Canadian Journal of Respiratory Therapy最新文献

{"title":"Association of inhalation injury with ventilator-associated pneumonia and clinical outcomes in critically ill patients with burns: A retrospective study.","authors":"Tatiana C Normann, Priscila Bellaver, Bianca I Limeira, Gabrielle B Dorneles, Mariane S Oliveira, Tatiana H Rech","doi":"10.29390/001c.159978","DOIUrl":"https://doi.org/10.29390/001c.159978","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of inhalation injury on the outcomes of patients with burns, especially ventilator-associated pneumonia (VAP) and mortality.</p><p><strong>Methods: </strong>Single-center retrospective study of patients admitted to the intensive care unit (ICU) with burn injuries. Data were obtained from medical records. The primary outcome was VAP incidence in patients with or without inhalation injury. Secondary outcomes included need and duration of mechanical ventilation (MV), incidence of acute respiratory distress syndrome (ARDS), rates of reintubation and tracheostomy, need for vasopressors and renal replacement therapy (RRT), length of ICU and hospital stay, hospital mortality, and comparison between survivors and non-survivors.</p><p><strong>Results: </strong>From January 2017 to December 2023, 242 patients with a median burn surface area of 23% (15%-37%) were included. The incidence of inhalation injury was 9.9% (<i>n</i> = 24). The overall incidence of VAP was 23%. VAP incidence was significantly higher in patients with inhalation injury than in those without inhalation injury (RR 2.1, CI 1.9-3.8) (<i>p</i> < 0.012). After adjustment for age, burn surface area, and duration of MV, the RR remained significant (2.1, CI 1.2-3.7) (<i>p</i> = 0.009). Patients with inhalation injury had higher rates of reintubation (12.5% vs. 2.8%, <i>p</i> = 0.048) and tracheostomy (54.2% vs. 21.6%, <i>p</i> < 0.001). The incidence of inhalation injury was similar in survivors and non-survivors (11.2% vs. 5.6%, <i>p</i> = 0.305), but non-survivors had a higher burn surface area than survivors (40% vs. 20%, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>The incidence of VAP was higher in patients with inhalation injury than in those without inhalation injury; however, the mortality was similar.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"64-73"},"PeriodicalIF":1.1,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147624054","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":"The effect of kinesiology tape on respiratory function in adults: A systematic review and meta-analysis.","authors":"Charlene du Plessis, Rubine De Beer-Brandon, Diphale Joyce Mothabeng, Anri Human","doi":"10.29390/001c.156353","DOIUrl":"10.29390/001c.156353","url":null,"abstract":"<p><strong>Background: </strong>Kinesiology taping may enhance respiratory function in various adult populations; however, current evidence remains limited. This systematic review aimed to review the existing literature on the effects of kinesiology tape on respiratory function in two adult cohorts.</p><p><strong>Methods: </strong>Studies involving adults (≥18 years), including healthy individuals and those with respiratory conditions, were considered. A comprehensive search was conducted using Cochrane methodology across eight electronic databases, a search engine, grey literature sources, and reference lists, guided by PICOS-based keywords. The Cochrane Risk of Bias tool, ROBINS-I, and Grades of Recommendation Assessment, Development, and Evaluation (GRADE) criteria were used to assess the risk of bias and evidence certainty.</p><p><strong>Results: </strong>Eighteen studies were included: eight involving healthy adults and athletes, and 10 focusing on adults with respiratory conditions. A total of 684 participants were enrolled in these studies, comprising 316 healthy individuals and 368 adults with respiratory conditions.</p><p><strong>Discussion: </strong>Respiratory function, cough efficacy, and muscle strength improved mainly in healthy adults, with clinical benefits noted in those with respiratory conditions. The meta-analysis showed no significant effect of kinesiology tape on respiratory function in either healthy adults or those with respiratory conditions. Most of the included studies presented a high risk of bias, and the certainty of evidence was very low.</p><p><strong>Conclusion: </strong>Evidence supporting the use of kinesiology taping to enhance respiratory function in healthy adults and individuals with respiratory conditions remains limited. Further well-designed, condition-specific clinical trials are needed before routine inclusion in respiratory care can be recommended.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"53-63"},"PeriodicalIF":1.1,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379097","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":"Feasibility of electrical impedance tomography-guided PEP in children with CF and TBM.","authors":"Hasan Nawaz Tahir, Dr Khansa Rehman, Mohammad Idrees, Dr Umema Tariq, Mursala Tahir, Yousaf Ali","doi":"10.29390/001c.158225","DOIUrl":"https://doi.org/10.29390/001c.158225","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"50-52"},"PeriodicalIF":1.1,"publicationDate":"2026-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327602","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":"Optimizing the gift of life: Respiratory therapist-led, EIT-guided donor lung management.","authors":"Jiaxiao Li","doi":"10.29390/001c.158139","DOIUrl":"https://doi.org/10.29390/001c.158139","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"47-49"},"PeriodicalIF":1.1,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12945394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327607","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":"How