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Priya Sharma, V Prem, Sakshee Jain
Background and Aims: One potential complication of acute respiratory distress syndrome (ARDS) is reduced dynamic compliance, saturation for peripheral oxygenation (SpO2 ) and increased sputum in patients that are mechanically ventilated. Airway clearance technique is the treatment given for patients on mechanically ventilator with ARDS. The purpose of the case series is to know the immediate effects of Acapella® on dynamic lung compliance (Cdyn) in subject with ARDS. Subjects and Methods: Patients who are on ventilator for more than 48hrs were included in the study...
February 2018: Indian Journal of Critical Care Medicine
Ruth Barker, Anthony A Laverty, Nicholas S Hopkinson
INTRODUCTION: Oscillatory positive pressure devices (OPEP) can be used as adjuncts to improve sputum clearance in chronic obstructive pulmonary disease (COPD), though the evidence base is incomplete. The attitudes of physiotherapists towards these devices in the care of patients with COPD is unknown. In addition, actual use compared with the prescription of medications has not been studied. METHODS: We analysed English prescribing data, obtained from OpenPrescribing...
2017: BMJ Open Respiratory Research
Annemarie L Lee, Angela T Burge, Anne E Holland
BACKGROUND: People with bronchiectasis experience chronic cough and sputum production and require the prescription of airway clearance techniques (ACTs). A common type of ACT prescribed is positive expiratory pressure (PEP) therapy. A previous review has suggested that ACTs including PEP therapy are beneficial compared to no treatment in people with bronchiectasis. However, the efficacy of PEP therapy in a stable clinical state or during an acute exacerbation compared to other ACTs in bronchiectasis is unknown...
September 27, 2017: Cochrane Database of Systematic Reviews
Mitsuhiro Kamimura, Nobuhisa Kameyama, Chie Homma, Tatsuya Ibe, Shinjiro Takeoka, Atsuto Mouri, Yoichiro Hamamoto
BACKGROUND: Expectoration of sputum can be difficult for patients with respiratory conditions such as chronic obstructive pulmonary disease, chronic bronchitis, or bronchiectasis because of the effects of decreased pulmonary function, respiratory muscle fatigue, altered sputum properties, and impaired ciliary function. We developed a new method for the vibratory stimulation of the cervical trachea and this study aimed to compare it with the Acapella (a current oscillation device) method...
July 2017: Respiratory Investigation
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)...
April 2017: Respiratory Care
Katherine O'Neill, Fidelma Moran, Michael M Tunney, J Stuart Elborn, Ian Bradbury, Damian G Downey, Jackie Rendall, Judy M Bradley
BACKGROUND: Streamlining the timing of treatments in cystic fibrosis (CF) is important to optimise adherence while ensuring efficacy. The optimal timing of treatment with hypertonic saline (HTS) and airway clearance techniques (ACT) is unknown. OBJECTIVES: This study hypothesised that HTS before ACT would be more effective than HTS during ACT as measured by Lung Clearance Index (LCI). METHODS: Adults with CF providing written informed consent were randomised to a crossover trial of HTS before ACT or HTS during ACT on consecutive days...
2017: BMJ Open Respiratory Research
S Pakhale, J Baron, M Armstrong, G Tasca, E Gaudet, S D Aaron, W Cameron, L Balfour
OBJECTIVE: This study builds on the limited research documenting Cystic Fibrosis (CF) patients' understanding of treatment recommendations and how this may impact adherence to therapy. METHODS: We surveyed adults with CF and their healthcare professional (HCP) to capture treatment recommendations provided by the HCP, and patients' knowledge, and frequency of performance, of these recommendations. We classified CF participants' understanding of treatment recommendations (correct/incorrect) as compared to the actual recommendations made by the HCP...
August 2016: Patient Education and Counseling
Vasanth R Singan, Jeremy C Simpson
BACKGROUND: Quantitative co-localization studies strengthen the analysis of fluorescence microscopy-based assays and are essential for illustrating and understanding many cellular processes and interactions. In our earlier study, we presented a rank-based intensity weighting scheme for the quantification of co-localization between structures in fluorescence microscopy images. This method, which uses a combined pixel co-occurrence and intensity correlation approach, is superior to conventional algorithms and provides a more accurate quantification of co-localization...
