Respiratory care
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With increasing life expectancy and ICU admission of elderly patients, mechanical ventilation, and weaning trials have increased worldwide. ⋯ The IWI was the independent variable found in weaning of elderly subjects that may contribute to the critical moment of this population in intensive care.
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Microalbuminuria, used as a marker of endothelial dysfunction, is a predictor of mortality for any reason and of cardiovascular events. Recent research on the management of COPD has focused more on comorbidities, including cardiovascular events. The objective of this study was to investigate the incidence of microalbuminuria and whether it is associated with physiological and clinical features in a subject group that was classified in line with the new version of the Global Initiative for Chronic Obstructive Lung Disease stages. ⋯ The results of this study indicate a strong relationship between microalbuminuria and cardiovascular events in subjects with COPD, particularly in subjects with more symptoms and high future risk. Therefore, microalbuminuria should be regularly monitored in this subgroup of subjects with COPD for risk of cardiovascular morbidity or mortality.
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Respiratory therapist (RT)-driven protocols have been in use for over 30 years. Protocols have been reported to decrease unnecessary or harmful therapy, health-care costs, and hospital stay. This study represents the evaluation of an original respiratory care protocol in the pediatric ICU at Arkansas Children's Hospital for β-agonist and airway clearance interventions where one did not exist. ⋯ In this institution, implementation of a β-agonist/airway clearance protocol resulted in significant reductions of subject interventions and improved outcomes by decreasing length of stay and ventilator days as well as contributing information where clinical evidence is scant, specifically the pediatric ICU.
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It is important to assess activities of daily living (ADL) in older adults due to impairment of independence and quality of life. However, there is no objective and standardized protocol available to assess this outcome. Thus, the aim of this study was to verify the reproducibility and validity of a new protocol for ADL assessment applied in physically independent adults age ≥50 y, the Londrina ADL protocol, and to establish an equation to predict reference values of the Londrina ADL protocol. ⋯ The Londrina ADL protocol was reproducible and valid in physically independent adults age ≥50 y. A reference equation for the protocol was established including only age as an independent variable (r(2) = 0.21), allowing a better interpretation of the protocol's results in clinical practice.
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To avoid symptoms, patients with COPD may reduce the amount of activities of daily living (ADL). Therefore, the aim of the present study was to develop a standardized protocol to evaluate ADL performance in subjects with COPD (Londrina ADL protocol) and to assess the validity and reliability of the protocol in this population. ⋯ The Londrina ADL protocol was a valid and reliable protocol to evaluate ADL performance in subjects with COPD. It is a protocol that can be used in clinical practice and in future studies to investigate ADL outcomes, including those studies that require gas analysis and the wearing of a mask.