can the collaboration between manufacturers of medical devices and bedside clinicians lead to improved applications of the devices?","authors":"Soumaya Osen, Ryan Echols, Darcy Crayton, Tryon Stalinescu","doi":"10.29390/001c.155277","DOIUrl":"10.29390/001c.155277","url":null,"abstract":"<p><strong>Introduction: </strong>In late 2019, the leaders of a respiratory department at an academic medical center (AMC) in the Southeastern United States (U.S.) decided to change the humidity delivered to patients via invasive and noninvasive mechanical ventilation from passive to active in the intensive care units (ICUs). The AMC purchased the humidifiers that were new in the U.S. market. The manufacturer provided education and training. Almost a year after implementation, the leaders found the humidifiers turned off or on standby, with a heat moisture exchanger (HME) placed in-line and a water trap by the expiratory filter.</p><p><strong>Approach: </strong>The leaders requested help from the manufacturer. The manufacturer sent its clinical specialist (CS) twice to the AMC to re-educate and re-train in real time at the bedside. Plan-Do-Study-Act (PDSA) cycles were implemented to troubleshoot problems and improve adherence to active humidity.</p><p><strong>Findings: </strong>The respiratory therapists (RTs) did not recall the appropriate steps for setting up the heaters. Instead of asking the leaders for help, the RTs took it upon themselves to turn off the humidifiers, use HMEs, and add a water trap by the expiratory filter to collect excess humidity in the circuit and reduce the need for frequent expiratory filter changes. In addition, other issues were discovered during the process. Those issues exacerbated the alarm situations.</p><p><strong>Discussion: </strong>A knowledge gap and a breakdown in communication led to inappropriate use of humidifiers and the implementation of active humidity in the ICUs. PDSA cycles and the involvement of the manufacturer's CS in real-time training and troubleshooting at the bedside resulted in the intended outcomes.</p><p><strong>Conclusion: </strong>The process was a learning experience for both the bedside clinicians and the manufacturer. The process led to improvements in the heater's design, its placement on the ventilator cart, the circuit design, and the development of educational materials to guide clinicians.<b>Practice Implications</b> The true test of a product is its release to the market for widespread use. The outcomes of the process improvement demonstrated the importance of collaboration among all stakeholders and that breaking silos across research, design, testing, and implementation is crucial for a successful new device launch.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"37-46"},"PeriodicalIF":1.1,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12898736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203267","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":"Ventilatory asynchronies induced by routine clinical practices in the intensive care unit: A systematic observation combined with a scoping review.","authors":"Andres Mauricio Enriquez Popayan, Henry Mauricio Parada-Gereda, Luis Alexander Peña-López","doi":"10.29390/001c.154940","DOIUrl":"10.29390/001c.154940","url":null,"abstract":"<p><strong>Background: </strong>Patient-ventilator asynchronies (PVAs) are common during mechanical ventilation and are associated with adverse outcomes. While most research has focused on ventilator modes, pulmonary mechanics, and sedation, the influence of routine clinical practices remains largely unexplored.</p><p><strong>Objectives: </strong>To document ventilatory asynchronies induced by routine clinical practices through systematic observation and to contrast these findings with a structured scoping review of the literature.</p><p><strong>Methods: </strong>Systematic observation of ventilator waveforms was performed during routine clinical interventions in critically ill patients receiving invasive mechanical ventilation. In parallel, a scoping review was conducted across five databases (Scopus, ScienceDirect, PubMed, LILACS, and Cochrane), guided by the PCC framework (Population, Concept, and Context) and PRISMA-ScR recommendations. Study selection was carried out independently by two reviewers using Rayyan software, with disagreements resolved by consensus.</p><p><strong>Results: </strong>Thirteen studies were included in the scoping review; only three addressed the eight PVAs described in the literature, and none reported induced asynchronies as a cause or risk factor. Our observational analysis demonstrated that routine interventions such as respiratory care, repositioning, and intrahospital transfers may trigger transient episodes of PVA.</p><p><strong>Conclusions: </strong>Routine clinical practices,including suctioning, repositioning, and intrahospital transport, can unintentionally induce PVAs. To the best of our knowledge, this phenomenon has not previously been reported in the literature, as confirmed by our scoping review. These findings highlight an overlooked source of asynchrony with potential clinical implications.