Resp Care
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Performance of Flutter® (Axcan Scandipharm Inc, Birmingham, AL), Acapella® (Smiths Medicals Inc, Rockland, MA) and Quake® (Thayer Medical, Tucson, AZ) were compared at similar frequencies and amplitudes of oscillations at nine angles of the device in clearing simulated mucus inside a tracheal model (trachea) oriented at three angles with or without simulated constrictions in airway upstream of trachea. ⋯ Mucus clearance can be significantly enhanced by coughing through oscillating positive expiratory devices that generate high amplitude oscillations at moderate frequencies, increasing frontal depths of mucus facing airflow and slightly increasing resistance to airflow in airways in COPD patients.
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Randomized Controlled Trial
Effect of slow expiration with glottis opened in lateral posture (ELTGOL) on mucus clearance in stable patients with chronic bronchitis.
Slow expiration with glottis opened in lateral posture (ELTGOL, l'expiration lente totale glotte ouverte en infralatéral) has been used in clinical practice to improve mucus clearance from peripheral airways. The purpose of this crossover study was to evaluate the effect of ELTGOL on mucus clearance of right and left lungs, especially of peripheral lung areas, in stable patients with chronic bronchitis. ⋯ ELTGOL was efficient in increasing peripheral airway clearance in dependent lung of patients with chronic bronchitis, most of them with mild to moderate COPD.
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Respiratory therapist (RT) is a nascent career in China, so little information is available about intensive care unit (ICU) respiratory care resources and practices, requirements for RTs, and barriers to recruit RTs. ⋯ ICU respiratory care equipment and the knowledge to use them are insufficient. Important differences exist in respiratory care practice, which is mostly provided by nurses and physicians. RTs have been gradually recognized and accepted by ICU staff, while professional training and education are needed.
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Review Meta Analysis
Diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle biopsy in mediastinal lymphadenopathy: a systematic review and meta-analysis.
To perform a systematic review and meta-analysis of prospectively conducted studies to define diagnostic performance of endobronchial ultrasound-guided transbronchial needle biopsy (EBUS-TBNB) in mediastinal and hilar lymphadenopathy. ⋯ Evidence of moderate quality confirms the high diagnostic performance of EBUS-TBNB for mediastinal and hilar lymphadenopathy, both in malignant and non-malignant conditions. Available evidence also demonstrates the safety of this procedure.