Respiratory care
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Review Meta Analysis Comparative Study
Thrombolysis Versus Anticoagulation for the Initial Treatment of Moderate Pulmonary Embolism: A Meta-Analysis of Randomized Controlled Trials.
Randomized trials and meta-analyses have reached conflicting conclusions regarding the risk benefit ratio of thrombolytic therapy or anticoagulant therapy in patients with moderate pulmonary embolism. To investigate the effect of initial thrombolysis and anticoagulant therapy in patients with moderate pulmonary embolism, we performed an updated meta-analysis. ⋯ Both mortality and pulmonary embolism recurrence are decreased with thrombolysis compared with heparin treatment in patients with moderate pulmonary embolism. The risk of non-major bleeding is increased, but the risk of major bleeding is not.
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Cough is part of life in patients with cystic fibrosis (CF). Weak coughing may add to increased respiratory disease that affects the mechanical properties of cough in these patients. In this study, we investigated cough characteristics in relation to forced expiratory flow/volume indices in CF. ⋯ The cough flow/volume maneuver reveals abnormalities in cough velocities and volume. A low secondary spike correlates with FEV1 severity level. The method may lead to earlier intervention to assist cough in CF.
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Despite the established causal relationship between tobacco smoking and cancer, many cancer patients continue to smoke after diagnosis. This partly reflects ignorance of the beneficial effects of smoking cessation, even after diagnosis. The aim of this study was to demonstrate the effects of continuing or quitting smoking in patients with diagnosed cancer. ⋯ Continued smoking after cancer diagnosis is related to reduced treatment efficacy and reduced survival, increased risk for second primary malignancies, and deterioration of quality of life.
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Randomized Controlled Trial Comparative Study
Open-Mouthpiece Ventilation Versus Nasal Mask Ventilation in Subjects With COPD Exacerbation and Mild to Moderate Acidosis: A Randomized Trial.
Open mouthpiece ventilation is efficacious in patients with neuromuscular disease. We used this ventilation technique in patients with exacerbations of COPD with mild to moderate acidosis. ⋯ Open mouthpiece ventilation is a useful technique and may prevent further deterioration of gas exchange in COPD patients with mild to moderate acidosis (similar to traditional NIV delivered by a nasal mask). www.chictr.org registration ChiCTR-TRC-12002672.
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Editorial
Analysis of Radial Artery Catheter Placement by Respiratory Therapists Using Ultrasound Guidance.
The use of ultrasound (US) guidance for radial artery cannulation has been shown to improve first attempt success rate, reduce time to successful cannulation, and reduce complications. We sought to determine whether properly trained respiratory therapists (RTs) could utilize US guidance for the placement of radial artery catheters. Primary outcome measurements were successful cannulation and first attempt success rate. Secondary outcomes included the effect of systolic blood pressure, prior attempts, palpable pulse strength, and gender in relation to US-guided radial artery cannulation success rates. ⋯ RTs can effectively utilize US technology to place radial artery catheters. Systolic blood pressure, prior attempts, and gender are not reliable predictors of success for US-guided radial artery cannulation. Training on the use of US should be strongly encouraged for all practitioners who place radial artery catheters.