Respiratory care
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The paradigm of supportive care of patients who are critically ill has changed significantly over the past 20 years. Patients on mechanical ventilation are no longer heavily sedated; the goal is a comfortable patient who can interact with health-care professionals and with their family members. Systematic, regular assessment of the patient for pain, anxiety, and sleep deprivation allows early recognition of these distressing symptoms. ⋯ The presence of family members during daily rounds and at the bedside can reduce the distress of the patient and enhance communication with the health-care team. All of these changes have created new challenges and opportunities for the multidisciplinary health-care team. This review aimed to describe the main components of evidence-based supportive care of patients on mechanical ventilation, beyond the specific settings of the ventilator.
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Randomized Controlled Trial
Use of a Home-Based Manual as Part of a Pulmonary Rehabilitation Program.
Pulmonary rehabilitation programs improve exercise capacity and quality of life in patients with COPD. Domiciliary strategies to maintain these benefits have been proposed. ⋯ The use of a simple, well-illustrated manual facilitated the maintenance of the benefits acquired in out-patient pulmonary rehabilitation over a period of 3 months after study termination.
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Comparative Study
A New Formula for Predicting the Fraction of Delivered Oxygen During Low-Flow Oxygen Therapy.
During O2 therapy at low flow in patients who breathe spontaneously, the fraction of delivered O2 (FDO2 ) is unknown. In recent years, FDO2 prediction formulas have been proposed. However, they do not take into account the effect of inspiratory flow (V̇I) on the FDO2 . The aim of this study was to validate a new FDO2 prediction formula, which takes into account the V̇I and compares it with other FDO2 prediction formulas. ⋯ The V̇I has a major impact on FDO2 during O2 therapy at low flow. FDO2 comparisons between frequently used prediction formulas and FDO2 measured on the bench indicated greater differences. Uncritical use of these formulas should be used cautiously to predict FDO2 . In this study, our prediction formula indicated a good accuracy for predicting FDO2 during supplemental oxygenation through a heat-and-moisture exchanger in patients who breathe spontaneously.
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Editorial Comment
Optoacoustic Evaluation of Endotracheal Tube Depth in Pediatrics.