Respiratory care
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Randomized Controlled Trial
Effects of an Educational Intervention of Physical Activity for Children and Adolescents With Cystic Fibrosis: A Randomized Controlled Trial.
Regular aerobic exercise in patients with cystic fibrosis (CF) improves aerobic conditioning and delays disease progression, resulting in better quality of life. The purpose of this study was to evaluate the effect of an aerobic exercise program based on verbal and written guidelines on maximum exercise capacity using a cardiopulmonary exercise test, quality of life, and the self-reported aerobic exercise practice of children and adolescents with CF. ⋯ Verbal and written guidelines for aerobic exercise, together with supervision over the telephone, had a positive impact on the self-reported regular physical exercise practice of children and adolescents. However, no improvement was found in lung function and maximum exercise capacity or domains of the quality of life questionnaire.
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Ventilation with low tidal volume is recommended for patients with acute lung injury. Current guidelines suggest limiting plateau pressure (Pplat) to < 30 cm H2O for septic patients needing mechanical ventilation. The aim of this study was to determine whether Pplat within the first 24 h of ICU admission is predictive of outcome and whether Pplat < 30 cm H2O is associated with lower mortality rates. ⋯ Pplat within the first 24 h of ICU admission is predictive of outcome, with lower Pplat associated with lower mortality rates. There is no safety margin for Pplat. Limiting Pplat should be considered even at < 30 cm H2O in septic patients with acute respiratory failure.
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Observational Study
Description and Microbiology of Endotracheal Tube Biofilm in Mechanically Ventilated Patients.
A biofilm is found on the inner side of endotracheal tubes (ETT) in mechanically ventilated patients, but its features and role in pneumonia remain unclear. ⋯ ETT biofilm is always present in intubated patients whatever the duration of intubation and appears quickly after intubation. Even after soft rinse, a small but measurable part of biofilm remains always present, and seems strongly adherent to the ETT lumen. It contains potentially pathogenic bacteria for the lung.
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The investigation of hospital air quality has been conducted in wards, ICUs, operating theaters, and public areas. Few studies have assessed air quality in respiratory care centers (RCCs), especially in mechanically ventilated patients with open suctioning. ⋯ RCC air quality deserves long-term monitoring and evaluation. Health-care workers must implement self-protection strategies during open suctioning to ensure their occupational health and safety in health-care settings.
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The impulse oscillometry system (IOS) is increasingly used to evaluate lung function, but individual results must be compared with appropriate reference values. We aimed to obtain such reference values in Mexican children and adolescents. ⋯ In this study, we generated reference equations for each IOS variable in healthy children and adolescents. Although these equations were generated in a Mexican population, they are probably also applicable in other Latin American populations with the same ethnic background.