Respiratory care
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A persistent patent ductus arteriosus (PDA) can have significant clinical consequences in preterm infants, depending on the degree of left-to-right shunting, its impact on cardiac performance, and associated perinatal risk factors that can mitigate or exacerbate the shunt. Although the best management strategy remains contentious, PDAs that have contraindications to, or have failed medical management have historically undergone surgical ligation. ⋯ The present review summarizes the pathophysiologic manifestations, treatment options and management of hemodynamically significant PDA in preterm infants. Additionally, we review the available literature surrounding the respiratory support and outcomes of preterm infants following definitive PDA closure.
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The mask leak test used for modern noninvasive ventilators can detect the leak characteristics of masks that are not recommended by the manufacturer, but it has not yet been determined whether this method is acceptable. ⋯ The mask leak test had no effect on the ventilator performance when masks not recommended by the manufacturer were used, but tidal volume monitoring may be more accurate when some masks were used.
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An increase in respiratory work load and resistance to respiration cause a decrease in respiratory muscle endurance (RME) in patients with obesity hypoventilation syndrome (OHS). We aimed to evaluate and compare RME in subjects with OHS and a control group using an incremental load test and compare the RME of subjects with OHS in whom noninvasive ventilation (NIV) was and was not used. ⋯ RME was low in subjects with OHS but higher in those who used NIV. The incremental load test could be performed easily and safely in a clinic setting.
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The perceptions of using noninvasive ventilation (NIV) during exercise in patients with COPD who are naïve to NIV is unknown. The present study aimed to examine the perceptions of using NIV during exercise in people with COPD and to determine the relationship between patient perceptions with both baseline patient characteristics and exercise outcomes. ⋯ Individuals with COPD, naïve to NIV, and using NIV during exercise for the first time reported a positive effect of NIV on breathlessness and exercise performance. Participants' perceived benefit of NIV correlated moderately with increased endurance time and resting hyperinflation and with a reduction in dynamic hyperinflation during exercise, suggesting that patient reports could also aid selection of those who will benefit from NIV during exercise.
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The use of YouTube for providing medical information is increasing, and patients with COPD are likely to use digital media to obtain information for their conditions. This study aimed to analyze the reliability and quality of the videos that were most frequently viewed by patients with COPD who searched YouTube for information on pulmonary rehabilitation. ⋯ Popular YouTube videos on pulmonary rehabilitation for COPD were reliable; however, they were biased and of low quality in terms of providing content. Given YouTube's advantage of easy accessibility and disadvantage of vulnerability to poor-quality information, professionals should pay more attention to uploading comprehensive high-quality videos for informational purposes.