Resp Care
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As hospitals begin to implement electronic medical records, the inadequacies of legacy paper charting systems will become more evident. One area of particular concern for respiratory therapists is the charting of mechanical ventilator settings. ⋯ Of particular note is the complexity related to set airway pressures when using modes whose primary control variable is pressure (versus volume). We review the clinically relevant issues surrounding documentation of the patient-ventilator interactions related to airway pressure and provide suggestions for a standardized vocabulary.
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Randomized Controlled Trial
Tai chi exercise for patients with chronic obstructive pulmonary disease: a pilot study.
To determine the feasibility of a randomized controlled trial of the effect of a tai chi program on quality of life and exercise capacity in patients with COPD. ⋯ A randomized controlled trial of tai chi is feasible in patients with moderate to severe COPD. Tai chi exercise as an adjunct to standard care warrants further investigation.
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Permissive hypoxemia is a lung-protective strategy that aims to provide a patient with severe acute respiratory distress syndrome (ARDS) a level of oxygen delivery that is adequate to avoid tissue hypoxia while minimizing the detrimental effects of the often toxic ventilatory support required to maintain normal arterial oxygenation. However, in many patients with severe ARDS it can be difficult to achieve a balance between maintaining adequate tissue oxygenation and avoiding ventilator-induced lung injury (VILI). ⋯ Although it has not yet been studied, this approach is theorized to improve clinical outcomes of critically ill patients with severe ARDS. We stress that the goal of this article is not to convince the reader that this approach is necessarily correct, as data are clearly lacking, but rather to provide a basis for continued thought, discussion, and potential research.