Resp Care
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Editorial Comment
Innovation in pulmonary rehabilitation: experimenting with a hybrid.
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Resource planning is essential for successful transport of the mechanically ventilated patient. Mechanically ventilated patients require adequate oxygen supplies to ensure transport is completed without incident. The LTV-1000 portable ventilator utilizes a program to calculate oxygen cylinder duration, based on cylinder size, fraction of inspired oxygen (F(IO(2))), and current minute ventilation. We evaluated the accuracy of the cylinder-duration algorithm in a laboratory setting. ⋯ Actual cylinder duration averaged 12% longer than the cylinder duration estimated by the algorithm of the LTV-1000. One explanation is that the E cylinders may contain more liters of oxygen than indicated by the sticker on the side of the tank. Additionally, the bias flow during expiration is affected by inspiratory-expiratory ratio and respiratory rate. Clinicians should be aware of these differences when planning for patient transport.
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The use of oxygen in the treatment of neonates with respiratory distress has been reported for more than a century. Oxygen therapy is generally titrated to one or more measures of blood oxygenation and administered to reverse or prevent hypoxia. Individual responses to oxygen therapy vary greatly, depending on the particular cause of hypoxia and the degree of impairment. ⋯ New and innovative ways to deliver and monitor this therapy have improved outcomes. Despite this vast experience there still remain some unanswered questions regarding the use of oxygen in the neonatal environment. Nonetheless, oxygen is a major staple in our treatment arsenal for neonates.
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Surfactant-replacement therapy is a life-saving treatment for preterm infants with respiratory distress syndrome, a disorder characterized by surfactant deficiency. Repletion with exogenous surfactant decreases mortality and thoracic air leaks and is a standard practice in the developed world. ⋯ Two of these disorders, meconium aspiration syndrome and bronchopulmonary dysplasia, might also be amenable to surfactant-replacement therapy. This paper discusses the use of surfactant-replacement therapy beyond respiratory distress syndrome and examines the evidence to date.
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Respiratory care education programs are being held accountable for student retention. Increasing student retention is necessary for the respiratory therapy profession, which suffers from a shortage of qualified therapists needed to meet the increased demand. The present study investigated the relationship between student retention rate and program resources, in order to understand which and to what extent the different components of program resources predict student retention rate. ⋯ Respiratory care education programs spending more money per student and utilizing more personnel in the program have higher mean performance in student retention. Therefore, respiratory care education programs must devote sufficient resources to retaining students so that they can produce more respiratory therapists and thereby make the respiratory therapy profession stronger.