Resp Care
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Randomized Controlled Trial Comparative Study
Short-term effects of humidification devices on respiratory pattern and arterial blood gases during noninvasive ventilation.
The impact of humidification devices on ventilatory and arterial blood gases parameters during noninvasive ventilation (NIV) remains controversial. The aim of the study was to compare the short-term impact of heat and moisture exchangers (HMEs) and heated humidifiers (HHs) during NIV for either hypercapnic or hypoxemic acute respiratory failure. ⋯ Use of an HME decreased CO(2) elimination during NIV, despite increased minute ventilation, especially in hypercapnic subjects.
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Randomized Controlled Trial
CPAP has no effect on clearance, sputum properties, or expectorated volume in cystic fibrosis.
Positive expiratory pressure (PEP) is used for airway clearance in cystic fibrosis (CF) patients. Hypertonic saline (HTS) aerosol increases sputum expectoration volume and may improve respiratory secretion properties. CPAP may also be used to maintain airway patency and mobilize secretions. To evaluate if CPAP would increase the beneficial clearance effect of HTS in subjects with CF, we investigated the effects of CPAP alone and CPAP followed by HTS on sputum physical properties and expectoration volume in CF subjects. ⋯ CPAP alone had no effect on mucus clearance, sputum properties, or expectorated volume, and did not potentiate the effect of HTS alone in CF subjects.
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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.