Respiratory care
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Randomized Controlled Trial Multicenter Study
Tobramycin Inhalation Powder in Cystic Fibrosis Patients: Response by Age Group.
Tobramycin powder for inhalation (TIP) is a drug-device combination designed to reduce treatment time and improve ease of use compared with tobramycin inhalation solution (TIS) in cystic fibrosis (CF) patients. However, the ability of patients to use dry powder inhalers, and the efficacy of the treatments, may vary by age. ⋯ TIP is comparable to TIS in efficacy outcomes and safety profile but had greater patient satisfaction in all the age groups.
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Randomized Controlled Trial
Randomized controlled trial of exercise training in chronic respiratory failure due to kyphoscoliosis.
Research has provided evidence for the safety, feasibility, and efficacy of exercise training in patients with COPD. However, little is known about the impact of exercise training in patients with chronic respiratory failure due to kyphoscoliosis. We evaluated the effect of an exercise training program on exercise capacity, muscle strength, dyspnea, and quality-of-life indices in subjects with chronic respiratory failure due to kyphoscoliosis. ⋯ In patients with chronic respiratory failure due to kyphoscoliosis, exercise training improved exercise capacity, peripheral muscle strength, dyspnea, and quality of life. (Deutschen Register Klinischer Studien DRKS00000443).
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Randomized Controlled Trial Comparative Study
Comparison of distinct incentive spirometers on chest wall volumes, inspiratory muscular activity and thoracoabdominal synchrony in the elderly.
Aging causes physiological and functional changes that impair pulmonary function. Incentive spirometry is widely used for lung expansion, but the effects of volume-oriented incentive spirometry (VIS) versus flow-oriented incentive spirometry (FIS) on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly are poorly understood. We compared VIS and FIS in elderly subjects and healthy adult subjects. ⋯ Incentive spirometry performance is influenced by age, and the differences between elderly and healthy adults response should be considered in clinical practice.
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Observational Study
Family reliance on physicians' decisions in life-sustaining treatments in acute-on-chronic respiratory diseases in a respiratory intensive care unit: A single center study.
In ICUs, many patients are unable to participate in decision-making regarding life-sustaining treatments. This study evaluated the opinions of family members about family and physician participation in life-sustaining treatment decisions and examined factors that influence those decisions. ⋯ A majority of the families relied on physicians to help in the decision-making process about life-sustaining treatments in patients with acute-on-chronic respiratory diseases. From the family's point of view, the principle of autonomy can be exercised by delegating the decision-making process to the physician. To assume a uniform ethical conduct is to antagonize the definition of ethics.