Canadian Journal of Respiratory Therapy最新文献

{"title":"Skin-to-Skin Therapy on High-Frequency Jet Ventilation: A Trauma-Informed Best Practice.","authors":"Dallyce Varty, Kuljit Minhas, Sarah Gillis, Sarah Rourke","doi":"10.29390/001c.84446","DOIUrl":"10.29390/001c.84446","url":null,"abstract":"<p><strong>Objective: </strong>To mitigate trauma for infants on high-frequency jet ventilation by decreasing exposure to noise and facilitating skin-to-skin therapy.</p><p><strong>Design: </strong>Key drivers were identified, and we designed and implemented equipment and processes through a series of interventions. A mixed methods evaluation was used. Retrospective chart reviews assessed safety (unplanned extubation) and stability parameters. Semi-structured interviews were conducted to understand parent and staff experiences.</p><p><strong>Results: </strong>Stability parameters demonstrated safe skin-to-skin therapy. Data from the interviews showed that parents and staff experiences focused on safety, connection and healing.</p><p><strong>Conclusion: </strong>Implementing safe processes to support skin-to-skin therapy during high-frequency jet ventilation is possible. We hope other units will be encouraged to examine their current practices for infants on high-frequency jet ventilation to help mitigate trauma for infants and parents while enhancing staff satisfaction.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"59 ","pages":"175-182"},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a5/3e/cjrt_2023_59_84446.PMC10540160.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41168995","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":"Application of the Perme Score to assess mobility in patients with COVID-19 in inpatient units.","authors":"Milena Siciliano Nascimento, Claudia Talerman, Raquel A C Eid, Simone Brandi, Luana L S Gentil, Fernanda M Semeraro, Fabiano B Targa","doi":"10.29390/001c.84263","DOIUrl":"10.29390/001c.84263","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the ability of the Perme Score to detect changes in the level of mobility of patients with COVID-19 outside the intensive care unit.</p><p><strong>Method: </strong>A retrospective cohort study was conducted in inpatient units of a private hospital. Patients older than 18, diagnosed with COVID-19, who were discharged from the intensive care unit and remained in the inpatient units were included. The variables collected included demographic characterization data, length of hospital stay, respiratory support, Perme Score values at admission to the inpatient unit and at hospital discharge and the mobilization phases performed during physical therapy.</p><p><strong>Result: </strong>A total of 69 patients were included, 80% male and with a mean age of 61.9 years (SD=12.5 years). The comparison of the Perme Score between the times of admission to the inpatient unit and at hospital discharge shows significant variation, with a mean increase of 7.3 points (95%CI:5.7-8.8; <i>p</i><0.001), with estimated mean values of Perme Score at admission of 17.5 (15.8; 19.3) and hospital discharge of 24.8 (23.3; 26.3). There was no association between Perme Score values and length of hospital stay (measure of effect and 95%CI 0.929 (0.861; 1.002; <i>p</i>=0.058)).</p><p><strong>Conclusion: </strong>The Perme Score proved effective for assessing mobility in patients diagnosed with COVID-19 with prolonged hospitalization outside the intensive care setting. In addition, we demonstrated by the value of the Perme Score that the level of mobility increases significantly from the time of admission to inpatient units until hospital discharge. There was no association between the Perme Score value and length of hospital stay.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"59 ","pages":"167-174"},"PeriodicalIF":0.0,"publicationDate":"2023-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/58/41/cjrt_2023_59_84263.PMC10540155.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41163554","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":"Effect of the modified snorkel mask as noninvasive ventilatory support in patients with acute hypoxemic respiratory failure due to COVID-19.","authors":"Raul Montalvo, Eyner Castro, Janet Rojas, Carlos Camargo, Carina Ninahuanca","doi":"10.29390/001c.83254","DOIUrl":"10.29390/001c.83254","url":null,"abstract":"<p><strong>Background: </strong>The shortage of mechanical ventilators during the COVID-19 pandemic led doctors to use alternative noninvasive ventilation systems, including a modified snorkel mask. Data on the use of the modified snorkel mask is limited.