Respiratory care最新文献

{"title":"The Evolution of Intermittent Mandatory Ventilation: Update and Implications for Home Care.","authors":"Robert L Chatburn, Umur Hatipoğlu","doi":"10.4187/respcare.12187","DOIUrl":"10.4187/respcare.12187","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1484-1486"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editor's Commentary.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":"69 11","pages":"i"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to Letter to Editor Concerning \"Nocturnal Pressure Controlled Ventilation Improves Sleep Efficiency in Patients Receiving Mechanical Ventilation\".","authors":"Tzu-Tao Chen, Kun-Ta Lee, Ka-Wai Tam, Ming-Chi Hu","doi":"10.4187/respcare.12339","DOIUrl":"10.4187/respcare.12339","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":"69 11","pages":"1488-1489"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Opioid Prescription on the Occurrence and Outcome of Pneumonia: A Nationwide Cohort Study in South Korea.","authors":"Tak Kyu Oh, In-Ae Song","doi":"10.4187/respcare.11870","DOIUrl":"10.4187/respcare.11870","url":null,"abstract":"<p><strong>Background: </strong>Opioids are known to cause respiratory depression, aspiration, and to suppress the immune system. This study aimed to investigate the relationship between short- and long-term opioid use and the occurrence and clinical outcomes of pneumonia in South Korea.</p><p><strong>Methods: </strong>The data for this population-based retrospective cohort analysis were obtained from the South Korean National Health Insurance Service. The opioid user group consisted of those prescribed opioids in 2016, while the non-user group, who did not receive opioid prescriptions that year, was selected using a 1:1 stratified random sampling method. The opioid users were categorized into short-term (1-89 d) and long-term (≥90 d) users. The primary end point was pneumonia incidence from January 1, 2017-December 31, 2021, with secondary end points including pneumonia-related hospitalizations and mortality rates during the study period.</p><p><strong>Results: </strong>In total, 4,556,606 adults were enrolled (opioid group, 2,070,039). Opioid users had a 3% higher risk of pneumonia and an 11% higher risk of pneumonia requiring hospitalization compared to non-users. Short-term users had a 3% higher risk of pneumonia, and long-term users had a 4% higher risk compared to non-users (<i>P</i> < .001). Additionally, short-term users had an 8% higher risk of hospital-treated pneumonia, and long-term users had a 17% higher risk compared to non-users (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>Both short- and long-term opioid prescriptions were associated with higher incidences of pneumonia and hospital-treated pneumonia. In addition, long-term opioid prescriptions were linked to higher mortality rates due to pneumonia.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1424-1431"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141451400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenge of Implementing Race-Neutral PFT Reference Equations.","authors":"Ellen A Becker","doi":"10.4187/respcare.12404","DOIUrl":"10.4187/respcare.12404","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":"69 11","pages":"1480-1481"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Evidence For Pulmonary Rehabilitation in the Treatment of Long COVID.","authors":"Dave M Burnett","doi":"10.4187/respcare.12413","DOIUrl":"10.4187/respcare.12413","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":"69 11","pages":"1477-1479"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549623/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Fasting Prior to Extubation on Prevalence of Empty Stomach in Enterally Fed and Mechanically Ventilated Patients.","authors":"Esther Tang, Albert Km Chan, Lowell Ling","doi":"10.4187/respcare.11618","DOIUrl":"10.4187/respcare.11618","url":null,"abstract":"<p><strong>Background: </strong>Practice on fasting prior to extubation in critically ill patients is variable. Efficacy of fasting in reducing gastric volume has not been well established. The primary objective of this study was to assess the effect of 4 h of fasting on prevalence of empty stomach using gastric ultrasonography in critically ill subjects who are fasted for extubation. The secondary objectives were to evaluate the change in gastric volumes during 4 h of fasting and to determine factors associated with empty stomach after fasting.</p><p><strong>Methods: </strong>This was a single-center, prospective, observational study on adult ICU subjects who were enterally fed for at least 6 h continuously and mechanically ventilated. Gastric ultrasound was performed immediately prior to commencement of fasting, after 4 h of fasting, and after nasogastric (NG) aspiration after 4 h of fasting. An empty stomach was defined as a gastric volume ≤ 1.5 mL/kg.</p><p><strong>Results: </strong>Forty subjects were recruited, and 38 (95%) had images suitable for analysis. The prevalence of empty stomach increased after 4 h of fasting (25 [65.8%] vs 31 [81.6%], <i>P</i> = .041) and after 4 h of fasting with NG aspiration (25 [65.8%] vs 34 [89.5%], <i>P</i> = .008). There was a significant difference in median (interquartile range) gastric volume per body weight between before fasting and 4 h after fasting (1.0 [0.5-1.8] mL/kg vs 0.4 [0.2-1.0] mL/kg, <i>P</i> < .001). No patient factors were associated with higher prevalence of empty stomach after 4 h of fasting.</p><p><strong>Conclusions: </strong>Most mechanically ventilated subjects had empty stomachs prior to fasting for extubation. Fasting for 4 h further increased the prevalence of empty stomach at extubation to > 80%.