Respiratory care
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The effect of application of fingernail polish on SpO2 measurement remains unclear. We conducted this systematic review to ascertain the impact of fingernail polish on SpO2 measurement. ⋯ Although fingernail polish of some colors can marginally reduce SpO2 reading or occasionally impede SpO2 measurement, the variability is clinically insignificant.
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Mechanical ventilation has long been recognized as the most vital therapy for patients with ARDS. Compared with lung-protective ventilation, debates that involve the open lung strategy, which consists primarily of the lung recruitment maneuver and higher PEEP, have never been resolved. ⋯ However, their limitations related to excessive generalization, accuracy, and identification of cutoff values cannot be omitted. Finally, future studies are warranted to combine these classic methods with newly invented techniques to achieve safer and more effective lung recruitment.
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Multicenter Study
DLCO Biologic Quality-Control Findings From a Multi-Center Global Study.
The 2017 American Thoracic Society/European Respiratory Society (ATS/ERS) diffusing capacity of the lung for carbon monoxide (DLCO) standards specify a control rule for assessing biologic quality control (BioQC) but have limited guidance on how to establish expected values for control rule variables. This study aimed to determine expected values for DLCO BioQC using coefficient of variation (CV) and compare that the mean ± 2 SD control rule yields the same precision as mean ± 12% of the mean. ⋯ A DLCO BioQC CV ≤ 6% is achievable across multiple sites, technologists, and brands of equipment. This CV value assures that measurements for control rule variables emerge from an expected range. A control rule of mean ± 2 SD appeared to yield similar results as the mean ± 12% of the mean rule reported in the 2017 ATS/ERS DLCO standards.
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Evidence-based practice relies on using research evidence to guide clinical decision-making. However, staying current with all published research can be challenging. ⋯ It provides a step-by-step guide to conducting a systematic review and meta-analysis, covering key steps such as formulating a research question, selecting studies, evaluating evidence quality, and reporting results. This paper is intended as a resource for clinicians looking to learn how to conduct systematic reviews and advance evidence-based practice in the field.
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Over the last decade, the literature exploring clinical applications for esophageal manometry in critically ill patients has increased. New mechanical ventilators and bedside monitors allow measurement of esophageal pressures easily at the bedside. ⋯ However, as with any measurement, technique, fidelity, and accuracy are paramount. This primer highlights key knowledge necessary to perform measurements and highlights areas of both uncertainty and ongoing development.