Respiratory care
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Recent studies show balance impairment in subjects with chronic respiratory disease. The aim of this proof-of-concept study was to investigate clinical and quantitative measures of balance in people with chronic respiratory disease following participation in an out-patient pulmonary rehabilitation (PR) program to better understand features of balance improvement. A secondary aim was to probe possible mechanisms for balance improvement to provide the foundation for optimal design of future studies. ⋯ Participation in an 8-week out-patient PR program improved balance, as assessed by clinical and laboratory measures. Detailed analysis of force plate measures demonstrated improvements primarily with respect to medial-lateral balance control. These data provide a basis for the development of larger scale studies to investigate the mechanisms for medial-lateral balance improvements following PR and to determine how PR may be refined to enhance balance outcomes in this population. (ClinicalTrials.gov registration NCT00864084.).
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Nasal cycling may present negative consequences for oxygen-dependent patients using a nasal cannula. This study investigates the effects of nasal cycling on the delivered F(IO2) via nasal cannula in an anatomic model following a baseline study comparing right and left prong nasal cannula oxygen flow delivery. ⋯ Oxygen delivery by nasal cannula may be inefficient in the presence of the nasal cycle. Delivered nasal cannula oxygen concentrations decreased when bilateral nasal patency changed to unilateral nasal patency. Although statistically different, nasal cannula prong oxygen flow may not be clinically important across the full range of flows.
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Observational Study
Pulse Oximetry Overestimates Oxygen Saturation in COPD.
Measurement of oxygen saturation with a handheld pulse oximeter is widely practiced as a surrogate to invasive arterial blood gas analysis. Oxygen saturation is an important parameter in cases of COPD, but there are insufficient data on the role of pulse oximetry in patients with COPD, moreso in diseases across its spectrum, such as chronic bronchitis and emphysema. We assessed the performance of pulse oximetry in acute respiratory failure of patients with COPD. ⋯ Pulse oximetry performed poorly in comparison with the invasive arterial blood gas analysis. The variability of the readings was greater in the subjects with chronic bronchitis than in those with emphysema.
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Smoking is a serious problem in prisons. This work aimed to assess smoking-related behaviors and the effectiveness of tobacco cessation therapy in prison. ⋯ Factors like stress and being in prison may provoke smoking. A smoking ban does not seem to be a total solution for preventing tobacco use in prisons. Tobacco cessation programs may be a better option. Cost-free cessation medications may increase quitting rates among prisoners and prison staff.