Respiratory care最新文献

{"title":"Empowering Respiratory Therapists and Reconsidering Mucolytics in Patients on Mechanical Ventilation: A Step Toward High-Value Care.","authors":"Brian J Ring","doi":"10.1089/respcare.13203","DOIUrl":"https://doi.org/10.1089/respcare.13203","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasopharyngeal Airspace Temperature During Rhinothermy.","authors":"Michael D Davis","doi":"10.1089/respcare.13247","DOIUrl":"https://doi.org/10.1089/respcare.13247","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Knowledge Gaps for Mechanical Insufflation-Exsufflation.","authors":"L Denise Willis","doi":"10.1089/respcare.13219","DOIUrl":"https://doi.org/10.1089/respcare.13219","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway Opening Pressure: Positively Perplexing Parameters.","authors":"Robert L Chatburn","doi":"10.1089/respcare.13139","DOIUrl":"https://doi.org/10.1089/respcare.13139","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeing in Synchrony: Toward Personalized Noninvasive Ventilation in Amyotrophic Lateral Sclerosis Through Dynamic Upper-Airway Visualization.","authors":"Tiina M Andersen, Bebiana Conde, Maria Vollsæter","doi":"10.1089/respcare.13193","DOIUrl":"https://doi.org/10.1089/respcare.13193","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attributes of Socio-Academic Culture in Successful Entry-to-Practice Respiratory Therapy Programs.","authors":"Thomas D Jones","doi":"10.1089/respcare.13073","DOIUrl":"https://doi.org/10.1089/respcare.13073","url":null,"abstract":"<p><p><b>Background:</b> Competencies desired of respiratory therapy (RT) graduates entering the workforce have been clearly defined. RT educators are strategic and purposeful when designing curriculum, securing program resources, and ensuring clinical rotations to aid students in achieving these competencies. Nonacademic factors, including academic culture, influence student engagement, learning readiness, motivation, and success. Research describing socio-academic culture in health professions programs is extremely limited. The attributes of socio-academic culture in successful respiratory therapy programs are unknown. The study's purpose was to discover the attributes that contribute to the socio-academic culture of successful entry-to-practice respiratory therapy programs as perceived by faculty. <b>Methods:</b> A qualitative, multiple-site, case-based inquiry of 6 successful entry-to-practice respiratory therapy programs from diverse academic and geographic settings was undertaken. Program data were obtained from public sources. Semi-structured interviews were conducted with key program personnel and full-time faculty members. Content saturation was assessed across all cases. Inductive analysis was used to code transcripts into individual characteristics and broader socio-academic themes. <b>Results:</b> Nineteen distinct characteristics and 8 defining themes related to socio-academic culture were identified. Successful programs were perceived to (1) build community, (2) create supportive environments, (3) establish expectations of excellence, (4) cultivate professionalism, (5) ensure meaningful clinical experiences, (6) emphasize reflection, (7) promote critical thinking, and (8) pursue continuous improvement. <b>Conclusions:</b> The defining themes describe the attributes of learning culture in successful respiratory therapy programs. Attributes of socio-academic culture in successful respiratory therapy programs align with predefined, essential RT professional competencies that support student development of the professional characteristics desired of entry-level respiratory therapists.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bench Evaluation of the Sedaconda Inhaled Sedation Device: Hygrometric Properties and Device Resistance.","authors":"François Lellouche, Laura-Ann Cyr, Pierre-Alexandre Bouchard","doi":"10.1089/respcare.12987","DOIUrl":"https://doi.org/10.1089/respcare.12987","url":null,"abstract":"<p><p><b>Background:</b> The Sedaconda Anesthetic Conserving Device (ACD-S) is used for inhaled sedation in intubated patients and has passive humidification properties linked to the carbon material. However, limited evaluations of the hygrometric performance are available. The main aim of the study was to assess the humidification performance of this device with different ventilator settings and ambient temperatures. <b>Methods:</b> We assessed hygrometry of inspiratory gases and resistance of the Sedaconda ACD-S