Respiratory care
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In a spontaneously breathing 3-dimensional printed nasal airway model of a preterm neonate, CPAP performance was assessed based on delivered pressure, oxygen level, and humidity at different settings. ⋯ Performance testing of the bubble CPAP system demonstrated accurate control of CPAP and oxygen concentration with humidity levels suitable for premature newborns on noninvasive support.
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The growing number of patients on home mechanical ventilation has driven considerable progress in the performance and functionality of ventilators, with features comparable with those used in the ICU. However, a publication gap exists in the evaluation and comparison of their performance and each ventilator choice depends on machine characteristics defined by manufacturers. ⋯ Great variability in terms of technical performance was observed among the 8 home-care ventilators analyzed. Asynchronies became a major issue when home mechanical ventilation was used under higher pressure-support values and lower muscle efforts. Our results may prove to be useful in helping choose the best suited machine based on a patient's clinical therapy needs.
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Nebulized 7% hypertonic saline is used to treat patients with cystic fibrosis. Clinical trials supporting its use were conducted with breath-enhanced nebulizers (BEN). It is not uncommon for the specific nebulizer used in studies or prescribed by a physician to be unavailable to patients. The investigator compared the aerosol characteristics of hypertonic saline delivered by nebulizers of different operating principles. ⋯ Hypertonic saline aerosols generated with the BEN and BAN devices were similar, while that generated with the CON was different. Airway delivery was similar between the BEN devices, but higher than that observed with the BAN and CON devices.
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Patients with coronavirus disease 2019 (COVID-19) often develop acute hypoxemic respiratory failure and receive invasive mechanical ventilation. Much remains unknown about their respiratory mechanics, including the trajectories of pulmonary compliance and [Formula: see text]/[Formula: see text], the prognostic value of these parameters, and the effects of prone positioning. We described respiratory mechanics among subjects with COVID-19 who were intubated during the first month of hospitalization. ⋯ Respiratory mechanics of the subjects with COVID-19 who were on mechanical ventilation were characterized by persistently low respiratory system compliance and [Formula: see text]/[Formula: see text], similar to ARDS due to other etiologies. The [Formula: see text]/[Formula: see text] was more tightly associated with mortality than with compliance.
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Multicenter Study Observational Study
Driving Pressure is a Risk Factor for ARDS in Mechanically Ventilated Subjects Without ARDS.
Driving pressure (ΔP) has been described as a risk factor for mortality in patients with ARDS. However, the role of ΔP in the outcome of patients without ARDS and on mechanical ventilation has received less attention. Our objective was to evaluate the association between ΔP on the first day of mechanical ventilation with the development of ARDS. ⋯ In the subjects without ARDS, a higher level of ΔP on the first day of mechanical ventilation was associated with later development of ARDS. (ClinicalTrials.gov registration NCT02731898.).