Resp Care
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Randomized Controlled Trial
Automatic tube compensation as an adjunct for weaning in patients with severe neuroparalytic snake envenomation requiring mechanical ventilation: a pilot randomized study.
This study aimed to evaluate if the combination of pressure-support ventilation (PSV) and automatic tube compensation (ATC) is superior to PSV alone in weaning patients with severe neurotoxic snake envenoming receiving mechanical ventilation. ⋯ The addition of ATC to a standard PSV-based weaning protocol significantly shortened time needed to wean patients with severe neurotoxic snake envenoming, without changing the duration of medical care, morbidity, or mortality.
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To determine whether outcomes (mortality and need for intensive care unit [ICU] readmission) of patients undergoing tracheostomy in the ICU can be predicted by common clinical or historical criteria. ⋯ These findings suggest that it is difficult to predict outcomes of patients who undergo tracheostomy in the ICU. Larger and prospective studies may help elucidate this matter.
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An aerosol of budesonide inhalation suspension is delivered when used with various jet-nebulizer/compressor combinations. The constant introduction of new nebulizer/compressor combinations raises the question of whether the performance of these match the performance of existing devices. The aim of this study was to determine in vitro the inhaled mass and aerosol characteristics of budesonide inhalation suspension from a selection of jet-nebulizer/compressor combinations presently marketed in the United States, Europe, and Japan. ⋯ The in vitro budesonide mass collected on the inhalation filter and delivery characteristics differed considerably between the 30 nebulizer/compressor combinations. The present in vitro characterization of jet nebulizers can be used as a guidance for selection of jet-nebulizer/compressor combinations for delivery of the budesonide nebulization suspension in the home-care setting. Further investigations of new nebulizer/compressor combinations are warranted.
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Nutritional support is frequently neglected in a busy intensive care unit (ICU) with overworked staff. There is a paucity of investigations on ICU nutrition from India. ⋯ Calorie and protein delivery to critically ill patients remains less than the recommended values. Inadequate calorie delivery is associated with higher odds of mortality.
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Measurements of chest wall circumference are commonly used by physical therapists in clinical practice in order to determine chest wall mobility. However, the variability in the method for measuring this has not been reported previously among patients with chronic obstructive pulmonary disease. ⋯ In summary, despite high reliability of intra-observer and inter-observer measurements, both within and between visits, high variability was observed in all chest wall mobility measurements. Although there was an association between inspiratory capacity and measurements made at the abdominal level, chest wall mobility did not correlate with pulmonary function.