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"22-36"},"PeriodicalIF":1.1,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12880812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146143787","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":"Improving internal medicine resident proficiency in non-invasive positive pressure ventilation and oxygen modalities through simulation training.","authors":"James Kang, Jonathan Otero-Colon, Joshua Fogel, Jagadish Akella","doi":"10.29390/001c.155174","DOIUrl":"10.29390/001c.155174","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation-based training is increasingly used to teach respiratory interventions, but limited studies have evaluated its impact on both non-invasive positive pressure ventilation (NIPPV) and supplemental oxygen delivery systems. We assessed changes in internal medicine residents' knowledge and attitudes before and after a simulation-based training program.</p><p><strong>Methods: </strong>This is a retrospective study of a simulation-based training program. There were 78 internal medicine residents from postgraduate first year (PGY1), postgraduate second year (PGY2), and postgraduate third year (PGY3) who participated in a one-hour training session, including lecture and three simulation stations covering oxygen delivery devices, high-flow nasal cannula, and bi-level positive airway pressure/continuous positive airway pressure (BIPAP/CPAP). Pre- and post-training questionnaires assessed attitudes and knowledge.</p><p><strong>Results: </strong>Attitudes for comfort level or recognition increased after training (all <i>p <</i> 0.001), and attitudes for needing more training decreased after training (all <i>p <</i> 0.001). Specific knowledge increased after training with percentage-point differences ranging from 48.7% to 60.3% for all of the questions (all <i>p <</i> 0.001). Case scenario knowledge increased after training with percentage-point differences ranging from 29.4% to 48.7% (all <i>p <</i> 0.001). Knowledge differences between postgraduate years were mostly eliminated after training. All residents rated the training highly.</p><p><strong>Conclusion: </strong>Simulation-based training improved attitudes and knowledge for both oxygen modalities and NIPPV. PGY1 and PGY2 residents achieved knowledge levels similar to PGY3 residents after the training. We recommend incorporating simulation-based respiratory training into residency programs to improve resident competency for both oxygen modalities and NIPPV.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"15-21"},"PeriodicalIF":1.1,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146054219","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":"Implementation of a point-of-care ultrasound course in the national Canadian Society of Respiratory Therapists annual conference.","authors":"Kimberley Lewis, Kelly Hassall, John Plumb, Brandon D'Souza, Kallirroi Laiya Carayannopoulos, Jill C Rudkowski, Euan Zhang, Alexis Soth, Mathew B Kiberd","doi":"10.29390/001c.154941","DOIUrl":"10.29390/001c.154941","url":null,"abstract":"<p><strong>Introduction: </strong>Point-of-care ultrasound (PoCUS) is a clinical tool that has been gaining popularity. Its purpose is to either guide procedures (for example, arterial or venous catheter insertions) or to supplement the physical exam to answer focused clinical questions. Despite the evidence supporting PoCUS and its generalized uptake, respiratory therapists lack formal PoCUS training prior to entry to practice. Therefore, our purpose was to create, deliver, and evaluate an evidence-based course aimed at teaching respiratory therapists the basics of lung PoCUS and PoCUS-guided vascular access.</p><p><strong>Methods: </strong>Using a scoping review conducted by our group to inform the curriculum, we created a one-day PoCUS introductory course that is delivered annually at the Canadian Society of Respiratory Therapists Conference. We have administered the course for three years and evaluated each occurrence for course design, delivery, and outcomes.</p><p><strong>Results: </strong>The course was delivered to 117 different participants. All participants felt that the difficulty of the content was at a \"perfect level\". There was a large improvement in self-reported confidence in transducer selection, image acquisition, and image interpretation for both lung PoCUS and PoCUS-guided intravascular cannulation. One hundred percent of participants enjoyed the workshop led by an interdisciplinary team and would recommend it to a colleague.</p><p><strong>Conclusions: </strong>We have assembled a strong interdisciplinary team to introduce the basic concepts of PoCUS in a reliable, easy-to-deliver format that is well-received by respiratory therapists who practice in Canada.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"4-14"},"PeriodicalIF":1.1,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004373","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":"Implementation of a peripherally inserted central catheter service by pediatric anesthesiologists and anesthesia assistants.","authors":"Mathew B Kiberd, Jeanette L Comeau, Sami Jreige, Marissa MacInnis, Tristan Dumbarton","doi":"10.29390/001c.154938","DOIUrl":"10.29390/001c.154938","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"62 ","pages":"1-3"},"PeriodicalIF":1.1,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12803477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991264","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":"Response to \"Letter to the Editor: The importance of quantifying training loads and applying exercise principles in respiratory muscle training studies\".","authors":"Chris Russian, Sharon Armstead","doi":"10.29390/001c.151220","DOIUrl":"10.29390/001c.151220","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"61 ","pages":"296-298"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12694927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745037","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}