Respiratory care
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Oxygen therapy via high-flow nasal cannula generates physiologic changes that impact ventilatory variables of patients. However, we know that there are detrimental effects on airway mucosa related to inhalation of gases. The objective of this study was to evaluate the performance in terms of absolute humidity, relative humidity, and temperature of different brands of heated humidifiers and circuits in the invasive mode during the use of high-flow oxygen therapy in flows between 30 and 100 L/min. ⋯ When heated humidifiers were used in the invasive mode for high-flow oxygen therapy, absolute humidity depended not only on the heated humidifiers and the combination of circuits but also on the programmed flow, especially at flows > 50 L/min. Moreover, the heated humidifiers exhibited different behaviors, in some cases inefficient, in delivering adequate humidification. However, some equipment improved performance when set to the invasive mode.
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New graduate respiratory therapists (RTs), regardless of the degree program, receive limited preparation in neonatal/pediatric diseases and management. Experienced RTs typically have adult knowledge but limited exposure to pediatrics. We developed a program that included competence-based simulation to improve orientation success. ⋯ The use of a competence-based orientation program showed educational advancements and helped determine successful orientation completion.
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The evidence regarding benefits of high-flow nasal cannula (HFNC) in patients with COVID-19 is controversial. The aim of this study was to evaluate the impact of HFNC in comparison with standard oxygen therapy on the frequency of endotracheal intubation at 28 d in subjects with acute hypoxemic respiratory failure (AHRF) secondary to SARS-CoV-2 infection. ⋯ In this study, HFNC therapy in subjects with AHRF secondary to COVID-19 was not an independent predictor of endotracheal intubation, compared with standard oxygen therapy, after adjusting for confounders.