Respiratory care
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Counting breaths for a full minute for all patients to determine breathing frequency could result in excessive work load for many medical staff. The aim of this study was to verify the agreement of 2 quick screening methods with counting breaths for a full minute. ⋯ The breathing time measurement method had better agreement with the 1-min breath count method than did the 15-s quadruple method in this study setting.
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In Asian countries, nationwide data on patients undergoing home mechanical ventilation are limited. ⋯ These data will aid in planning the optimal health-care system for users of home mechanical ventilation locally and will allow for comparison of home mechanical ventilation use rates among countries.
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There is significant concern about the respiratory health of deployed military service members given the reported airborne hazards in southwest Asia, which range from geologic dusts, burn pit emissions, chemical exposures, and increased rates of smoking. There has been no previous comparison of pre- and post-deployment lung function in these individuals. ⋯ Utilization of spirometry for the deploying military population had little benefit and did not identify individuals with lung disease after deployment. Routine use was not warranted before or after deployment in the absence of pulmonary symptoms.
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The present study aimed to characterize the behavior of 3 components of respiratory muscle function during mechanical ventilation weaning in children to better understand the respective impact of a spontaneous breathing trial on ventilatory mechanical action (esophageal pressure [Pes], ventilatory demand (electrical activity of the diaphragm [EAdi]), and oxygen consumption. ⋯ In these children who were critically ill, a spontaneous breathing trial induced a moderate and nonsignificant increase in work of breathing, as reflected by the respiratory drive with EAdi and respiratory mechanics with Pes. However, indirect calorimetry did not seem to be a sensitive tool to assess respiratory muscle function during the weaning phase in children who were on mechanical ventilation, especially when work of breathing was slightly increased.
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Current American Thoracic Society/European Respiratory Society guidelines recommend that patients hold their breath with minimum effort at total lung capacity during measurement of the single-breath diffusing capacity of the lung for carbon monoxide (DLCO) to avoid excessively positive or negative mouth pressures. We asked to what extent do these pressures range during single-breath DLCO testing and whether mouth pressures are associated with single-breath DLCO. ⋯ Mouth pressures varied widely during single-breath DLCO measurement but were not associated with the measurement of single-breath DLCO in the clinical setting of pulmonary function testing. Overall, these findings indicate that pulmonary function technologists need not discard efforts made during measurement of single-breath DLCO if only mild changes in mouth pressure occur.