Resp Care
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The purpose of this paper is to review the recent literature related to invasive mechanical ventilation, NIV, pediatric mechanical ventilation, and aerosol therapy. Topics covered related to invasive mechanical ventilation topics include the role of PEEP in providing lung protection during mechanical ventilation, unconventional modes for severe hypoxemia, and strategies to improve patient-ventilator interactions. ⋯ Topics covered related to aerosol therapy include short-acting β-adrenergic agents, long-acting β-adrenergic agents, long-acting antimuscarinic agents, inhaled corticosteroid therapy, phosphodiesterase type 4 (PDE4) inhibitors, long-acting β-adrenergic plus inhaled corticosteroid, long-acting antimuscarinic plus inhaled corticosteroid, nebulized hypertonic saline, inhaled mannitol, and inhaled antibiotic therapy. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of Respiratory Care.
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The American Association for Respiratory Care established a task force in late 2007 to identify likely new roles and responsibilities of respiratory therapists (RTs) in the year 2015 and beyond. A series of 3 conferences was held between 2008 and 2010. The first task force conference affirmed that the healthcare system is in the process of dramatic change, driven by the need to improve health while decreasing costs and improving quality. ⋯ Also accepted was the recommendation that the Certified Respiratory Therapist examination be retired, and instead, passing of the Registered Respiratory Therapist examination will be required for beginning clinical practice. A date of 2020 for achieving these changes was proposed, debated, and accepted. Recommendations were approved requesting resources be provided to help RT education programs, existing RT workforce, and state societies work through the issues raised by these changes.
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Comparative Study
Population-based study on the prevalence of spirometric obstructive pattern in Porto, Portugal.
The diagnosis of obstructive lung disease (OLD) based on clinical grounds is challenging. There have been no population-based COPD studies that collected pulmonary function data in Portugal, a country in transition between phases 2 and 3 of the smoking epidemic. ⋯ The prevalence of spirometric obstructive pattern was high. Considering Portugal's position in the smoking epidemic, together with the aging of the population, we can expect an increase in the prevalence of OLD in older people and in women. Our results confirm the limited validity of self-reported OLD in epidemiological studies.