Resp Care
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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.
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Randomized Controlled Trial
Evaluation of an alternative chest physiotherapy method in infants with respiratory syncytial virus bronchiolitis.
We proposed a new chest physiotherapy (CPT) secretion clearance method to treat respiratory syncytial virus bronchiolitis in infants. Our new CPT method consists of 15 prolonged slow expirations, then 5 provoked cough maneuvers. ⋯ Our new CPT method showed short-term benefits to some respiratory symptoms of bronchial obstruction in infants with acute respiratory syncytial virus bronchiolitis.
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Randomized Controlled Trial
Remifentanil improves breathing pattern and reduces inspiratory workload in tachypneic patients.
Properly titrated opiates decrease respiratory rate but do not affect tidal volume or induce respiratory acidosis. ⋯ Remifentanil improved respiratory pattern and decreased inspiratory muscles effort in patients with tachypnea or rapid shallow breathing, but did not affect oxygenation or sedation. Though the acid-base balance did not show clinically relevant changes on average, we cannot exclude the possibility that remifentanil might prolong weaning in hypercapnic patients. (Clinical-Trials.gov registration NCT00665119.)
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Randomized Controlled Trial Comparative Study
Tracheal secretion management in the mechanically ventilated patient: comparison of standard assessment and an acoustic secretion detector.
Standard indications for endotracheal suctioning are often based on clinical judgment on the deterioration of the patient's condition, and/or routine suctioning. TBA Care is a secretion detector that analyses airway sounds and indicates the need for suctioning. ⋯ TBA Care seems to give valid and timely indications for suctioning, anticipating clinical deterioration due to secretion retention and reducing unnecessary suctionings. (ClinicalTrials.gov registration NCT00932776.).
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Randomized Controlled Trial
Pilot study of a new device to titrate oxygen flow in hypoxic patients on long-term oxygen therapy.
The O(2) Flow Regulator (Dima, Bologna, Italy) is a new automated oxygen regulator that titrates the oxygen flow based on a pulse-oximetry signal to maintain a target S(pO(2)). We tested the device's safety and efficacy. ⋯ The O(2) Flow Regulator may be a safe and effective alternative to manual oxygen titration during exercise in hypoxic patients. It provided stable S(pO(2)) and avoided desaturations in our subjects.