Resp Care
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Though noninvasive positive-pressure ventilation (NPPV) is efficacious in treating patients with exacerbations of chronic obstructive pulmonary disease, little attention has been given to the optimal venue in which to provide NPPV. The aim of this prospective observational study was to assess the outcomes of NPPV initiated for acute respiratory failure on the regular in-patient ward. ⋯ Results of this observational study show that noninvasive positive-pressure ventilation is frequently used on the regular hospital ward and that the success rate is similar to that reported in series in which NPPV is used in the ICU.
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A substantial percentage of the aerosol produced by a nebulizer is lost down the expiratory limb of the ventilator circuit. We describe a method for the capture, return, and re-aerosolization of that undelivered aerosol. ⋯ This improvement in aerosol delivery is encouraging, but more comprehensive studies are needed before such a device could be implemented clinically.