Resp Care
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Editorial Comment
Improved oxygenation and increased comfort: a great combination.
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Comparative Study Clinical Trial
High-flow oxygen therapy in acute respiratory failure.
To compare the comfort of oxygen therapy via high-flow nasal cannula (HFNC) versus via conventional face mask in patients with acute respiratory failure. Acute respiratory failure was defined as blood oxygen saturation < 96% while receiving a fraction of inspired oxygen > or = 0.50 via face mask. ⋯ HFNC was better tolerated and more comfortable than face mask. HFNC was associated with better oxygenation and lower respiratory rate. HFNC could have an important role in the treatment of patients with acute respiratory failure.
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Obstructive sleep apnea (OSA) increases the risk of central and obstructive apneas after anesthesia, but the vast majority of patients with OSA are undiagnosed preoperatively. Current guidelines promote the use of postoperative continuous positive airway pressure (CPAP) in patients with OSA. Owing to the complex postoperative requirements of these patients, respiratory therapists (RTs) could substantially improve these patients' clinical management in the immediate postoperative period. We describe a system that identifies patients with suspected or documented OSA and automatically alerts the perioperative RT. ⋯ As part of a hospital-wide postoperative policy, our automated OSA alert and perioperative RT system helped prevent sudden-onset acute respiratory compromise in postoperative patients with OSA or at risk of OSA.
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To improve the heat and humidification that can be achieved with a heat-and-moisture exchanger (HME), a hybrid active (ie, adds heat and water) HME, the Hygrovent Gold, was developed. We evaluated in vitro the performance of the Hygrovent Gold. ⋯ The passive Hygrovent Gold provided adequate heat and moisture in normothermia, but the active Hygrovent Gold provided the highest humidity, in both normothermia and hypothermia.