Respiratory care
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Respiratory muscle function in patients with cystic fibrosis (CF) has been studied by measurement of maximal inspiratory pressure (P(Imax)), maximal expiratory pressure (P(Emax)), and the pressure-time index of the respiratory muscles (PTI(mus)). The maximum rate of pressure development (MRPD) during P(Imax) (MRPD-P(Imax)), MRPD during P(Emax) (MRPD-P(Emax)), maximal relaxation rate (MRR) during P(Imax) (MRR-P(imax)), and MRR during P(Emax) (MRR-P(Emax)) have not been studied in CF. Our aim was to study MRPD and MRR and investigate their possible application as accessory indices of respiratory muscle function in patients with CF. ⋯ The CF patients exhibited increased MRR and decreased MRPD during maximal respiratory effort, compared to controls. The differences in MRR-P(imax) and MRPD-P(Imax) between the controls and the complete group of CF patients were not significant. MRPD and MRR were significantly related to nutritional and pulmonary function impairment in CF patients. MRPD strongly correlated to maximal respiratory muscle pressures, and MRR strongly correlated to PTI(mus) in patients with CF. These findings suggest that CF patients are at increased risk of respiratory muscle fatigue. Regular determination of MRPD and MRR may be clinically useful in CF patients and help to initiate inspiratory muscle training and noninvasive ventilation.
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The introduction of reduced respiratory care may lead to worse long-term outcomes for patients undergoing prolonged mechanical ventilation (PMV) for more than 21 days. The objective of this study was to determine the survival for an integrated system of reduced intensive respiratory care (ISRIRC) by the Taiwan Bureau of National Health Insurance, in patients requiring PMV. ⋯ With the improvement of PMV technology in the early 2000s, the establishment of ISRIRC seems to be associated with an improved survival rate for subjects under PMV.
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Single-set resistance training (SSRT) improves strength and function in older adults with COPD. However, its effect on quality of life (QOL) has not been evaluated. This study evaluated the effect of SSRT on QOL in COPD patients enrolled in pulmonary rehabilitation (PR) and identified relationships between muscular strength, endurance and QOL. ⋯ The addition of SSRT to traditional PR does not affect overall improvements in QOL that are influenced primarily by an increase in upper body strength. Our findings suggest a threshold effect for exercise training, such that, once a threshold stimulus has been achieved, further improvements in QOL are not dose-dependent.
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Indoor air pollution and exposure to biomass smoke is a risk factor for pulmonary diseases among women in developing countries. We aimed to assess clinical and functional findings and exposure duration and to evaluate their relationships in patients who used biomass products as fuel and who presented to the clinic due to respiratory symptoms. ⋯ Biomass exposure can have effects on lung function test parameters. Animal dung use is primarily related to risk of deterioration of FEV(1)/FVC, when compared to other biomass fuels. Protective health measures should be taken by assessing the risks in areas where biomass exposure is intense, improving poor design of the stoves and ventilation, and switching to better clean energy sources such as natural gas and solar energy.