using a bench test. Hygrometric measurements were performed with 5 min ventilations from 4.8 to 18 L/min (at constant ambient temperature: 25 ± 1°C) and with 3 ambient temperatures, 22-24°C, 25 ± 1°C, and 28-30°C (at constant minute ventilation: 10 L/min). Simulation of physiologic expiratory gases with an absolute humidity of 35 mg H₂O/L was used for main measurements. Some measurements were made with expiratory humidity of 27.5 mg H₂O/L which corresponds to what is found in patients with moderate hypothermia. Three hygrometric measurements using the psychrometric method were performed for each tested condition. Device resistance was evaluated before utilization and after 96 h on the humidified bench and compared with a paper- and foam-based heat and moisture exchangers (HME) with similar dead spaces. <b>Results:</b> In tested conditions, mean humidity output was 29.8 ± 1.3 mg H₂O/L. We found slightly lower humidity output at low versus high minute ventilation (respectively 28.0 ± 0.3 vs 30.6 ± 0.3, <i>P</i> < .001) and lowest versus highest ambient temperature (29.6 ± 0.3 vs 31.0 ± 0.2 mg H₂O/L, <i>P</i> = .02). These differences are probably not clinically important. We found a linear relationship between expiratory and inspiratory humidity (<i>R</i>² = 0.98, <i>P</i> < .001). Resistance of the tested device was higher, in comparison with paper- and foam-based HMEs, and increased slightly after 96 h of use on the bench. <b>Conclusions:</b> The Sedaconda ACD-S is a high-performance passive humidifier device, within all tested conditions of minute ventilation, tidal volume, and ambient temperature. Resistance was slightly higher compared with HMEs with similar dead space and different materials.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Simulation-Enhanced Interprofessional Experiential Learning on Physical and Respiratory Therapy Students.","authors":"Michelle Keller, Jessica J Arndt, Matthew R Schumacher, Christine Sperle, Erin Haustveit","doi":"10.1089/respcare.12982","DOIUrl":"https://doi.org/10.1089/respcare.12982","url":null,"abstract":"<p><p><b>Background</b>: The urgent need for health care professionals to collaborate and create innovative care models is unprecedented. Interprofessional education (IPE) interventions aim to promote collaborative competence and improve health care processes and outcomes. Therefore, this study aims to examine the impact of a simulation-based interprofessional education (SIM-IPE) project on physical therapist (PT) and respiratory therapist (RT) students' knowledge, perceptions, and collaboration skills, as well as its influence on their attitudes and behaviors toward IPE and clinical practice. <b>Methods</b>: This study was a mixed-methods design that employed the Interprofessional Socialization and Valuing Scale-21 (ISVS-21) to assess students' comfort, value, and ability to work interprofessionally as well as their beliefs, behaviors, and attitudes toward IPE. At the conclusion of their SIM-IPE experience, students completed the Interprofessional Education Experience: Interprofessional Assignment Report created by the Interprofessional Education Collaborative. These reflections were qualitatively studied to assess the students' knowledge and attitudes toward one another's professions. Descriptive statistics were calculated and reported. A Wilcoxon signed-rank test examined pre- and postscores of the ISVS-21, whereas a thematic analysis was implemented for the qualitative analysis. <b>Results</b>: Forty total students participated in the SIM-IPE experience. A comparison of ISVS-21 preintervention (mean = 5.28, SD = 0.74) and postintervention total scores (mean = 6.34, SD = 0.56) showed a statistically significant improvement <i>(P</i> < .001). Qualitative analysis of student reflections showed key themes emphasizing the value of teamwork, the essential role of IPE in clinical practice, and the importance of understanding professional roles and responsibilities. <b>Conclusion</b>: This mixed-method study shows a successful SIM-IPE learning project used to enhance PT and RT students' abilities, values, and comfort with collaborative practice. It also positively influences their beliefs, behaviors, and attitudes toward IPE and clinical collaboration. Future research should address the long-term impacts and broader applicability of IPE between other varying disciplines.