Respiratory care
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Inspiratory muscle training (IMT) produces beneficial effects in COPD subjects, but the effects of expiratory muscle training (EMT) and EMT plus IMT in ventilatory training are still unclear. The aim of this study was to systematically review the effects of EMT and EMT plus IMT compared to control groups of COPD subjects. ⋯ EMT and EMT plus IMT improve respiratory muscle strength and can be used as part of the treatment during pulmonary rehabilitation of subjects with severe to very severe COPD.
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Tracheal intubation is used to establish a secure airway in patients who require mechanical ventilation. Unexpected extubation can have serious complications, including airway trauma and death. Various methods and devices have been developed to maintain endotracheal tube (ETT) security. Associated complications include pressure ulcers due to decreased tissue perfusion. Device consideration includes ease of use, rapid application, and low exerted pressure around the airway. ⋯ Noncommercial airway holders exert less force on a patient's face than commercial devices. Airway stability is affected by the type of securing method. Many commercial holders allow for rapid but secure movement of the artificial airway from one side of the mouth to the other.
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Review Case Reports
Necrotizing sarcoid granulomatosis with an uncommon manifestation: clinicopathological features and review of literature.
We report a rare case of an incidental diagnosis of necrotizing sarcoid granulomatosis (NSG) in a 60-y-old non-smoking male. The patient was admitted to the hospital for sudden back pain. Chest x-ray revealed areas of parenchymal consolidation and high-resolution computed tomography demonstrated a pulmonary nodular pattern with no lymph node enlargement. ⋯ The diagnosis of NSG was made by histopathological examination of a surgical lung biopsy and by excluding other causes of granulomatous disease. In paucisymptomatic/asymptomatic patients, as in our case, therapy is not necessary, with a good prognosis and complete recovery. NSG is a rare systemic disease similar to sarcoidosis and Wegener's granulomatosis with a benign clinical course and should always be considered for patients with nodular pulmonary lesions even with subclinical or uncommon features.
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Comparative Study Observational Study
Effects of Bronchoalveolar Lavage on Refractory Mycoplasma pneumoniae Pneumonia.
This study prospectively evaluated the effect of early bronchoalveolar lavage (BAL) on refractory Mycoplasma pneumoniae pneumonia with radiologically proven large pulmonary lesions in children. ⋯ BAL appeared to be efficacious and well-tolerated treatment for refractory M. pneumoniae pneumonia with radiologically proven large pulmonary lesions, and early application of BAL may be more beneficial.
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Accumulation of secretions may suddenly occlude an endotracheal tube (ETT), requiring immediate medical attention. The endOclear catheter (Endoclear LLC, Petoskey, Michigan) is a novel device designed to clear mucus and debris from an ETT and restore luminal patency. ⋯ The respiratory conditions rapidly improved, and all 3 patients tolerated the ETT-cleaning maneuver. These results show that such a device is safe and easy to use during an emergency airway situation for efficient and rapid removal of secretions from obstructed ETTs by respiratory therapists.