Respiratory care
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Editorial
Analysis of Radial Artery Catheter Placement by Respiratory Therapists Using Ultrasound Guidance.
The use of ultrasound (US) guidance for radial artery cannulation has been shown to improve first attempt success rate, reduce time to successful cannulation, and reduce complications. We sought to determine whether properly trained respiratory therapists (RTs) could utilize US guidance for the placement of radial artery catheters. Primary outcome measurements were successful cannulation and first attempt success rate. Secondary outcomes included the effect of systolic blood pressure, prior attempts, palpable pulse strength, and gender in relation to US-guided radial artery cannulation success rates. ⋯ RTs can effectively utilize US technology to place radial artery catheters. Systolic blood pressure, prior attempts, and gender are not reliable predictors of success for US-guided radial artery cannulation. Training on the use of US should be strongly encouraged for all practitioners who place radial artery catheters.
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Cough is part of life in patients with cystic fibrosis (CF). Weak coughing may add to increased respiratory disease that affects the mechanical properties of cough in these patients. In this study, we investigated cough characteristics in relation to forced expiratory flow/volume indices in CF. ⋯ The cough flow/volume maneuver reveals abnormalities in cough velocities and volume. A low secondary spike correlates with FEV1 severity level. The method may lead to earlier intervention to assist cough in CF.
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Case Reports
Pulmonary Necrobiotic Nodules in Crohn's Disease: A Rare Extra-intestinal Manifestation.
Pulmonary necrobiotic nodules represent a rare extra-intestinal manifestation of Crohn's disease. Histologically, they are composed of sterile aggregates of inflammatory cells with necrosis. ⋯ Our patient had new-onset Crohn's disease associated with both cavitating and non-cavitating lung nodules that were confirmed to be necrobiotic nodules by biopsy. The patient was started on mesalamine and prednisone, with subsequent improvement of his gastrointestinal symptoms and regression of the necrobiotic nodules.