Resp Care
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Review Case Reports
Emergency bedside extracorporeal membrane oxygenation for rescue of acute tracheal obstruction.
A 39-year-old man experienced total obstruction of a distal tracheal plastic stent by a tumor mass, preventing effective ventilation and resulting in cardiac arrest. Resuscitation by emergency bedside venoarterial extracorporeal membrane oxygenation (ECMO) permitted time to physically remove the obstructing tumor and reestablish successful ventilation and liberation from ventilatory support. We review several other reported cases of emergency ECMO to resuscitate patients with acute airway obstruction.
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For the busy clinician, educator, or manager, it is becoming an increasing challenge to filter the literature to what is relevant to one's practice and then update one's practice based on the current evidence. The purpose of this paper is to review the recent literature related to long-term oxygen therapy, pulmonary rehabilitation, airway management, acute lung injury and acute respiratory distress syndrome, respiratory care education, and respiratory care management. 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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Pulmonary function, in HIV infected patients, has been associated with reduction in pulmonary ventilation parameters. ⋯ AIDS subjects, in our study, had reduced parameters of maximal respiratory pressures and spirometry. The frequent dysfunction of respiratory muscles might be due to the association of multiple factors and not a particular one; moreover, smoking was independently associated with abnormal airway function. Pulmonary function tests should be implemented as an essential part of the medical assistance to AIDS patients.
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Current published guidelines on spirometry interpretation suggest an elevated FVC and FEV(1) > 100% of predicted with an obstructive ratio may represent a physiological variant. There is minimal evidence whether this finding can be indicative of symptomatic airways obstruction. ⋯ A normal FEV(1) > 90% of predicted with obstructive indices may not represent a normal physiological variant, as 28% of patients were found to have underlying AHR. These findings suggest that clinicians should evaluate for AHR, especially in symptomatic patients, even if the FEV(1) is > 90% of predicted.