Abstract:
BACKGROUND:Volume-targeted ventilation is increasingly used in low birthweight infants because of the potential for reducing volutrauma and avoiding hypocapnea. However, it is not known what level of air leak is acceptable during neonatal volume-targeted ventilation when leak compensation is activated concurrently. METHODS:Four ICU ventilators (Servo-i, PB980, V500, and Avea) were compared in available invasive volume-targeted ventilation modes (pressure control continuous spontaneous ventilation [PC-CSV] and pressure control continuous mandatory ventilation [PC-CMV]). The Servo-i and PB980 were tested with (+) and without (-) their proximal flow sensor. The V500 and Avea were tested with their proximal flow sensor as indicated by their manufacturers. An ASL 5000 lung model was used to simulate 4 neonatal scenarios (body weight 0.5, 1, 2, and 4 kg). The ASL 5000 was ventilated via an endotracheal tube with 3 different leaks. Two minutes of data were collected after each change in leak level, and the asynchrony index was calculated. Tidal volume (VT) before and after the change in leak was assessed. RESULTS:The differences in delivered VT between before and after the change in leak were within ±5% in all scenarios with the PB980 (-/+) and V500. With the Servo-i (-/+), baseline VT was ≥10% greater than set VT during PC-CSV, and delivered VT markedly changed with leak. The Avea demonstrated persistent high VT in all leak scenarios. Across all ventilators, the median asynchrony index was 1% (interquartile range 0-27%) in PC-CSV and 1.8% (0-45%) in PC-CMV. The median asynchrony index was significantly higher in the Servo-i (-/+) than in the PB980 (-/+) and V500 in 1 and 2 kg scenarios during PC-CSV and PC-CMV. CONCLUSIONS:The PB980 and V500 were the only ventilators to acclimate to all leak scenarios and achieve targeted VT. Further clinical investigation is needed to validate the use of leak compensation during neonatal volume-targeted ventilation.
journal_name
Respir Carejournal_title
Respiratory careauthors
Itagaki T,Bennett DJ,Chenelle CT,Fisher DF,Kacmarek RMdoi
10.4187/respcare.05012subject
Has Abstractpub_date
2017-01-01 00:00:00pages
10-21issue
1eissn
0020-1324issn
1943-3654pii
respcare.05012journal_volume
62pub_type
杂志文章相关文献
Respiratory Care文献大全abstract:BACKGROUND:Smoking is a serious problem in prisons. This work aimed to assess smoking-related behaviors and the effectiveness of tobacco cessation therapy in prison. METHODS:This study includes four visits to a prison in Bolvadin-Afyon, Turkey. Pharmacologic options for tobacco cessation were offered to the participan...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04122
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Most heat-and-moisture exchangers (HMEs) for patients with tracheostomy and spontaneously breathing are small and have suction ports that allow some expiratory gas to escape, which loses water vapor held in the expired gas. Recently, a heated-and-humidified high-flow system for spontaneously breathing patien...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06294
更新日期:2019-02-01 00:00:00
abstract:INTRODUCTION:Common modalities of clinical exercise testing for outcome measurement after pulmonary rehabilitation (PR) include walk tests, progressive cycle ergometry, and cycle endurance testing. We hypothesized that patients' responses to PR, as measured by those 3 tests, are differentially correlated, and we design...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2004-12-01 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::Ventilator circuits should not be changed routinely for infection control purposes. The maximum duration of time that circuits can be used safely is unknown. Evidence is lacking related to ventilator-associated pneumonia (VAP) and issues of heated versus unheated circuits, type of heated humidifier, method for filling...
journal_title:Respiratory care
pub_type: 指南,杂志文章,实务指引
doi:
更新日期:2003-09-01 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:Beneficial effects of high-flow nasal cannula (HFNC) oxygen on oxygenation and respiratory parameters have been reported in a small number of subjects with acute respiratory failure (ARF). We aimed to evaluate its effect in subjects with ARDS. METHODS:This was an observational single-center study. Prospecti...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03423
更新日期:2015-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to systematically review all current interventions that have been utilized to improve respiratory function and activity after stroke. METHODS:Specific searches were conducted. The experimental intervention had to be planned, structured, repetitive, purposive, and delivered with the...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.06000
更新日期:2018-07-01 00:00:00
abstract:INTRODUCTION:There is a need to develop simple, noninvasive, and sensitive outcome measures for respiratory therapy. Adventitious respiratory sounds (ie, crackles and wheezes) can be objectively characterized with computerized respiratory sound analysis (CORSA) and have been shown to contribute for diagnosis purposes; ...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.02765
更新日期:2014-05-01 00:00:00
abstract::Three devices used to humidify the air delivered to hospitalized patients were evaluated for their relative hazard as measured by the concentration of bacterial output delivered with the gas. Two of the devices were evaporative types (commonly called "humidifiers"), moisturizing with water vapor, while the third was a...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1979-03-01 00:00:00
abstract:BACKGROUND:Critically ill mechanically ventilated patients experience impaired airway clearance due to ineffective cough and impaired secretion mobilization. Cough augmentation techniques, including mechanical insufflation-exsufflation (MI-E), manually assisted cough, and lung volume recruitment, improve cough efficien...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04775
更新日期:2016-10-01 00:00:00
abstract:BACKGROUND:Gas exchange measurements for carbon dioxide elimination (V̇CO2 ) and oxygen consumption (V̇O2 ) have been used to derive resting energy expenditure and guide energy prescription. Volumetric capnography is used in intensive care units and provides V̇CO2 measurements that could be used for titrating respirato...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04282