2016: Source Code for Biology and Medicine
Anup Bhat, Kalyana Chakravarthy, Bhamini K Rao
CONTEXT: Neurological intensive care units (ICUs) are a rapidly developing sub-specialty of neurosciences. Chest physiotherapy techniques are of great value in neurological ICUs in preventing, halting, or reversing the impairments caused due to neurological disorder and ICU stay. However, chest physiotherapy techniques should be modified to a greater extent in the neurological ICU as compared with general ICUs. AIM: The aim of this study is to obtain data on current chest physiotherapy practices in neurological ICUs of India...
June 2014: Indian Journal of Critical Care Medicine
Y J Cho, H Ryu, J Lee, I K Park, Y T Kim, Y H Lee, H Lee, D M Hong, J H Seo, J H Bahk, Y Jeon
Lung resection surgery has been associated with numerous postoperative complications. Seventy-eight patients scheduled for elective video-assisted thoracoscopic lung resection were randomly assigned to receive standard postoperative care with incentive spirometry or standard care plus positive vibratory expiratory pressure treatment using the Acapella(®) device. There was no significant difference between incentive spirometry and the Acapella device in the primary outcome, forced expiratory volume in 1 s, on the third postoperative day, mean (SD) 53% (16%) vs 59% (18%) respectively, p = 0...
August 2014: Anaesthesia
Deepali Narula, Vivek Nangia
A 26-year-old, 14 week pregnant woman was admitted to our hospital with pneumonia with acute respiratory distress syndrome in an intubated and mechanically ventilated state. She was diagnosed to have polymicrobial infection and left-sided pneumothorax and was put on a ventilator for 2 weeks. Postextubation, she found it difficult to clear her respiratory secretions despite aggressive routine chest physiotherapy. She was planned to undergo a mini-tracheostomy for tracheobronchial toileting. However, before that, she was given a trial of Acapella, a hand-held oscillatory positive expiratory pressure (OPEP) therapy device, for facilitating airway clearance, with the aim to speed up the recovery...
2014: BMJ Case Reports
Gabi Mueller, Ines Bersch-Porada, Sabrina Koch-Borner, Anja M Raab, Marga Jonker, Michael Baumberger, Franz Michel
BACKGROUND: Secretion removal is a key issue in patients with respiratory diseases, and is known to be most effective at vibration frequencies of ∼ 13 Hz and with the greatest amplitudes possible. The Acapella devices and the water bottle are used for secretion removal in daily clinical practice but without detailed knowledge on optimal settings. The aim of this study was to evaluate the 3 different Acapella devices and the water bottle at various settings and flows to determine the optimal devices and settings for effective secretion removal...
May 2014: Respiratory Care
Fabrício O S Mesquita, Valdecir C Galindo-Filho, João Luis F Neto, André M Galvão, Simone C S Brandão, James B Fink, Armèle Dornelas-de-Andrade
BACKGROUND: The Acapella device produces high-frequency oscillations and positive expiratory pressure to promote bronchial secretion clearance. Its performance during aerosol delivery has not been described. We evaluated the effect of nebulizer and Acapella configuration on pulmonary deposition of radio-tagged aerosol in healthy subjects. METHODS: Ten healthy male subjects (mean age 24.4 ± 2.2 y) participated in a crossover study that compared pulmonary delivery of 4 mL of technetium-99m-labeled diethylene triamine penta-acetic acid (25 mCi) and 0...
March 2014: Respiratory Care
Ariel Berlinski
BACKGROUND: Patients with cystic fibrosis perform airway clearance techniques and receive nebulized medications on a regular basis. Some positive expiratory pressure (PEP) devices allow concomitant administration of aerosol. I hypothesized that this practice alters the aerosol characteristics and patient dose. I compared the aerosol characteristics and patient dose of nebulized albuterol from 2 types of nebulizer, alone and when connected to different PEP and vibratory PEP devices. METHODS: Three units of a continuous-output nebulizer (Up-Draft II Opti-Neb) and 3 units of a breath-enhanced nebulizer (LC Plus) were tested alone and connected to PEP devices (Acapella Choice, Acapella Duet, and EzPAP for Up-Draft II Opti-Neb, and Pari PEP at 2 different settings, and Pari PEP S system with the LC Plus)...
