Resp Care
-
Randomized Controlled Trial
Automated oxygen flow titration to maintain constant oxygenation.
One century after the introduction of the oxygen flow meter into clinical practice, we have developed a device, FreeO(2), that automatically titrates the oxygen flow delivered to spontaneously breathing patients, with the aim of maintaining a stable S(pO(2)). We evaluated this system in healthy subjects during induced hypoxemia. ⋯ In this model of induced hypoxemia, the FreeO(2) system that automatically titrates the oxygen flow was more efficient at maintaining the S(pO(2)) target, while ensuring a statistically significant reduction in the rates of severe hypoxemia and hyperoxia, in comparison with air or constant oxygen flow. These beneficial results were obtained with less oxygen, in comparison to a constant oxygen flow.
-
Randomized Controlled Trial
Response to albuterol MDI delivered through an anti-static chamber during nocturnal bronchospasm.
Decreasing electrostatic charge on valved holding chambers increases the amount of drug delivered. However, there are no data demonstrating that this increases bronchodilatation. ⋯ Delivery of albuterol through an anti-static chamber provides a clinically relevant improvement in bronchodilator response during acute, reversible bronchospasm such as nocturnal bronchospasm.
-
Randomized Controlled Trial Comparative Study
A prospective, comparative trial of standard and breath-actuated nebulizer: efficacy, safety, and satisfaction.
Nebulized drug delivery is a cornerstone of therapy for obstructive lung disease, but the ideal nebulizer design is uncertain. The breath-actuated nebulizer (BAN) may be superior to conventional nebulizers. This study compared the BAN to standard nebulizer with regard to efficacy, safety, and patient and respiratory therapist (RT) satisfaction. ⋯ Patients and RTs expressed greater satisfaction with the BAN, compared with standard nebulizer. Pre- and post-treatment vital signs did not differ between groups, but use of the BAN was associated with a shorter duration and a lower occurrence of adverse events. Taken together, these data support the use of the BAN for nebulized medication delivery.
-
Randomized Controlled Trial Multicenter Study
Findings from the MATREX study: a treatment protocol for the delivery of manual chest therapy in respiratory care.
One of the difficulties in comparing the numerous studies on manual chest therapy (MCT) is the wide variety of techniques used and terms employed to describe the intervention. This lack of consistency in therapeutic approach and the absence of defined tools for evaluation have led to a continued air of skepticism about its true value. This paper presents a treatment protocol used in a large randomized controlled trial examining the efficacy and cost effectiveness of MCT for patients hospitalized with exacerbations of COPD. ⋯ With respect to the essential elements of MCT, the treatment protocol used in the MATREX trial offers sufficient flexibility to the therapist, while being robust enough to maintain clinical trial integrity. The level of adherence by therapists indicates its professional acceptability with respect to delivering and evaluating this therapy.
-
Randomized Controlled Trial Comparative Study
The measurement of lung volumes using body plethysmography: a comparison of methodologies.
The statement of the American Thoracic Society and European Respiratory Society on the measurement of static lung volumes (SLV) suggests a preferred and alternate method for measuring and calculating SLV. ⋯ Differences in FRC, VC, RV, and TLC obtained using the preferred and alternate measurement methodologies exist in the clinical setting in select classification groups and individuals. Differing calculation methods dependent on measurement method used may be unnecessary.