Resp Care
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Pathogens in healthcare settings can be transmitted via skin contact and environmental media. This study investigates bacterial contamination rate on surfaces of mechanical ventilator systems and bedside equipment. An experimental study evaluates the effectiveness of 75% alcohol in killing bacteria on surfaces. ⋯ The surfaces of ventilator systems, including faceplates, Y-pieces, and water traps, must be disinfected frequently (at least every 8 h) to control bacterial growth. Disinfection using 75% alcohol spray with air drying effectively decreased S. aureus on ventilator system surfaces.
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Randomized Controlled Trial
A randomized trial of noninvasive positive end expiratory pressure in patients with acquired immune deficiency syndrome and hypoxemic respiratory failure.
Acquired immunodeficiency syndrome (AIDS) is a pandemic disease commonly associated with respiratory infections, hypoxemia, and death. Noninvasive PEEP has been shown to improve hypoxemia. In this study, we evaluated the physiologic effects of different levels of noninvasive PEEP in hypoxemic AIDS patients. ⋯ AIDS patients with hypoxemic respiratory failure improve oxygenation in response to a progressive sequential elevation of PEEP (up to 15 cm H(2)O). However, corresponding elevations in P(aCO(2)) limit the recommended level of PEEP to 10 cm H(2)O. At a level of 5 cm H(2)O, PSV promotes an improvement in the subjective sensation of dyspnea regardless of the PEEP level employed.
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CPAP is the first choice for most patients with obstructive sleep apnea (OSA), but the adherence to CPAP is suboptimal. The purpose of this study was to assess the adherence to CPAP therapy of Chinese OSA patients with CPAP therapy. ⋯ The CPAP adherence is low in Tianjin, China. Only one half of these patients remained adherent to the treatment, and the other one half of these patients either never initiated the treatment or had abandoned CPAP use. To improve CPAP adherence, the medical staff should pay attention to making the titration trial a comfortable first CPAP experience for the patients. It is also very important to give the patients education and support about CPAP use in the follow-up, especially early on in this treatment.