Respiratory care
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Endotracheal tube (ETT) depth in premature infants is of critical importance because potentially life-threatening adverse events can occur if the tube is malpositioned. Analysis of current data indicates that the accuracy of current resuscitation guidelines for infants <1 kg is poor. We hypothesized that a weight-based formula that is used clinically in our institution would accurately predict appropriate ETT placement in infants weighing < 1 kg. ⋯ Our weight-based, institutional formula had a low sensitivity for predicting proper ETT depth. Weight-based formulas may have clinical utility; however, analysis of current data did not support use in infants < 1 kg. Rapid radiologic assessment of ETT placement is required for this patient population.
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The 2009 H1N1 influenza epidemic saw a rise in the use of extracorporeal membrane oxygenation (ECMO) as a supportive therapy for refractory ARDS. We sought to determine whether ECMO utilization follows a seasonal pattern that matches the influenza season, and whether it can further be explained by the incidence of each influenza subtype. ⋯ Non-cardiac and cardiac ECMO use in the United States were significantly associated with influenza incidence. The influenza A, H1N1 2009, subtype had the strongest association.
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Waterpipe (hookah) smoking is a form of tobacco smoking that is noticeably increasing worldwide, particularly among young adults. A growing body of literature indicates that college students may not be as knowledgeable as they should be in making decisions about waterpipe smoking. ⋯ This study showed that waterpipe smoking was common but not widespread among this group of health-care students. Their knowledge of the risks and health-related attitudes toward waterpipe smoking was lacking. Many had misinformation and misconceptions when comparing waterpipe smoking versus cigarette smoking. Further studies are needed to fully understand the reasons for waterpipe smoking among health-care students. Also, there is a need to offer educational campaigns that increase students' knowledge and awareness as well as to correct misinformation that can lead to misguided beliefs and attitudes.