Respiratory care
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Crackles in COPD are believed to be generated by the re-opening of collapsed airways, which result from chronic inflammation, secretions, and loss of cartilaginous support through inflammation. However, it is unclear whether crackle characteristics can be used to identify COPD. This is the first study to examine the relationship between specific added lung sounds (crackles) and measurements of conductive airways and emphysema score obtained from high-resolution computed tomography (HRCT) in vivo in humans. A predictive relationship might permit the use of lung sounds as a biomarker for COPD. ⋯ Although there were some significant correlations between crackle characteristics and measurements of the conductive airways and emphysema score, the possibility that these correlations have occurred by chance cannot be ruled out. Therefore, this study provides no conclusive evidence that crackle characteristics are related to HRCT variables in COPD.
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Hyperoxia-induced hypercapnia in subjects with COPD is mainly explained by alterations in the ventilation/perfusion ratio. However, it is unclear why respiratory drive does not prevent CO2 retention. Some authors have highlighted the importance of respiratory drive in CO2 increases during hyperoxia. The aim of the study was to examine the effects of hyperoxia on respiratory drive in subjects with COPD. ⋯ In ready-to-wean subjects with COPD exacerbations, hyperoxia is followed by an increase in P(aCO2), but it does not significantly modify the respiratory drive or the ventilatory response to hypercapnia.
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Various portable monitors for identifying obstructive sleep apnea (OSA) have been investigated and reported to enable accurate recording of OSA severity. However, more information is needed from different populations. This study was conducted to evaluate the efficiency of a portable 2-channel sleep apnea device (SleepView) for screening OSA in the Chinese population. ⋯ The SleepView device exhibited acceptable diagnostic accuracy for OSA in the Chinese population, especially in the severe OSA group. A practical predictive model comprising waist circumference, AHI, and oxygen desaturation index obtained with the SleepView was highly effective for screening even mild OSA. This simple and practical device may serve as a useful tool to screen for OSA. Further studies are required to validate the diagnostic efficiency of the SleepView in the home environment and in different populations.
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Lifelong physical activity is an important component of the therapeutic management of patients with cystic fibrosis (CF). Use of the internet to monitor and encourage participation in physical activity has not been assessed in adults with CF. We aimed to establish the feasibility and acceptability of a specifically developed internet-based program to monitor and encourage physical activity participation in adults with CF. ⋯ Use of an internet-based program to encourage participation in physical activity was both feasible and acceptable to adults with CF. Feasibility may be further improved with the ability to access the program through a mobile application.
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High-frequency pressure oscillations created by gas bubbling through an underwater seal during bubble CPAP may enhance ventilation and aid in lung recruitment in premature infants. We hypothesized that there are no differences in the magnitude of oscillations in lung volume (ΔV) in a preterm neonatal lung model when different bubble CPAP systems are used. ⋯ The major finding of this study is that bubble CPAP can provide measureable ventilation effects in an infant lung model. We speculate that the differences noted in ΔV between the different devices are a combination of the circuit/nasal prong configuration, bubbler configuration, and frequency of oscillations. Additional testing is needed in spontaneously breathing infants to determine whether a physiologic benefit exists when using the different bubble CPAP systems.