Respiratory care
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Randomized Controlled Trial
Effect of a Conical-PEP Mask on Exercise in Subjects With COPD.
Dynamic hyperinflation (DH) is a major pathophysiology of COPD that is directly related to dyspnea and exercise intolerance. Positive expiratory pressure (PEP) might reduce DH and dyspnea during exercise, but at present, there is insufficient evidence to conclude whether it is beneficial for DH, dyspnea, and exercise capacity in COPD. ⋯ Breathing with a 5 cm H2O conical-PEP mask improved exercise time (median 27.1% [0.6-52.9]) in subjects with COPD. The improvement in exercise with the conical-PEP mask was associated with slower development of breathlessness, possibly due to delays in DH development.
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Perceived organizational support has been linked to employee commitment and job satisfaction. Understanding the effects of perceived organizational support on employees allows leaders to improve employees' performance and the success of their organizations. The purpose of this study was to identify the perceived organizational support across different respiratory care education programs in the United States. ⋯ Age, sex, job title, years of administrative experience, students' TMC scores, and the type of programs offered impacted perceived organizational support by respiratory care directors. Student-, program- and participant-related factors can be used to improve perceived organizational support in respiratory care education.
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The greater and stronger your knowledge about a subject, the more you will be able to address a new problem in that subject. In entry-level respiratory care education, incorporating research into curricula can be challenging due to the limited time to cover all necessary topics. This is also true in clinical post-graduate respiratory care practice. ⋯ Devoting resources to develop research expectations and priorities should be a joint effort of educators and leaders. Mentorship is critically important to guide and nurture those with an inquisitive mindset. However, first, educators must cultivate an interest in research.
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Unplanned extubation (UE) is defined as unintentional dislodgement of an endotracheal tube (ETT) from the trachea. UEs can lead to instability, cardiac arrest, and may require emergent tracheal re-intubation. As part of our hospital-wide quality improvement (QI) work, a multidisciplinary committee reviewed all UEs to determine contributing factors and evaluation of clinical outcomes to develop QI interventions aimed to minimize UEs. The objective was to investigate occurrence, contributing factors, and clinical outcomes of UEs in the pediatric ICU (PICU), cardiac ICU (CICU), and neonatal ICU (NICU) in a large academic children's hospital. We hypothesized that these would be substantially different across 3 ICUs. ⋯ UEs occurred commonly in a large academic children's hospital. Whereas UE was associated with adverse events, re-intubation rates within 72 h were < 70% and variable across the units.