Respiratory care
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There is currently no standardized way to determine suitability for extubation of pediatric ICU (PICU) patients, potentially resulting in prolonged duration of mechanical ventilation. We aimed to design and implement a protocol for screening all intubated PICU patients for extubation readiness. ⋯ An acceptable and safe ERT protocol was implemented and found to improve outcomes in PICU subjects on mechanical ventilation.
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Severity of radiographic abnormalities on chest radiograph in subjects with COVID-19 has been shown to be associated with worse outcomes, but studies are limited by different scoring systems, sample size, subject age, and study duration. Data regarding the longitudinal evolution of radiographic abnormalities and its association with outcomes are scarce. We sought to evaluate these questions using a well-validated scoring system (the Radiographic Assessment of Lung Edema [RALE] score) using data over 6 months from a large, multihospital health care system. ⋯ The RALE score was reproducible and easily implementable in adult subjects presenting to the ED with COVID-19. Its association with physiologic parameters and outcomes at baseline and longitudinally makes it a readily available tool for prognostication and early ICU triage, particularly in patients with worsening radiographic edema.
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Although quality control standards are recommended to ensure accurate test results, the coefficient of variation for the FVC and FEV1 biologic quality control (BioQC) is not specified. The primary aim of this study was to evaluate variations in spirometry BioQCs in a large and diverse cohort of individuals to determine an acceptable standard for the coefficient of variation. ⋯ Interlab biologic control variation values of < 4% for FVC and FEV1 are achievable; however, individual labs should strive to attain lower values. Acceptable coefficients of variation can be achieved within 28 d.
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Electronic cigarettes (e-cigarettes) and hookah smoking have gained tremendous popularity over the past decade. With the constantly evolving e-cigarette market and potential impact of the COVID-19 pandemic on users of these tobacco products, research is needed to assess the prevalence and safety of these devices as well as potential public health implications and cessation tools. For this year in review, PubMed was searched from January 2021-December 14, 2021, for articles related to e-cigarettes, vaping-related lung injury, and hookah smoking. ⋯ Hookah smoking has remained stable across the past several years and remains a primarily social activity among youth. New e-cigarette devices are constantly emerging, resulting in an increased demand to understand the safety of these devices. Additionally, hookah smoking continues to be a concerning public health issue with the increase in hookah bars and venues coupled with lack of policy regulations for hookah smoking.