Respiratory care
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Randomized Controlled Trial Comparative Study
Gradual versus sudden weaning from nasal CPAP in preterm infants: a pilot randomized controlled trial.
There is paucity of information on the weaning of nasal CPAP (NCPAP) in preterm infants. As the weaning from NCPAP can be gradual or sudden, we wanted to determine which of the 2 methods was better. ⋯ There was no difference in the success of weaning from NCPAP between the 2 weaning methods. The weight and postmenstrual age at the time of successful NCPAP wean also did not differ between the 2 groups. These findings suggest that factors other than the method of CPAP wean, such as pulmonary maturity, may determine the success of NCPAP wean in preterm infants.
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Randomized Controlled Trial Comparative Study
Peak expiratory flow in bed? A comparison of 3 positions.
Current guidelines for the correct peak expiratory flow (PEF) maneuver include standing. In the hospital setting, PEF values are often ordered to assess response to asthma therapy for exacerbations. We have observed that the PEF is sometimes performed with the patient in bed. ⋯ Clinicians should ensure that PEF is obtained with patients out of bed and in the standing position.
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Randomized Controlled Trial
Evaluation of recruited lung volume at inspiratory plateau pressure with PEEP using bedside digital chest X-ray in patients with acute lung injury/ARDS.
We wanted to assess whether there was a significant relationship between recruited lung volume (V(rec)) and change in density on digital processed chest x-ray measured at 2 different levels of inspiratory plateau pressure corresponding to 2 PEEP levels in patients with acute lung injury or ARDS. ⋯ Digital chest x-ray done at the bedside in acute lung injury/ARDS subjects was able to detect a reduction in density between PEEP 5 cm H2O and PEEP 15 cm H2O, which correlated with V(rec).
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Randomized Controlled Trial
Assessing exercise capacity using telehealth: a feasibility study in adults with cystic fibrosis.
Provision of healthcare from a remote site may assist patients to access important services. We aimed to establish the feasibility of monitoring an assessment of exercise capacity using telehealth technology. ⋯ Exercise capacity assessment using the 3-min step test is feasible and accurate via remote videoconferencing in adults with CF.
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Randomized Controlled Trial
Noninvasive ventilation coupled with nebulization during asthma crises: a randomized controlled trial.
Despite the clinical improvements attributed to noninvasive ventilation (NIV) during asthma crises, and the well established effects of nebulization, there are few studies on the effects of these interventions together. We hypothesized that nebulization coupled to NIV should raise radio-aerosol pulmonary deposition in asthmatics. The aims of this study were to assess the effects of coupling β-agonist nebulization and NIV during asthma exacerbations on radio-aerosol pulmonary deposition, using scintigraphy and cardiopulmonary parameters, to correlate pulmonary function with radio-aerosol deposition index, radio-aerosol penetration index, and pulmonary clearance. ⋯ Coupling nebulization and NIV during asthma exacerbation did not improve radio-aerosol pulmonary deposition, but we observed clinical improvement of pulmonary function in these subjects. (ClinicalTrials.gov registration NCT01012050).