Respiratory care
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Obesity is one of the most prominent risk factors for obstructive sleep apnea (OSA). Weight loss decreases the number of shorter respiratory events (<40 s), whereas the number of longer events remains almost unchanged. However, it is unknown how body mass index (BMI) affects individual obstruction event severity within OSA severity categories when age, sex, smoking, daytime sleepiness, snoring, hypertension, heart failure, and sleeping posture are considered. Therefore, we investigated whether individual obstruction event severity varies with BMI within the OSA severity categories when considering the most important confounding factors. ⋯ Because BMI is related to the duration of individual obstruction events, its effect on OSA severity is more complex than its effect on AHI would implicate. Therefore, overall severity of OSA may not be the same for non-obese patient and obese patient who have similar AHI. Thus, these patient-specific characteristics of individual breathing cessations should be considered when estimating the severity of disease and risk of related adverse health effects.
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Nocturnal desaturation in cystic fibrosis (CF) may have prognostic implications because a significant and maintained nocturnal desaturation can contribute to the development and progression of pulmonary hypertension with cor pulmonale. Its relation with the desaturation in exercise has not been sufficiently studied. We aimed to determine whether desaturation during 6MWT can be an indicator of nocturnal desaturation in adult subjects with CF. ⋯ Desaturation observed in 6MWT cannot predict desaturation at night in adults with CF. Other parameters were identified as predictors of desaturation.
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Prolonged endurance running may acutely reduce spirometric lung values. This study examined changes in spirometry before and immediately after prolonged endurance exercise (running and/or walking). Specifically, we examined potential factors that predict the presence of at least a 10% postexercise reduction in FEV1. ⋯ Exercise-induced bronchoconstriction (EIB) is the most probable explanation for the reduction in post-race FEV1. Prolonged endurance exercise reduced spirometric lung function by ∼20% in those with EIB. Age was the only predictor for EIB, and EIB did not affect the finish times among recreational runners and/or walkers.
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Patients undergoing prolonged mechanical ventilation represent up to 15% of all patients requiring weaning from mechanical ventilation. Although recent guidelines have recommended including physiotherapy early during mechanical ventilation to speed the process of weaning, only indirect evidence supporting the use of physiotherapy is available for patients receiving prolonged mechanical ventilation. The aim of our study was to evaluate the effects of a physiotherapy program in subjects requiring prolonged mechanical ventilation and the correlates of successful weaning. ⋯ Our data support the inclusion of physiotherapy in the management of patients requiring prolonged mechanical ventilation.
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Exacerbation of idiopathic interstitial pneumonias (IIPs) requiring mechanical ventilation is associated with high mortality. However, evidence for the optimal management strategy in patients on mechanical ventilation for exacerbation of IIPs is scarce. This study aimed to evaluate the association between continuous rocuronium infusion and in-hospital mortality in patients with exacerbation of IIPs requiring mechanical ventilation. ⋯ Continuous rocuronium infusion was not significantly associated with decreased mortality in patients with exacerbation of IIPs requiring mechanical ventilation.