Respiratory care
-
Inspiratory capacity (IC) is often overlooked as an important measured index of spirometry in patients with cystic fibrosis (CF). Abnormally low IC may indicate the onset of static/dynamic hyperinflation, which may be accompanied by dyspnea and an increase in the work of breathing. This cross-sectional study sought to determine whether measuring IC during spirometry, may add clinical value to FEV1 measurements in CF subjects. ⋯ Measuring IC in CF subjects may reveal silent worsening of lung function as indicated by a decline in IC < 50% predicted while FEV1 is still > 40% predicted. This condition may lead to inefficient breathing at high lung volumes, which may explain a subjective sensation of breathlessness and lead to an increase in hospitalization days/year.
-
Pulmonary contusions are thought to worsen outcomes. We aimed to evaluate the effects of pulmonary contusion on mechanically ventilated trauma subjects with severe thoracic injuries and hypothesized that contusion would not increase morbidity. ⋯ Overall, no significant differences were noted in mortality, length of stay, or pneumonia rates between severely injured trauma subjects with and without pulmonary contusions.
-
The aim of this bench study was to investigate the performances of 8 devices for noninvasive CPAP. ⋯ We found a significant variation in the performances of the 8 CPAP devices examined in this study. The technical characteristics and limitations of different CPAP devices should be considered when using in patients with hypoxemic acute respiratory failure.
-
Observational Study
Positive Correlation Between Regional Cerebral Oxygen Saturation and Mixed Venous Oxygen Saturation During Off-Pump Coronary Artery Bypass Surgery.
The balance of oxygen delivery and consumption is essential in patients who are critically ill. Mixed venous oxygen saturation (Sv̄O2 ) is a standard method to evaluate oxygen delivery and consumption during anesthesia. However, Sv̄O2 is monitored through a pulmonary artery catheter, which is invasive. Regional cerebral oxygenation (rScO2) reflects oxygen saturation in a small region of the frontal lobes and is monitored noninvasively through near-infrared spectroscopy. In the present study, the correlation between rScO2 and Sv̄O2 was calculated during off-pump coronary artery bypass grafting surgery to determine whether a positive correlation exists between rScO2 and Sv̄O2 . ⋯ There was a positive correlation between rScO2 and Sv̄O2 during off-pump coronary artery bypass grafting surgery, and there also was a positive correlation in the variation trend between rScO2 and Sv̄O2 .
-
Duchenne muscular dystrophy (DMD) is characterized by progressive degeneration, wasting, and weakness of skeletal musculature, including respiratory muscles. Cough is also compromised with disease progression. Among cough-augmentation techniques, mechanical insufflation-exsufflation (MI-E) has demonstrated several clinical benefits in patients with chronic airway secretion obstruction and muscular weakness. In clinical practice, the use of MI-E in DMD patients is also suggested when they are stable with no airway infections. However, there is a paucity of studies that consider the effect of MI-E specifically on stable DMD patients who have adapted to the use of MI-E. ⋯ A single treatment of MI-E in subjects with stable DMD already adapted to the device can provide beneficial changes in breathing pattern through a significant decrease in breathing frequency and rapid shallow breathing. These findings suggest an improvement in short-term dyspnea, although there were no changes in lung-volume recruitment or unassisted cough peak flow.