Respiratory investigation
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Respiratory investigation · Sep 2018
Comparative StudyStudy of the usefulness of small-bore aspiration catheters (Aspiration Kit®) for treating pneumothorax.
Small-bore aspiration catheters (Aspiration Kit®) cause less pain than conventional trocar catheters in patients. The objective of this study was to examine the usefulness of these less invasive small-bore aspiration catheters for drainage of pneumothorax. ⋯ The numbers of patients with anticoagulant use (P < 0.0001), ischemic stroke (P = 0.0063), and atrial fibrillation (P = 0.0410) were significantly different between the two groups. No significant intergroup differences were noted with respect to the length of hospitalization, drainage duration, subcutaneous emphysema, and treatment failure. Logistic regression analyses of baseline characteristics showed that the severity of pneumothorax, localization of pneumothorax, and recurrent pneumothorax were significantly associated with drainage treatment failure, but the type of drainage catheter was not significantly associated with treatment failure. [Conclusions] The results suggest that small-bore aspiration catheters, which cause less pain in patients, are potentially useful for pneumothorax drainage.
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Respiratory investigation · Jul 2018
Meta AnalysisBalloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension: A systematic review.
Balloon pulmonary angioplasty (BPA) has been performed for inoperable chronic thromboembolic pulmonary hypertension (CTEPH) or residual pulmonary hypertension after pulmonary endarterectomy (PEA). We performed a systematic review to assess the efficacy and safety of BPA, especially compared to medical treatment or PEA. ⋯ This systematic review suggests that BPA improves hemodynamics, has acceptable early mortality, and may improve long-term survival compared with medical treatment in inoperable CTEPH patients.
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Respiratory investigation · Jul 2018
Clinical TrialPatient-oriented optimal depth of conscious sedation using midazolam during flexible bronchoscopy: A prospective open-labeled single-arm trial.
The British Thoracic Society guidelines for diagnostic flexible bronchoscopy (FB) in adults recommend that intravenous sedation should be offered to patients undergoing bronchoscopy. However, it is difficult to determine the adequate depth of sedation for each patient because of inter-individual variability. ⋯ The optimal depth of conscious sedation during FB for conventional examination was achieved at an RSS of 4. The patients' subjective evaluations indicated that a deep level of conscious sedation does not seem necessary for FB.
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Respiratory investigation · Jul 2018
Prognosis of chronic pulmonary aspergillosis in patients with pulmonary non-tuberculous mycobacterial disease.
Pulmonary non-tuberculous mycobacterial disease (PNTM) is a known risk factor for chronic pulmonary aspergillosis (CPA). However, few studies have focused on the prognosis of PNTM-associated CPA. In the present investigation, we aimed to elucidate the clinical course and prognostic factors of CPA in patients with PNTM. ⋯ CPA frequently developed in patients with MAC and M. kansasii PNTM. The treatment course of PNTM was not associated with all-cause mortality. However, systemic corticosteroid use and high CRP levels were negative prognostic factors of CPA in patients with PNTM. Since the prognosis is poor, early diagnosis and treatment of CPA are important in patients with PNTM.
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Respiratory investigation · May 2018
The clinical practice of high-flow nasal cannula oxygen therapy in adults: A Japanese cross-sectional multicenter survey.
High-flow nasal cannula oxygen therapy (HFNC) is widely used mainly in the acute care setting, but limited data are available on real-world practice in adults. The objective of this study was to describe HFNC practices in Japanese adults. ⋯ We documented patient demographics, clinical indications, and settings of HFNC use in the real world. We also demonstrated positive effects of HFNC on respiratory parameters. Further studies are urgently needed regarding the efficacy and safety of HFNC in populations outside of previous clinical trials.