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Impact of Inspiratory Pressure Rise Time on Lung-Emptying in Time Controlled Adaptive Ventilation. 适时调节适应性通气中吸气压力上升时间对肺排空的影响。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-25 DOI: 10.1177/19433654251359959
Benjamin Neetz, Patrick Rehn, Nicole Kraus, Werner Schmidt, Lars Reinhardt, Thomas Flohr, Christoph Laußer, Markus Alexander Weigand, Mascha O Fiedler-Kalenka
{"title":"Impact of Inspiratory Pressure Rise Time on Lung-Emptying in Time Controlled Adaptive Ventilation.","authors":"Benjamin Neetz, Patrick Rehn, Nicole Kraus, Werner Schmidt, Lars Reinhardt, Thomas Flohr, Christoph Laußer, Markus Alexander Weigand, Mascha O Fiedler-Kalenka","doi":"10.1177/19433654251359959","DOIUrl":"https://doi.org/10.1177/19433654251359959","url":null,"abstract":"<p><p><b>Background:</b> The airway pressure release ventilation (APRV)-based time controlled adaptive ventilation (TCAV) protocol can potentially minimize ventilator-induced lung injury (VILI). Inspiratory pressure rise time (IPRT) is a parameter available in pressure-controlled ventilation modes, yet its role within TCAV remains unclear. We hypothesized that varying IPRTs impact lung emptying and associated ventilatory parameters (driving pressure [ΔP], intrinsic PEEP [PEEPi], exhaled tidal volume [V<sub>Te</sub>]). <b>Methods:</b> This single-center, prospective exploratory study included 10 intubated subjects ventilated utilizing the TCAV protocol. Subjects underwent consecutive experimental trials with IPRTs of 500 and 1,000 ms, each preceded by a baseline (BL) with an IPRT of 0 ms. Analyzed parameters were ventilator-derived ΔP (ΔP<sub>vent</sub>), PEEPi, and V<sub>Te</sub>. Elastance (E<sub>RS</sub> = ΔP<sub>vent</sub>/V<sub>Te</sub>) and elastance-derived ΔP (ΔP<sub>elast</sub> = E<sub>RS</sub> × V<sub>Te</sub>) were calculated. End-expiratory lung volume (EELV) and end-inspiratory lung volume were assessed through electrical impedance tomography (EIT). <b>Results:</b> Prolonged IPRT increased ΔP<sub>elast</sub> compared with ΔP<sub>vent</sub> in each baseline/trial combination (ΔP<sub>vent</sub> 13.5 ± 1.5 cm H<sub>2</sub>O vs ΔP<sub>elast</sub> 18.4 ± 2.7 cm H<sub>2</sub>O at 1,000 ms IPRT, <i>P</i> < .001) through a loss of PEEPi. Conventional PEEPi measurements did not detect these changes. The EIT data showed a reduction in EELV during the trials. <b>Conclusions:</b> IPRT prolongation under TCAV reduced EELV/PEEPi, therefore increasing ΔP. Conventional PEEPi measurement methods are misleading in this context. We therefore suggest adding the recommendation to set IPRT to 0 ms for the TCAV protocol.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966781","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}
引用次数: 0
Advanced Respiratory Team Implementation for Perioperative Ventilation in Class III Obesity in the Operating Room. 先进呼吸小组在手术室III型肥胖患者围手术期通气中的实施。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-25 DOI: 10.1177/19433654251360615
Cristina Mietto, Florencia Rodriguez Sendic, Nicolette Duong, Bijan Safaee Fakhr, Stefano Spina, Glasiele Alcala, Alexander Balikian, Roberta Ribeiro De Santis Santiago, Jeanine Wiener-Kronish, Lorenzo Berra
{"title":"Advanced Respiratory Team Implementation for Perioperative Ventilation in Class III Obesity in the Operating Room.","authors":"Cristina Mietto, Florencia Rodriguez Sendic, Nicolette Duong, Bijan Safaee Fakhr, Stefano Spina, Glasiele Alcala, Alexander Balikian, Roberta Ribeiro De Santis Santiago, Jeanine Wiener-Kronish, Lorenzo Berra","doi":"10.1177/19433654251360615","DOIUrl":"https://doi.org/10.1177/19433654251360615","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966674","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}
引用次数: 0
Aerosol Delivery to Simulated Spontaneously Breathing Tracheostomized Children's Models with High-Flow Tracheal Oxygen. 高流量气管供氧对模拟自主呼吸气管造口儿童模型的气溶胶输送。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-25 DOI: 10.1177/19433654251360623
