Resp Care
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Randomized Controlled Trial Multicenter Study
Preventive use of noninvasive ventilation after extubation: a prospective, multicenter randomized controlled trial.
The effectiveness of noninvasive ventilation (NIV) after extubation in preventing post-extubation respiratory failure is still controversial. ⋯ Preventive use of NIV after extubation in patients who passed spontaneous breathing trial did not show benefits in decreasing extubation failure rate or the mortality rate.
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Randomized Controlled Trial Comparative Study
A randomized trial of conventional chest physical therapy versus high frequency chest wall compressions in intubated and non-intubated adults.
Conventional chest physical therapy (CCPT), applied by therapists using cupped hands to perform percussion, is commonly used in hospitalized adults. However, increased work load demands and occupational health concerns (eg, carpal tunnel syndrome) limit the overall utilization of this therapy. Therefore, we conducted a study to compare the overall effectiveness of CCPT to high-frequency chest wall compressions (HFCWC) applied via a vibratory vest. ⋯ This study was inadequately powered for the primary outcome of interest and hence we cannot make recommendations on the preferential use of HFCWC or CCPT for intubated and non-intubated adult patients. HFCWC was associated with statistically better comfort scores. (ClinicalTrials.gov registration NCT00717873.).
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Randomized Controlled Trial Comparative Study
AccuO2 oximetry-driven oxygen-conserving device versus fixed-dose oxygen devices in stable COPD patients.
Because standard home oxygen (O2) systems deliver O2 at fixed rates, these systems are not designed to ensure optimal oxygen delivery based on physiologic need. We tested the ability of the AccuO2 (OptiSat Medical, Minneapolis, Minnesota), a portable, closed-loop, oximetry-driven, O2-conserving device to maintain SpO2 at ≥ 90%, compared to continuous-flow oxygen and a standard O2-conserving device (CR-50, Puritan-Bennett, Pleasanton, California). ⋯ Compared to continuous-flow O2 or the CR-50, the AccuO2 maintained SpO2 closer to the target, and AccuO2 had a higher conservation ratio than CR-50.
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Randomized Controlled Trial Comparative Study
Effects of 2 exercise training programs on physical activity in daily life in patients with COPD.
The effects of different exercise training programs on the level of physical activity in daily life in patients with COPD remain to be investigated. ⋯ Neither training program significantly improved time spent active or energy expenditure in daily life. The training regimens similarly improved quality of life and functional status. Exercise capacity and muscle force significantly improved only in the high-intensity endurance-and-strength group.
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Randomized Controlled Trial Comparative Study
Volume-targeted versus pressure-targeted noninvasive ventilation in patients with chest-wall deformity: a pilot study.
Long-term noninvasive ventilation (NIV) is an effective treatment for patients with chronic respiratory failure due to chest-wall deformity, but it is unknown if the time required for the patient to adjust to long-term NIV depends on whether the NIV is volume-targeted or pressure-targeted. ⋯ There was no significant difference in days needed to successfully establish volume NIV versus pressure NIV in patients with chest-wall deformity. However, two patients switched successfully from volume NIV to pressure NIV, which suggests that they preferred pressure NIV.