</p><p><strong>Purpose: </strong>The study aims to describe the effect and clinical characteristics of patients with COVID-19 treated with a snorkel mask and to investigate the factors associated with the failure to use noninvasive ventilation with a snorkel mask.</p><p><strong>Methods: </strong>In this retrospective observational study, adult patients with COVID-19 who were treated with a snorkel mask at Daniel Alcides Carrion Hospital of Huancayo-Perú were selected.</p><p><strong>Results: </strong>Of the 390 patients included, 158 (20.5%) received noninvasive ventilation with a snorkel, 84 (53.2%) patients were discharged alive without intubation, and the mortality rate was 22%. In the control group that received standard treatment, 129 patients (55.6%) failed (i.e., deceased or admitted to a mechanical ventilator). The mortality rate was 33.2%. ROX index < 4.8, consolidation-type tomographic pattern, and the presence of complications, such as bacterial pneumonia or thromboembolism, were independently associated with a higher risk of noninvasive ventilation failure with snorkels.</p><p><strong>Conclusions: </strong>Using the snorkel system resulted in an absolute mortality reduction of 11%, and recovery increased by 15% compared to the standard treatment system. Therefore, this device can be used as an acceptable alternative in the absence of mechanical ventilators.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"59 ","pages":"145-153"},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/6b/79/cjrt_2023_59_83254.PMC10540154.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41132842","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":"Purpose Built Catheters for Minimally Invasive Surfactant Therapy: Experience from a Canadian Tertiary Level Neonatal Intensive Care Unit.","authors":"Talib Al Harthy, Michael R Miller, Orlando daSilva, Soume Bhattacharya","doi":"10.29390/001c.77606","DOIUrl":"10.29390/001c.77606","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surfactant therapy (MIST), a method of surfactant delivery via a thin catheter during spontaneous breathing, is an increasingly popular alternative to intubation and surfactant administration. Recently, purpose-built catheters for MIST received regulatory approval in Canada and became available for use. However, procedural success and user experience with such catheters have not been described.</p><p><strong>Methods: </strong>This retrospective cohort study included neonates who received MIST using purpose-built catheters between January 1, 2021, and March 31, 2022. Two types of purpose-built catheters were used in this period - SurfCath™ and BLEScath™. Procedural success, number of attempts, and adverse events in neonates receiving MIST via the two catheters were compared using chi-square or Fisher's tests. User experience was described using an ease-of-use scale.</p><p><strong>Results: </strong>Thirty-seven neonates met eligibility criteria; 22 received MIST via SurfCath™, whereas 15 received MIST via BLEScath™. Success rates were 91% in SurfCath™ and 93% in BLEScath™ (P> 0.994). Failed attempts were lower in SurfCath™ (23%) in comparison to BLEScath™ (33%), but the difference was not statistically significant (P=0.708). Among operators, 90% found SurfCath™ very easy/relatively easy to use compared to 43% of users reflecting the same degree of use with BLEScath™ (P=.021). There was no difference in adverse events.</p><p><strong>Conclusion: </strong>This is the first study in Canada to report MIST with purpose-built catheters. Overall, the success rate was equally high with both catheters. Users subjectively reported higher ease of use with SurfCath™. Commercially available purpose-built catheters should facilitate universal adaptation of the MIST method.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"59 ","pages":"137-144"},"PeriodicalIF":0.0,"publicationDate":"2023-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/06/fa/cjrt_2023_59_77606.PMC10540161.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41151863","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":"Proceedings from the Canadian Society of Respiratory Therapists Annual Conference May 13-14, 2023","authors":"","doi":"10.29390/cjrt-2023-023","DOIUrl":"https://doi.org/10.29390/cjrt-2023-023","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76245700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of inhaled furosemide on dyspnea and pulmonary function in people with COPD: A literature review.","authors":"Zeina Atwi","doi":"10.29390/cjrt-2022-007","DOIUrl":"https://doi.org/10.29390/cjrt-2022-007","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether inhaled furosemide can be effectively used in patients with chronic obstructive pulmonary disease (COPD) to improve feelings of dyspnea and improve pulmonary function values.