Abstract:
BACKGROUND:Directed cough maneuvers are often included in physiotherapy management aimed at preventing postoperative pulmonary complications after open heart surgery, but there is little scientific evidence of the effectiveness of directed cough maneuvers. METHODS:We conducted a randomized intra-subject crossover trial to evaluate the effect of thoracic support (patient holds his or her hands over the incision) and maximal inspiration on cough peak expiratory flow (CPEF), cough expiratory volume (CEV), and incision pain during cough in the early period after open heart surgery. Cough evaluation was undertaken on the first and second morning after surgery. On both measurement days the subject did a baseline cough (baseline cough 1) then, in a random sequence, performed 3 cough conditions: an additional baseline cough (baseline cough 2), supported cough, and supported cough preceded by maximal inspiration. In these test conditions a P < .008 was deemed to indicate a statistically significant difference. RESULTS:Twenty-one subjects participated. Thoracic support alone did not significantly affect CPEF or CEV (Bonferroni adjusted P > .008). With a maximal inspiration and thoracic support, CPEF and CPEV were significantly higher than in all other cough conditions (Bonferroni adjusted P < .008). Pain during cough was not influenced by the different cough conditions (P > .05). There was no significant difference in the cough variables or pain during the different cough conditions on the first day versus the second measurement day. CONCLUSIONS:Maximal inspiration increased CPEF and CEV, but the method of thoracic support we used did not reduce pain during cough or influence the cough values we measured.
journal_name
Respir Carejournal_title
Respiratory careauthors
Fiore JF Jr,Chiavegato LD,Denehy L,Paisani DM,Faresin SMsubject
Has Abstractpub_date
2008-08-01 00:00:00pages
1027-34issue
8eissn
0020-1324issn
1943-3654journal_volume
53pub_type
杂志文章,随机对照试验相关文献
Respiratory Care文献大全abstract:BACKGROUND:Unplanned extubation (UE) is an important quality metric in the neonatal ICU that is associated with hypoxia, bradycardia, and risk for airway trauma with emergent re-intubation. Initial efforts to reduce UE in our level 4 neonatal ICU included standardized securement of the endotracheal tube (ETT) and requi...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07446
更新日期:2020-11-01 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:BACKGROUND:We recently demonstrated in a randomized study the feasibility and effectiveness of telephone-based health coaching using motivational interviewing on decreasing hospital readmissions and improving quality of life at 6 and 12 months after hospital discharge. In this qualitative study, we sought to explore th...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.05574
更新日期:2017-11-01 00:00:00
abstract::Aerosolized medications are routinely used for the treatment of critically ill patients. This paper reviews aerosol delivery devices with a focus on issues related to their performance in pulmonary critical care. Factors affecting aerosol drug delivery to mechanically ventilated adults and spontaneously breathing pati...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.03790
更新日期:2015-06-01 00:00:00
abstract::Gorham syndrome is a rare disease that presents as progressive osteolysis, and may affect any part of the skeleton. The pathologic process involves the replacement of normal bone by aggressively expanding but non-neoplastic vascular tissue, resulting in massive osteolysis of the adjacent bone. If the spine and ribs ar...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02355
更新日期:2013-11-01 00:00:00
abstract:INTRODUCTION:Automatic tube compensation (ATC), a new ventilation mode that compensates for the work of breathing imposed by endotracheal tube resistance, recently became commercially available. METHODS:We conducted a laboratory study with a lung model and a Nellcor Puritan Bennett 840 ventilator to compare ATC and pr...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract::Explaining the meaning of the results to the reader is the purpose of the discussion section of a research paper. There are elements of the discussion that should be included and other things that should be avoided. Always write the discussion for the reader; remember that the focus should be to help the reader unders...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2004-10-01 00:00:00
abstract::Optimizing patient-ventilator synchrony is essential in managing patients who require prolonged mechanical ventilation in the long-term acute-care hospital. Inadequate synchrony can increase work of breathing, cause patient discomfort, and delay both weaning and general rehabilitation. Achieving optimal synchrony in t...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.01084
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Metered-dose inhalers with valved holding chambers (MDI-VHCs) have been shown to be equivalent to small-volume nebulizers (SVNs) for the delivery of bronchodilators in children. At Seattle Children's Hospital and Regional Medical Center we sought to implement the conversion from SVN to MDI-delivered albutero...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:High-flow nasal cannula (HFNC) use has greatly increased in recent years. In non-neonatal pediatric patients, there are limited data available to guide HFNC use, and clinical practice may vary significantly. The goal of this study was to evaluate current HFNC practice by surveying practicing pediatric respir...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.05961
更新日期:2018-07-01 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::As the basis for this paper, it must be acknowledged that children are not simply small adults. But this acknowledgment must go further: infants are not simply small adolescents. As data for pediatric mechanical ventilation, in general, and the management for pediatric acute lung injury, more specifically, are very l...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.01413
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Capnometry detects hypoventilation earlier than pulse oximetry while supplemental oxygen is being administered. We compared the end-tidal CO2 (PETCO2 ) measured using a newly developed oxygen nasal cannula with a CO2-sampling port and the PaCO2 in extubated subjects after abdominal surgery. We also investiga...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04634
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:Calculation of physiologic dead space (dead space divided by tidal volume [VD/VT]) using the Enghoff modification of the Bohr equation requires measurement of the partial pressure of mean expired CO2 (PĒCO2) by exhaled gas collection and analysis, use of a metabolic analyzer, or use of a volumetric CO2 monit...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02116
更新日期:2013-07-01 00:00:00
abstract::An electronic literature search for articles published between January 1990 and October 2009 was conducted by using MEDLINE, CINAHL, and Cochrane Library databases. The update of this clinical practice guideline is the result of reviewing a total of 114 clinical trials, 62 reviews and 6 meta-analyses on endotracheal s...
