Respiratory care
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Continuous high-frequency oscillation (CHFO) creates a pressure gradient in the small airways that accelerates expiratory flow. The intended use of CHFO therapy is to facilitate secretion removal and treat atelectasis. Our objective was to assess the feasibility, safety, and efficacy of CHFO in the mechanically ventilated pediatric population. ⋯ CHFO is feasible and seems safe in our cohort of mechanically ventilated pediatric subjects. The rate of pneumothorax was consistent with that seen in similar pediatric ICU populations. These preliminary results suggest that CHFO may be beneficial by improving lung compliance in pediatric subjects with secretion-induced atelectasis. Prospective clinical studies are needed to further evaluate the clinical efficacy and safety of CHFO in children receiving invasive mechanical ventilation.
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Randomized Controlled Trial
Automatic Oxygen Titration During Walking in Subjects With COPD: A Randomized Crossover Controlled Study.
Arterial oxygen desaturation frequently occurs in patients with COPD during daily activities at home. Oxygen flow is usually set at fixed and low rates for ambulatory patients. We evaluated an innovative closed-loop system (FreeO2) that automatically adjusts the oxygen flow to the patient's needs in subjects with COPD during walking followed by recovery time, such as during ambulatory conditions. ⋯ Automatic titration of oxygen flow during walking to maintain oxygen saturation in a specified range improves oxygenation and may improve exercise tolerance during daily activity, such as walking, in patients with COPD in comparison with room air and fixed oxygen administration. (ClinicalTrials.gov registration: NCT02150434.).
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Editorial Randomized Controlled Trial
Endotracheal Tubes Cleaned With a Novel Mechanism for Secretion Removal: A Randomized Controlled Clinical Study.
Intubation compromises mucus clearance, allowing secretions to accumulate inside the endotracheal tube (ETT). The purpose of this trial was to evaluate a novel device for ETT cleaning. We hypothesized that its routine use would reduce tube occlusion due to mucus accumulation, while decreasing airway bacterial colonization. ⋯ The endOclear is a safe and effective device. It prevents luminal occlusion, thereby better preserving ETT nominal function.
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This systematic review focuses on respiratory effects of inhalational marijuana. The systematic review of the literature was conducted using a comparative method between 2 researchers. Abstracts were reviewed for inclusion of respiratory effects related to inhalational marijuana. ⋯ The research indicates that there is a risk of lung cancer from inhalational marijuana as well as an association between inhalational marijuana and spontaneous pneumothorax, bullous emphysema, or COPD. A variety of symptoms have been reported by inhalational marijuana smokers, including wheezing, shortness of breath, altered pulmonary function tests, cough, phlegm production, bronchodilation, and other symptoms. It is important to stay current with research findings to educate patients on this smoking behavior.