Respiratory care
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The Cystic Fibrosis Foundation recently deemed the use of extended-interval dosing (EID) of aminoglycosides acceptable for the treatment of cystic fibrosis (CF) pulmonary exacerbations. However, current practice across United States adult CF programs and affiliate programs is unknown. The objectives of this research are to characterize the practice trends, dosing strategies, therapeutic drug-monitoring practices, and adverse effect monitoring of the EID of aminoglycosides in the treatment of pulmonary exacerbations across United States adult CF programs. ⋯ This study indicates that the use of EID of aminoglycosides across United States adult CF programs has increased considerably since the publication of the CF pulmonary exacerbation guidelines and now appears to be the most common method for dosing aminoglycosides in adults with CF.
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Comparative Study
Effect of mask dead space and occlusion of mask holes on delivery of nebulized albuterol.
Infants and children with respiratory conditions are often prescribed bronchodilators. Face masks are used to facilitate the administration of nebulized therapy in patients unable to use a mouthpiece. Masks incorporate holes into their design, and their occlusion during aerosol delivery has been a common practice. Masks are available in different sizes and different dead volumes. The aim of this study was to compare the effect of different degrees of occlusion of the mask holes and different mask dead space on the amount of nebulized albuterol available at the mouth opening in a model of a spontaneously breathing child. ⋯ Neither decreasing the dead space of the mask nor occluding the mask holes increased the amount of nebulized albuterol captured at the mouth opening.
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Comparative Study
Humidification performances of two high flow nasal cannula devices: a bench study.
Delivering heated and humidified medical gas at 20-60 L/min, high-flow nasal cannula (HFNC) creates low levels of PEEP and ameliorates respiratory mechanics. It has become a common therapy for patients with respiratory failure. However, independent measurement of heat and humidity during HFNC and comparison of HFNC devices are lacking. ⋯ During bench use of HFNC, AH increased with increasing HFNC flow. When the inspiratory flow of spontaneous breathing exceeded the HFNC flow, AH was influenced by VT. At all experimental settings, AH remained > 30 mg/L.