Abstract:
BACKGROUND:Assisted coughing via mechanical in-exsufflation (MI-E) is a first-line treatment for secretion management in patients with amyotrophic lateral sclerosis (ALS) with unassisted CPF < 4.25 L/s. Some devices enable oscillations to be added to MI-E (MI-E+O). We sought to determine whether adding oscillations to MI-E enables a reduction in the use of invasive secretion management procedures (ie, bronchoscopy or tracheostomy) in subjects with ALS. METHODS:We conducted a 12-month, prospective, randomized follow-up study of subjects with ALS for whom assisted coughing techniques were indicated. One group was treated with oscillations in addition to MI-E (MI-E+O), and the other group was treated with conventional MI-E. RESULTS:29 subjects were included in the MI-E group and 27 subjects were included in the MI-E+O group. Five subjects (8.9%) required invasive techniques for secretion management (3 in the MI-E group and 2 in the MI-E+O group, P = .70). Treatment with MI-E+O did not alter the risk of invasive procedures (odds ratio 0.69, 95% CI 0.10-4.50, P = .70). The mean number of respiratory infections was 0.58 ± 0.16 in the MI-E group and 0.025 ± 0.08 in the MI-E+O group (P = .10). Survival was 8.96 ± 0.18 months in the MI-E group and 7.70 ± 0.70 months in the MI-E+O group (P = .10). CONCLUSION:Adding oscillations to MI-E did not enable a reduction in the need to perform invasive procedures for secretion management in subjects with ALS.
journal_name
Respir Carejournal_title
Respiratory careauthors
Sancho J,Burés E,Ferrer S,Bondía E,Servera Edoi
10.4187/respcare.07202subject
Has Abstractpub_date
2020-05-01 00:00:00pages
596-602issue
5eissn
0020-1324issn
1943-3654pii
respcare.07202journal_volume
65pub_type
杂志文章相关文献
Respiratory Care文献大全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: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:INTRODUCTION:Electrostatic attraction of aerosolized particles to the inner walls of an aerosol holding chamber (HC) made from a nonconducting material can reduce medication delivery, particularly if there is a delay between actuation and inhalation. OBJECTIVE:Compare total emitted mass and fine-particle mass (mass of...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2006-05-01 00:00:00
abstract:OBJECTIVE:Evaluate the effects of continuous positive airway pressure (CPAP)/positive end-expiratory pressure (PEEP) and pressure support ventilation (PSV) on work of breathing (WOB). METHODS:With 13 anesthetized lambs we measured WOB with an esophageal balloon and flow signals. All the animals were sedated, intubated...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVE:To determine whether outcomes (mortality and need for intensive care unit [ICU] readmission) of patients undergoing tracheostomy in the ICU can be predicted by common clinical or historical criteria. METHODS:We conducted a retrospective review of data from the medical record and Project Impact database in a ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2009-12-01 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:Inhaled sedation is efficient and easily controllable; in low concentrations it causes minimal changes in the patient and very little interference with hemodynamics. Awakening after inhaled sedation is quick and predictable. The major reason inhaled sedation has not become widely used in intensive care is th...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2008-10-01 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:UNLABELLED:Lectures and demonstrations have been the teaching and testing strategies most often employed by the American Heart Association in Advanced Cardiac Life Support (ACLS) training. I compared the abilities of interactive videodisc (IVD) courseware and ACLS instructors to evaluate airway management skills. METH...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1991-08-01 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::COPD is a complex collection of conditions. All share the feature of limited expiratory air flow. It is a "disease" in the same sense as is "chronic renal failure." Like most other chronic organ failure "diseases," COPD has disparate causes, and patients are heterogeneous in their prognosis and response to treatment. ...
journal_title:Respiratory care
pub_type:
doi:10.4187/respcare.01419
更新日期:2011-08-01 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: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: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:BACKGROUND:The utilization of noninvasive ventilation (NIV) in the Veterans Affairs health-care system is not well characterized. A survey of physicians and respiratory therapists was conducted to better understand its use. METHODS:Three hospitals in each of 21 Veterans Affairs networks were selected based on severity...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2009-10-01 00:00:00
abstract:BACKGROUND:The 2005 American Thoracic Society/European Respiratory Society guidelines on spirometry emphasize examination of the inspiratory curve of the flow-volume loop for evidence of intrathoracic or extrathoracic upper airway obstruction. We sought to determine how frequently evaluations are performed for abnormal...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2009-04-01 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::Inhaled aerosol drugs commonly used by patients with chronic obstructive pulmonary disease include short-acting and long-acting bronchodilators, as well as corticosteroids. These agents are available in a variety of inhaler devices, which include metered-dose inhalers (MDI), breath-actuated MDIs, nebulizers, and, curr...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:
更新日期:2006-02-01 00:00:00
abstract:BACKGROUND:Because of our concern for the safety of bedside caregivers who care for infants receiving ribavirin for long periods of time each day for many days, we evaluated the effectiveness of a double-tent enclosure with vacuum scavengers during simulated and actual patient administration. MATERIALS & METHODS:Part ...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract::We describe a unique presentation of polymyositis-associated pneumonitis. A 45-year-old man with a history of polymyositis presented with an episode of fever, cough, dyspnea, rapidly progressive respiratory failure, and unilateral pulmonary infiltrates. Although bacterial pneumonia was initially suspected, all culture...
journal_title:Respiratory care
pub_type: 杂志文章
doi:
更新日期:2007-12-01 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: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:Arterial oxygen desaturation frequently occurs in patients with COPD during daily activities at home. Oxygen flow is usually set at fixed and low rates for ambulatory patients. We evaluated an innovative closed-loop system (FreeO2) that automatically adjusts the oxygen flow to the patient's needs in subjects...
journal_title:Respiratory care
pub_type: 杂志文章,随机对照试验
doi:10.4187/respcare.04406
更新日期:2016-11-01 00:00:00
abstract::Extracorporeal life support (ECLS), or extracorporeal membrane oxygenation (ECMO) as it is also known, has been used to support over 45,000 patients to date. Overall survival is 62%. After many years of no change in equipment and technology, there has been a recent flurry of new pumps, cannulas, and oxygenators avail...
journal_title:Respiratory care
pub_type: 杂志文章,评审
doi:10.4187/respcare.01369
更新日期:2011-09-01 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: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: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: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::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:BACKGROUND:Emphysema and fibrosis, typically the idiopathic pulmonary fibrosis (IPF) form of usual interstitial pneumonia (UIP), can co-exist as combined pulmonary fibrosis emphysema (CPFE). It is unknown whether there is a pathobiologic basis for CPFE beyond the coexistence of fibrosis and emphysema. The aim of this s...
journal_title:Respiratory care
pub_type: 杂志文章
doi:10.4187/respcare.03389
更新日期:2015-02-01 00:00:00