Respiratory care
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Review Meta Analysis
Effect of CPAP on Endothelial Function in Subjects With Obstructive Sleep Apnea: A Meta-Analysis.
Obstructive sleep apnea (OSA) is related to endothelial dysfunction. CPAP is the first-line treatment for OSA. We conducted a meta-analysis to evaluate the effect of CPAP on endothelial function in subjects with OSA. ⋯ Sensitivity analyses indicated that the protective effect of CPAP on endothelial function was robust. CPAP significantly improved flow-mediated dilation in subjects with OSA. Long-term randomized controlled trials with larger sample sizes are needed to confirm the positive effect of CPAP on endothelial function in subjects with OSA.
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Editorial Randomized Controlled Trial Comparative Study
A Comparison of Metered-Dose Inhaled Albuterol Versus Endotracheal Liquid Bolus Albuterol for the Treatment of Bronchoconstriction.
Aerosolized albuterol delivery is a mainstay treatment for bronchoconstriction; however, almost no data exist that evaluate the clinical outcome of instillation of an endotracheal liquid bolus (ELB) of a bronchodilator directly into the airway. ⋯ ELB albuterol lavage may be a viable option to reverse bronchoconstriction in intubated patients with limited response to traditional aerosolized albuterol via MDI.
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Comparative Study
A Evaluation of an Oxygen Mask-Based Capnometry Device in Subjects Extubated After Abdominal Surgery.
For early detection of respiratory and hemodynamic changes during anesthesia, continuous end-tidal carbon dioxide concentration (PETCO2) is monitored by capnometry. However, the accuracy of CO2 monitoring during spontaneous breathing in extubated patients remains undetermined. Therefore, we aimed to compare P(ETCO2) measured by capnometry using an oxygen mask with a carbon dioxide sampling port (capnometry-type oxygen mask) and P(CO2) in extubated subjects who had undergone abdominal surgery. Furthermore, we investigated whether spontaneous deep breathing affected dissociation between P(aCO2) and P(ETCO2). ⋯ It is possible to measure the P(ETCO2) under varying breathing conditions with the capnometry-type oxygen mask in subjects receiving oxygen supplementation after extubation following upper abdominal surgery to determine whether they are properly ventilating. (ClinicalTrials.gov registration UMIN000011925.).
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Cough impairment is often described as part of the pathophysiological basis of postoperative pulmonary complications (PPCs). However, there have been few studies examining cough effectiveness and its relationship with PPCs following open upper abdominal surgery. The goal of this study was to estimate (1) changes in cough efficacy after upper abdominal surgery through the assessment of peak cough flow and (2) the extent to which cough impairment is associated with postoperative pain, FVC, and risk of PPCs. ⋯ Cough effectiveness is impaired after upper abdominal surgery. Postoperative restrictive lung dysfunction seems to be associated with this impairment. There is no significant association between peak cough flow and PPCs; however, cough impairment might result in clinically important consequences in a high-risk population.
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Some technologists worry that patients with very severe lung disease are unable to complete several spirometry maneuvers, which require considerable effort. ⋯ Severe lung disease should not be used as an excuse for not meeting spirometry quality goals.