Respiratory care
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Progressive resistance inspiratory muscle training is the principle of inspiratory air-flow resistance loading training to restore diaphragm function, increase alveolar compliance, and further improve respiratory function. However, there is a lack of research on the effectiveness of progressive resistance inspiratory training in post-lobectomy rehabilitation and the accurate assessment of lung volumes. ⋯ Progressive resistance inspiratory muscle training was effective in improving lung volume and lung function, and in reducing the length of hospital stay and chest drain closure time after lobectomy.
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COVID-19 is associated with variable symptoms and clinical sequelae. Studies have examined the clinical course of these patients, finding a prolonged need for invasive ventilation and variable re-intubation rates. However, no research has investigated factors and outcomes related to re-intubation secondary to respiratory failure among patients with COVID-19 with ARDS. ⋯ Midazolam, fentanyl, and higher APACHE II scores were independently associated with re-intubation secondary to respiratory failure in subjects with COVID-19-related ARDS. Furthermore, age, male sex, positive CAM-ICU, and re-intubation were independently associated with mortality. Re-intubation also correlated with prolonged hospital and ICU stay.
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Automode is a feature on Servo ventilators that automatically switches between mandatory and spontaneous breaths. Spontaneous breaths suppress mandatory breaths until apnea. The period from the last spontaneous breath to the first mandatory breath is automatically adjusted by a calculated apnea time limit based on a maximum apnea time setting, the mandatory breathing frequency setting, and the spontaneous breath count. The purpose of this study was to validate the apnea time algorithm by using simulated mechanical ventilation. ⋯ The measured apnea time for simulated ventilation settings was within 2% of calculated times. Automode allowed a spontaneous frequency lower than expected based on the mandatory frequency.
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Increasing numbers of patients have obesity-hypoventilation syndrome (OHS) because of the increasing prevalence of obesity. The accuracy of transcutaneous [Formula: see text] ([Formula: see text]) has recently been validated. However, no study evaluated systematically measuring nocturnal [Formula: see text] in the follow-up of patients with OHS and home mechanical ventilation to detect residual nocturnal hypoventilation. We aimed to evaluate the contribution of nocturnal [Formula: see text] to assess nocturnal hypoventilation compared with current routine examinations, that is, daytime arterial blood gases and nocturnal pulse oximetry. ⋯ The assessment of [Formula: see text] in comparison with nocturnal pulse oximetry and arterial blood gases provides important information for the diagnosis of residual nocturnal hypoventilation in the subjects with OHS who were ventilated at home.