Resp Care
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Randomized Controlled Trial Comparative Study
Short-term effects of humidification devices on respiratory pattern and arterial blood gases during noninvasive ventilation.
The impact of humidification devices on ventilatory and arterial blood gases parameters during noninvasive ventilation (NIV) remains controversial. The aim of the study was to compare the short-term impact of heat and moisture exchangers (HMEs) and heated humidifiers (HHs) during NIV for either hypercapnic or hypoxemic acute respiratory failure. ⋯ Use of an HME decreased CO(2) elimination during NIV, despite increased minute ventilation, especially in hypercapnic subjects.
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Randomized Controlled Trial
Does experience influence the performance of neonatal and pediatric manual hyperinflation?
Manual hyperinflation (MH) is used to improve mucociliary clearance and alveolar expansion in mechanically ventilated patients. Despite the popularity of MH, studies with adults have shown considerable variability in the results from its use. This study assessed if professional training on the application of MH influences its performance. ⋯ The experienced and inexperienced groups were similar in their overall MH performance; the only difference was the observation of the highest PIF in the results from the experienced group.
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Randomized Controlled Trial
Heated and humidified high-flow oxygen therapy reduces discomfort during hypoxemic respiratory failure.
Non-intubated critically ill patients are often treated by high-flow oxygen for acute respiratory failure. There is no current recommendation for humidification of oxygen devices. ⋯ Upper airway caliber was not significantly modified by HHFO₂, compared to standard oxygen therapy, but HHFO₂ significantly reduced discomfort in critically ill patients with respiratory failure. The system is usually preferred over standard oxygen therapy.
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Randomized Controlled Trial
Prophylactic use of helmet CPAP after pulmonary lobectomy: a prospective randomized controlled study.
Patients undergoing pulmonary lobectomy carry a high risk of respiratory complications after surgery. The postoperative prophylactic treatment with helmet CPAP may prevent postoperative acute respiratory failure and improve the P(aO(2))/F(IO(2)). ⋯ The prophylactic use of helmet CPAP improved the P(aO(2))/F(IO(2)), but the oxygenation benefit was not lasting. In our study, helmet CPAP was a secure and well tolerated method in subjects who underwent pulmonary lobectomy. It might be safely applied whenever necessary.
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Randomized Controlled Trial
Randomized controlled trial of a breath-activated nebulizer in patients with exacerbation of COPD.
Exacerbations of COPD (ECOPD) are characterized by increased dyspnea due to dynamic pulmonary hyperinflation. This study sought to determine whether the AeroEclipse II breath-activated nebulizer (BAN) would produce greater bronchodilator responses than a continuous flow small-volume nebulizer (SVN) in patients with ECOPD. ⋯ In this cohort of patients with ECOPD, a BAN was more effective in reducing lung hyperinflation and respiratory frequency than a continuous-flow SVN.