Resp Care
-
Exercise training is an essential component of pulmonary rehabilitation and is associated with improved function and other important outcomes in persons with chronic lung disease. A subset of pulmonary rehabilitation patients experience hypoxemia that may occur or worsen with exercise. ⋯ There is a paucity of evidence and clinical guidelines that address assessment and management of this important manifestation of chronic lung disease. This review presents background of this topic and suggests strategies for assessment, management, and safety measures for patients with severe exercise-induced hypoxemia.
-
Comparative Study
Comparison of Alpha 200 and CoughAssist as intermittent positive pressure breathing devices: a bench study.
Intermittent positive pressure breathing (IPPB) is used in non-intubated patients to increase lung volume and to enhance coughing. Alpha 200 (Salvia Lifetec, Kronberg, Germany) is a specific IPPB device. CoughAssist (Respironics France, Carquefou, France) is a mechanical insufflator-exsufflator used to remove secretions in patients with inefficient cough. Both can also be used for intubated or tracheotomized patients. We assessed the impact of various artificial airways on the ability of the Alpha 200 and CoughAssist to generate insufflated volume. ⋯ This bench study has shown that in the presence of artificial airways the value of the insufflated volume generated by the CoughAssist device was significantly lower than that generated by the Alpha 200 device.
-
While the etiologies of solitary pulmonary nodules (SPNs) in immunocompetent patients are well established, common etiology, diagnostic techniques, and guidelines to assess SPNs in patients infected with human immunodeficiency virus (HIV) have not been established. ⋯ Etiologies of SPN in HIV-infected patients are varied and difficult to diagnose. In our study, SPN was attributable to infectious etiology in 50% of cases. Sputum analysis was of no diagnostic value. Biopsy is necessary for definitive diagnosis and treatment.
-
To develop a scoring system that can assess the multidisciplinary management of respiratory failure in a pediatric ICU. ⋯ A task-based scoring instrument for a primary airway provider's performance with a multidisciplinary pediatric ICU team on simulated pediatric respiratory failure was developed. Reliability and validity evaluation supports the developed scale.