Respiratory care
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A pneumatic tube system (PTS) is a cost-effective, rapid transport modality that utilizes induced pressure changes. We evaluated the clinical importance of 2 transport modalities, human courier and PTS, for blood gas specimens. ⋯ The difference in the PO2 and PaCO2 of paired (walked vs tubed) arterial and venous blood gas specimens demonstrated a slight bias. PaCO2 values demonstrated the greatest bias, however not clinically important. Thus, PTS transport does not impact clinical interpretations of blood gas values.
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In several studies, low spirometric levels have been shown to increase the success rates of smoking cessation, whereas other studies have indicated that pulmonary function has no effects on quitting smoking. Given the fact that there are contradictory results on this subject, we aimed to investigate the effect of identifying airway obstruction via spirometry and its explanation to subjects on the success rate of smoking cessation in the short term. ⋯ Advanced age and the presence of obstruction on PFT increase the success of smoking cessation. Pulmonary function tests should be performed on all patients who apply to smoking cessation out-patient clinics, and patients should be informed about their condition.
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The impulse oscillometry system is a noninvasive method of evaluating respiratory mechanics that is being increasingly used in the pediatric population. To date, no reference equations have been developed for healthy Brazilian children and adolescents. The purpose of the study was to determine the reference equations for impulse oscillometry system parameters in healthy children and adolescents. ⋯ Reference equations were developed for males and females, and height was the most influential predictor variable for most impulse oscillometry system parameters in the population studied.
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Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and fatal interstitial lung disease associated with poor prognosis and limited effective treatment options. Reliable predictors of outcome in daily clinical practice are needed to determine high-risk patients for urgent lung transplantation referral. This study aimed to identify practical prognostic predictors of mortality using cardiopulmonary exercise testing (CPET) in IPF subjects. ⋯ This study provides simple, practical, and novel cut-off points for CPET as predictors of prognosis to identify high-risk IPF subjects. Impairment in exercise capacity and abnormal ventilatory responses during CPET were associated with poorer survival in IPF subjects. The findings suggest considering the use of CPET for IPF risk stratification and prediction of prognosis. (ClinicalTrials.gov registration NCT01499745.).
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Research on subthreshold compliance with positive airway pressure (PAP) therapy in sleep apnea patients may inform clinical sleep medicine practice. We retrospectively assessed compliant and subthreshold compliant sleep apnea subjects to test whether regular but fewer hours of PAP use would demonstrate clinically meaningful improvements and correlate with outcomes. ⋯ In a clinical sample, 86% of sleep apnea subjects regularly used PAP, but adherence was 63%. Regular users showed clinical treatment effects and potential dose-response relationships, suggesting that the term use offers advantages over the term adherence. Currently, subthreshold compliance may not merit insurance coverage in many countries, an issue affecting many sleep apnea patients.