Resp Care
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Comparative Study
Endotracheal tube extubation force: adhesive tape versus endotracheal tube holder.
Adhesive tape is commonly used to secure the endotracheal tube (ETT) in anesthesia and intensive-care settings. ⋯ With tape strips of sufficient length and width, a conventional tape method was superior to the 2 tested commercial ETT holders in holding the ETT in place in the manikin.
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Editorial Comment
Noninvasive ventilation failure: the answer is blowing in the leaks.
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Comparative Study
Comparison of the lower confidence limit to the fixed-percentage method for assessing airway obstruction in routine clinical practice.
Although the statistically derived lower limit of normal (LLN) for the ratio of FEV(1) to FVC is considered superior to a fixed cutoff value (such as 0.70) for diagnosing airway obstruction, the fixed-cutoff method continues to be used and advocated. ⋯ The negative age-dependence of FEV(1)/FVC results in over-diagnosis of airway obstruction in middle-aged and elderly men, and under-diagnosis in young men, with the fixed-percentage method. Airway obstruction should be assessed with the LLN of FEV(1)/FVC, with the LLN derived from appropriate reference equations.
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During noninvasive ventilation (NIV), leak around the mask may cause inadequate ventilatory support or patient-ventilator asynchrony such as auto-triggering. Some NIV ventilators may be better than others at compensating for leak. ⋯ Some of the ventilators compensated for leak better than others. With the larger leak none of the ventilators maintained the set PEEP or pressure support.
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Case Reports
Surgical resection and liposomal amphotericin B to treat cavitary pulmonary zygomycosis in a patient with diabetes.
We describe a 24-year-old man with type 1 diabetes mellitus and a cavitary lesion in the right upper lobe, caused by a zygomycete. Surgical resection plus liposomal amphotericin B therapy was successful. We discuss predisposing condition, clinical findings, diagnosis, and treatment of pulmonary zygomycosis.