Respiratory care
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Randomized Controlled Trial Comparative Study
Effect of ventilatory variability on occurrence of central apneas.
To compare the influence of 2 ventilation strategies on the occurrence of central apneas. ⋯ NAVA was associated with increased ventilatory variability, compared to constant-level PSV. With NAVA the absence of over-assistance during sleep coincided with absence of central apneas, suggesting that load capacity and/or neuromechanical coupling were improved by NAVA and that this improvement decreased or abolished central apneas.
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There is a growing interest in the role of comorbid anxiety in patients with COPD. Comorbid anxiety has a major impact on physical functioning, health-related quality of life, and healthcare utilization. However, the prevalence of clinical anxiety, particularly specific anxiety diagnoses, in patients with COPD remains unclear. ⋯ There is a high prevalence of clinical anxiety in patients with COPD. Social phobia and specific phobia appear to be particularly prevalent, yet they have received little attention within existing literature. Further research into effective management and screening for clinical anxiety disorders is warranted.
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Asthma has long been recognized as a common respiratory disease, and the recognition of sleep-disordered breathing is becoming more prevalent. Patients with these disorders are commonly seen by clinicians caring for patients with respiratory disease. There is also much academic interest in asthma and sleep-disordered breathing. The purpose of this paper is to review the recent literature related to asthma and sleep-disordered breathing in a manner that is most likely to have interest to the readers of Respiratory Care.
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Comparative Study
Prediction of optimal CPAP pressure and validation of an equation for Asian patients with obstructive sleep apnea.
The Hoffstein formula is the most widely used equation to predict optimal CPAP pressure in patients with obstructive sleep apnea, but it is based on data from white patients. The purpose of this study was to develop an equation for optimal CPAP based on data from Asian patients, and to compare this new formula with the Hoffstein formula. ⋯ Although our equation was somewhat better to predict optimal CPAP level in Asian subjects than the Hoffstein equation, the CPAP prediction equation did not accurately predict the prescribed CPAP level. Therefore, the usefulness of the CPAP prediction formula is limited in some clinical settings.
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New home ventilators are able to provide clinicians data of interest through built-in software. Monitoring of tidal volume (VT) is a key point in the assessment of the efficacy of home mechanical ventilation. ⋯ The inclusion of algorithms that calculate the pressure loss as a function of the flow exiting the ventilator in commercial models may increase the reliability of VT estimation.