Respiratory care
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A ventilator includes the function to measure flow velocity. We aimed to compare the predictive accuracy for re-intubation diagnosed by cough peak flow (CPF) measured by a spirometer and a ventilator. ⋯ CPF measurement by a ventilator was convenient, affordable, and safe. It had a predictive accuracy for re-intubation similar to that of a spirometer.
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The primary goals of this study were to evaluate early changes in pulmonary function and retrobulbar hemodynamics and to examine the correlation between these parameters in patients with type 2 diabetes during the preclinical stages of diabetic retinopathy. ⋯ Pulmonary function and retrobulbar hemodynamics changed during the preclinical stages of diabetic retinopathy. Regulating glycemia may improve retrobulbar hemodynamics in the retrobulbar arteries (ie, central retinal artery, posterior ciliary artery, and arteria ophthalmica). By detecting the retrobulbar resistivity index and the levels of glycosylated hemoglobin A1c, we could predict future changes in pulmonary function during the preclinical stages of diabetic retinopathy as well as the degree of retinopathy. (ClinicalTrials.gov registration NCT02774733.).
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The terms sedentary behavior and physical inactivity have been confusingly mixed. Although the association between physical inactivity and mortality has been shown previously in subjects with COPD, this association had not yet been investigated with regard to sedentarism. The aim of this work was to investigate the impact of sedentary behavior on mortality of subjects with COPD and to propose a cutoff point of sedentarism with prognostic value. ⋯ Sedentary behavior was an independent predictor of mortality in subjects with COPD, even adjusting for moderate-to-vigorous physical activity and a number of other variables. Mortality was higher in subjects with COPD who spend ≥8.5 h/d in activities requiring <1.5 MET. These findings may open room for future studies aiming at decreasing sedentary time as a promising strategy to reduce mortality risk in subjects with COPD.
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The fundamental goals of mechanical ventilation are to improve pulmonary gas exchange and relieve respiratory distress, thus permitting lung and airway healing, while at the same time lessening the risk for iatrogenic complications. This review will summarize some of the advances in mechanical ventilation in 2016, with a particular focus on ventilator-associated clinical challenges and outcomes.