Resp Care
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Randomized Controlled Trial
Automatic tube compensation as an adjunct for weaning in patients with severe neuroparalytic snake envenomation requiring mechanical ventilation: a pilot randomized study.
This study aimed to evaluate if the combination of pressure-support ventilation (PSV) and automatic tube compensation (ATC) is superior to PSV alone in weaning patients with severe neurotoxic snake envenoming receiving mechanical ventilation. ⋯ The addition of ATC to a standard PSV-based weaning protocol significantly shortened time needed to wean patients with severe neurotoxic snake envenoming, without changing the duration of medical care, morbidity, or mortality.
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Randomized Controlled Trial
Hallway versus treadmill 6-minute-walk tests in patients with chronic obstructive pulmonary disease.
The 6-min-walk test is widely used for functional evaluation of patients with chronic obstructive pulmonary disease (COPD), but the test requires a 30-m unobstructed hallway, which is not available in all institutions. A treadmill 6-min walk test might be more practical. ⋯ The hallway and treadmill walk tests are not interchangeable. We need further study and standardization of the treadmill 6-min walk test.
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To determine the relationship between tracheostomy tube in place after intensive-care-unit (ICU) discharge and hospital mortality. ⋯ In our critical-care setting, lack of decannulation of conscious tracheostomized patients before ICU discharge to the general ward was associated with higher mortality.
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Nutritional support is frequently neglected in a busy intensive care unit (ICU) with overworked staff. There is a paucity of investigations on ICU nutrition from India. ⋯ Calorie and protein delivery to critically ill patients remains less than the recommended values. Inadequate calorie delivery is associated with higher odds of mortality.
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An aerosol of budesonide inhalation suspension is delivered when used with various jet-nebulizer/compressor combinations. The constant introduction of new nebulizer/compressor combinations raises the question of whether the performance of these match the performance of existing devices. The aim of this study was to determine in vitro the inhaled mass and aerosol characteristics of budesonide inhalation suspension from a selection of jet-nebulizer/compressor combinations presently marketed in the United States, Europe, and Japan. ⋯ The in vitro budesonide mass collected on the inhalation filter and delivery characteristics differed considerably between the 30 nebulizer/compressor combinations. The present in vitro characterization of jet nebulizers can be used as a guidance for selection of jet-nebulizer/compressor combinations for delivery of the budesonide nebulization suspension in the home-care setting. Further investigations of new nebulizer/compressor combinations are warranted.