Respiratory care
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Editorial Comment
Assessment of humidification performance: still no easy method!
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Multicenter Study
Effects of inhaled corticosteroids on pneumonia severity and antimicrobial resistance.
Limited information is available regarding the impact of prior use of inhaled corticosteroids (ICS) in patients subsequently developing community-acquired pneumonia (CAP). We assessed the effects of prior ICS use on severity of illness and microbiology in CAP hospitalized patients. ⋯ Prior ICS use was associated with higher severity of illness at admission and higher incidence of antimicrobial-resistant pathogens in CAP hospitalized patients.
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Multicenter Study
Absence of airway secretion accumulation predicts tolerance of noninvasive ventilation in subjects with amyotrophic lateral sclerosis.
To assess factors that predict good tolerance of noninvasive ventilation (NIV), in order to improve survival and quality of life in subjects with amyotrophic lateral sclerosis. ⋯ Our study reveals 3 factors that are predictive of good NIV tolerance, in particular the absence of airway secretion accumulation, which should prompt NIV initiation before its appearance.
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We describe the various therapies for infant acute viral bronchiolitis and the contradictory results obtained with chest physical therapy. The treatment target is bronchial obstruction, which is a multifactorial phenomenon that includes edema, bronchoconstriction, and increased mucus production, with a clinical grading defined as severe, moderate, or mild. Chest physical therapy is revisited in its various modalities, according to preliminary scoring of the disease.
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Randomized Controlled Trial
Individualized PEEP Setting in Subjects With ARDS: A Randomized Controlled Pilot Study.
Low-tidal-volume ventilation may be associated with repetitive opening and closing of terminal airways. The use of PEEP is intended to keep the alveoli open. No method of adjusting the optimal PEEP has shown to be superior or to improve clinical outcomes. We conducted a pilot study to evaluate the effect of setting an individualized level of PEEP at the highest compliance on oxygenation, multiple-organ-dysfunction, and survival in subjects with ARDS. ⋯ In ARDS subjects, protective mechanical ventilation with PEEP application according to the highest compliance was associated with less organ dysfunction and a strong nonsignificant trend toward lower mortality. ClinicalTrials.gov Number NCT01119872.