Respiratory care
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Editorial Observational Study
Outcome of Frail Do-Not-Intubate Subjects With End-Stage Chronic Respiratory Failure and Their Opinion of Noninvasive Ventilation to Reverse Hypercapnic Coma.
The use of noninvasive ventilation (NIV) in the emergency setting to reverse hypercapnic coma in frail patients with end-stage chronic respiratory failure and do-not-intubate orders remains a questionable issue given the poor outcome of this vulnerable population. We aimed to answer this issue by assessing not only subjects' outcome with NIV but also subjects' point of view regarding NIV for this indication. ⋯ In the frailest subjects with supposed end-stage chronic respiratory failure that justifies treatment limitation decisions, it is worth trying NIV when acute hypercapnic respiratory failure occurs, even in the case of extreme respiratory acidosis with hypercapnic coma at admission.
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Amyotrophic lateral sclerosis (ALS) is considered a multisystem degenerative disease due to its autonomic dysfunction effects. Autonomic cardiac control disorders can be seen in ALS and influence the quality of life and the life expectancy of affected individuals. We evaluated heart rate variability in subjects with ALS and with variable lung capacity. ⋯ The subjects with ALS and with decreased pulmonary capacity had reduced heart rate variability.
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This study sought to explore factors in adults with cystic fibrosis (CF) that predicted whether (i) someone was engaged in full-time paid work, and (ii) those engaged in paid work reported problems with absenteeism and/or presenteeism. ⋯ In this study, the majority of adults with cystic fibrosis worked full time and a low percentage of the sample reported problems with absenteeism and presenteeism.
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Because both dyspnea and pain have common features from a clinical and physiologic point of view, we hypothesized that stellate ganglion irradiation by using a linear polarized near-infrared ray device, which is often used for pain management, might be applicable for dyspnea relief. To evaluate the use of stellate ganglion irradiation as a novel noninvasive treatment for dyspnea, we investigated the influence of stellate ganglion irradiation on dyspnea. ⋯ Stellate ganglion irradiation significantly alleviated dyspnea induced by an external inspiratory load in healthy adults. Stellate ganglion irradiation might be an option to treat dyspnea in some cases. Further studies in individuals with diverse types of dyspnea and clinical settings are warranted.