</p><p><strong>Methods: </strong>This literature review was conducted using randomized control trials and a literature review in which the participants consisted of or included patients with COPD receiving inhaled furosemide as a potential treatment option for their dyspnea and low pulmonary function values.</p><p><strong>Results: </strong>Searches in four databases and secondary sources using five key terms yielded 83 unduplicated articles. Ultimately, four studies, one of which was a literature review, were included which studied the short-term result of inhaled furosemide on dyspnea and pulmonary function values. All studies measured dyspnea as an outcome and three found a statistically significant improvement in patient reported symptoms. Pulmonary function values were measured in all studies which all found improvements.</p><p><strong>Conclusion: </strong>The effect of inhaled furosemide on the dyspnea and pulmonary function values in people with COPD remains uncertain, and questions have emerged regarding the long-term impact on these patients. While this therapy is promising for dyspnea relief and improvement of pulmonary function values in people with COPD, further consideration and additional data still need to be gathered.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"170-174"},"PeriodicalIF":0.0,"publicationDate":"2022-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0b/c4/cjrt-2022-007.PMC9586464.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40461902","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":"Rebreathing of carbon dioxide during non-invasive ventilation. Is PEEP the final solution?","authors":"Mridul Dhar,&nbsp;Sameer Sharma,&nbsp;Antonio M Esquinas","doi":"10.29390/cjrt-2022-054","DOIUrl":"https://doi.org/10.29390/cjrt-2022-054","url":null,"abstract":"Rebreathing carbon non-invasive","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"169"},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/54/48/cjrt-2022-054.PMC9556029.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40461901","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":"Validation of a structured questionnaire to assess the perception and satisfaction of respiratory therapy students toward career prospects and learning resources.","authors":"Jithin K Sreedharan,&nbsp;Udaya Kumar Rao,&nbsp;Mohammed Al Ahmari,&nbsp;Shashidhar M Kotian,&nbsp;Praveen B Mokshanatha","doi":"10.29390/cjrt-2022-032","DOIUrl":"https://doi.org/10.29390/cjrt-2022-032","url":null,"abstract":"<p><strong>Background: </strong>Respiratory therapy is an emerging profession that has existed in India since 1995. Respiratory therapy students will play a significant role in strengthening various aspects of healthcare in the future. There are no validated instruments to evaluate students' perceptions of their careers and satisfaction with the learning resources. The primary objective of the current study is to develop and validate a structured questionnaire (SQ) for respiratory therapy students in India, encompassing all the components of their career development and satisfaction.</p><p><strong>Methods: </strong>Based on the literature review and content validity from respiratory therapy experts through multiple focused group discussions, a reliable SQ was generated with 40 items based on the Likert scale. After getting institutional ethics clearance and informed consent, the SQ was administered to 904 respiratory therapy students across the country. We performed principal component analysis (PCA), structural equation modeling, and confirmatory factor analysis (CFA) for the global fit. Cronbach's alpha was performed to estimate the internal consistency.</p><p><strong>Results: </strong>The PCA generated a 4-factor model, and internal consistency for the total scale exceeded the standard criterion of >0.70. Satisfactory goodness of fit data were yielded from CFA. Average variances extracted were higher than the correlation coefficients of the factors, which show sufficient discriminant validity.</p><p><strong>Conclusion: </strong>This study shows a clinically acceptable model, it fits and suggests the possibility of applying a SQ to a respiratory therapy student with relatively good construct validity and internal consistency, based on the results of CFA.