Resp Care
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Randomized Controlled Trial
Does experience influence the performance of neonatal and pediatric manual hyperinflation?
Manual hyperinflation (MH) is used to improve mucociliary clearance and alveolar expansion in mechanically ventilated patients. Despite the popularity of MH, studies with adults have shown considerable variability in the results from its use. This study assessed if professional training on the application of MH influences its performance. ⋯ The experienced and inexperienced groups were similar in their overall MH performance; the only difference was the observation of the highest PIF in the results from the experienced group.
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Comparative Study
Comparison of cardiopulmonary responses during 2 incremental step tests in subjects with COPD.
It is well established that the work rate increment size affects the duration of test and physiological responses to exercise during cycling in patients with COPD. However, this has never been tested for incremental step tests. ⋯ The slower the work rate increment during step test, the higher the exercise tolerance. Regardless of the work rate increment, cardiopulmonary stress and exertion effort at peak exercise were equivalent between tests.
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A correlation has been observed between obstructive sleep events and sleep quality. The aim of the study was to assess if there is also a correlation between nocturnal hypoxemia and hypercapnia and sleep efficiency and sleep fragmentation in children. ⋯ In children with nocturnal hypoventilation, nocturnal hypoxemia but not hypercapnia correlates with sleep efficiency and sleep fragmentation on actigraphy.
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Heated and humidified high flow nasal cannula oxygen therapy (HFNC) represents a new alternative to conventional oxygen therapy that has not been evaluated in the emergency department (ED). We aimed to study its feasibility and efficacy in patients exhibiting acute respiratory failure presenting to the ED. ⋯ HFNC is possible in the ED, and it alleviated dyspnea and improved respiratory parameters in subjects with acute hypoxemic respiratory failure.
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We have previously demonstrated aerosol delivery during conventional and high frequency oscillatory (HFOV) ventilation using magnetic resonance imaging (MRI) in piglets. There are no reports on aerosol delivery during high frequency jet ventilation (HFJV). ⋯ This is the first report of effective aerosol delivery in a neonatal HFJV circuit. Future studies are needed for more accurate quantification of aerosol deposition.