Canadian Journal of Respiratory Therapy最新文献

{"title":"The effect of inspiratory muscle training on the inspiratory muscle metaboreflex: A systematic review.","authors":"Thiago Bezerra Wanderley E Lima, Brunna Beatriz Dos Santos Silva, Ana Paula Silva de Souza, Dalyane Mirelly Fonseca Aires, Marina Gomes Fagundes","doi":"10.29390/001c.132324","DOIUrl":"10.29390/001c.132324","url":null,"abstract":"<p><strong>Background: </strong>Increases in respiratory work and, consequently, the development of respiratory muscle fatigue can result in activation of the inspiratory muscle metaboreflex (IMM). This central nervous system response includes redirection of blood flow from skeletal muscles to respiratory muscles, which can limit exercise capacity. Therefore, developing approaches that may minimize the need for IMM is important. Recent studies have suggested that inspiratory muscle training (IMT) may reduce the IMM response. This review aims to synthesize studies that examine the efficacy of IMT in reducing IMM.</p><p><strong>Methods: </strong>Databases were systematically searched for randomized controlled clinical trials (RCTs) and non-randomized controlled trials evaluating the effect of IMT on the IMM. Searches were performed in MEDLINE/PubMed, SCOPUS, Web of Science and LILACS from inception to December 2023. Assessment of the methodological quality of the included studies was guided by the PEDro scale.</p><p><strong>Results: </strong>Four studies met the inclusion criteria, two RCTs and two non-randomized controlled trials, collectively including 76 subjects. Three studies included healthy subjects, and one included patients with heart failure. In all studies, IMT demonstrated a significant attenuating effect on the IMM, increasing inspiratory muscle strength and time of exercise tolerance (Tlim).</p><p><strong>Conclusion: </strong>Current evidence suggests that IMT may provide an effective approach for attenuating the IMM and increasing inspiratory muscle strength and Tlim. However, the small collective sample size and heterogeneity across studies limit current recommendations.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"51-59"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory therapy education in Ghana: A perspective.","authors":"Esther Y Brobbey, Audrey G Forson, Rodger G Okpara, Christian Owoo, Robert Djagbletey, Karen S Schell, Lisa M Trujillo","doi":"10.29390/001c.131882","DOIUrl":"https://doi.org/10.29390/001c.131882","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"44-50"},"PeriodicalIF":0.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychometric properties of volitional tests used to measure respiratory muscle strength and endurance: A systematic review.","authors":"Thiago Queiroz Pires, Bruno Prata Martinez, Leilane Marcos, Ísis Resende Ramos, Virgínia Pinheiro, Mansueto Gomes Neto","doi":"10.29390/001c.131842","DOIUrl":"10.29390/001c.131842","url":null,"abstract":"<p><strong>Introduction: </strong>It is essential that diagnostic tests for evaluating respiratory muscles have proven reliability and validity. This study aims to synthesize studies that evaluated the psychometric properties of volitional tests used to measure respiratory muscle strength and endurance.</p><p><strong>Methods: </strong>A systematic literature search was conducted in MEDLINE/PubMed, LILACS, Cochrane Central Register of Controlled Trials, Scopus and SciELO. Primary studies that evaluated the reliability and validity of volitional tests to measure respiratory muscle strength and endurance were included. The quality of the included studies was assessed using the Critical Appraisal Tool (CAT).</p><p><strong>Results: </strong>Twenty-eight studies were included in this review, describing the psychometric properties of eight different approaches to measuring respiratory muscle strength and endurance. Respiratory muscle strength and endurance were assessed using static maximal inspiratory pressure, static maximal expiratory pressure, dynamic maximal inspiratory pressure, sustained maximal inspiratory pressure, nasal inspiratory pressure, manual respiratory muscle measurements, and maximal incremental inspiratory muscle performance. Overall, the studies included were of good methodological quality. Data related to validity and reliability showed excellent results for the maximum inspiratory pressure and maximum expiratory pressure, with maximum ICC values of 0.979 (CI 0.947-0.991) and 0.989 (CI 0.022-0.001), respectively. Other tests evaluated did not present high reliability and validity.</p><p><strong>Conclusion: </strong>This review concluded that volitional tests vary in reliability for measures of respiratory muscle strength and endurance. The more traditional ones, such as maximum inspiratory pressure and maximum expiratory pressure, presented higher validity and reliability values compared to the other tests.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"33-43"},"PeriodicalIF":0.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing respiratory therapists' compliance with cystic fibrosis guidelines in Saudi Arabia: A descriptive quantitative study.","authors":"Jameel Hakeem, Faisal Turkestani, Mohammed Alqahtani, Ziyad Al Nufaiei, Raid Al Zhranei, Fahad Alhadian, Rana Altabee, Mazen Homoud, Ayedh Ahmari, Ralph Zimmerman, Robert Murray, Douglas Gardenhire","doi":"10.29390/001c.129988","DOIUrl":"10.29390/001c.129988","url":null,"abstract":"<p><strong>Introduction: </strong>Cystic fibrosis (CF) is a severe autosomal recessive disorder caused by mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This condition disrupts chloride channels and leads to the production of thick, sticky mucus, affecting the respiratory and gastrointestinal systems. CF's prevalence is particularly high in Saudi Arabia, where the incidence has increased from 1 in 2,000 to 1 in 1,000 births. Effective management of CF is essential for improving patient outcomes, yet there is a notable lack of understanding regarding respiratory therapists' (RTs) adherence to established CF management protocols.