Canadian Journal of Respiratory Therapy最新文献

{"title":"Outcomes and follow-up for children intubated in an adult-based community hospital system: A retrospective chart review.","authors":"Mika L Nonoyama,&nbsp;Vinay Kukreti,&nbsp;Efrosini Papaconstantinou,&nbsp;Natascha Kozlowski,&nbsp;Sarah Tsimelkas","doi":"10.29390/cjrt-2022-015","DOIUrl":"https://doi.org/10.29390/cjrt-2022-015","url":null,"abstract":"<p><strong>Objectives: </strong>Emergency intubation is a high-risk procedure in children. Studies describing intubation practices in locations other than pediatric centres are scarce and varied. This study described pediatric intubations in adult-based community emergency departments (EDs) and determined what factors were associated with intubated-related adverse events (AEs) and described outcomes of children transferred to a quaternary care pediatric institution.</p><p><strong>Methods: </strong>This is a retrospective review of data collected between January 2006 and March 2017 at Lakeridge Health and Hospital for Sick Children (SickKids). Patients were <18 years and intubated in Lakeridge Health EDs; those intubated prior to ED arrival were excluded. Primary outcomes were intubation first-pass success (FPS) and AEs secondary to intubation.</p><p><strong>Results: </strong>Patients (<i>n</i> = 121) were analyzed, and median (interquartile range (IQR)) age was 3.7 (0.4-14.3) years. There were 76 (62.8%) FPS, with no difference between pediatricians (<i>n</i> = 25, 23%) or anaesthetists (<i>n =</i> 12, 11%), versus all other providers (paramedic <i>n =</i> 13 (12%), ED physician <i>n =</i> 37 (34%), respiratory therapist <i>n =</i> 20 (18%), transfer team <i>n =</i> 2 (2%)). The proportion of AEs was 24 (19.8%, <i>n =</i> 21 minor, <i>n =</i> 3 major), with no significant difference between pediatricians or anaesthetists versus all other providers. Data from 68 children transferred to SickKids were available, with the majority extubated within a short median (IQR) time of admission, 1.2 (0.29-3.8) days.</p><p><strong>Conclusions: </strong>Pediatric intubations were rare in a Canadian adult-based community hospital system. Most intubations demonstrated FPS with relatively few AEs and no significant differences between health provider type. Future investigations should utilize multi-centred data to inform strategies suited for organizations' unique practice cultures, including training programs.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":" ","pages":"69-76"},"PeriodicalIF":0.0,"publicationDate":"2022-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a6/a0/cjrt-2022-015.PMC9187052.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40403082","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":"MESSAGE FROM THE EDITOR-IN-CHIEF.","authors":"Elizabeth Rohrs","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"167"},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/0e/cjrt-2021-080.PMC8698157.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39858594","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":"Noninvasive ventilation in acute exacerbation of COPD: Homer is close to shore.","authors":"Umur Hatipoğlu,&nbsp;Laith Ghazala,&nbsp;Manshi Li,&nbsp;Xiaofeng Wang,&nbsp;Abhijit Duggal","doi":"10.29390/cjrt-2021-072","DOIUrl":"https://doi.org/10.29390/cjrt-2021-072","url":null,"abstract":"Can J Respir Ther Vol 57 This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http:// creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact editor@csrt.com Published online at https://www.cjrt.ca on 29 November 2021 LETTER TO THE EDITOR","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"160"},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/33/31/cjrt-2021-072.PMC8629373.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39687916","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":"Students' perceived self-efficacy, expectations, barriers, and support in enrolling in a master's degree program in respiratory care.","authors":"Vincent Showalter,&nbsp;Chris Russian,&nbsp;Joshua Gonzales,&nbsp;Arzu Ari","doi":"10.29390/cjrt-2021-020","DOIUrl":"https://doi.org/10.29390/cjrt-2021-020","url":null,"abstract":"<p><strong>Background: </strong>Respiratory care programs are under pressure to recruit and retain students in both undergraduate and graduate programs. Factors that influence undergraduate students' decisions to continue their education into an advanced degree program are not fully understood. The purpose of this study is to determine students' perceived self-efficacy, outcome expectations, barriers, and support to attend a Master of Science in Respiratory Care (MSRC) program.</p><p><strong>Methods: </strong>This study used a survey from a previous study that included questions on undergraduate student self-efficacy, outcome expectations, perceived barriers and was utilized to assess students' perceptions of the support to attend an MSRC and its impact on their career goals. Student self-efficacy is defined as a person's beliefs and ability about his/her capacity to succeed in a specific situation. All undergraduate students (<i>n</i> = 89) in the Bachelor of Science in Respiratory Care program at Texas State University were invited to participate in the study.</p><p><strong>Results: </strong>A total of 87 surveys were collected (42 juniors and 45 seniors) with a response rate of 97.7%. Ninety percent of study participants were female, and the average age was 22.54 ± 3.50 years. Self-efficacy results indicate that 88.5% of our undergraduate students believe they would be successful if enrolled in the MSRC program. Only 58.6% are interested in pursuing the MSRC, possibly because 51.7% do not think the MSRC is required for the job they want. However, 98.8% believe the MSRC will create more opportunities for them. Cost (34%), tired of schoolwork (20%), and marriage (10%) are the three main reasons not to attend the MSRC. Of those interested in an MSRC program, 71.3% reported that they do not know if they can receive financial support for graduate studies, 71% are unaware of how to contact a graduate program coordinator, and 89% fear difficulty in navigating graduate school and networking with others.