Respiratory care
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EzPAP Positive Airway Pressure System (EzPAP) is a noninvasive positive expiratory pressure (PEP) device designed to promote lung expansion. The aim of this study was to evaluate the effects of PEP on gas exchange. Secondary objectives included assessing the early effects of PEP on radiological atelectasis score (RAS), hemodynamics, and dyspnea. These outcomes were compared between spontaneously breathing subjects with and without tracheostomy. ⋯ In critically ill, spontaneously breathing subjects, PEP therapy significantly improved RAS without affecting hemodynamic stability or respiratory symptoms.
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Respiratory care departments are experiencing an increased need to demonstrate value in the care they deliver. Value efficiency is a concept that incorporates the value of individual treatments into the normal operations of a department. The purpose of this study was to describe respiratory care leaders' attitudes about the value of services provided by respiratory care departments. ⋯ In a small sample of respiratory therapy leaders, there was limited consensus on what respiratory care services are the most and least valuable. Lack of consensus on high- and low-value services and physician prescribing practice were the primary barriers to value efficiency. Nearly all respondents felt value should be considered when evaluating respiratory care services.
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Cardiac arrest (CA) remains a major cause of death despite advancements in cardiopulmonary resuscitation (CPR), post-resuscitation care, and international efforts to develop evidence-based guidelines. Effectively managing ventilation and oxygenation during and after CPR is vital for patient survival and neurological outcomes, yet it remains a challenging task. This review examines current strategies for ventilation and oxygenation during and after CPR, focusing on evidence-based guidelines, the balance between ventilation effectiveness and risks, and proposed methods for monitoring ventilation quality. ⋯ The review also explores mechanical ventilation as an alternative to manual methods and the use of feedback devices. The impact of post-CA ventilation and oxygenation on patient outcomes and recommended management strategies are discussed. Finally, the review highlights current gaps in the literature and the need for more well-designed large clinical studies, such as the impact of different ventilation variables (tidal volume and breathing frequency) on the return of spontaneous circulation and long-term outcomes.
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COVID-19, caused by SARS-CoV-2 infection, led to a pandemic of acute respiratory illness that is ongoing. High-flow nasal cannula (HFNC) is a commonly used form of respiratory support during acute respiratory distress and is used to treat patients with COVID-19 in many centers. ⋯ This is a review of key peer-reviewed manuscripts from 2022-2023 discussing the efficacy and best practices for using HFNC for patients with COVID-19. Efficacy of HFNC for COVID-19, the use of the respiratory oxygenation index to guide HFNC for COVID-19, and concerns of generated/fugitive aerosols when using HFNC for COVID-19 are emphasized.