Respiratory care
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The aim of this work was to describe the frequency and spectrum of sinopulmonary complications among subjects with primary immunodeficiency disorders. ⋯ Sinopulmonary complications are common in subjects with primary immunodeficiency. They can be serious and continue to occur even after proper treatment is initiated. The pulmonologist should play an important role in the management of subjects with primary immunodeficiency disorder.
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Randomized Controlled Trial
Exploring the Benefits to Caregivers of a Family-Oriented Pulmonary Rehabilitation Program.
COPD is a highly incapacitating disease, particularly among older people, implying significant burden for family caregivers. Involving caregivers in comprehensive pulmonary rehabilitation programs might benefit their functional coping to care demands; however, there is no objective evidence to sustain such assumption. This study is a secondary analysis aiming to analyze the effects of a family-based pulmonary rehabilitation program on close family caregivers of older subjects with COPD. ⋯ The findings provide valuable evidence to recommend the inclusion of COPD family caregivers in comprehensive pulmonary rehabilitation. Family-oriented pulmonary rehabilitation maximizes caregivers' adaptive coping and potentially prevents negative psychological outcomes; however, further research is needed.
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This paper will present a focused and personal history of physiologic monitoring, beginning with the discovery of modern anesthesia and its development from a technical practice to a scientific discipline. Emphasis will be on the essence of monitoring in the anesthesia evolution, and this work will attempt to answer the question of how to evaluate the impact of monitoring on patient outcome. ⋯ The invention and rapid spread of pulse oximetry will be highlighted and used as an example throughout, but the principles developed will apply to other monitors and patient monitoring in general. The problems created by monitoring alarms will also be discussed.
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Multicenter Study
Intratracheal Administration of Antimicrobial Agents in Mechanically Ventilated Adults: An International Survey on Delivery Practices and Safety.
Intratracheal antibiotic administration is increasingly used for treating respiratory infections. Limited information is available on delivery devices, techniques, and safety. ⋯ Intratracheal antibiotic administration is a common therapeutic modality in ICUs, but inadequate practices were widely encountered, independent of the level of experience with the technique. This suggests a need to develop standardization to reduce variability and improve safety and efficacy.
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Colorimetric end-tidal carbon dioxide (ETCO2) detectors can identify airway obstruction during noninvasive ventilation and successful intubation during newborn resuscitation. The resistance of these devices is not well described, and the information provided by manufacturers is incomplete. ⋯ We found significant differences in resistance between devices used to detect ETCO2 during resuscitation of premature infants. Future trials are needed to determine the effects of this resistance on work of breathing, particularly on very premature newborns receiving mask CPAP.