Respiratory care
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Aerosol delivery via high-flow nasal cannula (HFNC) has gained popularity due to the increased use of the modality for treating hypoxemic and hypercapnic respiratory failure. Various HFNC devices are available in the United States; however, the effectiveness of aerosol delivery via HFNC devices remains unclear. Thus, this study aimed to investigate the impact of various commercially available devices on transnasal aerosol delivery. ⋯ Transnasal aerosol delivery was significantly impacted by the types of HFNC devices and flow settings. Nominal doses might need to be adjusted if changing HFNC devices or flow is not an option.
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Review Meta Analysis
Risk of Fracture and Osteoporosis in Patients With COPD and Inhaled Corticosteroids Treatment.
There are disputes whether inhaled corticosteroids (ICS) increase the incidence of fracture or osteoporosis among patients with COPD. The aim of this meta-analysis was to assess the effect of ICS treatment on the risk of fracture and osteoporosis in subjects with COPD. ⋯ ICS use did not increase the incidence of fracture or osteoporosis in subjects with COPD.
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Mechanical ventilation is a lifesaving intervention that may also induce further lung injury by exerting excessive mechanical forces on susceptible lung tissue, a phenomenon termed ventilator-induced lung injury (VILI). The concept of mechanical power (MP) aims to unify in one single variable the contribution of the different ventilatory parameters that could induce VILI by measuring the energy transfer to the lung over time. ⋯ Currently, due to different limitations, the clinical application of MP is debatable. Further clinical studies are required to enhance our understanding of the relationship between MP and the development of VILI, as well as its potential impact on clinical outcomes.
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Randomized Controlled Trial
Alleviation of Dyspnea and Changes in Physical Activity Level by Blowing Air to the Face with a Fan.
Dyspnea is an unpleasant subjective symptom and is associated with decreased physical activity level (PAL). Effect of blowing air toward the face has received a great deal of attention as a symptomatic therapy for dyspnea. However, little is known about the duration of its effect and its impact on PAL. Therefore, this study aimed to measure dyspnea severity and changes in dyspnea and PALs with air blasts to the face. ⋯ No significant difference was observed for dyspnea and PALs in subjects after blowing air toward their own faces with a small fan for 3 weeks at home. Disease variability and impact of protocol violations were high due to small number of cases. Further studies with a design focused on subject protocol adherence and measurement methods are required to understand impact of air flow on dyspnea and PAL.
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First health care professionals arriving at the bedside in tracheostomy-related emergencies are rarely the surgical subspecialists who placed the tracheostomy and are unfamiliar with the relevant anatomy and tracheostomy specifications for the individual patient. We hypothesized that implementing a bedside airway safety placard would increase caregiver confidence, understanding of airway anatomy, and management of patients with a tracheostomy. ⋯ Given the limitations of a low survey response rate, our findings suggest that an educational airway safety placard initiative can be a simple, feasible, and low-cost quality improvement tool to enhance airway safety and possibly decrease potentially life-threating complications among pediatric patients with a tracheostomy. The implementation of the tracheostomy airway safety survey at our single institution warrants a larger multi-center study and validation of the survey.