Respiratory care
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The aim of the present study was to assess how volume-oriented incentive spirometry applied to patients after a stroke modifies the total and compartmental chest wall volume variations, including both the right and left hemithoraces, compared with controls. ⋯ Incentive spirometry promotes increased expansion in all compartments of the chest wall and reduces asymmetric expansion between the right and left parts of the pulmonary rib cage; therefore, it should be considered as a tool for rehabilitation.
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Case Reports
Obstructive Fibrinous Tracheal Pseudomembrane: A Rare condition in post-extubation stridor.
Obstructive fibrinous tracheal pseudomembrane (OFTP) is an airway complication that occurs after endotracheal intubation. It originates from superficial mucosal abrasion and desquamation of necrotic tracheal epithelium at the site of cuff pressure. ⋯ We present a case of postextubation stridor secondary to OFTP, resulting in clinical features of upper airway obstruction > 8 h after extubation. The case features complete obstruction at the tip of the endotracheal tube from OFTP.
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The battery life (BL) of portable home ventilator batteries is reported by manufacturers. The aim of this study was to evaluate the effects of ventilator mode, breathing frequency, PEEP, and leaks on the BL of 5 commercially available portable ventilators. ⋯ The BL of home ventilators depends on the ventilator settings. BL is not affected by the ventilator mode (VC-CMV or PSV) or the addition of PEEP. BL decreases with an increase in breathing frequency and during leaks with a PSV mode, whereas leaks increase the duration of ventilator BL during VC-CMV.
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Patients with COPD have impaired respiratory muscle strength. Twitch mouth pressure (Ptw,m) in response to magnetic stimulation of the cervical nerve has been suggested to clinically reflect inspiratory muscle strength. However, studies on Ptw,m values and their relationship with disease severity are limited. Thus, we tested the Ptw,m values of subjects with COPD and investigated the relationship of these values with disease severity. ⋯ Ptw,m values are 26.8% lower in male subjects with COPD and 25.3% lower in female subjects with COPD compared with the controls. The Ptw,m values of subjects with COPD decrease with increasing disease severity. Ptw,m was better correlated with the BODE index and exercise capacity than SNIP and PImax , which suggests that Ptw,m more accurately reflects the overall severity and burden of COPD.