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"162-168"},"PeriodicalIF":0.0,"publicationDate":"2022-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b6/93/cjrt-2022-032.PMC9541297.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40427536","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":"Tracheostomy in critically ill patients with SARS 2 COVID-19 infection: a prospective observational multi-center study of short- and long-term outcomes.","authors":"Alberto Corona,&nbsp;Vincenzo De Santis,&nbsp;Domenico Vitale,&nbsp;Cecilia Nencini,&nbsp;Antonella Potalivo,&nbsp;Anna Prete,&nbsp;Nicoletta Barzaghi,&nbsp;Sara Tardivo,&nbsp;Marina Terzitta,&nbsp;Anna Malfatto,&nbsp;Luigi Tritapepe,&nbsp;Alessandro Locatelli,&nbsp;Mervyn Singer","doi":"10.29390/cjrt-2022-018","DOIUrl":"https://doi.org/10.29390/cjrt-2022-018","url":null,"abstract":"<p><strong>Background: </strong>We report the characteristics, timing, and factors related to the decision to perform a tracheostomy in patients with confirmed COVID-19 infection admitted to eight Italian intensive care units (ICUs).</p><p><strong>Materials and methods: </strong>Prospective observational cohort study of patients with COVID-19 disease on mechanical ventilation. Long-term functional impairment (up to 180 days' post-hospital discharge) was assessed using the Karnofsky scale. Kaplan-Meier analysis assessed differences in survival and freedom from tracheostomy in relation to ICU stay. Cox regression model was used to assess which variables impacted on tracheostomy as a categorical outcome.</p><p><strong>Results: </strong>A total of 248 patients were recruited in the eight participating ICUs. Patients undergoing tracheostomy (<i>n</i> = 128) had longer ICU (25 (18-36) vs. 10 (7-16), <i>P</i> = 0.001) and hospital (37 (26.5-50) vs. 19 (8.5-34.5) <i>P</i> = 0.02) stays. ICU and hospital mortality of patients tracheostomized was 34% and 37%, respectively. Cumulative survival Kaplan-Meier analysis documented improved survival rates in patients undergoing tracheostomy (Log-Rank, Mantel-Cox = 4.8, <i>P</i> = 0.028). Median Karnofsky scale values improved over time but were similar between survivors receiving or not receiving tracheostomy. No healthcare worker involved in the tracheostomy procedure developed COVID-19 infection during the study period.</p><p><strong>Conclusions: </strong>Patients with COVID-19 infection who underwent tracheostomy had a better cumulative survival but similar long-term functional outcomes at 30, 60, and 180 days after hospital discharge.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"155-161"},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/aa/cjrt-2022-018.PMC9524274.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40430080","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":"A longitudinal study on the impact of simulation on positive deviance through speaking up.","authors":"Efrem M Violato","doi":"10.29390/cjrt-2022-006","DOIUrl":"https://doi.org/10.29390/cjrt-2022-006","url":null,"abstract":"<p><strong>Background: </strong>Students reported positive learning outcomes during a simulation study addressing compliance and speaking up.</p><p><strong>Purpose: </strong>Investigate if the impacts of the simulation had a lasting effect on participants after moving into practice.</p><p><strong>Method: </strong>Semi-structured interviews focusing on memory of the study, psychological impacts, educational impacts, professional impacts, and experiences in practice were conducted with Advanced Care Paramedics (3) and Respiratory Therapists (7) between 19 and 24 months after the original study.</p><p><strong>Discussion: </strong>Participants indicated the simulation helped them develop the skill and confidence to speak up, preparing them to speak up in practice. Primary findings included: (<i>i</i>) the importance of experience for speaking up, (<i>ii</i>) the benefit of high-impact simulation, and (<i>iii</i>) the importance of simulation training.</p><p><strong>Conclusions: </strong>Simulation for speaking up should occur early. Conducting high-impact simulations for speaking up is a practical and actionable intervention that appears to enhance confidence, ability, and likelihood of speaking up in practice.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"137-142"},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9d/46/cjrt-2022-006.PMC9422874.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40366971","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}