</p><p><strong>Methods: </strong>This descriptive quantitative study aimed to assess RTs' adherence to the Cystic Fibrosis Foundation's guidelines. Using a convenience sampling technique, a self-report survey was distributed to 750 members of the Saudi Society for Respiratory Care (SSRC), resulting in 351 responses, of which 166 were fully completed and met the inclusion criteria. The survey focused on RTs' knowledge and management practices related to CF. Data analysis was conducted using SPSS version 25, with descriptive statistics (mean, standard deviation, frequency, percentage, and mode) and non-parametric tests. The Kruskal-Wallis Test was employed to evaluate differences in adherence scores across demographic groups (e.g., education level, years of experience). Chi-square analysis was applied to examine relationships between categorical demographic variables (e.g., region of practice) and adherence to guidelines.</p><p><strong>Results: </strong>The analysis revealed significant gaps in RTs' adherence to CF guidelines, with only 42.8% accurately identifying the sweat chloride threshold for CF diagnosis and a limited 36.1% recognizing Pseudomonas aeruginosa as a common CF pathogen. Additionally, just 56.6% correctly identified the gold-standard airway clearance therapy. The Wilcoxon signed-ranks test further highlighted a statistically significant disparity (p = 0.00) between RTs' theoretical knowledge and practical application of CF management techniques, emphasizing the need for improved training.</p><p><strong>Discussion: </strong>The findings suggest a need for enhanced training and resources to bridge the gap between theoretical knowledge and practical management of CF. The lack of adherence to clinical guidelines could impact patient outcomes and survival rates.</p><p><strong>Conclusion: </strong>Improving RTs' adherence to CF management guidelines through ongoing education and updated clinical standards is essential. Addressing these gaps could elevate the standard of care and contribute to better patient outcomes and survival rates in Saudi Arabia.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"20-32"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11901341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reflections on leadership and professional growth in respiratory therapy.","authors":"Michael B Andrews","doi":"10.29390/001c.129001","DOIUrl":"10.29390/001c.129001","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"17-19"},"PeriodicalIF":0.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a guide for continuous positive airway pressure use - A good fit: Making continuous positive airway pressure work for you.","authors":"Adeel Meraj, Lauren Koep, Muhammad R Baig","doi":"10.29390/001c.127656","DOIUrl":"10.29390/001c.127656","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is highly prevalent in veterans with mental illnesses such as post-traumatic stress disorder (PTSD). Untreated OSA reduces the effectiveness of the treatment of PTSD. Treatment of OSA has been shown to reduce daytime sleepiness and symptoms of PTSD and depression. Continuous positive airway pressure (CPAP) therapy is the most effective treatment for OSA. A large number of veterans cannot tolerate CPAP therapy due to anxiety and PTSD symptoms. Positive airway pressure (PAP) NAP, a daytime sleep study for patients with anxiety about starting CPAP and exposure-based cognitive behavioural interventions are the mainstay for the management of CPAP intolerance. However, these options are not readily available to veterans in rural areas, who constitute about 40% of veterans registered in the South Texas Veterans Health Care System (STVHCS).</p><p><strong>Methods: </strong>After getting local IRB exemption, we surveyed thirty (30) veterans in the outpatient clinic setting who could not tolerate CPAP therapy to evaluate the need for a tool to improve CPAP adherence. We reviewed the literature and conducted focused group meetings with local and national experts. We also convened consumer groups and stakeholder meetings, including primary care, sleep medicine, and mental health providers.</p><p><strong>Results: </strong>After a comprehensive evaluation process, we compiled a concise self-help guide combining principles of cognitive behavioural therapy using a behavioural hierarchy approach towards CPAP desensitization. This guide can be used by veterans independently at their homes to improve CPAP use. A printer-friendly version is available for download on the South Central Mental Illness, Research, Education and Clinical Center (SC MIRECC) and the South Texas Veterans Healthcare System (STVHCS) website. The guide will be provided to veterans during the initial CPAP setup and available in clinic waiting rooms throughout the system.</p><p><strong>Conclusion: </strong>Our guide will serve as an effective self-help tool to improve CPAP adherence. It may result in the improvement of various medical and psychiatric conditions.