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1417-1423"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549618/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Lung Injury and Abdominal Insufflation on Respiratory Mechanics and Lung Volume During Time-Controlled Adaptive Ventilation.","authors":"Harry Ramcharran, Gregory Wetmore, Scott Cooper, Jacob Herrmann, Andrea Fonseca da Cruz, David W Kaczka, Joshua Satalin, Sarah Blair, Penny L Andrews, Nader M Habashi, Gary F Nieman, Michaela Kollisch-Singule","doi":"10.4187/respcare.11745","DOIUrl":"10.4187/respcare.11745","url":null,"abstract":"<p><strong>Backgroud: </strong>Lung volume measurements are important for monitoring functional aeration and recruitment and may help guide adjustments in ventilator settings. The expiratory phase of airway pressure release ventilation (APRV) may provide physiologic information about lung volume based on the expiratory flow-time slope, angle, and time to approach a no-flow state (expiratory time [T_E]). We hypothesized that expiratory flow would correlate with estimated lung volume (ELV) as measured using a modified nitrogen washout/washin technique in a large-animal lung injury model.</p><p><strong>Methods: </strong>Eight pigs (35.2 ± 1.0 kg) were mechanically ventilated using an Engström Carescape R860 on the APRV mode. All settings were held constant except the expiratory duration, which was adjusted based on the expiratory flow curve. Abdominal pressure was increased to 15 mm Hg in normal and injured lungs to replicate a combination of pulmonary and extrapulmonary lung injury. ELV was estimated using the Carescape FRC INview tool. The expiratory flow-time slope and T_E were measured from the expiratory flow profile.</p><p><strong>Results: </strong>Lung elastance increased with induced lung injury from 29.3 ± 7.3 cm H₂O/L to 39.9 ± 15.1cm H₂O/L, and chest wall elastance increased with increasing intra-abdominal pressures (IAPs) from 15.3 ± 4.1 cm H₂O/L to 25.7 ± 10.0 cm H₂O/L in the normal lung and 15.8 ± 6.0 cm H₂O/L to 33.0 ± 6.2 cm H₂O/L in the injured lung (<i>P</i> = .39). ELV decreased from 1.90 ± 0.83 L in the injured lung to 0.67 ± 0.10 L by increasing IAP to 15 mm Hg. This had a significant correlation with a T_E decrease from 2.3 ± 0.8 s to 1.0 ± 0.1 s in the injured group with increasing insufflation pressures (ρ = 0.95) and with the expiratory flow-time slope, which increased from 0.29 ± 0.06 L/s² to 0.63 ± 0.05 L/s² (ρ = 0.78).</p><p><strong>Conclusions: </strong>Changes in ELV over time, and the T_E and flow-time slope, could be used to demonstrate evolving lung injury during APRV. Using the slope to infer changes in functional lung volume represents a unique, reproducible, real-time, bedside technique that does not interrupt ventilation and may be used for clinical interpretation.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1432-1443"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139973341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocturnal Pressure Support Ventilation: Truth or Dare?","authors":"Aurio Fajardo-Campoverdi, Alberto Medina, Angelo Roncalli-Rocha","doi":"10.4187/respcare.12319","DOIUrl":"10.4187/respcare.12319","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":"69 11","pages":"1486-1487"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142506918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rehabilitation Is Associated With Improvements in Post-COVID-19 Sequelae.","authors":"Andreas Asimakos, Stavroula Spetsioti, Spyros Mentzelopoulos, Ioannis Vogiatzis, Alice G Vassiliou, Pantelis Gounopoulos, Archontoula Antonoglou, Dimitrios Spaggoulakis, Sofia Pappa, Spyros Zakynthinos, Ioanna Dimopoulou, Paraskevi Katsaounou","doi":"10.4187/respcare.11863","DOIUrl":"10.4187/respcare.11863","url":null,"abstract":"<p><strong>Background: </strong>Post-COVID-19 syndrome has affected millions of people, with rehabilitation being at the center of non-pharmacologic care. However, numerous published studies show conflicting results due to, among other factors, considerable variation in subject characteristics. Currently, the effects of age, sex, time of implementation, and prior disease severity on the outcomes of a supervised rehabilitation program after COVID-19 remain unknown.</p><p><strong>Methods: </strong>This was a non-randomized case-control study. Subjects with post-COVID-19 sequelae were enrolled. Among study participants, those who could attend an 8-week, supervised rehabilitation program composed the intervention group, whereas those who couldn't the control group. Measurements were collected at baseline and 8 weeks thereafter.</p><p><strong>Results: </strong>Study groups (<i>N</i> = 119) had similar baseline measurements. Participation in rehabilitation (<i>n</i> = 47) was associated with clinically important improvements in the 6-min walk test (6MWT) distance, adjusted (for potential confounders) odds ratio (AOR) 4.56 (95% CI 1.95-10.66); 1-min sit-to-stand test, AOR 4.64 (1.88-11.48); Short Physical Performance Battery, AOR 7.93 (2.82-22.26); health-related quality of life (HRQOL) 5-level EuroQol-5D (Visual Analog Scale), AOR 3.12 (1.37-7.08); Montreal Cognitive Assessment, AOR 6.25 (2.16-18.04); International Physical Activity Questionnaire, AOR 3.63 (1.53-8.59); Fatigue Severity Scale, AOR 4.07 (1.51-10.98); Chalder Fatigue Scale (bimodal score), AOR 3.33 (1.45-7.67); Modified Medical Research Council dyspnea scale (mMRC), AOR 4.43 (1.83-10.74); Post-COVID-19 Functional Scale (PCFS), AOR 3.46 (1.51-7.95); and COPD Assessment Test, AOR 7.40 (2.92-18.75). Time from disease onset was marginally associated only with 6MWT distance, AOR 0.99 (0.99-1.00). Prior hospitalization was associated with clinically important improvements in the mMRC dyspnea scale, AOR 3.50 (1.06-11.51); and PCFS, AOR 3.42 (1.16-10.06). Age, sex, and ICU admission were not associated with the results of any of the aforementioned tests/grading scales.</p><p><strong>Conclusions: </strong>In this non-randomized, case-control study, post-COVID-19 rehabilitation was associated with improvements in physical function, activity, HRQOL, respiratory symptoms, fatigue, and cognitive impairment. These associations were observed independently of timing of rehabilitation, age, sex, prior hospitalization, and ICU admission.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1361-1370"},"PeriodicalIF":2.4,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}