Respiratory care
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Observational Study
Is nasopharyngeal tube effective as interface to provide bilevel non-invasive ventilation?
The nasopharyngeal tube (NT) is a potential interface for noninvasive ventilation (NIV) available in all health care centers. The aim of the study was to describe our experience in the use of the NT for bi-level NIV in infants and its effectiveness. ⋯ Use of the NT showed 73% effectiveness, with few complications. The effectiveness was higher in e-NIV than i-NIV.
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In March 2013, the first patient infected with the avian influenza A H7N9 virus was identified in China. The infection progressed rapidly, and the patient died of ARDS. ⋯ When the viral infection was identified, strict procedures for disinfection and protection were carried out. None of the health care workers involved in the management of the patient were infected.
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Ventilator-associated pneumonia (VAP) is a nosocomial infection of multifactorial etiology and has a negative influence on cardiovascular surgery (CVS) outcomes. ⋯ Oral hygiene and mouth rinses with chlorhexidine under supervision of a dentist proved effective in reducing the incidence of VAP.
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Comparative Study Observational Study
Comparison of Bronchoscopic and Nonbronchoscopic Methods of Airway Culturing in Tracheostomized Children.
Distal airway secretions can be sampled by bronchoscopic bronchoalveolar lavage (B-BAL), blind protected BAL (BP-BAL), and tracheal aspiration (TA). We quantitatively compared the cultures of distal airway secretions from BP-BAL, B-BAL, and TA specimens, and assessed the efficacy of the three above methods in diagnosing bronchitis in tracheostomized children. ⋯ BP-BAL allows for more accurate sampling of lower airway secretions in tracheostomized children and is more accurate in the diagnosis of bronchitis in this group.
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Unilateral primary pulmonary hypoplasia is rare in adulthood. It is usually present in the neonatal period or in early childhood, and is characterized by a decreased number of bronchial segments and decreased/absent alveolar air space. ⋯ A thorough workup, including imaging modalities and bronchoscopy, disclosed a hypoplastic left lung, which had gone undiagnosed for 25 years. Embryological, clinical, and diagnostic aspects are briefly discussed.