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Preoperative Diaphragm Thickening Fraction and Postoperative Pulmonary Complications Following Thoracoscopic Esophagectomy.","authors":"Kazuki Okura, Kakeru Hasegawa, Ririko Sakamoto, Yusuke Takahashi, Yushi Nagaki, Akiyuki Wakita, Yusuke Sato, Yuji Kasukawa, Naohisa Miyakoshi","doi":"10.1089/respcare.12686","DOIUrl":"https://doi.org/10.1089/respcare.12686","url":null,"abstract":"<p><p><b>Background:</b> This study aimed to investigate the association between preoperative diaphragm thickening assessed using ultrasound imaging and postoperative pulmonary complications (PPCs) in patients undergoing thoracoscopic esophagectomy for esophageal cancer. <b>Methods:</b> This single-center, prospective, cohort study enrolled subjects with esophageal cancer who were scheduled to undergo thoracoscopic esophagectomy between June 2021 and May 2024. The diaphragm thickening fraction (DTF) was measured using ultrasound imaging preoperatively and 1 and 2 weeks postoperatively. Our primary outcome comprised overall PPCs. We investigated the longitudinal change in the DTF and the relationship between the DTF and PPCs. We also examined the optimal cutoff value for the ability of the DTF to predict PPCs. <b>Results:</b> This study enrolled 73 subjects. PPCs occurred in 21 (29%) subjects, 10 (14%) of whom had pneumonia. The estimated difference between the preoperative and 1-week postoperative least squares means of the DTF was -56.3% (95% credible interval [CrI] -65.4, -47.2), and -36.5% (95% CrI: -43.7, -29.2) between the preoperative and 2-week postoperative values. The mean relative risk of preoperative DTF to PPCs was 0.89 per 10% increase (95% CrI: 0.80, 0.99), after adjusting for potential confounders. In the posterior distribution, the probability that the RR of the DTF per 10% increase would be <1 was 98.0%. According to the receiver operating characteristic curve, the optimal cutoff value of preoperative DTF predicting PPCs was 123.6%. <b>Conclusions:</b> DTF is decreased 1 and 2 weeks after thoracoscopic esophagectomy in subjects with esophageal cancer. The higher the preoperative DTF, the lower the risk of occurrence of PPCs.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ventilator-Associated Pneumonia in Patients Using Proton Pump Inhibitors Versus Histamine H2 Receptor Antagonists: A Systematic Review and Meta-Analysis.","authors":"Francisco Willamy Pedrosa Alves Filho, Nágila Alves Lima, Beatriz Ximenes Mendes, Ivna Cavalcante Barros Sales","doi":"10.1089/respcare.12397","DOIUrl":"https://doi.org/10.1089/respcare.12397","url":null,"abstract":"<p><p><b>Background:</b> The common use of proton pump inhibitors (PPIs) and histamine 2 receptor antagonists (H2RA) in critically ill patients may increase the incidence of pneumonia associated with mechanical ventilation caused by alkalinization of gastric pH and microaspirations. Given the differences in the mechanisms of action of these drugs, we propose to evaluate, through a systematic review and meta-analysis, the incidence of ventilator-associated pneumonia (VAP) in this patient profile. <b>Methods:</b> We systematically searched PubMed, Embase, and Cochrane, and we included articles that evaluated subjects admitted to the ICU using mechanical ventilation for >48 hours, comparing PPI versus H2RA, to evaluate VAP as the primary outcome. Review Manager 5.4.1 was used for statistical analysis, and heterogeneity was examined with the <i>I</i>² statistic. We use Mantel-Haenszel as a statistical test. <b>Results:</b> A total of 33,471 subjects from 4 randomized controlled trials (RCTs) and 5 nonrandomized cohorts were included. In total, 16,515 (49.34%) subjects received PPI and 16,956 (50.65%) received H2RA. The average age of the population was 56 years. There was no difference in the incidence of VAP when using PPI versus H2RA (5.8% vs 6.1%; odds ratio [OR] 1.04, 95% CI 0.81-1.34, <i>P</i> = .77; <i>I</i>² = 69%) or all-cause mortality (31.88% vs 20.35%; OR 1.30, 95% CI 0.96-1.76, <i>P</i> = .09; <i>I</i>² = 93%) between groups. In a subanalysis of RCT-only data (469 subjects), the use of PPI or H2RA was also no different in the incidence of VAP (26.52% vs 20.50%; OR 1.41, 95% CI 0.50-3.98; <i>P</i> = .52; <i>I</i>² = 76%). <b>Conclusions:</b> The data show that the use of PPI or H2RA was indifferent to the incidence of VAP in subjects receiving mechanical ventilation for more than 48 hours. Furthermore, there was also no difference between the groups in relation to all-cause mortality, hospital stay, ICU stay, or duration of mechanical ventilation.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}