Resp Care
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The combination of high PEEP and low tidal volume (V(T)) decreases some risks of mechanical ventilation, including pulmonary overdistention, damage due to cyclic opening and closing of the alveoli, and inflammatory responses that can lead to multiple-organ dysfunction. We hypothesized that high V(T) and high PEEP induce mesenteric microcirculatory disturbances and that those disturbances would be attenuated by pentoxifylline, which is anti-inflammatory. ⋯ Low V(T) with high PEEP was lung-protective, and early pentoxifylline reduced the inflammatory response to high V(T) with high PEEP (and presumed lung overdistention) during mechanical ventilation.
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Randomized Controlled Trial Comparative Study
AccuO2 oximetry-driven oxygen-conserving device versus fixed-dose oxygen devices in stable COPD patients.
Because standard home oxygen (O2) systems deliver O2 at fixed rates, these systems are not designed to ensure optimal oxygen delivery based on physiologic need. We tested the ability of the AccuO2 (OptiSat Medical, Minneapolis, Minnesota), a portable, closed-loop, oximetry-driven, O2-conserving device to maintain SpO2 at ≥ 90%, compared to continuous-flow oxygen and a standard O2-conserving device (CR-50, Puritan-Bennett, Pleasanton, California). ⋯ Compared to continuous-flow O2 or the CR-50, the AccuO2 maintained SpO2 closer to the target, and AccuO2 had a higher conservation ratio than CR-50.
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Comparative Study
Vibration-response imaging versus quantitative perfusion scintigraphy in the selection of patients for lung-resection surgery.
In patients being considered for lung-resection surgery, quantitative perfusion scintigraphy is used to predict postoperative lung function and guide the determination of lung-resection candidacy. Vibration-response imaging has been proposed as a noninvasive, radiation-free, and simpler method to predict postoperative lung function. We compared vibration-response imaging to quantitative perfusion scintigraphy for predicting postoperative FEV(1) and diffusing capacity of the lung for carbon monoxide (D(LCO)). ⋯ Vibration-response imaging may be a good alternative to quantitative perfusion scintigraphy in evaluating lung-resection candidacy.
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Prolonged slow expiration (PSE) is a physiotherapy technique often applied in infants to reduce pulmonary obstruction and clear secretions, but there have been few studies of PSE's effects on the respiratory system. ⋯ It was possible to confirm and quantify that PSE deflates the lung to ERV. PSE caused no changes in PEF, induced sigh breaths, and decreased V(T), which is probably the main mechanical feature for mucus clearance.
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Use of inhalers requires accurate completion of multiple steps to ensure effective medication delivery. ⋯ Despite differences in Jordan's and Australia's health systems, pharmacists from both Australia and Jordan had difficulty with the same Diskus and Turbuhaler steps. In both countries, the errors made by the asthma patients were similar to those made by the pharmacists.