Respiratory care
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Prone positioning reduces mortality in patients with moderate/severe ARDS. It remains unclear which physiological parameters could guide clinicians to assess which patients are likely to benefit from prone position. This study aimed to determine the association between relative changes in physiological parameters at 24 h of prone positioning and ICU mortality in adult subjects with ARDS. ⋯ In subjects with ARDS receiving prone positioning, a relative decline in the ventilatory ratio at 24 h was associated with lower ICU mortality.
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Background: Respiratory therapists (RTs) provide various types of patient care in different clinical settings. Burnout can have an undesirable effect on RTs and their patients. Managing the COVID-19 pandemic, specifically in hospitals, could induce stress in RTs and increase the likelihood of burnout. ⋯ Burnout is associated with several factors, and interventions should target all domains of burnout. RT management and staff are responsible for addressing their needs and collaboratively working together to overcome burnout. Further investigations focusing on techniques and strategies to alleviate burnout are required.
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When helmet CPAP is performed using a Venturi system, filters are frequently interposed in the respiratory circuit to reduce noise within the helmet. The effect of the interposition of these filters on delivered fresh gas flow and the resulting FIO2 is currently unknown. ⋯ The use of filters during helmet CPAP reduced the flow delivered to the helmet and, consequently, modified FIO2 . If filters are applied, an adequate gas flow should be administered to guarantee a constant CPAP during the entire respiratory cycle and avoid rebreathing. Moreover, it might be important to measure the effective FIO2 delivered to the patient to guarantee a precise assessment of oxygenation.