Respiratory care
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Randomized Controlled Trial Comparative Study
Comparison of the Feasibility and Safety of Nasotracheal Suctioning With Curved Edge Catheter Versus Conventional Suction Catheter in Critically Ill Subjects: A Prospective Randomized Crossover Trial.
Nasotracheal suctioning (NTS) is accomplished by inserting a suction catheter into the trachea through the nasopharynx. It is a useful procedure in critically ill patients whose ability to cough and mobilize secretions is impaired. Ιt was assumed that using a suction catheter with an angular tip would facilitate entry into the trachea. The primary outcome was the success rate and the ease of insertion by using a curved edge catheter (Tiemann type) compared with a conventional suction catheter. The secondary outcome was the monitoring of subject's vital signs during the intervention. ⋯ It is more likely that tracheal access will be achieved using a curved edge catheter. A shorter process time and fewer attempts are required for successful NTS using a curved edge catheter, and it seems to be an equally safe procedure. (ClinicalTrials.gov registration NCT02261428.).
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Comparative Study
The Short-Term Effect of Breathing Tasks Via an Incentive Spirometer on Lung Function Compared With Autogenic Drainage in Subjects With Cystic Fibrosis.
Forced expiration may assist secretion movement by manipulating airway dynamics in patients with cystic fibrosis (CF). Expiratory resistive breathing via a handheld incentive spirometer has the potential to control the expiratory flow via chosen resistances (1-8 mm) and thereby mobilize secretions and improve lung function. Our objective was to explore the short-term effect of using a resistive-breathing incentive spirometer on lung function in subjects with CF compared with the autogenic drainage technique. ⋯ These 2 techniques may allow lower thoracic pressures and assist in the prevention of central airway collapse. The resistive-breathing incentive spirometer is a self-administered simple method that may aid airway clearance and has the potential to improve lung function as measured by FVC, FEV1, and FEF25-75% in patients with CF.
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COPD will become the third leading cause of death by 2020. There are many situations in which spirometry, the primary tool for diagnosis of COPD, cannot be performed, and thus, the staging and status of these patients cannot be determined. To date, there is no known biochemical marker used for diagnosing COPD. This study aimed to explore the utility of biomarkers for diagnosis of COPD. ⋯ Biomarkers can be reliably utilized in the diagnosis of COPD. Of all the markers, SPD appears to be the most promising in smokers, whereas ferroxidase activity shows promise in nonsmokers. To rule out COPD, ferroxidase activity or glutathione peroxidase can be potentially useful, whereas to rule in COPD, ferroxidase activity and glutathione peroxidase appear to be the most promising combination in both nonsmoking and smoking subjects.