to 10 L/min of heated and humidified gas, and FIO2 can be adjusted to between 0.21 and 1.0. With adults, humidification and actual FIO2 are known to vary according to inspiratory and HFNC gas flow, tidal volume (VT), and ambient temperature. There have been few studies focused on humidification and FIO2 in HFNC settings for neonates/infants, so we performed a bench study to investigate the influence of gas flow, ambient temperature, and respiratory parameters on humidification and actual FIO2 in a neonate/infant simulation...
February 7, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28143964/development-validity-and-reliability-of-the-londrina-activities-of-daily-living-protocol-for-subjects-with-copd
#6
Thaís Sant' Anna, Leila Donária, Karina C Furlanetto, Fernanda Morakami, Antenor Rodrigues, Talita Grosskreutz, Nidia A Hernandes, Rik Gosselink, Fabio Pitta
BACKGROUND: To avoid symptoms, patients with COPD may reduce the amount of activities of daily living (ADL). Therefore, the aim of the present study was to develop a standardized protocol to evaluate ADL performance in subjects with COPD (Londrina ADL protocol) and to assess the validity and reliability of the protocol in this population. METHODS: The Londrina ADL protocol was created based on activities included in previous studies aimed at investigating outcomes from ADL...
January 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28143963/londrina-activities-of-daily-living-protocol-reproducibility-validity-and-reference-values-in-physically-independent-adults-age-50-years-and-older
#7
Thaís Paes, Letícia Fernandes Belo, Diego Rodrigues da Silva, Andrea Akemi Morita, Leila Donária, Karina Couto Furlanetto, Thaís Sant'Anna, Fabio Pitta, Nidia Aparecida Hernandes
BACKGROUND: It is important to assess activities of daily living (ADL) in older adults due to impairment of independence and quality of life. However, there is no objective and standardized protocol available to assess this outcome. Thus, the aim of this study was to verify the reproducibility and validity of a new protocol for ADL assessment applied in physically independent adults age ≥50 y, the Londrina ADL protocol, and to establish an equation to predict reference values of the Londrina ADL protocol...
January 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28143962/pressures-and-oscillation-frequencies-generated-by-bubble-positive-expiratory-pressure-devices
#8
Mary D Santos, Maree A Milross, John P Eisenhuth, Jennifer A Alison
BACKGROUND: Positive expiratory pressure (PEP) devices are used to assist with airway clearance. Little is known about the therapist-made or commercially available bubble-PEP devices. The aim of this study was to determine the end-expiratory pressures (cm H2O) and oscillation frequencies (Hz) generated when a range of flows were applied to the therapist-made bubble-PEP devices (Bubble-PEP-3cm and Bubble-PEP-0cm) and commercial bubble-PEP devices (AguaPEP, Hydrapep, and Therabubble). METHODS: This was a bench-top experimental study using a compressed air source, flow rotameter (flows of 5, 10, 15, 20, and 25 L/min), and pressure transducer...
January 31, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28119497/risk-for-cardiorespiratory-instability-following-transfer-to-a-monitored-step-down-unit
#9
Eliezer Bose, Lujie Chen, Gilles Clermont, Artur Dubrawski, Michael R Pinsky, Dianxu Ren, Leslie A Hoffman, Marilyn Hravnak
BACKGROUND: Hospitalized patients who develop at least one instance of cardiorespiratory instability (CRI) have poorer outcomes. We sought to describe the admission characteristics, drivers, and time to onset of initial CRI events in monitored step-down unit (SDU) patients. METHODS: Admission characteristics and continuous monitoring data (frequency 1/20 Hz) were recorded in 307 subjects. Vital sign deviations beyond local instability trigger threshold criteria, with a tolerance of 40 s and cumulative duration of 4 of 5 min, were classified as CRI events...
