Respiratory care
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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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Comparative Study
Noninvasive CPAP with face mask: comparison among new air-entrainment masks and the Boussignac valve.
The performances of 2 noninvasive CPAP systems (high flow and low flow air-entrainment masks) were compared to the Boussignac valve in 3 different scenarios. ⋯ High-flow air-entrainment mask showed the best performance in human subjects. During high flow demand, the Boussignac valve delivered lower than expected F(IO(2)) and showed higher dynamic hyper-pressurization than the air-entrainment masks.
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Airway clearance therapy (ACT) is critical in cystic fibrosis (CF). ⋯ Study outcomes showed a high rate of ACT adherence in adult CF subjects. Lower level of education was the most important factor in poor adherence to ACT. Self-reported adherence and treatment recommendations were in best agreement with positive expiratory pressure and flutter device techniques.
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Severe tracheomalacia (STM) is being increasingly recognized as a cause for respiratory failure in the ICU. The diagnosis is often overlooked, as chest radiography appears normal, and the role of invasive diagnostic testing for this diagnosis is not well described in the ICU setting. The prevalence and risk factors for STM are not known, and computed tomography (CT) based diagnostic criteria for ventilated patients are not well studied. ⋯ STM was associated with prolonged ICU stay. A distal tracheal antero-posterior diameter < 7 mm on a non-intubated CT chest was suggestive of STM that required a confirmatory bronchoscopy. Gastroesophageal reflux disease and obesity were potential risk factors.
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Portable ventilators are increasingly utilized in the intra- and inter-hospital transport of patients. We evaluated 4 portable ventilators, Impact EMV, CareFusion LTV 1200, Newport HT70, and Hamilton T1, in terms of triggering, delivered tidal volume (V(T)) accuracy, battery duration, delivered F(IO(2)) accuracy, and gas consumption. ⋯ Manufacturers continue to improve the performance of portable ventilators. All the ventilators we tested performed well on V(T) delivery across a range of settings, using both the internal drive mechanism (F(IO(2)) 0.21) and compressed oxygen (F(IO(2)) 1.0). Two of the ventilators were unable to deliver accurate F(IO(2)) across the range of V(T). None of the devices was clearly superior to the others in all aspects of our evaluation.