Articles: chest-wall-oscillation.
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The Acapella is a respiratory rehabilitation device designed to aid sputum clearance. When the patient exhales through this device, continuous and oscillatory pressure levels are produced. The adequate practical use of the Acapella is critically dependent on the characteristics of the produced pressure, which include the production of a mean pressure>or=10 cm H2O and a matching of the oscillation frequency with the respiratory-system resonance frequency, and/or with the frequency of ciliary movement (approximately 13 Hz). The development of a dedicated software tool would contribute to optimize the clinical application of this device. Thus, the aim of this study was 2-fold: to characterize the mechanical behavior of the Acapella, and to develop a software tool to ease the practical use of this device. ⋯ The Acapella device may produce clinically adequate values of mean pressure and oscillation frequency. However, it depends on its use at optimized conditions. The user-friendly software proposed in this study could help the user to achieve these conditions.
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Comparative Study
Neonatal CPR: room at the top--a mathematical study of optimal chest compression frequency versus body size.
To explore in detail the expected magnitude of systemic perfusion pressure during standard CPR as a function of compression frequency for different sized people from neonate to adult. ⋯ Fundamental geometry and physics suggest that the most effective chest compression frequency in CPR depends upon body size and weight. In neonates there is room for improvement at the top of the compression frequency scale at rates >120/min. In adults there may be benefit from lower compression frequencies near 60/min.
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Randomized Controlled Trial
Air stacking and chest compression increase peak cough flow in patients with Duchenne muscular dystrophy.
To evaluate cough efficiency using two manually-assisted cough techniques. ⋯ Both chest compression and air stacking techniques were efficient in increasing PCF. However, the combination of these two techniques had a significant additional effect (p < 0.0001).
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Although current cardiopulmonary resuscitation (CPR) performance can increase the rates of restoration of spontaneous circulation (ROSC) and survival to hospital admission, the discharge rates of patients remain disappointing. The high mortality rate is attributed to post-cardiac arrest brain injury. The discovery of the postconditioning phenomenon opens a door to endogenous neuroprotection. ⋯ The Post-CCR includes applying three cycles of 18s chest compression and 10s interruption for ventilation first, and then executing chest compression only CPR until the patients return spontaneous circulation. Post-CCR can not only provide vital blood flow to the heart and brain but also activate endogenous protective mechanism to lessen post-cardiac arrest brain injury. We consider that it would become a feasible, safe and efficient cerebralprotective intervention in the prevention and alleviation of post-cardiac arrest brain injury, which would also improve the outcome after cardiac arrest.
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Cystic fibrosis (CF) is the most common life-shortening inherited disease affecting Caucasian people. In CF, the major feature of lung disease is the retention of mucus due to impaired clearance of abnormally viscous airway secretions. ⋯ ACTs include conventional chest physiotherapy, active cycle of breathing techniques, autogenic drainage, positive expiratory pressure and high-frequency chest compression. In order to suit the needs of patients, families and care-givers, ACTs need to be individually and continuously adapted.