January 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28119496/treatment-of-pulmonary-arterial-hypertension-using-initial-combination-therapy-of-bosentan-and-iloprost
#10
Xinpeng Han, Yuhai Zhang, Liang Dong, Liying Fang, Yaqin Chai, Mengjie Niu, Yongping Yu, Lingli Liu, Xuemin Yang, Shuoyao Qu, Shengqing Li
BACKGROUND: Monotherapy and sequential combination therapy have been widely used in the treatment of pulmonary arterial hypertension (PAH). There is limited evidence for initial combination therapy in patients with PAH, particularly those with World Health Organization (WHO) functional class III or IV. METHODS: Twenty-seven consecutive treatment-naive PAH subjects with WHO functional class III or IV PAH were randomized into 3 groups with a 1:1:1 ratio: a combination therapy group with 125 mg of bosentan twice daily plus 10 μg of iloprost 4-6 times/d; a bosentan monotherapy group with 125 mg of bosentan twice daily; and a iloprost monotherapy group with 10 μg of iloprost 4-6 times/d...
January 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28096477/the-future-of-respiratory-care-results-of-a-new-york-state-survey-of-respiratory-therapists
#11
Stephen G Smith, Lisa M Endee, Lisa A Benz Scott, Pamela L Linden
BACKGROUND: In the current health-care environment, respiratory care may need to make significant changes to academic preparation and clinical practice. The purpose of this research was to assess current needs of respiratory therapists (RTs) in New York State and to understand how RTs perceive their future clinical and academic roles. METHODS: This study employed a descriptive, cross-sectional non-experimental design. Between October and December 2014, a 32-item online survey was distributed via e-mail to the 2,170 members of the New York State Society of Respiratory Care...
January 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28096476/accuracy-of-oxygen-consumption-and-carbon-dioxide-elimination-measurements-in-2-breath-by-breath-devices
#12
Craig D Smallwood, John N Kheir, Brian K Walsh, Nilesh M Mehta
BACKGROUND: Although accurate quantification of oxygen consumption (V̇O2 ) and carbon dioxide elimination (V̇CO2 ) provides important insights into a patient's nutritional and hemodynamic status, few devices exist to accurately measure these parameters in children. Therefore, we assessed the accuracy and agreement of 2 devices currently on the market using a pediatric in vitro model of gas exchange. METHODS: We utilized a Huszczuk simulation model, which simulates oxygen consumption and carbon dioxide production using gas dilution, to examine the accuracy of two FDA-cleared respiratory modules (E-COVX and E-sCAiOVX-00)...
January 17, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28073994/vibrating-mesh-nebulizer-compared-with-metered-dose-inhaler-in-mechanically-ventilated-subjects
#13
Meagan N Dubosky, Yi-Fan Chen, Mary E Henriksen, David L Vines
BACKGROUND: The impact of various aerosol delivery devices on patient outcomes during mechanical ventilation is unknown. If one method of delivery results in a higher ventilator-associated pneumonia (VAP) rate than another, multiple patient outcomes may be affected. This study aimed to determine whether there was a difference in VAP occurrence and patient outcomes (days receiving ventilation and in-hospital mortality) between the vibrating mesh nebulizer (AeroNeb Solo) and the metered-dose inhaler (MDI)...
January 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28073993/daily-goals-formulation-and-enhanced-visualization-of-mechanical-ventilation-variance-improves-mechanical-ventilation-score
#14
Brian K Walsh, Craig Smallwood, Jordan Rettig, Robert Kacmarek, John Thompson, John H Arnold
BACKGROUND: The systematic implementation of evidence-based practice through the use of guidelines, checklists, and protocols mitigates the risks associated with mechanical ventilation, yet variation in practice remains prevalent. Recent advances in software and hardware have allowed for the development and deployment of an enhanced visualization tool that identifies mechanical ventilation goal variance. Our aim was to assess the utility of daily goal establishment and a computer-aided visualization of variance...
January 10, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28049743/alternative-indexes-to-estimate-the-functional-capacity-from-the-6-minute-walk-test-in-children-and-adolescents-with-cystic-fibrosis
#15
Renata Tiemi Okuro, Maria Angela Gonçalves de Oliveira Ribeiro, José Dirceu Ribeiro, Rafaela Coelho Minsky, Camila Isabel Santos Schivinski
BACKGROUND: Cystic fibrosis is a multi-systemic disease related to reduced functional capacity. The distance covered in the 6-min walk test (6MWT) has been known to assess functional capacity, but little is known about other indexes that can be derived. We sought to compare the performance during the 6MWT and the estimated indexes of functional capacity from the 6MWT between subjects with cystic fibrosis (CF) and healthy individuals as well as to assess the relationship among these indexes and disease severity, pulmonary function, and nutritional status in CF...
