Respiratory care
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Previous bench studies suggest that dynamic hyperinflation may occur if intrapulmonary percussive ventilation (IPV) is superimposed on mechanical ventilation in volume controlled continuous mandatory ventilation (VC-CMV) mode. We tested the hypothesis that pressure controlled continuous mandatory ventilation (PC-CMV) can protect against this risk. ⋯ When IPV is added to mechanical ventilation, the risk of hyperinflation is greater with VC-CMV than with PC-CMV. We recommend using PC-CMV to deliver IPV and adjusting the trigger variable to avoid autotriggering.
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Patients with congestive heart failure or COPD may share an increased response in minute ventilation (V̇E) to carbon dioxide output (V̇CO2 ) during exercise. The goal of this study was to ascertain whether the V̇E/V̇CO2 slope and V̇E/V̇CO2 intercept can discriminate between subjects with congestive heart failure and those with COPD at equal peak oxygen uptake (V̇O2 ). ⋯ The ventilatory response to V̇CO2 during exercise was significantly different between subjects with congestive heart failure and those with COPD in terms of the V̇E/V̇CO2 slope with moderate-to-severe reduction in exercise capacity and in terms of the V̇E/V̇CO2 intercept regardless of exercise capacity.
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Fatigue is a frequent symptom of patients with sarcoidosis. The origin of fatigue associated with sarcoidosis is unclear. The aim of this study was to assess the impact of affected organs, medication, and comorbidity on fatigue related to sarcoidosis. ⋯ It is important to consider that multiple clinical factors, especially comorbidities, contribute to the high degrees of fatigue in sarcoidosis.
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Observational Study
Endurance time is the most responsive exercise measurement in idiopathic pulmonary fibrosis.
Although pulmonary rehabilitation (PR) has been reported to improve exercise capacity in patients with idiopathic pulmonary fibrosis, it is unknown which exercise measurement is the most responsive for evaluation of PR efficacy. The purpose of this study was to compare the responsiveness of 5 exercise measurements by evaluating the efficacy of PR in subjects with idiopathic pulmonary fibrosis. ⋯ ET is the most responsive exercise measurement for evaluating PR efficacy in patients with idiopathic pulmonary fibrosis.
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The aim of the present study was to assess how volume-oriented incentive spirometry applied to patients after a stroke modifies the total and compartmental chest wall volume variations, including both the right and left hemithoraces, compared with controls. ⋯ Incentive spirometry promotes increased expansion in all compartments of the chest wall and reduces asymmetric expansion between the right and left parts of the pulmonary rib cage; therefore, it should be considered as a tool for rehabilitation.