Respiratory care
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To compare helmet noninvasive ventilation (NIV), in terms of patient-ventilator interaction and performance, using 2 different circuits for connection: a double tube circuit (with one inspiratory and one expiratory line) and a standard circuit (a Y-piece connected only to one side of the helmet, closing the other side). ⋯ The double tube circuit had significantly better patient-ventilator interaction and a lower rate of wasted effort at 30 breaths/min.
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Comparative Study
Factors Affecting CPAP Acceptance in Elderly Patients With Obstructive Sleep Apnea in Taiwan.
The prevalence of obstructive sleep apnea (OSA) increases with age. Treatment often includes CPAP. CPAP adherence is correlated with disease severity and symptoms. We hypothesized that CPAP acceptance rates in elderly patients with OSA would be lower than in younger patients with OSA, and examined factors associated with CPAP acceptance. ⋯ CPAP acceptance is low in elderly patients in Taiwan. CPAP acceptance, instead of CPAP adherence, is the critical issue with elderly patients with OSA.
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Comparative Study
Bench assessment of a new insufflation-exsufflation device.
The Nippy Clearway is a new mechanical insufflation-exsufflation device used to assist cough. ⋯ In this bench study, PEF with the Nippy Clearway was greater than with the CoughAssist at low respiratory-system compliance.
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Breathing through a tracheostomy results in insufficient warming and humidification of inspired air. This loss of air-conditioning can be partially compensated for with the application of a heat and moisture exchanger (HME) over the tracheostomy. In vitro (International Organization for Standardization [ISO] standard 9360-2:2001) and in vivo measurements of the effects of an HME are complex and technically challenging. The aim of this study was to develop a simple method to measure the ex vivo HME performance comparable with previous in vitro and in vivo results. ⋯ Assessment of the weight change between end of inhalation and end of exhalation is a valid and simple method of measuring the water exchange performance of an HME.
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Heat and moisture exchangers (HMEs) are commonly used for humidifying respiratory gases administered to mechanically ventilated patients. While they are also applied to tracheostomized patients with spontaneous breathing, their performance in this role has not yet been clarified. We carried out a bench study to investigate the effects of spontaneous breathing parameters and oxygen flow on the humidification performance of 11 HMEs. ⋯ None of the HMEs provided adequate humidification when supplemental oxygen was added. In the ICU, caution is required when applying HME to tracheostomized patients with spontaneous breathing, especially when supplemental oxygen is required.