Respiratory care
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Exercise training is an effective and low-cost tool for COPD rehabilitation. Thus, validating a non-exhaustive method to determine a patient's anaerobic threshold would be a very interesting tool in practical settings. We aimed to test the reproducibility of critical velocity values determined in a non-exhaustive manner (CVNE) and tolerance for exercise performed at this physiological marker in subjects with COPD. ⋯ Although most of the subjects presented good tolerance for exercise at CVNE, fair levels of reproducibility were observed in subjects with COPD, even using lactate. Thus, the use of CVNE determined through double 3-min efforts should be considered with caution.
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Observational Study
Air Travel for Subjects Receiving Long-Term Oxygen Therapy.
Ambulatory oxygen (O2) is the recommended treatment for hypoxemia at rest or induced by exercise. Commercial aircraft often fly at altitudes of 30,000 feet; their cabins are pressurized to altitudes of 6,000-8,000 feet, with an equivalent FIO2 of 0.15. O2 supplementation, for those receiving baseline ambulatory O2, is paramount. ⋯ Air travel is challenging; however, those who did travel reported a mainly positive experience. Increasing available information on options for travel should help individuals.
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Compressor/nebulizer units are used to deliver inhaled medications to patients with cystic fibrosis. Practitioners and parents frequently replace either the compressor or the nebulizer with a similar component from a different brand. We hypothesized that these changes could affect the compressor/nebulizer flow-pressure and aerosol characteristics. ⋯ Our findings indicate that, in general, replacing the nebulizer or compressor with a different brand changes the flow-pressure and aerosol characteristics. Practitioners should be cautious when changing compressor/nebulizer pairs unless they are aware of the resulting impact on the flow-pressure and aerosol characteristics.
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High-flow nasal cannula (HFNC) oxygen therapy produces noise at a level such that patients often complain. However, the noise level has not been measured digitally. ⋯ The findings in this study show that the noise level of HFNC/Venturi could be reduced by attaching an intake filter. However, the noise level of HFNC/blender and HFNC/turbine decreased in comparison with HFNC/Venturi without an intake filter.
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It has been suggested that use of a high-flow nasal cannula (HFNC) could be a first-line therapy for patients with acute hypoxic respiratory failure. The purpose of this study was to determine if protocolized use of HFNC decreases unplanned intubation and adverse outcomes in an ICU population. ⋯ Extubation to HFNC led to a significant decrease in pulmonary infections and bronchodilator therapy in Cohort 1 but did not reduce length of stay or rates of failed extubation. When HFNC was used early and per protocol (Cohort 2), ICU and hospital lengths of stay were reduced and HFNC was initiated more quickly when the need for respiratory support escalated.