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 nebulization (2.8 mol/L), record diaphragm excursions during reflexive coughs in stroke subjects at risk of silent aspiration, and compare these values with those of stroke subjects without risk of aspiration or dysphagia. METHODS:Twenty-one subjects with subacute stroke (mean stroke onset, 13.6 d) at risk of silent aspiration (penetration-aspiration scale, 8) and 21 stroke subjects without dysphagia or aspiration (controls) were included. Diaphragmatic excursions were assessed using real-time sonography in all subjects; the main outcome measure was reflexive CPF induced by citric acid nebulization. RESULTS:The median (interquartile range) values of citric acid-induced CPF values were significantly more reduced in the 21 subjects with silent aspiration (45 [0-83] L/min) than in the control subjects (97 [66-162] L/min) (P = .004). Diaphragmatic excursions during the reflexive coughs were also significantly reduced (P < .001), although both groups had a similar range in the initial National Institutes of Health Stroke Scale scores and level of disability, as measured by the modified Barthel index. Citric acid-induced CPF was significantly correlated with the number of generated coughs (rs = 0.69), voluntary cough CPF (rs = 0.85), and degree of diaphragm excursion on both sides (rs = 0.50 [hemiplegic] and rs = 0.55 [nonhemiplegic]) but not correlated with the degree of hemiparesis, National Institutes of Health Stroke Scale score, or modified Barthel index scores. The 6-month follow up revealed that 7 subjects in group A experienced aspiration pneumonia. CONCLUSIONS:Stroke subjects at risk of silent aspiration showed reduced CPF and more limited diaphragm excursion during the citric acid-induced reflexive cough test. (ClinicalTrials.gov registration NCT02080988.).
journal_name
Respir Carejournal_title
Respiratory careauthors
Choi YM,Park GY,Yoo Y,Sohn D,Jang Y,Im Sdoi
10.4187/respcare.05488subject
Has Abstractpub_date
2017-12-01 00:00:00pages
1571-1581issue
12eissn
0020-1324issn
1943-3654pii
respcare.05488journal_volume
62pub_type
杂志文章相关文献
Respiratory Care文献大全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 benefits of contract learning have been identified in the literature as increased individualization to meet the student's individual needs, promotion of learner independence, and development of lifelong learning behaviors among students. METHODS:I used an "action research" approach to implement the cont...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:The aim of this study was to develop an efficient, low-cost, home-based pulmonary rehabilitation program and to evaluate the impact of the program on exercise as measured by the 6-min walk test (6MWT) and treadmill endurance test. METHODS:Twenty-nine subjects with COPD (FEV1 = 62.4 ± 10.7% of predicted, 62....
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:10.4187/respcare.02994
更新日期:2015-04-01 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:The frequency of combined obstruction and restriction identified in pulmonary function tests has not been well described. Moreover, although the causes of combined-obstruction-and-restriction patterns are known, the frequency of the various etiologies has received little attention. METHODS:We retrospectivel...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2010-03-01 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::Several algorithms exist to facilitate spirometric interpretation in clinical practice, yet there is a lack of consensus on how spirometric criteria for asthma, COPD, and restrictive disorders should be incorporated into spirometry interpretation algorithms suitable for use in day-to-day primary care management. The p...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07294
更新日期:2020-10-01 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: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
abstract:BACKGROUND:Weaning through noninvasive ventilation (NIV) after early extubation may facilitate invasive ventilation withdrawal and reduce related complications in patients with hypercapnic respiratory failure. However, the effects of NIV weaning are uncertain in patients with acute hypoxemic respiratory failure (AHRF)....