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"7-16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11760215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is CT pulmonary angiography overutilized in the evaluation of patients with suspected pulmonary embolism? A retrospective study.","authors":"Rabbani Mahmoud Daoud, Ahmed Majeed Mohamed, Muath Salahuddin Almajthoob, Salim Fredericks, Israa ElSayed Daoud, Moath Mahmoud Daoud, Mahmood AlSaeed","doi":"10.29390/001c.127660","DOIUrl":"10.29390/001c.127660","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the high mortality rate of acute untreated pulmonary embolism (PE) at 30%, diagnosing PE is challenging. While the prevalence of PE has decreased in recent years, the overuse of computed tomography pulmonary angiography (CTPA) remains a concern. The National Institute for Health and Care Excellence (NICE) provides guidelines using the Wells score for PE assessment. The Royal College of Radiologists (RCR) recommends a positive yield of 15.4% - 37% for CTPA tests. This study assesses the positive yield of CTPA for suspected PE patients and evaluates the potential reduction through Wells score/D-dimer assessment as recommended by NICE.</p><p><strong>Methods: </strong>All patients who underwent CTPA between September 1, 2019, and January 31, 2020, at Salmaniya Medical Complex were included. Data on patient demographics and pre-CTPA workup were collected from electronic patient records (EPR) and stored in MS Excel 2019 for analysis.</p><p><strong>Results: </strong>Of 188 suspected PE patients (mean age 50 ±12.3 years; 62.8% female), 12.2% were diagnosed with PE. None had documented Wells scores. A low-risk Wells score (≤4) was assigned to 68.6% of patients, with only 26.1% undergoing D-dimer testing. PE was confirmed in 4 patients with low-risk Wells scores and elevated D-dimers. All 10 patients with low-risk Wells scores and negative D-dimers were PE-negative.</p><p><strong>Conclusion: </strong>In total, 5.3% - 47.9% of the CTPAs conducted could have been avoided by following NICE guidelines. We propose integrating an algorithm-based checklist with validated tools like the Wells and Geneva scores into the ePMA system to guide appropriate CTPA referrals, promote evidence-based decision-making, reduce unnecessary imaging, and optimize patient care and resource use.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"127660"},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlighting the year's most transformative research as voted by the editorial board: Exploring knowledge gaps and research needs in respiratory therapy.","authors":"Elizabeth Rohrs","doi":"10.29390/001c.126973","DOIUrl":"10.29390/001c.126973","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"176-178"},"PeriodicalIF":0.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11634185/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Earning a Journal Impact Factor: Progress, recognition, and growth for the CJRT.","authors":"Marco Zaccagnini, Carly Brockington, Elizabeth Rohrs","doi":"10.29390/001c.125457","DOIUrl":"10.29390/001c.125457","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"173-175"},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11602234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CPAP vs HFNC in treatment of patients with COVID-19 ARDS: A retrospective propensity-matched study.","authors":"Ivan Šitum, Lovro Hrvoić, Ante Erceg, Anja Mandarić, Dora Karmelić, Gloria Mamić, Nikolina Džaja, Anđela Babić, Slobodan Mihaljević, Mirabel Mažar, Daniel Lovrić","doi":"10.29390/001c.125145","DOIUrl":"10.29390/001c.125145","url":null,"abstract":"<p><strong>Background: </strong>Previous studies exploring the application of noninvasive ventilation or high-flow nasal cannula in patients with COVID-19-related acute respiratory distress syndrome (ARDS) have yielded conflicting results on whether any method of respiratory support is superior. Our aim is to compare the efficacy and safety of respiratory therapy with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure in treatment of COVID-19-related ARDS.</p><p><strong>Methods: </strong>This is a retrospective cohort study based on data from patients who received respiratory support as part of their treatment in the COVID intensive care unit at the University Hospital Centre Zagreb between February 2021 and February 2023. Using propensity score analysis, 42 patients treated with high-flow nasal cannula (HFNC group) were compared to 42 patients treated with noninvasive ventilation with continuous positive airway pressure (CPAP group). Primary outcome was intubation rate.</p><p><strong>Results: </strong>Intubation rate was 71.4% (30/42) in the HFNC group and 40.5% (17/42) in the CPAP group (<i>p</i> = 0.004). Hazard ratio for intubation was 3.676 (95% confidence interval [CI] 1.480 to 9.232) with the HFNC versus CPAP group. Marginally significant difference in survival between the two groups was observed at 30 days (<i>p</i> = 0.050) but was statistically significant at 60 days (<i>p</i> = 0.043).</p><p><strong>Conclusions: </strong>Respiratory support with high-flow nasal cannula and noninvasive ventilation with continuous positive airway pressure yielded significantly different intubation rates in favour of continuous positive airway pressure. The same patients also had better 30-day and 60-day survival post-admission.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"60 ","pages":"164-172"},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}