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 nebulizer systems. Using common, commercially available nebulizer systems, we defined the interaction of system components (nebulizer type, face mask configuration, and compressor characteristics) on aerosol delivery with and without blow-by. METHODS:A pediatric model consisting of a ventilated mannequin fitted with a filter (inhaled mass), and 3 commercial nebulizer/compressor/face mask systems (Pari Sprint, Respironics Sidestream, and Salter 8900) were used to nebulize budesonide (1.0 mg/2 mL) at 0, 2, and 4 cm from the face. Inhaled mass and the deposition on face, eyes, and mask were measured using high-performance liquid chromatography and reported as a percent of nebulizer charge. RESULTS:At 0 cm, inhaled mass for the Pari, Respironics, and Salter systems was 5.33%, 1.14%, and 3.50%, respectively; at 4 cm from the face, inhaled mass decreased to 1.83%, 0.13%, and 1.14%. Facial (1.12%, 0.63%, and 2.94%) and eye (0.35%, 0.12%, and 0.68%) deposition varied significantly. Pari compressor/nebulizer flow rate was lower than Respironics and Salter (3.5 L/min vs 5.7 L/min and 5.9 L/min), resulting in longer run time (7.7 min vs 4.0 min and 5.3 min). CONCLUSIONS:At 4 cm, the Pari system delivered more drug than Respironics at 0 cm, suggesting adequate therapy during blow-by for some systems. Our results indicate that pediatric aerosol delivery is a strong function of the nebulizer system as a whole, and not simply a function of blow-by distance from the face or nebulizer efficiency. In uncooperative children, blow-by can be an effective means of drug delivery with the appropriate nebulizer system.
journal_name
Respir Carejournal_title
Respiratory careauthors
Mansour MM,Smaldone GCdoi
10.4187/respcare.01653subject
Has Abstractpub_date
2012-12-01 00:00:00pages
2004-11issue
12eissn
0020-1324issn
1943-3654pii
rc01653r2mansourjournal_volume
57pub_type
杂志文章相关文献
Respiratory Care文献大全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:Thousands of children require mechanical ventilation each year. Although mechanical ventilation is lifesaving, it is also associated with adverse events if not properly managed. The systematic implementation of evidence-based practice through the use of guidelines and protocols has been shown to mitigate ris...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04723
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Percutaneous dilational tracheostomy (PDT) can potentially lead to hypoxia and alveolar derecruitment. The aim of this prospective study was to evaluate the efficacy of performing a recruitment maneuver (RM) before tracheostomy, in order to improve oxygenation. METHODS:We enrolled 29 eligible trauma patient...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:10.4187/respcare.01798
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Electrical impedance tomography measures changes in lung impedance, which are mainly related to changes in lung volume. We used electrical impedance tomography to investigate the effects of high-flow nasal cannula (HFNC) and body position on global and regional end-expiratory lung impedance variation (ΔEELI)...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02086
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:To determine whether propofol affects spontaneous breathing patterns in critically ill patients recovering from respiratory failure during initial attempts at liberation from mechanical ventilation. DESIGN:Observational cohort study. PATIENTS:Ten critically ill patients in the medical intensive care unit of...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2002-02-01 00:00:00
abstract:INTRODUCTION:Patients receiving invasive mechanical ventilation with an endotracheal tube (ETT) can often benefit from pharmaceutical aerosols; however, drug delivery through the ventilator circuit is known to be very inefficient. The objective of this study was to improve the delivery of aerosol through an invasive me...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02782
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:In patients suffering from brain injury, end-tidal PCO2 (PETCO2 ) monitoring is controversial, but transcutaneous PCO2 (PtcCO2 ), which is noninvasive and utilizes immediate display, may be an alternative method. We hypothesized that PtcCO2 would be more accurate than PETCO2 for monitoring PaCO2 in patients ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02726
更新日期:2014-08-01 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:BACKGROUND:Symptom burden increases during pulmonary exacerbations of cystic fibrosis (CF), and patient-reported outcome measures (PROMs) are often used to evaluate symptoms as either primary or secondary outcomes. However, there is currently no guidance on the use of PROMs to assess symptom burden during pulmonary exa...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.05638
更新日期:2018-03-01 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:Some patients with obstructive sleep apnea syndrome remove the CPAP device during sleep, although they start CPAP at bedtime. We hypothesized that body position changes and oxygen desaturations may be associated with patient removal of the CPAP device. METHODS:We consecutively enrolled 36 poor CPAP adherers...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03520
更新日期:2015-05-01 00:00:00
abstract::As hospitals begin to implement electronic medical records, the inadequacies of legacy paper charting systems will become more evident. One area of particular concern for respiratory therapists is the charting of mechanical ventilator settings. Our profession's lack of a standardized and generally accepted taxonomy fo...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:High-flow nasal cannula (HFNC) enables delivery of humidified gas at high flow while controlling the FIO2 . Although its use is growing in patients with acute respiratory failure, little is known about the impact of HFNC on lung volume. Therefore, we aimed to assess lung volume changes in healthy subjects at...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06031
