Abstract:
:Aerosolized medications have been used for centuries to treat respiratory diseases. Until recently, inhalation therapy focused primarily on the treatment of asthma and chronic obstructive pulmonary disease, and the pressurized metered-dose inhaler was the delivery device of choice. However, the role of aerosol therapy is clearly expanding beyond that initial focus. This expansion has been driven by the Montreal protocol and the need to eliminate chlorofluorocarbons (CFCs) from traditional metered-dose inhalers, by the need for delivery devices and formulations that can efficiently and reproducibly target the systemic circulation for the delivery of proteins and peptides, and by developments in medicine that have made it possible to consider curing lung diseases with aerosolized gene therapy and preventing epidemics of influenza and measles with aerosolized vaccines. Each of these drivers has contributed to a decade or more of unprecedented research and innovation that has altered how we think about aerosol delivery and has expanded the role of aerosol therapy into the fields of systemic drug delivery, gene therapy, and vaccination. During this decade of innovation, we have witnessed the coming of age of dry powder inhalers, the development of new soft mist inhalers, and improved pressurized metered-dose inhaler delivery as a result of the replacement of CFC propellants with hydrofluoroalkane. The continued expansion of the role of aerosol therapy will probably depend on demonstration of the safety of this route of administration for drugs that have their targets outside the lung and are administered long term (eg, insulin aerosol), on the development of new drugs and drug carriers that can efficiently target hard-to-reach cell populations within the lungs of patients with disease (eg, patients with cystic fibrosis or lung cancer), and on the development of devices that improve aerosol delivery to infants, so that early intervention in disease processes with aerosol therapy has a high probability of success.
journal_name
Respir Carejournal_title
Respiratory careauthors
Laube BLkeywords:
subject
Has Abstractpub_date
2005-09-01 00:00:00pages
1161-76issue
9eissn
0020-1324issn
1943-3654journal_volume
50pub_type
杂志文章,评审相关文献
Respiratory Care文献大全abstract::There is now clear evidence that asthma prevalence increased significantly, especially in developed countries, during the second part of the 20th century. What caused this increase is currently unknown. Recent reports from the United States and the United Kingdom suggest that asthma prevalence may have plateaued betwe...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2008-05-01 00:00:00
abstract::End-stage liver disease and its complications are a leading cause of death among adults in the United States, and thousands of patients await liver transplantation. The liver plays a central role in health and homeostasis and thus the diseased liver leads to many deleterious effects on multiple organ systems, includin...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2007-08-01 00:00:00
abstract:INTRODUCTION:A mass-casualty respiratory failure event where patients exceed available ventilators has spurred several proposed solutions. One proposal is use of a single ventilator to support 4 patients. METHODS:A ventilator was modified to allow attachment of 4 circuits. Each circuit was connected to one chamber of...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01236
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Aspiration is a serious clinical concern in patients with long-term artificial airways. The purpose of this study was to determine the reliability of a bedside colored dye assessment of aspiration in tracheostomized patients and to determine its comparability to a more sophisticated videofluoroscopic study. ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2001-03-01 00:00:00
abstract:BACKGROUND:Airway remodeling is a characteristic structural change that occurs extensively in the airways of patients with asthma. The change can be evaluated by measuring airway dimensions by using high-resolution computed tomography. This study aimed to explore the variation trends of airway dimensions from the secon...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06050
更新日期:2018-11-01 00:00:00
abstract::Numerous ventilation modes and ventilation options have become available as new mechanical ventilators have reached the market. Ventilator manufacturers have no standardized terminology for ventilator modes and ventilation options, and ventilator operator's manuals do not help the clinician compare the modes of ventil...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2001-06-01 00:00:00
abstract::The cardiopulmonary physiology of dinosaurs-and especially of the long-necked sauropods, which grew much larger than any land animals before or since-should be inherently fascinating to anyone involved in respiratory care. What would the blood pressure be in an animal 12 m (40 ft) tall? How could airway resistance and...
journal_title:Respiratory care
pub_type:
doi:10.4187/002013209793800286
更新日期:2009-07-01 00:00:00
abstract::A number of adjuncts to mechanical ventilation have been the focus of recent research. Automatic tube compensation (the regulation of airway pressure by estimation of tracheal pressure) appears to be an ideal approach to unloading the resistive effort imposed by the endotracheal tube. Randomized controlled trials have...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Left-ventricular dysfunction associated with COPD exacerbation is frequently underestimated. We tested whether finger plethysmography waveform change during the Valsalva maneuver could aid in the distinction between patients with COPD exacerbation with and without left-ventricular dysfunction. METHODS:We in...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04091
更新日期:2016-04-01 00:00:00
abstract::Fibrosing mediastinitis is underdiagnosed because of the nonspecific character of the presenting symptoms. The endobronchial findings obtained via flexible bronchoscopy are not defined in the literature. We describe 3 cases of fibrosing mediastinitis, most likely caused by histoplasmosis. All 3 patients presented with...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2003-11-01 00:00:00
abstract::A summary of the 2-day Journal Conference on Current Trends in Neonatal and Pediatric Respiratory Care is provided. Topics included: diagnosis and management of common respiratory disorders of infants and children such as asthma, respiratory syncytial virus bronchiolitis, and cystic fibrosis; and common pediatric resp...