February 2014: Respiratory Care
Alexandra R Lang, Jennifer L Martin, Sarah Sharples, John A Crowe
Adolescents are currently overlooked in many fields of healthcare research and as a result are often required to use medical devices that have been designed for use by either children or adults. This can lead to poor adherence and a reduction in health outcomes. This study examines the role of device design in the real-world effectiveness of a medical device used in the treatment of cystic fibrosis from the perspective of adolescent users. Interactive design interviews were carried out with 20 adolescent users of the acapella(®) physiotherapy device to investigate user requirements and themes about the user-device relationship that are important to this user group...
September 2013: Applied Ergonomics
Ji Zhou, Thomas Spallek, Christine Faulkner, Silke Robatzek
UNLABELLED: HASH(0x4549c78) BACKGROUND: Quantification of callose deposits is a useful measure for the activities of plant immunity and pathogen growth by fluorescence imaging. For robust scoring of differences, this normally requires many technical and biological replicates and manual or automated quantification of the callose deposits. However, previously available software tools for quantifying callose deposits from bioimages were limited, making batch processing of callose image data problematic...
2012: Plant Methods
Alexandre Pereira dos Santos, Rogério Contato Guimarães, Eliane Maria de Carvalho, Ada Clarice Gastaldi
BACKGROUND: Flutter VRP1, Shaker, and Acapella are devices that combine positive expiratory pressure (PEP) and oscillations. OBJECTIVES: To compare the mechanical performance of the Flutter VRP1, Shaker, and Acapella devices. METHODS: An experimental platform and a ventilator, used a flow generator at 5, 10, 15, 20, 26, and 32 L/min, were employed at angles of -30°, 0°, and +30° to evaluate Flutter VRP1 and Shaker, whereas Acapella was adjusted at intermediate, higher, and lower levels of resistance, including positive expiratory pressures (PEP) along with air outflow rates and oscillation frequencies...
February 2013: Respiratory Care
Anpalaki J Ragavan
BACKGROUND: Performance of Flutter® (Axcan Scandipharm Inc, Birmingham, AL), Acapella® (Smiths Medicals Inc, Rockland, MA) and Quake® (Thayer Medical, Tucson, AZ) were compared at similar frequencies and amplitudes of oscillations at nine angles of the device in clearing simulated mucus inside a tracheal model (trachea) oriented at three angles with or without simulated constrictions in airway upstream of trachea. METHODS: Displacement of 0.4mL of simulated mucus prepared with viscoelastic properties similar to healthy individuals (syrup-like) or patients with COPD (gel-like) using locust bean gum(LBG) solution (0...
March 13, 2012: Respiratory Care
Sandra Duffy, Vicky M Avery
With the increasing occurrence of drug resistance in the malaria parasite, Plasmodium falciparum, there is a great need for new and novel anti-malarial drugs. We have developed a 384-well, high-throughput imaging assay for the detection of new anti-malarial compounds, which was initially validated by screening a marine natural product library, and subsequently used to screen more than 3 million data points from a variety of compound sources. Founded on another fluorescence-based P. falciparum growth inhibition assay, the DNA-intercalating dye 4',6-diamidino-2-phenylindole, was used to monitor changes in parasite number...
January 2012: American Journal of Tropical Medicine and Hygiene
C E Alves, L Q Nunes, P L Melo
This article aims to characterize the mechanical behavior of the Acapella Blue, a respiratory rehabilitation device designed to aid sputum clearance. In this scope, the present study initially describes in detail the peak-to-peak oscillation amplitude (App) and peak frequency (fp) behavior, as well as positive pressure level (Ppl), in the flow range more comonly found in practice. The parameters were evaluated in all 5 adjustment levels of the equipment in intervals of 50 mL/s. The device characterization has shown fp up to 23 Hz, App from 0...
2010: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
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