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07542
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:The addition of heated humidification to CPAP has been shown to improve nasal adverse effects in subjects with obstructive sleep apnea (OSA). However, current data regarding improvement in CPAP adherence is conflicting. Furthermore, there are no data from a tropical climate area with a high humidity level. ...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:10.4187/respcare.04536
更新日期:2016-09-01 00:00:00
abstract::In blood gas laboratory quality-assurance programs, which are routinely included with materials sold for quality control, raw data are sent to a data processing center for reduction to statistics meaningful to the laboratory's quality-control effort. This data reduction service usually requires a turn-around time of 2...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1984-04-01 00:00:00
abstract:BACKGROUND:The diagnosis of tuberculous pleural effusion (TBPE) has some limitations. We studied the efficacy of interleukin-27 (IL-27) in the diagnosis of TBPE. METHODS:We measured IL-27, adenosine deaminase (ADA), ADA-2, interferon-gamma (IFNγ), and the ADA·IL-27 and ADA-2·IL-27 products in all the pleural effusion ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02749
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:To maximize the likelihood of successful long-term mechanical ventilation (MV) in patients with neuromuscular diseases, ventilator characteristics and settings must be chosen carefully, taking into account both medical requisites and the patient's preference and comfort. OBJECTIVES:To evaluate patients' kno...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02229
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Pneumothorax is a well known complication of pulmonary tuberculosis (TB), particularly in patients with advanced TB. METHODS:At our national TB-referral hospital, we compared the medical records of 53 TB patients with pneumothorax and 106 TB patients without pneumothorax, seen in 2003 to 2008. We analyzed d...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.00695
更新日期:2011-03-01 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:BACKGROUND:The purpose of this study was to examine socioeconomic variations in the use of prescription medicines among elderly subjects with COPD. METHODS:Data from the Danish national administrative registers were used. The study population included 1,365 individuals >60 y old residing in the Municipality of Copenha...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.04335
更新日期:2016-07-01 00:00:00
abstract::A 20-year-old man was admitted in the neurology ICU after the drainage of a large frontal hematoma related to the spontaneous bleeding of a recently diagnosed cavernoma. On admission the Glasgow coma score was 4/15, with evidence of sub-falcorial herniation and elevated intracranial pressure. On the 4th postoperative...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01322
更新日期:2012-07-01 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:In this study, we aimed to validate the agreement between pulmonary function measurements obtained with a portable spirometer and measurements obtained with conventional spirometry in Chinese pediatric and adult populations. METHODS:Pulmonary function testing was performed to evaluate subjects enrolled at S...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.07116
更新日期:2020-05-01 00:00:00
abstract::Two electronic systems for monitoring respiratory rates in critical care patients were evaluated--one a system using impedance sensors and the other a system using thermistor sensors. The thermistor sensor, attached to a nasal cannula or air-entrainment mask, was connected to a sensitivity calibrating control and a di...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1981-03-01 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:BACKGROUND:Heliox and forward-leaning posture (torso inclined forward at 50-60° with the elbows resting on the thighs) are adjuncts in the administration of nebulized bronchodilator to patients with acute asthma. METHODS:We randomized 59 patients who presented to the emergency department in severe asthma crisis, into ...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:10.4187/respcare.00963
更新日期:2011-07-01 00:00:00
abstract::Dexmedetomidine is a selective alpha-2 receptor agonist that possesses both sedative and analgesic properties, with minimal respiratory depression. We report the successful administration of dexmedetomidine on a 16-year-old primigravida woman that allowed the patient to tolerate application of bi-level positive airwa...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.01733
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:Pneumoperitoneum and Trendelenburg position affect respiratory system mechanics and oxygenation during elective pelvic robotic surgery. The primary aim of this randomized pilot study was to compare the effects of a conventional low tidal volume ventilation with PEEP guided by gas exchange (VGas-guided) versu...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:10.4187/respcare.07238
更新日期:2020-05-01 00:00:00
abstract::Bronchopulmonary dysplasia (BPD) is a common long-term complication in premature newborns requiring ventilatory support and is the most common cause of chronic diffuse lung disease in this population. We present the clinical course of a premature newborn with a complicated neonatal respiratory course that was initiall...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.02847
更新日期:2014-11-01 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:HYPOTHESIS:We hypothesized that aerosol distribution in the lungs of patients with cystic fibrosis changes with positive expiratory pressure (PEP). METHODS:Eight patients were randomized to one of 2 conditions. On one study day, patients inhaled saline aerosol containing 99mtechnetium generated by a Pari LC Plus nebul...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:
更新日期:2005-11-01 00:00:00
abstract::The federal government regulates human research with a local institutional review board (IRB) at your institution. Your IRB's main responsibility is to protect the rights and welfare of human subjects recruited to participate in research. The IRB is responsible for reviewing and approving all research protocols that i...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2008-10-01 00:00:00
abstract::The problem of patients in isolation becoming disconnected from their ventilator systems is a serious one, as the closed doors of an isolation room usually prevent hospital personnel outside the room from hearing or seeing standard ventilator alarms To overcome this potentially life-threatening problem, we modified a ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1986-05-01 00:00:00