Respiratory care
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Randomized Controlled Trial
Home-Based Pulmonary Rehabilitation for Subjects With COPD: A Randomized Study.
The aim of this study was to develop an efficient, low-cost, home-based pulmonary rehabilitation program and to evaluate the impact of the program on exercise as measured by the 6-min walk test (6MWT) and treadmill endurance test. ⋯ This study demonstrates that a simple, low-cost, home-based pulmonary rehabilitation program adapted to real-life situations leads to improvement in exercise capacity and quality of life.
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Neuromuscular diseases (NMDs) lead to different weakness patterns, and most patients with NMDs develop respiratory failure. Inspiratory and expiratory muscle strength can be measured by maximum static inspiratory pressure (PImax) and maximum static expiratory pressure (PEmax), and the relationship between them has not been well described in healthy subjects and subjects with NMDs. Our aim was to assess expiratory/inspiratory muscle strength in NMDs and healthy subjects and calculate PEmax/PImax ratio for these groups. ⋯ Healthy individuals and subjects with NMDs showed higher PEmax in comparison to PImax regarding the PEmax/PImax ratio. Based on the ratio, it is possible to state that NMDs show different patterns of respiratory muscle strength loss. PEmax/PImax ratio is a useful parameter to assess the impairment of respiratory muscles in a patient and to customize rehabilitation and treatment.
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We hypothesize that oxygen consumption (V̇o2) estimation in patients with respiratory symptoms is inaccurate and can be improved by considering arterial blood gases or spirometric variables. ⋯ We developed more accurate formulae to predict resting V̇o2 in subjects with respiratory symptoms; however, equations had wide limits of agreement, particularly in certain groups of subjects. Arterial blood gases and spirometric variables did not significantly improve the predictive equations.
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Use of noninvasive ventilation (NIV) for the treatment of patients with acute respiratory failure (ARF) has greatly increased in the last decades. In contrast, the increasing knowledge of its effectiveness and physician confidence in managing this technique have been accompanied by a declining number of available ICU beds. As a consequence, the application of NIV outside the ICU has been reported as a growing phenomenon. Previously published surveys highlighted a great heterogeneity in NIV use, clinical indications, settings, and efficacy. Moreover, they revealed a marked heterogeneity with regard to staff training and technical and organizational aspects. We performed the first worldwide web-based survey focused on NIV use in general wards for ARF. ⋯ Use of NIV in general wards was reported as effective, common, and gradually increasing. Improvement in staff training and introduction of protocols could help to make this technique safer and more common when applied in general wards setting.
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True arterial blood samples are essential in making clinical decisions for respiratory patients. Previous studies using only the Portex Pro-Vent arterial sampler have shown a significant difference between arterial and venous filling times. The goal of this study was to determine whether there is a statistically significant difference between sampler filling times measured at a normal mean arterial pressure among multiple arterial samplers with plungers and to determine whether there is a statistically significant difference in filling times between venous and normal mean arterial pressures for a sampler without a plunger. ⋯ Although there was a statistically significant difference between arterial filling times among various samplers with plungers, the difference was < 1 s and was not deemed clinically important. Regardless of the sampler brand being used, respiratory therapists and other clinicians performing arterial punctures can use sampler filling time to identify a successful arterial puncture while drawing blood.