Respiratory care
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Objective measures of adherence to high-frequency chest wall compression (HFCWC), a form of airway clearance therapy for patients with cystic fibrosis, are lacking. We used a novel electronic monitoring device integrated into an HFCWC vest to measure adherence compared with self-reported adherence. We determined factors that influenced adherence and how adherence correlated with baseline pulmonary function and pulmonary exacerbations. ⋯ Greater adherence to HFCWC measured directly by a novel recorder was associated with better baseline pulmonary function and fewer exacerbations in the pre-study and baseline period. Adherence decreased with age and prescribed therapy time and increased with therapy assistance. Self-report overestimation is large and thus not an accurate measure of adherence.
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The purpose of this study was to correlate airway parameters of COPD determined by low-dose high-resolution computed tomography (HRCT) with pulmonary function testing (PFT) results. ⋯ The results of this study suggest that airway parameters in different COPD grades have no uniform tendency of correlation with PFT, but some HRCT parameters are correlated to some PFT parameters.
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Cardiovascular collapse is a life-threatening event after unplanned extubations (UEs) in the pediatric ICU (PICU). However, there is a paucity of pediatric studies assessing this complication. We sought to assess the incidence, risk factors, and outcome of cardiovascular collapse after UEs in PICU patients. ⋯ Cardiovascular collapse is a frequent complication of UEs, particularly in the youngest children. Specific bundles to prevent UEs may reduce morbidity related to these events.
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High-frequency jet ventilation (HFJV) has been used in conjunction with conventional ventilation for infants with respiratory failure. We sought to identify parameters that were associated with successful application of HFJV in patients with hypercapnic respiratory failure. ⋯ We identified that lower postmenstrual age, improvements in capillary PCO2 and pH at 1 h, and a reduction of FIO2 were associated with good response to HFJV. These data may help to identify patients who are likely to benefit from HFJV in the neonatal intensive care unit.
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High-flow nasal cannula (HFNC) is supposed to provide additional PEEP compared with conventional oxygen therapy. However, the exact determinants of this PEEP effect are unclear. We investigated the factors that might affect the PEEP and compared PEEP performance among 3 HFNC devices. ⋯ The mouth status, flow, and compliance were the 3 major influencing factors of PEEP effect, whereas performance of the 2 mechanical ventilators was slightly superior to that of the AIRVO 2 device at higher flows.