Respiratory care
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Current American Association for Respiratory Care (AARC) clinical practice guidelines recommend a suction catheter to endotracheal tube ratio (SC/ETT) based on the external diameter of the SC and the internal diameter of the ETT. An SC/ETT ratio of < 50% is consistent with the current recommendation. We theorized that a more satisfactory assessment of SC/ETT ratio could be accomplished using volume or area formulas and expansion of diameter recommendations. Some respiratory care texts recommend an SC/ETT ratio that exceeds the clinical practice guideline standard. ⋯ Our results support an alternative SC/ETT ratio when pairing SCs and ETTs.
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Children with neurological impairment often suffer from insufficient airway secretion clearance, which substantially increases their respiratory morbidity. The goal of the study was to assess the clinical feasibility of high-frequency chest wall compression (HFCWC) therapy in neurologically impaired children with respiratory symptoms. ⋯ Regular HFCWC therapy may reduce the number of hospitalizations in neurologically impaired children.
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Comparative Study
Effect of High Flow Nasal Cannula on Thoraco-abdominal Synchrony in Adult Critically Ill Patients.
High-flow nasal cannula (HFNC) creates positive oropharyngeal airway pressure and improves oxygenation. It remains unclear, however, whether HFNC improves thoraco-abdominal synchrony in patients with mild to moderate respiratory failure. Using respiratory inductive plethysmography, we investigated the effects of HFNC on thoraco-abdominal synchrony. ⋯ HFNC improved thoraco-abdominal synchrony in adult subjects with mild to moderate respiratory failure.
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Aspiration of a tooth in facial trauma is a known complication. There have been few reports on the consequences of maxillofacial trauma, especially when the patient is intubated. ⋯ A special technique using flexible bronchoscopy with simultaneous tracheotomy was used for safe and successful removal of aspirated teeth. We suggest that simultaneous tracheostomy is a safe and effective method for removal of a bronchial foreign body in a maxillofacial traumatized patient.
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Smoking, depression, and anxiety increase the risk of death in patients with COPD, but the combined effect of these factors is unknown. We assessed the interactive effects of smoking, depression, and anxiety on mortality in patients with COPD. ⋯ Smoking, depression, and anxiety are associated with higher risk of death in patients with COPD. The risk of death, depression, and anxiety increases with increasing duration of smoking (years) and cigarette pack-years. Chinese Clinical Trials Registration ChiCTR-TRC-12001958.