Respiratory care
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Cognitive impairment (CI), which has been reported in COPD, has been related to physical performance. However, the association between CI and upper-extremity functions is unknown. We aimed to compare upper-extremity exercise capacity and grip strength between subjects with COPD with and without CI and to determine the relationship of upper-extremity functions with specific cognitive domains. ⋯ These findings suggest that upper-extremity functions might be decreased especially concerning executive functions and attention in subjects with COPD with CI.
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Noninvasive respiratory support (NRS) for pediatric critical asthma includes CPAP; bi-level positive airway pressure (BPAP); and heated, humidified, high-flow nasal cannula (HFNC). We used the Virtual Pediatric System database to estimate NRS by prescribing rates for pediatric critical asthma and characterize patient clinical features and in-patient outcomes by the initial NRS device applied. ⋯ In this multi-center cohort study, we observed that children with critical asthma are increasingly exposed to HFNC compared with BPAP and CPAP. Rates of HFNC failure were greater than those of BPAP failure, but a majority were transitioned to BPAP without subsequent invasive ventilation. The next steps include prospective trials, including practical end points such as patient comfort and optimal delivery of nebulized treatments to distinguish device superiority and suitable NRS utilization.
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The purpose of this article is to identify (by brand name) and then classify the modes available on contemporary portable ventilators used for noninvasive ventilation in the United States. We propose a formal taxonomy that identifies the modes by their control variable, breath sequence, and targeting scheme, therefore describing what the mode does. Use of this taxonomy should be helpful in finding modes with comparable functionality that cater to the specific goal of mechanical ventilation and effective ventilatory strategies for each disease state.
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Predicting Hospital Readmission in Medicaid Patients With COPD Using Administrative and Claims Data.
The goals of this study were to develop a model that predicts the risk of 30-d all-cause readmission in hospitalized Medicaid patients diagnosed with COPD and to create a predictive model in a retrospective study of a population cohort. ⋯ Our model identified with acceptable accuracy hospitalized Medicaid patients with a diagnosis of COPD who are at high risk of readmission. One can use the model to develop post-discharge management interventions for reducing readmissions, for adjusting comparisons of readmission rates between sites/providers or over time, and to guide a patient-centered approach to patient care.