Respiratory care
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Left-ventricular dysfunction associated with COPD exacerbation is frequently underestimated. We tested whether finger plethysmography waveform change during the Valsalva maneuver could aid in the distinction between patients with COPD exacerbation with and without left-ventricular dysfunction. ⋯ An increased plethysmographic pulse amplitude ratio associated with COPD exacerbation is a good predictor of left-ventricular dysfunction. This simple and noninvasive index could help emergency department physicians to detect or rule out left-ventricular dysfunction in patients with COPD exacerbation who are able to perform the Valsalva maneuver. (ClinicalTrials.gov registration NCT01619540.).
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There are still gaps in the knowledge regarding the damage to mucociliary and autonomous systems from passive exposure to cigarette smoke. Also, the influence of the frequency and duration of exposure on these systems is still unclear. The objective of this work was to verify the effects of passive smoking on mucociliary clearance and adult autonomic nervous systems and investigate the influence of frequency and time of passive exposure on these systems. ⋯ Passive smokers presented worse mucociliary clearance, and there was a correlation between passive exposure load and damage to the hemodynamic response, pulmonary function and autonomic nervous system.
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The objective of the present study was to develop predictive equations for maximum respiratory pressures in women according to anthropometric characteristics. ⋯ Body mass was the variable that best contributed to predicting maximum respiratory pressures values in women (11.70% of the variations of the P(Imax) and 21.05% of the variations of the P(Emax)). For P(Imax) measurements, the equation -0.2 × body mass - 65.6 was established, and for P(Emax), the equation 0.3 × body mass + 66.4 was used. It is suggested that the predictive equations developed in this study can be used in the interpretation of the assessment of respiratory muscle strength in morbidly obese women 25-65 y of age.
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The objective of this work was to evaluate the time course of clinical and health-related quality of life outcomes of long-stay ICU survivors' and caregivers' burden. ⋯ In prolonged-ICU-stay survivors, EQ-5Dindex at hospital discharge is related to clinical status and caregivers' strain. Subjects' clinical status and EQ-5Dindex improves over time, but caregivers' burden remains high, suggesting the need to monitor/support caregivers.
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There is little evidence in the medical literature to guide empiric treatment of pediatric patients with long-term tracheostomies who present with signs and symptoms of a bacterial respiratory infection. The overall goal of this study was to describe the respiratory microbiology in this study population at our institution. ⋯ This study provides an updated overview of the variety of potential pathogens isolated from respiratory cultures of pediatric subjects with long-term tracheostomies.