Resp Care
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Pressure support ventilation (PSV) should be applied so that the inspiratory muscles are unloaded appropriately. We developed a computerized advisory system that assesses the load on the inspiratory muscles to spontaneously inhale, reflected by the automatically and noninvasively measured work of breathing per minute, and tolerance for that load, reflected by spontaneous breathing frequency and tidal volume, in a fuzzy-logic algorithm that provides recommendations for setting PSV. We call this a load and tolerance strategy for determining PSV. ⋯ A load and tolerance strategy with a computerized PSV advisory system provided valid recommendations for setting PSV to unload the inspiratory muscles, and the recommendations were essentially the same as the recommendations from experienced critical-care RRTs. The PSV advisory system operates continuously and automatically and may be useful in clinical environments where experts are not always available.
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Mixing of nebulized drugs is common in real life, but its consequences on aerosol output and granulometry are poorly known. ⋯ Both the SideStream and VentStream-Pro have good aerosol performance in nebulizing budesonide or beclomethasone dipropionate alone, and when mixed with albuterol and ipratropium bromide.
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Journal clubs are employed by education and healthcare institutions to facilitate learning about study design, to teach critical reading of the literature, and to help trainees and practitioners keep abreast in their fields. Our respiratory care department initiated a journal club that was open to all respiratory therapists in the community. The articles were selected by the journal club coordinator and posted on the club's web site. However, attendance remained poor despite changes in venue, time, and day of the week. In Washington State, respiratory therapists are required to obtain continuing respiratory care education credits (CRCEs), so we hypothesized that offering American Association for Respiratory Care CRCEs for journal club attendance would increase participation. ⋯ Providing CRCE credits for attendance was associated with increased participation in our departmental journal club.