Respiratory care
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Achieving effective ventilation is challenging for anesthesia care providers and emergency medical personnel, as difficult mask ventilation and difficult intubation frequently occur. The aim of this study was to determine whether video-laryngoscopes equipped with a ventilation feature can produce effective ventilation. ⋯ Video-laryngoscopes equipped with a ventilation feature provided effective V(T) in simulated clinical scenarios. Further clinical study is required to validate these findings.
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Percutaneous dilational tracheostomy is normally a bronchoscope-guided procedure. The insertion of a bronchoscope into an endotracheal tube (ETT) affects resistance, flow, and alveolar pressure. To improve airway management and ventilation during percutaneous tracheostomy, we developed a double lumen endotracheal tube (DLET). The aim of this in vitro study was to compare the linear constant of the Rohrer equation (K1), the nonlinear constant of the Rohrer equation (K2), the inspiratory and expiratory airway resistance, and ventilatory and airway pressures using the DLET with different standard sized ETTs. ⋯ Use of the DLET during percutaneous dilational tracheostomy allows fiberoptic bronchoscopy without imposing excessive airway resistance. Reduced tube resistance during this procedure may confer additional safety in what is well known to be a hazardous procedure.
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Mid-frequency ventilation (MFV) is a mode of pressure control ventilation based on an optimal targeting scheme that maximizes alveolar ventilation and minimizes tidal volume (VT). This study was designed to compare the effects of conventional mechanical ventilation using a lung-protective strategy with MFV in a porcine model of lung injury. Our hypothesis was that MFV can maximize ventilation at higher frequencies without adverse consequences. We compared ventilation and hemodynamic outcomes between conventional ventilation and MFV. ⋯ In this pilot study, we demonstrate that MFV allows the use of higher breathing frequencies and lower V(T) than conventional ventilation to maximize alveolar ventilation. We describe the ventilatory or hemodynamic effects of MFV. We also demonstrate that the application of a decision support algorithm to manage MFV is feasible.
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Studies on the submaximal aerobic capacity of exclusive narghile smokers (ENS) seem necessary in view of effective prevention of cardiorespiratory diseases. The goal of the study was to assess, by 6-min walk test (6MWT) data, the submaximal aerobic capacity of ENS, to identify factors influencing their 6-min walk distance (6MWD), and to compare their data with those of a healthy non-smoker (HNS) group. ⋯ Narghile use may play a role in reducing submaximal aerobic capacity. The present study suggests that a program of pulmonary rehabilitation is an excellent axis to follow.
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Observational Study
Association of Influenza-Like Illness and Climatic Parameters With Hemoptysis.
Although some authors have suggested that there is some seasonal periodicity of hemoptysis, or relation to respiratory tract infections, the association of influenza or climatic parameters with hemoptysis has been poorly investigated. Our aim was to describe the relationship between influenza and climatic parameters with severe hemoptysis that required bronchial artery embolization (BAE). ⋯ There is a strong long running relationship between severe hemoptysis and low monthly mean temperature. A weaker association of hemoptysis with influenza activity was also found.