Fai A Albuainain, Xiaoyan Man, Jie Li
{"title":"Aerosol Delivery to Simulated Spontaneously Breathing Tracheostomized Children's Models with High-Flow Tracheal Oxygen.","authors":"Fai A Albuainain, Xiaoyan Man, Jie Li","doi":"10.1177/19433654251360623","DOIUrl":"https://doi.org/10.1177/19433654251360623","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966760","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}
引用次数: 0
Bench Evaluation of CPAP Devices for Resource-Limited Environments. 资源有限环境下CPAP设备的台架评价。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-25 DOI: 10.1177/19433654251366894
Eloïse de Beaufort, Lucille Hornoy, Pascale Labedade, Mathilde Lefranc, Mathilde Taillantou-Candau, François Beloncle, Alain Mercat, Armand Mekontso-Dessap, Jean-Christophe Richard, Arnaud Lesimple, Guillaume Carteaux
{"title":"Bench Evaluation of CPAP Devices for Resource-Limited Environments.","authors":"Eloïse de Beaufort, Lucille Hornoy, Pascale Labedade, Mathilde Lefranc, Mathilde Taillantou-Candau, François Beloncle, Alain Mercat, Armand Mekontso-Dessap, Jean-Christophe Richard, Arnaud Lesimple, Guillaume Carteaux","doi":"10.1177/19433654251366894","DOIUrl":"https://doi.org/10.1177/19433654251366894","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966806","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}
引用次数: 0
Evaluating the Sealing Capacities of Different Endotracheal Tube Cuff Designs. 评价不同气管插管袖套设计的密封能力。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-01 Epub Date: 2025-04-11 DOI: 10.1089/respcare.12465
Junichi Michikoshi, Makoto Yamamoto, Kumiko Takagi, Takeko Kudo, Yoshihiro Tange, Tadashi Tomo
{"title":"Evaluating the Sealing Capacities of Different Endotracheal Tube Cuff Designs.","authors":"Junichi Michikoshi, Makoto Yamamoto, Kumiko Takagi, Takeko Kudo, Yoshihiro Tange, Tadashi Tomo","doi":"10.1089/respcare.12465","DOIUrl":"10.1089/respcare.12465","url":null,"abstract":"<p><p><b>Background:</b> Endotracheal tube (ETT) cuffs prevent over-the-cuff secretions from flowing into the lower airways. However, they may not completely prevent fluid leakage around ETTs. To validate a cuff design with high sealing capacity, we compared ETTs with varying cuff materials and structural properties. <b>Methods:</b> We used 7 ETTs with different cuff materials (polyvinyl chloride [PVC], polyurethane [PU]), shapes (conical, tapered, or cylindrical), wall thickness, and cuff sizes (contact area with the trachea). Wall thickness was measured after cutting the cuff using a micrometer. The contact area was calculated based on the long diameter of the cuff when expanded within a clear acrylic tube. The sealing capacity was defined as the time taken for 10 mL of distilled water to leak past the cuff. The sealing capacities of the cuffs were compared by inserting them into the simulated trachea (silicone corrugated tube). <b>Results:</b> The wall thicknesses were 29-29.3 µm for PU and 45.6-285 µm for PVC cuffs. The contact areas with the trachea were 18.7-27.1 and 12.5-22.3 cm for PU and PVC cuffs, respectively. The mean (SD) sealing capacities were 2,381 (484), 437 (177), 56 (12), and 24 (4) s for the cylindrical PU, conical PU, tapered PVC, and conical PVC cuffs, respectively. For the 3 cylindrical PVC cuffs (A, B, and C, respectively), the mean (SD) sealing capacities were 53 (11), 15 (2), and 9 (2) s. <b>Conclusions:</b> The PU cuff had a higher sealing capacity than the PVC cuff, and the cylindrical cuff had a higher sealing capacity than the conical cuff. For the PVC cuff, thinner materials had higher sealing capacities. Furthermore, the contact area between the cuff and model trachea significantly affected the sealing capacity.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"962-967"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044882","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}
