Respiratory care
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Randomized Controlled Trial
Lung volume changes during cleaning of closed endotracheal suction catheters: a randomised crossover study using electrical impedance tomography.
Airway suctioning in mechanically ventilated patients is required to maintain airway patency. Closed suction catheters (CSCs) minimize lung volume loss during suctioning but require cleaning post-suction. Despite their widespread use, there is no published evidence examining lung volumes during CSC cleaning. The study objectives were to quantify lung volume changes during CSC cleaning and to determine whether these changes were preventable using a CSC with a valve in situ between the airway and catheter cleaning chamber. ⋯ When there is no valve between the airway and suction catheter, cleaning of the CSC results in significant derangements in lung volume. Therefore, the presence of such a valve should be considered essential in preserving lung volumes and uninterrupted ventilation in mechanically ventilated patients.
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Observational Study
REPRODUCIBILITY OF CADENCE FREE SIX-MINUTE STEP TEST IN SUBJECTS WITH COPD.
Six-minute step test (6MST) has been used to assess functional capacity in chronic conditions; however, its reproducibility in the COPD population has not been evaluated. Our study objective was to evaluate 6MST reproducibility. ⋯ 6MST proved to be reproducible in the COPD population when performed by the same assessor.
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Observational Study
The Correlation Between Esophageal and Abdominal Pressures in Mechanically Ventilated Patients Undergoing Laparoscopic Surgery.
Intrathoracic pressure in patients undergoing laparoscopic surgery may be affected by intra-abdominal pressure during surgery. We investigated the relationship between intra-abdominal pressure (Pabd) and esophageal pressure (Pes) in mechanically ventilated patients undergoing laparoscopic surgery. ⋯ There was a limited correlation between baseline Pes and Pabd in patients undergoing elective laparoscopic surgery, suggesting a limited value of Pabd measurements in the management of mechanically ventilated patients.
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The 2-min walk test (2MWT) has been used in several health conditions, but the interpretation of its results is limited due to a lack of reference values. The aim of this study was to establish a reference equation to predict the distance walked (DW) in the 2MWT for healthy adults and the elderly and to test its reproducibility. ⋯ We established a prediction equation that may be used as a reference to interpret performance on the 2MWT of adults and the elderly with different health conditions.
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Observational Study
Long Term Acute Care Patients Weaning From Prolonged Mechanical Ventilation Maintain Circadian Rhythm.
Circadian rhythm regulates many physiologic and immunologic processes. Disruption of these processes has been demonstrated in acutely ill, mechanically ventilated patients in the ICU setting. Light has not been studied as an entraining stimulus in the chronically mechanically ventilated patient. The purpose of this study was to determine the association of naturally occurring ambient light levels in a long-term acute care (LTAC) hospital with circadian rhythm in patients recovering from critical illness and requiring prolonged mechanical ventilation (PMV). ⋯ Despite requiring continued high-level care and a prolonged stay in a medical facility, patients recovering from critical illness and actively weaning from PMV maintain their circadian rhythm in phase with normal diurnal variations of light.