Respiratory care
-
The influence of percutaneous tracheostomy on ventilator-dependence and clinical outcomes has been investigated in a number of studies. However, except for the variations during the procedure, the impact of tracheostomy on gas exchange has been scarcely explored. We investigated the effect of tracheostomy on respiratory function in a cohort of ICU patients. ⋯ Percutaneous tracheostomy did not worsen gas exchange in a cohort of ICU patients. In hypoxemic patients, tracheostomy appeared to improve oxygenation and ventilation.
-
Comparative Study
Physician-ordered aerosol therapy versus respiratory therapist-driven aerosol protocol: the effect on resource utilization.
The utilization of respiratory therapist (RT) driven protocols for single interventions, such as oxygen titration and bronchopulmonary hygiene, and protocols consisting of multiple interventions have been associated with improvements in resource utilization. Based on this, we started a quality improvement project to transition the delivery of respiratory care services from physician-ordered treatments to RT-driven protocols. During the first phase of our quality improvement project, we compared the frequency of bronchodilator administration and its associated costs, between a physician-ordered bronchodilator strategy and a RT-driven bronchodilator protocol strategy. ⋯ The application of an RT-driven bronchodilator protocol can hypothetically reduce the frequency of bronchodilator treatments, compared with a physician-ordered strategy, resulting in a theoretical reduction of costs in patients who require bronchodilator therapy.
-
Indoor air pollution and exposure to biomass smoke is a risk factor for pulmonary diseases among women in developing countries. We aimed to assess clinical and functional findings and exposure duration and to evaluate their relationships in patients who used biomass products as fuel and who presented to the clinic due to respiratory symptoms. ⋯ Biomass exposure can have effects on lung function test parameters. Animal dung use is primarily related to risk of deterioration of FEV(1)/FVC, when compared to other biomass fuels. Protective health measures should be taken by assessing the risks in areas where biomass exposure is intense, improving poor design of the stoves and ventilation, and switching to better clean energy sources such as natural gas and solar energy.