引用次数: 0
When Simple Solutions Spark Unnecessary Complexity. 当简单的解决方案引发不必要的复杂性。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-01 Epub Date: 2025-05-30 DOI: 10.1089/respcare.13183
Emiliano Gogniat, Emilio Steinberg, Gustavo A Plotnikow
{"title":"When Simple Solutions Spark Unnecessary Complexity.","authors":"Emiliano Gogniat, Emilio Steinberg, Gustavo A Plotnikow","doi":"10.1089/respcare.13183","DOIUrl":"10.1089/respcare.13183","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1072-1073"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180196","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}
引用次数: 0
Empowering Respiratory Therapists and Reconsidering Mucolytics in Patients on Mechanical Ventilation: A Step Toward High-Value Care. 授权呼吸治疗师并重新考虑机械通气患者的黏液溶解：迈向高价值护理的一步。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-01 Epub Date: 2025-06-12 DOI: 10.1089/respcare.13203
Brian J Ring
{"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":"10.1089/respcare.13203","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1062-1064"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411408/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nasopharyngeal Airspace Temperature During Rhinothermy. 鼻热治疗时鼻咽部空气温度。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-01 Epub Date: 2025-06-12 DOI: 10.1089/respcare.13247
Michael D Davis
{"title":"Nasopharyngeal Airspace Temperature During Rhinothermy.","authors":"Michael D Davis","doi":"10.1089/respcare.13247","DOIUrl":"10.1089/respcare.13247","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1065-1066"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411407/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postextubation Noninvasive Respiratory Support in Children. 儿童拔管后无创呼吸支持。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-01 Epub Date: 2025-03-28 DOI: 10.1089/respcare.12922
Andrew G Miller, Alexandre T Rotta
{"title":"Postextubation Noninvasive Respiratory Support in Children.","authors":"Andrew G Miller, Alexandre T Rotta","doi":"10.1089/respcare.12922","DOIUrl":"10.1089/respcare.12922","url":null,"abstract":"<p><p>Infants and children frequently require mechanical ventilation. Daily extubation readiness testing is currently recommended to minimize time on mechanical ventilation, which is associated with the development of morbidities. Re-intubation rates vary between patient populations and have been associated with significant adverse patient outcomes, including increased length of stay and mortality. Noninvasive respiratory support (NRS) is often used to help decrease the risk of re-intubation. NRS encompasses high-flow nasal cannula (HFNC), CPAP, noninvasive ventilation, and negative-pressure ventilation. This article will cover risk factors for re-intubation, assessing extubation readiness, rationale for NRS use, delivery systems for NRS, evidence for various NRS modalities, how to choose NRS modalities, practical considerations, and future research opportunities.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1023-1032"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143731327","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}
引用次数: 0
Telemonitoring to Reduce COPD Exacerbations: A Work in Progress. 远程监测减少COPD恶化：一项正在进行的工作。
IF 2.1 4区 医学
Respiratory care Pub Date : 2025-08-01 Epub Date: 2025-05-09 DOI: 10.1089/respcare.13121
Umur Hatipoğlu
{"title":"Telemonitoring to Reduce COPD Exacerbations: A Work in Progress.","authors":"Umur Hatipoğlu","doi":"10.1089/respcare.13121","DOIUrl":"10.1089/respcare.13121","url":null,"abstract":"","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1067-1068"},"PeriodicalIF":2.1,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053683","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}
引用次数: 0
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