Resp Care
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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
A randomized trial of noninvasive positive end expiratory pressure in patients with acquired immune deficiency syndrome and hypoxemic respiratory failure.
Acquired immunodeficiency syndrome (AIDS) is a pandemic disease commonly associated with respiratory infections, hypoxemia, and death. Noninvasive PEEP has been shown to improve hypoxemia. In this study, we evaluated the physiologic effects of different levels of noninvasive PEEP in hypoxemic AIDS patients. ⋯ AIDS patients with hypoxemic respiratory failure improve oxygenation in response to a progressive sequential elevation of PEEP (up to 15 cm H(2)O). However, corresponding elevations in P(aCO(2)) limit the recommended level of PEEP to 10 cm H(2)O. At a level of 5 cm H(2)O, PSV promotes an improvement in the subjective sensation of dyspnea regardless of the PEEP level employed.
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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
Chair-sitting exercise intervention does not improve respiratory muscle function in mechanically ventilated intensive care unit patients.
Chair-sitting may allow for more readily activated scalene, sternocleidomastoid, and parasternal intercostal muscles, and may raise and enlarge the upper thoracic cage, thereby allowing the thoracic cage to be more easily compressed. ⋯ Six days of chair-sitting exercise training did not significantly improve respiratory muscle function in mechanically ventilated patients.