Respiratory care
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Long-term oxygen therapy in COPD is usually supervised through home-care respiratory programs. Such programs often involve an intensive education intervention at the initiation of long-term oxygen therapy, followed by an extended follow-up period that aims toward home oxygen adherence. The objective of this study was to estimate the cost-effectiveness ratio of such a maintenance program. ⋯ An extended home-visit program to maintain or improve adherence to long-term oxygen therapy in patients with COPD would most likely be cost-effective.
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Review
AARC Clinical Practice Guidelines: Capillary Blood Gas Sampling for Neonatal and Pediatric Patients.
In the absence of an indwelling arterial catheter, capillary blood gas sampling may be used to evaluate the acid/base and ventilation status of neonatal and pediatric patients with cardiorespiratory conditions. These guidelines were developed from a comprehensive review of the literature to provide guidance for the collection, handling, and interpretation of blood obtained from an arterialized capillary sample. Capillary and venous blood gas measurements are a useful alternative to arterial blood gas measurements for neonatal and pediatric patients who do not require close monitoring of [Formula: see text] In the presence of alterations in body temperature, blood pressure, or peripheral perfusion, agreement between a capillary blood gas with an arterial sample is recommended to determine whether changes in these physiologic conditions reduce reliability. ⋯ To reduce the cumulative pain effect and risk of complications, the capillary puncture procedure should be minimized when possible. Non-pharmacologic interventions should be used to reduce pain associated with capillary blood gas sampling. Automatic lancets are preferred to puncture the skin for capillary blood gas collection.
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Multicenter Study Clinical Trial
Predictors of Respiratory Support Use in Emergency Department Patients With COVID-19-Related Respiratory Failure.
Given the known downstream implications of choice of respiratory support on patient outcomes, all factors influencing these decisions, even those not limited to the patient, warrant close consideration. We examined the effect of emergency department (ED)-specific system factors, such as work load and census, on the use of noninvasive versus invasive respiratory support. ⋯ High ED work load was associated with higher odds on HFNC/NIV prior to invasive mechanical ventilation.
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Randomized Controlled Trial
Arterial Cannulation Simulation Training in Novice Ultrasound Users.
Arterial cannulation is an important procedure for hemodynamic monitoring and blood sampling. Traditional radial artery cannulation is performed by using anatomical knowledge and pulse palpation as a guide. Arterial cannulation using ultrasound (US) requires specific training, especially for new US users. We hypothesized that even for new US users, US guidance would facilitate the successful puncture by lower attempts before successful intraluminal cannulation of a simulation model of the radial artery. ⋯ US technique was more successful than traditional palpation technique for novice US users performing arterial cannulations for the first time. A study in the clinical practice is needed to confirm these results.