Respiratory care
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Obesity is one of the most prominent risk factors for obstructive sleep apnea (OSA). Weight loss decreases the number of shorter respiratory events (<40 s), whereas the number of longer events remains almost unchanged. However, it is unknown how body mass index (BMI) affects individual obstruction event severity within OSA severity categories when age, sex, smoking, daytime sleepiness, snoring, hypertension, heart failure, and sleeping posture are considered. Therefore, we investigated whether individual obstruction event severity varies with BMI within the OSA severity categories when considering the most important confounding factors. ⋯ Because BMI is related to the duration of individual obstruction events, its effect on OSA severity is more complex than its effect on AHI would implicate. Therefore, overall severity of OSA may not be the same for non-obese patient and obese patient who have similar AHI. Thus, these patient-specific characteristics of individual breathing cessations should be considered when estimating the severity of disease and risk of related adverse health effects.
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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.
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Randomized Controlled Trial
Effect of High-Flow Nasal Cannula on Thoraco-Abdominal Synchrony in Pediatric Subjects After Cardiac Surgery.
We previously reported the effects of high-flow nasal cannula (HFNC) oxygen therapy on thoraco-abdominal synchrony. This study was designed to clarify the effect of HFNC on thoraco-abdominal synchrony in pediatric subjects after cardiac surgery and to investigate HFNC optimal flow in this population. ⋯ After cardiac surgery, HFNC oxygen therapy at 2 L/kg/min improved thoraco-abdominal synchrony and decreased breathing frequency in pediatric subjects. (Clinical trial registration: UMIN000023426.).
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Review
Significance of Pulmonary Rehabilitation in Improving Quality of Life for Subjects With COPD.
Increasingly, studies have shown that application of pulmonary rehabilitation (PR) may improve the quality of life (QOL) of patients with COPD. However, some studies remain controversial and were limited to small number of participants. We designed a systematic review and meta-analysis to evaluate the efficacy of PR in improving the QOL for subjects with COPD. ⋯ PR may constitute an important component of COPD management and may be beneficial in improving QOL.
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Muscle weakness is an important systemic consequence in adults with cystic fibrosis, but it can be challenging to evaluate clinically. This study examined the validity of lower-extremity functional tests to assess quadriceps muscle strength and muscle power. ⋯ Functional tests can be applied clinically to measure leg muscle strength and power, with the stair-climb power test having the strongest associations with the standard measures. The utility of using functional tests to evaluate longitudinal changes in muscle function and its association with clinical outcomes should be examined in cystic fibrosis.