Respiratory care
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The fundamental goals of mechanical ventilation are to improve pulmonary gas exchange and relieve respiratory distress, thus permitting lung and airway healing, while at the same time lessening the risk for iatrogenic complications. This review will summarize some of the advances in mechanical ventilation in 2016, with a particular focus on ventilator-associated clinical challenges and outcomes.
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Comparative Study
Spiritual Well-Being and Correlated Factors in Subjects With Advanced COPD or Lung Cancer.
Spiritual care for patients with COPD has rarely been discussed, and thus much remains unknown about their needs. The aims of this study were to identify the factors associated with spiritual well-being and to compare the levels of spiritual well-being between subjects with advanced COPD and those with inoperable lung cancer. ⋯ These results suggest that subjects with advanced COPD experience spiritual well-being similar to that of subjects with inoperable lung cancer.
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Lung clearance index (LCI), a measure of ventilation inhomogeneity derived from a multiple-breath washout test, is a promising tool for assessing airway function in patients with non-cystic fibrosis bronchiectasis. However, it is unknown whether ventilation inhomogeneity could improve after successful elimination of excessive secretions within bronchiectasis. The objective of this work was to assess the short-term effects of lung secretion clearance using the autogenic drainage technique on standard lung function tests and LCI in subjects with non-cystic fibrosis bronchiectasis. ⋯ In adults with non-cystic fibrosis bronchiectasis and mucus hypersecretion, autogenic drainage improved ventilation inhomogeneity. LCI change may be the result of the maximum recruited lung volume and the amount of cleared mucus secretion. (ClinicalTrials.gov registration NCT02411981.).
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A ventilator includes the function to measure flow velocity. We aimed to compare the predictive accuracy for re-intubation diagnosed by cough peak flow (CPF) measured by a spirometer and a ventilator. ⋯ CPF measurement by a ventilator was convenient, affordable, and safe. It had a predictive accuracy for re-intubation similar to that of a spirometer.
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Noninvasive ventilation (NIV) is an important modality in clinical practice and is extensively studied. The growth of literature related to NIV over the past 20 years has made it difficult for clinicians to stay up to date with current best practice. This article will summarize some of the important NIV literature published in 2016 and describe any impact it may have related to the clinical use of NIV.