Respiratory care
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Review Meta Analysis
Effects of Home-Based Breathing Exercises in Subjects With COPD.
We sought to investigate the effects of home-based breathing exercises on pulmonary function, respiratory muscle strength, exercise capacity, dyspnea, and health-related quality of life in patients with COPD. ⋯ As an alternative method of home-based pulmonary rehabilitation program, breathing exercises can improve pulmonary function, respiratory muscle strength, exercise capacity, dyspnea, health-related quality of life in patients with COPD.
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Review Meta Analysis
Effect of High-Flow Nasal Cannula Oxygen Therapy in Immunocompromised Subjects With Acute Respiratory Failure.
Various studies have been performed to examine the effect of high-flow nasal cannula (HFNC) in immunocompromised patients with acute respiratory failure (ARF). However, the results were inconsistent. Thus, we conducted a meta-analysis to evaluate the effect of HFNC oxygen therapy in immunocompromised patients with ARF versus conventional oxygen therapy and noninvasive ventilation (NIV). ⋯ Our results suggest that HFNC may be a feasible alternative to NIV, with lower intubation rates and no increased risk for ICU-acquired infections compared to standard oxygen therapy. However, HFNC did not appear to reduce mortality in immunocompromised subjects with ARF compared with other noninvasive therapies. Further high-quality randomized controlled trials should be performed to confirm these findings.
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Editorial Multicenter Study
Mechanical Ventilation in Children on Venovenous ECMO.
Venovenous extracorporeal membrane oxygenation (VV-ECMO) is used when mechanical ventilation can no longer support oxygenation or ventilation, or if the risk of ventilator-induced lung injury is considered excessive. The optimum mechanical ventilation strategy once on ECMO is unknown. We sought to describe the practice of mechanical ventilation in children on VV-ECMO and to determine whether mechanical ventilation practices are associated with clinical outcomes. ⋯ Ventilator mode and some settings vary in practice. The only ventilator setting associated with mortality was FIO2 , even after adjustment for disease severity. Ventilator FIO2 is a modifiable setting that may contribute to mortality in children on VV-ECMO.