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:COPD is one of the most common respiratory diseases. Patients with COPD experience and suffer from various physical and psychological symptoms. We performed this study to identify symptom clusters and the effects on quality of life (QOL) in patients with COPD. METHODS:A total of 130 COPD subjects were recru...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.05374
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Field walking tests are commonly used in patients with chronic pulmonary diseases for assessment of functional capacity. However, the physiological demands and magnitude of desaturation on 6-min walk test (6MWT), incremental shuttle walk test (ISWT), and endurance shuttle walk test (ESWT) have not been inves...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07171
更新日期:2020-05-01 00:00:00
abstract::A previously healthy 23-year-old man with nonproductive cough and sore throat presented to the hospital a few hours after chlorine gas exposure at a fitness center swimming pool. Initial physical examination and chest radiograph were normal. Thirty-six hours later he developed worsening dyspnea and cough, with develop...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2004-03-01 00:00:00
abstract::Noninvasive support of ventilation is commonly needed in patients with neuromuscular disease. Body ventilators, which are used rarely, function by applying intermittent negative pressure to the thorax or abdomen. More commonly, noninvasive positive-pressure ventilation (NPPV) is used. This therapy can be applied with ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:Healthy individuals without respiratory symptoms can sometimes present with low FEV1/FVC. The objective of this study was to characterize and compare subjects without symptoms and with reduced FEV1/FVC but normal FEV1 with subjects with mild obstructive lung disease. METHODS:Fifty healthy subjects with FEV1...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06131
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Definite diagnosis of transudative or exudative pleural fluids often presents a diagnostic dilemma. The aim of this study was to evaluate whether amino-terminal brain natriuretic peptide (NT-proBNP) levels in pleural fluid has a diagnostic value for discriminating heart-failure-related pleural effusions from...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01818
更新日期:2013-02-01 00:00:00
abstract::CPAP is a spontaneous mode of ventilation that maintains a constant airway pressure during the inspiratory and expiratory phases. This therapeutic modality is used across the continuum of care from pre-hospital treatment to intensive and acute care units to the home care environment to treat a host of acute and chroni...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.06625
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Recent literature suggests that optimization of tidal driving pressure (ΔP) would be a better variable to target for lung protection at the bedside than tidal volume (VT) or plateau pressure (Pplat), the traditional indicators of ventilator-induced lung injury. However, the usual range or variability of ΔP o...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06599
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:For early detection of respiratory and hemodynamic changes during anesthesia, continuous end-tidal carbon dioxide concentration (PETCO2) is monitored by capnometry. However, the accuracy of CO2 monitoring during spontaneous breathing in extubated patients remains undetermined. Therefore, we aimed to compare ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03557
更新日期:2015-05-01 00:00:00
abstract::Technological innovations in the ICU have led to artificially prolonged life, with an associated cost. Chronic critical illness (CCI) occurs in patients with prolonged mechanical ventilation and allostatic overload, and is associated with a discrete and consistent metabolic syndrome. Metabolic interventions are extra...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.01620
更新日期:2012-06-01 00:00:00
abstract::Chronic obstructive pulmonary disease is easily detected in its preclinical phase, using office spirometry. Successful smoking cessation prevents further disease progression in most patients. Spirometry measures the ratio of the forced expiratory volume in the first second to the forced vital capacity (FEV(1)/FVC), wh...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2003-12-01 00:00:00
abstract::In the critical care setting, usually the most important outcome is survival. However, this is not the only important outcome of critical care. There are increasing data that the patient's quality of life and functional status can be affected long after an intensive care unit stay, and some data suggest that mechanica...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2002-04-01 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:Chronic hypoxemia in patients with COPD is a limiting factor that is associated with disease progression and significantly contributes to decreased physical activity. Although correction of hypoxemia results in physiological improvements, oxygen therapy may be related to social isolation and inactivity. Howe...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06206
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:The human respiratory airway undergoes dramatic growth during infancy and childhood, which induces substantial variability in air flow pattern and particle deposition. However, deposition studies have typically focused on adult subjects, the results of which cannot be readily extrapolated to children. We dev...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02568
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Elevated dead space fraction (the ratio of dead space to tidal volume [V(D)/V(T)]) is a feature of ARDS. PEEP can partially reverse atelectasis, prevent alveoli recollapse, and improve lung compliance and gas exchange in patients with ARDS. However, whether V(D)/V(T) variables have a close relationship with ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01497
更新日期:2012-10-01 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