Respiratory care
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Editorial Randomized Controlled Trial
Silver-Coated Endotracheal Tubes Cleaned With a Mechanism for Secretion Removal.
Biofilm on the surface of endotracheal tubes (ETTs) is associated with ventilator-associated pneumonia. The use of silver-coated ETTs has been suggested to reduce the occurrence of ventilator-associated pneumonia by preventing biofilm formation. However, mucus accumulation can reduce the antibacterial activity of silver-coated ETTs by isolating bacterial colonies from the silver surface. We hypothesized that, in mechanically ventilated subjects, periodic removal of secretions through the use of a cleaning device would enhance the antimicrobial properties of silver-coated ETTs and thus reduce bacterial colonization. ⋯ In 39 critically-ill subjects intubated with silver-coated ETTs, periodic cleaning maneuvers did not decrease bacterial colonization of the ETTs and did not lower respiratory tract colonization compared to the standard suctioning. (Clinicaltrials.gov registration NCT02120001.).
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Review Meta Analysis
Peak Oxygen Uptake and Mortality in Cystic Fibrosis: Systematic Review and Meta-Analysis.
Aerobic fitness, as measured by peak oxygen uptake (V̇O2 peak), correlates with survival in children and adults with cystic fibrosis (CF). We sought to evaluate the effects of V̇O2 peak on mortality rates in subjects with CF. ⋯ Low levels of peak oxygen uptake are associated with an increase of 4.9 in the risk of mortality in subjects with CF. This indicates that V̇O2 could be an important follow-up variable to measure, in addition to FEV1.