January 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28049742/feasibility-of-mid-frequency-ventilation-among-infants-with-respiratory-distress-syndrome
#16
Ramachandra Bhat, John Kelleher, Namasivayam Ambalavanan, Robert L Chatburn, Eduardo Mireles-Cabodevila, Waldemar A Carlo
BACKGROUND: Mid-frequency ventilation, a strategy of using conventional ventilators at high frequencies, may reduce lung injury but has had limited evaluation in neonates. Hence, a randomized crossover study was designed to assess the feasibility of using mid-frequency ventilation in preterm infants with respiratory distress syndrome. METHODS: Twelve preterm infants (≥500 g and ≥24 weeks gestational age) who were receiving pressure-limited conventional ventilation with frequencies ≤60 breaths/min for respiratory distress syndrome were randomized to periods of mid-frequency ventilation (conventional ventilation with the fastest frequency up to 150 breaths/min that gave complete inspiration and expiration) or conventional ventilation (frequency ≤60 breaths/min), each lasting 2 h using a crossover design...
January 3, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28028190/beliefs-and-attitudes-associated-with-hookah-smoking-among-a-united-states-college-population
#17
Mary P Martinasek, Linda G Haddad, Christopher W Wheldon, Tracey E Barnett
BACKGROUND: This study explores the differences among smokers of waterpipe tobacco in a college population to better inform campaigns to curb waterpipe use. METHODS: Participants included undergraduate and graduate students attending a liberal arts university in Florida. E-mail-based, cross-sectional surveys were collected in 2 sequential years. RESULTS: The majority of respondents (64%) reported having ever smoked a hookah, even if just 1-2 puffs...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28028189/implementation-of-a-%C3%AE-agonist-airway-clearance-protocol-in-a-pediatric-icu
#18
Gary R Lowe, J Randy Willis, Shasha Bai, Mark J Heulitt
BACKGROUND: Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children's Hospital for β-agonist and airway clearance interventions where one did not exist. METHODS: This project was composed of 2 parts: a survey administered to RTs and licensed independent practitioners and a retrospective review of outcome data comparing a therapist-driven β-agonist/airway clearance protocol with physician-directed respiratory care ordering in a patient population admitted for acute respiratory failure...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/28028188/feasibility-of-a-respiratory-movement-evaluation-tool-to-quantify-thoracoabdominal-movement-for-neuromuscular-diseases
#19
Fumio Liu, Michiyuki Kawakami, Kimimasa Tamura, Yoshihito Taki, Katsumi Shimizu, Tomoyoshi Otsuka, Tetsuya Tsuji, Chieko Miyata, Syoichi Tashiro, Ayako Wada, Katsuhiro Mizuno, Yoshimitsu Aoki, Meigen Liu
BACKGROUND: An objective method to evaluate thoracoabdominal movement is needed in daily clinical practice to detect patients at risk of hypoventilation and to allow for timely interventions in neuromuscular diseases. The clinical feasibility, reliability, and validity of a newly developed method for quantifying respiratory movement using fiber grating sensors, called the Respiratory Movement Evaluation Tool (RMET), was evaluated. METHODS: The time needed to measure respiratory movement and the usability of the measurement were determined by 5 clinicians using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2...
December 27, 2016: Respiratory Care
https://www.readbyqxmd.com/read/27999152/optimizing-peep-by-electrical-impedance-tomography-in-a-porcine-animal-model-of-ards
#20
Nadine Hochhausen, Ingeborg Biener, Rolf Rossaint, Andreas Follmann, Christian Bleilevens, Till Braunschweig, Steffen Leonhardt, Michael Czaplik
BACKGROUND: Mechanical ventilation is necessary in diverse clinical circumstances. Especially in the context of ARDS, so-called protective ventilation strategies must be followed. It is already known that PEEP might enhance oxygenation in ARDS. However, determining the optimal PEEP settings in clinical routines is challenging. Electrical impedance tomography (EIT) is a promising technique with which to adjust ventilator settings. We investigated whether the combination of different EIT parameters, namely the global inhomogeneity and hyperdistension indices, may lead to a feasible and safe PEEP setting...
December 20, 2016: Respiratory Care
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