journal_title:Respiratory care
pub_type:
doi:
更新日期:2003-04-01 00:00:00
abstract::Rotational beds, prone position, and semi-recumbent position have been proposed as procedures to prevent ventilator-associated pneumonia (VAP). Rotational therapy uses a special bed designed to turn continuously, or nearly continuously, the patient from side to side; specific designs include kinetic therapy and contin...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2005-07-01 00:00:00
abstract:BACKGROUND:The impact of anxiety and depression on quality of life (QOL) in adult patients with cystic fibrosis (CF) is fully unknown. We investigated the prevalence and factors associated with anxiety and depression, including QOL, in adult CF patients. METHODS:One hundred twenty-one adult CF subjects, age ≥ 18 year...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01328
更新日期:2012-04-01 00:00:00
abstract::The story of the development of oxygen and its role in mitigating the ravages of chronic stable hypoxemia have been fascinating. Today, over one million Americans receive home oxygen each day, usually for COPD, from one of the three available systems. The future requires less expensive, highly portable, and practical ...
journal_title:Respiratory care
pub_type: 历史文章,杂志文章
doi:
更新日期:2000-01-01 00:00:00
abstract::The presence of bronchiectasis (BR) in patients with rheumatoid arthritis (RA) has been recognized for many decades; nevertheless, little research has been undertaken in this area. It is important to recognize that BR coexistent with RA differs from the other types of BR. The purpose of this descriptive review was to ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.01857
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:In several studies, low spirometric levels have been shown to increase the success rates of smoking cessation, whereas other studies have indicated that pulmonary function has no effects on quitting smoking. Given the fact that there are contradictory results on this subject, we aimed to investigate the effe...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04490
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:Spirometry is important for the differential diagnosis of dyspnea. However, some patients cannot exhale for ≥6 s to achieve the American Thoracic Society/European Respiratory Society criteria. The aim of this study was to demonstrate the reliability of a new parameter that quantifies the degree of concavity ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.05016
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:COPD is now included in Medicare's hospital readmission reduction program. Hospitals with excessive risk-adjusted 30-d readmission rates receive financial penalties. Race/ethnicity is not included in the risk-adjustment models. We examined whether race/ethnicity was independently associated with readmission ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06475
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:In patients with kyphoscoliosis, long-term mechanical ventilation improves chronic alveolar hypoventilation during spontaneous breathing, improves quality of life, decreases the need for hospitalization, and improves survival. In these patients respiratory infection can precipitate acute respiratory failure ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Although tobacco practices and the effects of tobacco use among the general American population are well described, minimal data exist regarding tobacco use and barriers to smoking cessation among homeless individuals. METHODS:Anonymous, voluntary surveys based on a previously implemented instrument were co...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04439
更新日期:2016-05-01 00:00:00
abstract:INTRODUCTION:There is no published standard for the ratio of staff to patients during exercise sessions in outpatient pulmonary rehabilitation. This lack of a standard raises concern about patient safety and the ability to monitor patients adequately. OBJECTIVE:Determine a staff-to-patient ratio standard by examining ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Ventilation with low tidal volume is recommended for patients with acute lung injury. Current guidelines suggest limiting plateau pressure (Pplat) to < 30 cm H2O for septic patients needing mechanical ventilation. The aim of this study was to determine whether Pplat within the first 24 h of ICU admission is ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03138
更新日期:2015-01-01 00:00:00
abstract::Sialorrhea or drooling represents quite a common problem in patients with amyotrophic lateral sclerosis (ALS). In this review, we describe the possible treatments for this issue. Current medical management is not always effective: anticholinergic drugs (atropine, glycopyrrolate, amitriptyline, hyoscyamine, and transde...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.02856
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Diaphragm excursion is limited during respiratory maneuvers after a stroke. How the diaphragm is limited during reflexive coughs and affects the effectiveness of cough in stroke patients is unclear. This study aimed to measure reflexive cough strength by cough peak flow (CPF) induced by citric acid nebulizat...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.05488
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:This study compared 3 nebulizer technologies for inter- and intradevice reproducibility, humidification, and fill volume sensitivity during mechanical ventilation: a breath-enhanced jet nebulizer, a vibrating mesh nebulizer, and a jet nebulizer. The breath-enhanced jet nebulizer featured a new design located...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07639
更新日期:2020-10-01 00:00:00
abstract::The estimation of pleural pressure with esophageal manometry has been used for decades, and it has been a fertile area of physiology research in healthy subject as well as during mechanical ventilation in patients with lung injury. However, its scarce adoption in clinical practice takes its roots from the (false) idea...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.07425
更新日期:2020-06-01 00:00:00
abstract::Pressure support ventilation (PSV) is a commonly used mode. It is patient-triggered, pressure-limited, and (normally) flow-cycled. Triggering difficulty occurring during PSV is usually due to intrinsic positive end-expiratory pressure. The airway pressure generated at the initiation of inhalation is determined by the ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Limited adult data suggest that airway driving pressure might better reflect the potential risk for lung injury than tidal volume based on ideal body weight, and the parameter correlates with mortality in ARDS. There is a lack of data about the effect of driving pressure on mortality in pediatric ARDS. This ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.08024
更新日期:2020-10-06 00:00:00
abstract::Pulmonary hypertension (PH) is a common consequence of COPD. It has been speculated that patients showing serious PH and vascular remodeling without severe airway obstruction might benefit from vasoactive treatment. There is no approved drug available for COPD-induced PH. Most trials assessing the efficacy of vasoacti...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02058
更新日期:2013-08-01 00:00:00
abstract::Dieulafoy disease of the bronchus is a rare condition. A 28-y-old male patient with recurrent exacerbations of hemoptysis (producing up to 300 mL) over the previous 4 y was admitted to our hospital following an acute episode. A 3-mm sessile lesion covered with somewhat ulcerated smooth mucosa was detected at the dista...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03307
更新日期:2015-01-01 00:00:00