Respiratory care
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Comparative Study
Performance of the New Turbine Mid-Level Critical Care Ventilators.
During recent years, ventilators using turbines as flow-generating systems have become increasingly more relevant. This bench study was designed to compare triggering and pressurization of 7 turbine mid-level ICU ventilators. ⋯ Pressure support mode for tested ventilators worked properly, but pressurization capacity and trigger function performance were clearly superior in the newest machines. The use of PEEP did not modify the results.
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Comparative Study
Performance of the PneuX System: A Bench Study Comparison With 4 Other Endotracheal Tube Cuffs.
Cuff design affects microaspiration, a risk factor for pneumonia. We questioned whether the PneuX low-volume fold-free cuff design would prevent cuff leakage and maintain the same tracheal wall pressure as high-volume, low-pressure (HVLP) cuffs. ⋯ The PneuX cuff generally exerted acceptable tracheal wall pressure, but the tracheal wall pressure monitor allowed pressures exceeding 30 cm H2O in some trials and was the only ETT to prevent leak in all tests. For HVLP cuffs, leak was reduced by PU and PEEP and eliminated by lubrication.
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Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. ⋯ The PB980 and V500 were the only ventilators to acclimate to all leak scenarios and achieve targeted VT. Further clinical investigation is needed to validate the use of leak compensation during neonatal volume-targeted ventilation.
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Comparative Study
Economics of Home Monitoring for Apnea in Late Preterm Infants.
Apnea of prematurity affects a small proportion but large absolute number of late preterm infants, with out-patient management variably utilized despite relative clinical equipoise and potential for improved cost-effectiveness. ⋯ Out-patient management of discharge-delaying ABD events in a late preterm and term population was a cost-effective alternative to prolonged in-patient observation.
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Comparative Study
A Comparison of Different Techniques for Interfacing Capnography With Adult and Pediatric Supplemental Oxygen Masks.
Accurately measuring the partial pressure of end-tidal CO2 (PETCO2 ) in non-intubated patients is problematic due to dilution of expired CO2 at high O2 flows and mask designs that may either cause CO2 rebreathing or inadequately capture expired CO2. We evaluated the performance of 2 capnographic O2 masks (Cap-ONE and OxyMask) against a clinically expedient method using a standard O2 mask with a flow-directed nasal cannula used for capnography (CapnoLine) in a spontaneous breathing model of an adult and child under conditions of normal ventilation, hypoventilation, and hyperventilation. ⋯ Both of the specially designed O2 capnography masks provided reasonably stable PETCO2 without significant CO2 rebreathing at the commonly used O2 flows. Because of their open design, PETCO2 measured at high O2 flows may produce artificially lower readings that may not reflect arterial CO2 levels compared with lower O2 flows.