Resp Care
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Comparative Study
Nocturnal oximetry and transcutaneous carbon dioxide in home-ventilated neuromuscular patients.
Pulse oximetry alone has been suggested to determine which patients on home mechanical ventilation (MV) require further investigation of nocturnal gas exchange. In patients with neuromuscular diseases, alveolar hypoventilation (AH) is rarely accompanied with ventilation-perfusion ratio heterogeneity, and, therefore, oximetry may be less sensitive for detecting AH than in patients with lung disease. ⋯ Pulse oximetry alone is not sufficient to exclude AH when assessing home MV efficiency in patients with neuromuscular diseases. Both P(tcCO(2)) and S(pO(2)) should be recorded overnight as the first-line investigation in this population.
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Physical assessment of breathing is an important component of physical therapy evaluations. However, there are no standardized reference values of breathing movements available for use in clinical practice. The purpose of this study was to determine the 3-dimensional distances of observational points on the thorax and abdomen during breathing in healthy subjects and to assess the effects of age, posture, and sex on breathing movements. ⋯ We found that the observed breathing movements were related to the effects of age, sex, and posture. These findings are in agreement with those reported in previous studies. The results may be helpful in assessing breathing movement by physical examination.
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Tobacco smoke has detrimental effects on the respiratory system. This study investigated the associations of active and passive smoking with asthma symptoms in Hong Kong adolescents. ⋯ Adolescents who are heavy smokers and having parents and a best friend who smoke are more likely than others to have asthma symptoms. Both active and passive smoking are related to asthma symptoms in adolescents.
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Electrical activity of the diaphragm (E(di)) has been proposed as a parameter to evaluate respiratory function. Normative values of electrical activity of the diaphragm in full-term neonates are not known. This is a small case series to establish preliminary values of E(di) in term neonates and to determine how these values vary while awake and asleep and during feeding states. ⋯ These are the first preliminary values for E(di) in neonates. Higher E(di) peak while awake may reflect larger tidal volume to meet increased metabolic requirements when awake and active. Post-prandial lower E(di) peak and higher respiratory rate may indicate compensation for decreased tidal volume from increased intra-abdominal pressure. These data may be useful in identifying respiratory pathology in neonates and monitoring progression toward respiratory health.
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Patients with COPD and patients with bronchiectasis undertake airway clearance therapy and exercise as part of management, but the effect of these activities on gastroesophageal acid exposure is unknown. This study aimed to determine if positive expiratory pressure (PEP) therapy and standardized exercise tasks were associated with increased gastroesophageal reflux. ⋯ Episodes of gastroesophageal reflux may occur during physiotherapy tasks, including airway clearance therapy using mouthpiece PEP, the 6MWT, and a measure of upper limb movement. However, as these activities did not increase the frequency of these events, no modifications to these tasks to minimize the occurrence of gastroesophageal reflux are necessary.