Respiratory care
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Review Meta Analysis
Physical training and non-invasive ventilation in stable chronic obstructive pulmonary disease patients: a meta-analysis and meta-regression.
Exercise training improves both exercise tolerance and quality of life in patients with COPD. The intensity of exercise training is crucial to achieve a true physiologic effect. However, in COPD patients, exertional dyspnea and leg fatigue mean that the patient cannot maintain intensity of training for enough time to yield a physiologic training effect. The use of noninvasive ventilation (NIV) support has been proposed as an alternative strategy to improve exercise tolerance and respiratory and cardiovascular performances. The first aim of our meta-analysis was to evaluate exercise training with NIV in terms of physiologic effects after the completion of a pulmonary rehabilitation program. The second aim was to investigate the dose-response relationship between physical improvement and training intensity. ⋯ Given the small number of available studies, the small sample sizes, and the complete absence of power calculation, we think that this topic deserves a more in-depth investigation. Randomized clinical trials with larger sample sizes based on statistical power calculations and designed to investigate the effect of training duration and intensity on rehabilitation are needed to confirm results in this important field.
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Randomized Controlled Trial Multicenter Study
Guaifenesin has no effect on sputum volume or sputum properties in adolescents and adults with an acute respiratory tract infection.
Guaifenesin (glyceryl guaiacolate ether [GGE]) has been studied as a cough suppressant and as an expectorant; however, published studies to date have failed to find a consistent benefit. ⋯ The recommended dose of GGE had no measurable effect on sputum volume or properties and is unlikely to be an expectorant or mucolytic when used to treat acute RTI. (ClinicalTrials.gov registration NCT01046136.).
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Randomized Controlled Trial
Influence of ambient temperature and minute ventilation on passive and active heat and moisture exchangers.
During invasive mechanical ventilation, inspired gases must be humidified. We previously showed that high ambient temperature greatly impaired the hygrometric performance of heated wire-heated humidifiers. The aim of this bench and clinical study was to assess the humidification performance of passive and active heat and moisture exchangers (HMEs) and the impact of ambient temperature and ventilator settings. ⋯ In this study both passive and active HMEs had stable humidification performance with negligible influence of ambient temperature and minute ventilation. This contrasts with previous findings with heated wire-heated humidifiers. Although there are no clear data demonstrating that higher humidification impacts outcomes, it is worth noting that humidity was significantly higher with the active HME.