Resp Care
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Nutritional support is frequently neglected in a busy intensive care unit (ICU) with overworked staff. There is a paucity of investigations on ICU nutrition from India. ⋯ Calorie and protein delivery to critically ill patients remains less than the recommended values. Inadequate calorie delivery is associated with higher odds of mortality.
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Measurements of chest wall circumference are commonly used by physical therapists in clinical practice in order to determine chest wall mobility. However, the variability in the method for measuring this has not been reported previously among patients with chronic obstructive pulmonary disease. ⋯ In summary, despite high reliability of intra-observer and inter-observer measurements, both within and between visits, high variability was observed in all chest wall mobility measurements. Although there was an association between inspiratory capacity and measurements made at the abdominal level, chest wall mobility did not correlate with pulmonary function.
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To measure the delivered fractional oxygen concentration (F(DO(2))) from preterm-size Laerdal silicone resuscitators (PLSR) without a reservoir. ⋯ The F(DO(2)) measured during this study did not differ from PLSR specifications. The F(DO(2)) did, however, differ from information contained in the North American Neonatal Resuscitation Program manual regarding use of a self-inflating bag without a reservoir. Care should be taken when selecting a self-inflating resuscitation device to provide blended air and oxygen, as high concentrations of oxygen may be delivered by these devices even when the reservoir is removed. American and Canadian recommendations for the provision of supplemental oxygen with self-inflating bags require reevaluation.
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Randomized Controlled Trial
Hallway versus treadmill 6-minute-walk tests in patients with chronic obstructive pulmonary disease.
The 6-min-walk test is widely used for functional evaluation of patients with chronic obstructive pulmonary disease (COPD), but the test requires a 30-m unobstructed hallway, which is not available in all institutions. A treadmill 6-min walk test might be more practical. ⋯ The hallway and treadmill walk tests are not interchangeable. We need further study and standardization of the treadmill 6-min walk test.