更新日期:2016-03-01 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:BACKGROUND:Though smokers are known to have elevated blood carboxyhemoglobin (COHb), due to inhalation of carbon monoxide (CO) in cigarette smoke, limited data exist regarding COHb levels in nonsmokers exposed to secondhand smoke. METHODS:COHb was measured using a new noninvasive pulse CO-oximeter (Rad-57, Masimo, Irv...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2006-07-01 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::The development and evolution of the endotracheal tube (ETT) have been closely related to advances in surgery and anesthesia. Modifications were made to accomplish many tasks, including minimizing gross aspiration, isolating a lung, providing a clear facial surgical field during general anesthesia, monitoring laryngea...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.02868
更新日期:2014-06-01 00:00:00
abstract::Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrotic lung disease with no clear etiology and few therapeutic options. Growth factors that act as mediators in the development of this disease might be important therapeutic targets. Nintedanib is a triple-tyrosine kinase inhibitor and a potent antagoni...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.03023
更新日期:2014-09-01 00:00:00
abstract::Mechanical ventilation incurs substantial morbidity, mortality, and costs. Both premature extubation and delayed extubation can cause harm. Therefore, weaning that is both expeditious and safe is highly desirable. The purpose of this review is to summarize the literature related to weaning modes, spontaneous breathing...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2001-12-01 00:00:00
abstract::Congenital parenchymal lung malformations have an estimated incidence at 1:25,000-1:35,000 births. We present a case of this rare congenital abnormality in a 38 year-old male, review the current literature with discussion of proposed causes, malignant potential, and management strategies. A 38-year-old white male pre...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.00727
更新日期:2012-02-01 00:00:00
abstract::Appropriately designed and conducted research is necessary for improving patient care and optimizing health outcomes, but access to best evidence is not enough to make these things happen. In respiratory care, as in other fields, patients do not benefit as much as they should from research findings and evidence-based ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:Jet nebulizers constitute the aerosolization devices most frequently used during mechanical ventilation. Continuous nebulization can influence the delivered tidal volume (V(T)) and lead to significant medication loss during expiration. Ventilators thus provide integrated jet nebulization systems that are syn...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02637
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Asthma is defined by airway inflammation associated with various respiratory symptoms, and pharmacologic treatment is based on inhaled corticosteroids and bronchodilators. Physical activity, educational training, nutritional support, and psychological counseling are considered part of non-pharmacologic treat...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06761
更新日期:2019-12-01 00:00:00
abstract::Extracorporeal membrane oxygenation (ECMO) is a form of cardiopulmonary bypass adapted for long-term use. Blood is drained from the patient, pumped through an artificial lung or membrane where gas exchange is augmented, and then re-infused back to the patient. ECMO provides support for the neonate with severe respirat...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Microalbuminuria, used as a marker of endothelial dysfunction, is a predictor of mortality for any reason and of cardiovascular events. Recent research on the management of COPD has focused more on comorbidities, including cardiovascular events. The objective of this study was to investigate the incidence of...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.05168
更新日期:2017-03-01 00:00:00
abstract::Because of the design characteristics, flow-triggering appears to offer measurable advantages over pressure-triggering, particularly during spontaneous breathing. During the trigger phase, flow-triggering provides a relatively shorter time delay than pressure-triggering. A trigger sensitivity that does not cause autoc...
journal_title:Respiratory care
pub_type: 共识发展会议,杂志文章,评审
doi:
更新日期:1992-09-01 00:00:00
abstract:BACKGROUND:Continuous high-frequency oscillation (CHFO) is a therapeutic mode for the mobilization of secretions. The Metaneb CHFO device also incorporates aerosol administration using an integrated jet nebulizer. However, the effectiveness of aerosol delivery and influential factors remain largely unreported. METHODS...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07050
更新日期:2020-02-01 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::We present a patient with acute-onset dyspnea and unexplained severe hypoxemia. No signs of severe cardiopulmonary disease, pulmonary arterial hypertension, or pulmonary embolism were present. The patient was diagnosed with hepatopulmonary syndrome, since liver disease of alcoholic origin was present, markedly increa...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01612
更新日期:2012-11-01 00:00:00
abstract::It should be recognized that the advent of LTOT created a new health care system that is based on powerful scientific data. Oxygen therapy studies such as those by the Nocturnal Oxygen Therapy Trial Group and the British Medical Research Council study clearly demonstrated that LTOT improves both the length and quality...
journal_title:Respiratory care
pub_type: 共识发展会议,杂志文章,评审
doi:
更新日期:2000-08-01 00:00:00
abstract:BACKGROUND:Clinical preceptors in respiratory therapy (RT) are expected to possess effective teaching skills and qualities that signify their knowledge, expertise, and professionalism. Thus, it is important to determine which teaching characteristics are effective among RT clinical preceptors from the administrators' p...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.06947
更新日期:2020-02-01 00:00:00