Respiratory care
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Low tidal volume (VT) ventilation has become the preferred approach in patients in the ICU. Sedation reduces VT by attenuating respiratory drive. Even in deep sedation, some patients exhibit high VT. We aimed to determine factors associated with low VT ventilation in deeply sedated subjects who exhibited an inspiratory effort by examination of the acid/base balance using the Stewart model. ⋯ Despite weak effects of high SID and low ATOT, efficient management of the buffering function might be a feasible strategy to achieve low VT ventilation.
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Adults with cystic fibrosis (CF) must continuously manage their condition, while working for a living, and want a normal life. Adherence rates to treatments/medications are less than optimal. Existing theory offers little to explain adherence rates. The purpose of this study was to develop a theory to further the understanding of how people with CF manage their condition in an adherence-driven health care system. ⋯ Participants did not relate to the term nonadherent; rather they described working overtime to manage CF, to work, and to have a normal life. Health care provider and researcher perspectives on adherence differ from those of people with CF. Engaging adults with CF and health care providers in a dialogue in which expectations are shared may lead to individualized treatment regimens that work, because adults with CF will do what works.
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Editorial Comment
Spontaneous Inspiratory Effort During Lung-Protective Ventilation.
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Multicenter Study Clinical Trial
The Double-Trunk Mask Improves Oxygenation During High-Flow Nasal Cannula Therapy for Acute Hypoxemic Respiratory Failure.
High-flow nasal cannula (HFNC) oxygen therapy is used to deliver an FIO2 from 0.21 to 1.0. The double-trunk mask (DTM) is a device designed to increase the FIO2 in patients with a high inspiratory flow demand. The aim of our study was to evaluate the effect of DTM in hypoxemic subjects already receiving HFNC. ⋯ In subjects receiving oxygen via HFNC, the addition of the DTM over the HFNC increased PaO2 without changing the PaCO2 .