Respiratory care
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Sampler filling time begins with the initial flash of blood in the needle hub until the preset sampler volume is obtained. Previous studies have shown statistically significant differences between arterial and venous sampler filling times, but included only a few subjects with abnormal blood pressures. ⋯ There is a significant difference between arterial and venous filling rates. There was no relationship between filling time and abnormal mean arterial pressure. Regardless of the arterial pressure, the arterial sampler filling time can be used as an indicator of a successful arterial puncture at the bedside.
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Prolonged mechanical ventilation, longer hospital stay, and a lower rate of home discharge have been reported with patient-ventilator asynchrony in medical patients. Though commonly encountered, asynchrony is poorly defined within the traumatically injured population. ⋯ Ventilator asynchrony is common in trauma patients. It may be associated with SIMV with a set breathing frequency of ≥ 10 breaths/min, though not with longer mechanical ventilation, longer stay, or discharge disposition. (ClinicalTrials.gov NCT01049958).
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Exercise intolerance is the hallmark of COPD. Static lung hyperinflation and increased dynamic hyperinflation during exercise are associated with reduced functional capacity in COPD patients. Inspiratory capacity correction for the total lung capacity, defined as inspiratory fraction (IF), may be functionally more representative than other traditional indices in these patients. ⋯ Compared to FEV1, IF is a robust factor to reflect lung hyperinflation and to estimate the exercise capacity of subjects with stable moderate to severe COPD.
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Therapeutic gases and other modalities delivered by inhalation may affect the accuracy of capnographic measurements in 2 ways. First is the specificity of the measurement of CO2 within the device, and second is the dilution effect of supplemental gases in the ambient air during CO2 sampling by the device. Our goal was to determine if variables such as inhaled gas composition, gas flows delivered via non-rebreather mask, and mouth open or closed affect measurements of end-tidal CO2 pressure (PETCO2) measured with the Capnostream 20 capnograph. ⋯ In normal subjects, PETCO2 measurements with the Capnostream 20 were not affected by heliox or gas flow at 10 or 15 L/min through a non-rebreathing mask.