Respiratory care
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Exercise testing is part of the regular assessment of patients with cystic fibrosis (CF). We aimed to evaluate (1) the convergent validity of the 1-min sit-to-stand (STS) test in CF by investigating its relationships with peak oxygen uptake (peak V̇O2 ), quadriceps strength, and quality of life and (2) to compare these associations with those of the 6-min walk test (6MWT). ⋯ The STS test cannot be used as a replacement for CPET to accurately assess peak exercise capacity in CF. The STS test may have utility in detecting patients with CF who may exhibit a high level of oxygen desaturation during heavy exercise. Further studies should identify the factors contributing to STS performance to confirm the potential interest of STS repetitions × body weight outcome as a useful submaximal exercise parameter in CF.
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Artificial airway resistance as provided by small-lumen tracheal tubes or catheters increases the risk of intrinsic PEEP (PEEPi). We hypothesized that by active expiration assistance, larger minute volumes could be generated without causing PEEPi compared with conventional mechanical ventilation when using small-lumen tracheal tubes or a cricothyrotomy catheter. ⋯ For mechanical ventilation via small-lumen tubes or thin catheters, active compensation of airway resistance might be a necessary means to generate adequate minute ventilation without causing PEEPi. Active expiration assistance can generate reasonable respiratory minute volumes via small-lumen tubes or thin catheters.
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Pneumothorax is one of the most important complications after bronchoscopy. This study was conducted to determine the risk factors for post-bronchoscopy pneumothorax. ⋯ Pneumothorax occurred significantly more frequently when bronchoscopy was performed for subinterlobular pleural lesions. Close attention and care should be taken during bronchoscopy, especially when target lesions are abutting the interlobular pleura.
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Pulmonary mechanics may play a role in exercise intolerance in patients with congenital heart disease (CHD). A reduced FVC volume could increase the ratio between mid-flow (FEF25-75%) and FVC, which is termed high dysanapsis. The relationship between high dysanapsis and the response to maximum-intensity exercise in children with CHD had not yet been studied. The aim of this work was to examine whether high dysanapsis is related to the cardiopulmonary response to maximum-intensity exercise in pediatric subjects with CHD. ⋯ In children and adolescents with corrected CHD, high dysanapsis was associated with a lower ventilatory capacity and reduced aerobic fitness, which may indicate respiratory muscle impairments.
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Observational Study
Assessment of Upper-Airway Configuration in Obstructive Sleep Apnea Syndrome With Computed Tomography Imaging During Müller Maneuver.
The purpose of this observational study was to investigate the relationship between upper-airway configuration assessed by CT imaging during the Müller maneuver state and the severity of obstructive sleep apnea syndrome (OSAS). ⋯ Subjects with severe OSAS have more significant abnormalities of the upper airway. Obesity, mCSA of nasopharynx, upper-airway length, and MPH may contribute to the severity of OSAS. Obesity and sex should be taken into account when evaluating the abnormalities of upper-airway anatomy in snorers and patients with OSAS.