Respiratory care
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The reduction of instrumental dead space is a recognized approach to preventing ventilation-induced lung injury in premature infants. However, there are no published data regarding the effectiveness of instrumental dead-space reduction in endotracheal tube (ETT) connectors. We tested the impact of the Y-piece/ETT connector pairs with reduced instrumental dead space on CO2 elimination in a model of the premature neonate lung. ⋯ Both methods of instrumental dead-space reduction led to improvements in artificial lung ventilation. Negative effects on resistance and work of breathing appeared minimal. Further testing in vivo should be performed to confirm the lung model results and, if successful, translated into clinical practice.
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Due to the heterogeneity of cystic fibrosis (CF), the longer survival observed in cohorts of adult subjects, and inter-population variations, there is a clear need to seek further information about clinical outcomes and prognostic factors in different cohorts of subjects with CF. Our objectives were to evaluate clinical outcomes and prognostic factors in a cohort of adult subjects with CF after a 7-y follow-up period and investigate longitudinal changes in clinical scores, spirometry, 6-min walk test performance, and pulmonary artery systolic pressure as assessed by Doppler echocardiography. ⋯ After 7 y of follow-up, 20% of subjects with CF had a poor outcome. Pulmonary artery systolic pressure of ≥42 mm Hg and FEV1 of ≤30% were the most significant prognostic predictors of poor outcome. Clinical and functional deterioration was observed in survivors.
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Multicenter Study
Complications of Convex-Probe Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: A Multi-Center Retrospective Study.
Infrequent serious complications of convex-probe endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) have been reported. The aim of this study was to assess serious complications related to convex-probe EBUS-TBNA and to determine the complication rate in a large group of subjects. ⋯ Convex-probe EBUS-TBNA is a safe method in general. However, serious complications, including infections, can be encountered rarely. All precautions should be taken for complications before and during the procedure.
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Exercise testing is recommended before prescribing individualized exercise intensity. However, there are few data demonstrating how exercise test responses are translated into individualized training intensity using a simple method. We previously developed a simple method to rate dyspnea called the count scale, including the count scale number (CSN) and count scale time. The purpose of this study was to assess the CSN for translation of exercise test response to training intensity. ⋯ Exercise guided by the CSN alone could result in a given heart rate response, suggesting that the CSN is a simple and practical tool in translating exercise test results into individualized training intensity. With the CSN as the intensity indicator, patients can exercise safely and effectively.
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Obstructive sleep apnea (OSA) is a highly prevalent breathing disorder in sleep. It is characterized by intermittent hypoxia leading to hypoxemia, hypercapnia, sleep fragmentation, and increased respiratory efforts. We evaluated the relationship between OSA and myeloperoxidase activity, the oxidative stress index (OSI), total anti-oxidative capacity (TAC), and total oxidative capacity (TOC). ⋯ In our study, there were no differences in studied parameters between control and OSA groups. Furthermore, our low number of cases was a restrictive factor. Further studies should be undertaken to clarify this relation.