Respiratory care
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Dynamic airway resistance from obstructive disease causes a concavity in the mid-expiratory portion of the spirometric flow-volume loop. We developed a simple model to measure the exponential decay in air flow during forced exhalation to quantify the extent of dynamic airway obstruction and facilitate the detection of obstructive airway diseases clinically. ⋯ Flow decay distinguished subjects with obstructive lung defects from healthy subjects. It is a straightforward representation of spirometry data that provides a reproducible index to quantify dynamic airway obstruction.
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We aimed to test the performance of PRESERVE and RESP scores to predict death in patients with severe ARDS receiving extracorporeal membrane oxygenation (ECMO) with different case mixes. ⋯ The use of these scores in helping physicians to determine the patients with ARDS most likely to benefit from ECMO should be limited in clinical practice because of their relatively poor performance in predicting death in subjects with severe ARDS receiving ECMO support. Before widespread use is initiated, these scoring systems should be tested in large prospective studies of subjects with severe ARDS undergoing ECMO treatment.
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Tracheostomy decannulation is accompanied by several clinical concerns due to air leakage. In this study, we introduced a novel tracheostoma closure device that facilitates the use of noninvasive ventilation, improvement of pulmonary function, and vocalization in the newly decannulated patient. The biosafety and feasibility of the device were evaluated in an animal model. ⋯ The study demonstrated that the tracheostoma closure device is feasible and biosafe in a porcine animal model, but the design and quality of the materials need to be improved before clinical trials.
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The objectives of this study were: (1) to assess the prevalence of and types of education methods provided to participants who use a metered-dose inhaler (MDI), (2) to determine the prevalence of MDI misuse in adults using objective and subjective assessments, and (3) to determine whether any associations exist between the education method and the participant's ability to properly use an MDI. ⋯ Although most participants received inhaler education, inhaler misuse was very common. No associations were found regarding method of education and proper inhaler technique.