Respiratory care
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Randomized Controlled Trial
Effectiveness of controlled breathing techniques on anxiety and depression in hospitalized COPD: a randomized clinical trial.
Anxiety and depression are prevalent comorbidities in patients with COPD. Breathing techniques can improve anxiety and depression in patients hospitalized for COPD exacerbation. ⋯ Controlled breathing exercises improve anxiety and depression in patients hospitalized for COPD exacerbation. (ClinicalTrials.gov NCT01826682).
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Review Meta Analysis
BETA-2-AGONIST FOR THE TREATMENT OF ACUTE LUNG INJURY: A SYSTEMATIC REVIEW AND META-ANALYSIS.
The use of β2 agonist as an intervention for acute lung injury (ALI) and ARDS patients is controversial, so we performed a systematic review and meta-analysis of the published randomized controlled trials of using β2 agonists to improve outcomes (mortality and ventilator free days) among patients with ALI/ARDS. ⋯ In subjects with ALI/ARDS, β2 agonists were not only nonbeneficial in improving the survival, but were harmful and increased morbidity (reduced organ-failure-free days and ventilator-free days). The current evidence discourages the use of β2 agonist in ALI/ARDS patients. (International Prospective Register of Systematic Reviews, http://www.crd.york.ac.uk/prospero, 2012:CRD42012002616.).
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Evidence-based practice (EBP) has been proposed as a core competence to improve healthcare quality. The profile of EBP among respiratory therapists (RTs) has not been explored. We investigated how RTs in Taiwan perceive the implementation of EBP. ⋯ EBP is not widespread among RTs in Taiwan. We have identified important factors in the implementation of EBP. The data provide valuable evidence for plotting strategies for disseminating EBP implementation.
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Comparative Study
Outcome of patients treated with noninvasive ventilation by Medical Emergency Team on the wards.
Initiation of noninvasive ventilation (NIV) on the wards is not universally accepted. Medical emergency teams (METs) provide acute care and monitoring to deteriorating patients on the general wards. Whether it is safe for an MET to start NIV in ward patients with respiratory distress remains unclear. ⋯ In selected ward patients, especially those with COPD or pulmonary edema, NIV can be safely initiated by an MET.
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Editorial Comment
High-frequency oscillatory ventilation: the devil may be in the details.