journal_title:Respiratory care
pub_type: 杂志文章,实务指引
doi:
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:The periodic administration of positive airway pressure combined with directed cough could aid mucus clearance in patients with cystic fibrosis (CF) and severe airway obstruction. OBJECTIVE:To compare the short-term effect of positive expiratory pressure (PEP) physiotherapy via mask (mask PEP), continuous p...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2006-10-01 00:00:00
abstract::The evaluation of new therapy poses a formidable challenge in intensive care medicine. When therapy evaluation cannot be double-blinded, as in the evaluation of extracorporeal support, the problem becomes more difficult. The result of the extracorporeal clinical trial, like that of the ECMO trial in the 1970s, is a po...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:1993-07-01 00:00:00
abstract::Ventilation during chest compressions can lead to an increase in peak inspiratory pressure. High inspiratory pressure can raise the risk of injury to the respiratory system and make it challenging to deliver the required tidal volume. The utilization of mechanical devices for chest compression has exacerbated this cha...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.07775
更新日期:2021-02-01 00:00:00
abstract::Delivering long-term oxygen therapy in the homes of persons who live in remote areas can be a problem. Four isolated areas in North America--rural Manitoba, Canada; the Northwest Territories of Canada; Alaska; and the Colorado mountains--have home oxygen programs that illustrate that these problems can be overcome. Th...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract::Respiratory volume monitoring (RVM) has been developed to noninvasively measure minute ventilation (V̇E), tidal volume, and breathing frequency and to display real-time respiratory curves in nonintubated patients. Although RVM was originally developed for post-anesthesia and monitored anesthesia care, we describe 3 ap...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03744
更新日期:2015-05-01 00:00:00
abstract::Health care costs continue to skyrocket, and a large portion of these costs can be attributed to technology. Some technology, such as oximetry, is relatively inexpensive compared to CAT scanning and magnetic resonance imaging. Therefore, it may elude close scrutiny and direct health care planning and, with little fanf...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1988-04-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated the safety of flexible bronchoscopy (FB) in mechanically ventilated subjects. However, the safety of FB in adult subjects receiving extracorporeal membrane oxygenation (ECMO) has not been described previously. METHODS:A retrospective review was conducted of all adult subje...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04456
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:To describe the self-expanding endobronchial occluder, as utilized in bronchoscopic lung volume reduction, with a 36 month follow-up procedure. METHODS:Twenty-three subjects with severe emphysema were recruited and underwent flexible bronchoscopic placement of self-expanding endobronchial occluders. Outcomes...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02218
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:It is well established that the work rate increment size affects the duration of test and physiological responses to exercise during cycling in patients with COPD. However, this has never been tested for incremental step tests. OBJECTIVE:To compare the exercise tolerance time, cardiopulmonary stress, and p...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01742
更新日期:2012-11-01 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:UNLABELLED:The development of an expanded understanding of employees' reaction to their job may be important for improvement in the quality of work life and of services rendered. We sought to determine the factors, or rewards, that significantly affect respiratory therapists' job satisfaction. METHOD:Questionnaires de...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1989-03-01 00:00:00
abstract:BACKGROUND:Obstructive lung disease is diagnosed by a decreased ratio of FEV1 to the vital capacity (VC). Although the most commonly used VC is FVC, American Thoracic Society guidelines suggest alternative VCs, for example, slow VC (SVC), may offer a more-accurate evaluation of breathing capacity. There is recent evide...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06419
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Chest x-ray (CXR) is widely used for diagnosing and screening pulmonary tuberculosis (PTB), yet its validity is debatable and its costs are relatively high. This study aimed to determine the validity of CXR screening in detecting radiological findings compatible with active PTB or with old healed tuberculos...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01475
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:Blow-by, a common form of nebulizer therapy, in which the device is held away from a child's face, has been dismissed as ineffective because studies have demonstrated incremental aerosol drop-off with increasing distances from the face. Many of these studies do not take into account differences among nebuliz...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01653
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Adaptive pressure control is a mode of mechanical ventilation where inflation pressure is adjusted by the ventilator to achieve a target tidal volume (VT). This means that as patient effort increases, inflation pressure is reduced, which may or may not be clinically appropriate. The purpose of this study was...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2009-11-01 00:00:00