</p><p><strong>Conclusion: </strong>Respiratory care students have self-efficacy to attend an MSRC program and believe it will provide more opportunities for them. However, cost and resource awareness are the main barriers to enrolling in the graduate program. This study highlights students' perceived barriers and challenges in advancing their knowledge and continuing their education with an MSRC degree and the need for student support.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"154-159"},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/2b/cjrt-2021-020.PMC8629374.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39687511","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":"Relationship between potential barriers to early mobilization in adult patients during intensive care stay using the Perme ICU Mobility score.","authors":"Esther C Wilches Luna,&nbsp;Christiane Perme,&nbsp;Ada Clarice Gastaldi","doi":"10.29390/cjrt-2021-018","DOIUrl":"https://doi.org/10.29390/cjrt-2021-018","url":null,"abstract":"<p><strong>Background: </strong>Identifying barriers to early mobilization is essential for the management of patients in the intensive care unit (ICU). Our objective was to identify the potential barriers to early mobilization in adult patients using the Perme ICU Mobility Score (Perme Score) and its relationship with days of mechanical ventilation (MV) and length of stay in ICU.</p><p><strong>Methods: </strong>This was a pilot, observational, and prospective study. We included 142 adult patients admitted to a 14-bed ICU, in a fourth-level complexity hospital in Cali, Colombia. The Perme Score was used to evaluate potential barriers to mobility. We used the Spearman's correlation coefficient to find potential correlations between the number of barriers to mobility per patient and the duration of MV and ICU stay.</p><p><strong>Results: </strong>We identified significant inverse correlations between total days in MV and the total score of barriers to mobility at ICU admission (<i>r</i> = -0.773; <i>p</i> < 0.05) and at ICU discharge (<i>r</i> = -0.559; <i>p</i> < 0.05). Also, between ICU length of stay and total score of barriers to mobility at ICU admission (<i>r</i> = -0.420; <i>p</i> < 0.05) and at ICU discharge (<i>r</i> = -0.283; <i>p</i> < 0.05). Moreover, we found a significant correlation between total score of the barriers item and total Perme score (<i>r</i> = 0.91; <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Using the Perme Score we identified potential barriers to mobility upon admission to the ICU that were maintained until discharge. Our findings indicate a strong positive correlation at ICU admission between the total Perme Score and the total score of \"Category #2 - Potential Mobility Barriers\" in the Perme Score.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"148-153"},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/73/89/cjrt-2021-018.PMC8607990.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39656181","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":"Noninvasive ventilation duration as an outcome predictor in acute exacerbation of COPD and respiratory failure: The saga continues.","authors":"Habib Md Reazaul Karim,&nbsp;Maria João Araújo,&nbsp;Antonio M Esquinas","doi":"10.29390/cjrt-2021-069","DOIUrl":"https://doi.org/10.29390/cjrt-2021-069","url":null,"abstract":"147 This open-access article is distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-NC) (http:// creativecommons.org/licenses/by-nc/4.0/), which permits reuse, distribution and reproduction of the article, provided that the original work is properly cited and the reuse is restricted to noncommercial purposes. For commercial reuse, contact editor@csrt.com Published online at https://www.cjrt.ca on 29 October 2021 LETTER TO THE EDITOR","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"147"},"PeriodicalIF":0.0,"publicationDate":"2021-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e9/56/cjrt-2021-069.PMC8555524.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609938","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":"Multimodal treatment for acute empyema based on the patient's condition, including patients who are bedridden: A single center retrospective study.","authors":"Tomoki Nishida,&nbsp;Yuto Igarashi,&nbsp;Yuma Suno,&nbsp;Takaaki Murata,&nbsp;Katsunori Miyake,&nbsp;Naoko Isogai,&nbsp;Rai Shimoyama,&nbsp;Jun Kawachi,&nbsp;Hiroyuki Kashiwagi,&nbsp;Toshitaka Tsukiyama,&nbsp;Ryuta Fukai","doi":"10.29390/cjrt-2021-032","DOIUrl":"https://doi.org/10.29390/cjrt-2021-032","url":null,"abstract":"Background The incidence of acute empyema has increased in various countries; some elderly patients with acute empyema have contraindications for surgery under general anesthesia. Therefore, suitable management based on a patient’s clinical condition is required. Methods We evaluated the different surgical and nonsurgical therapeutic approaches available for patients with acute empyema. This was a retrospective study of 57 patients with acute empyema who received treatment in our department between May 2015 and February 2019. For patients who did not initially improve with drainage or drainage combined with fibrinolytic therapy, surgery, or additional percutaneous drainage was performed based on their general condition. We compared several clinical factors pertaining to the patients who underwent surgical versus nonsurgical treatment. Results Our study showed that the patients with a performance status of 0–2 and an American Society of Anesthesiologists physical status classification of class II or lower underwent surgery safely without major operative complications. The combination of repeated drainage of the pleural cavity and fibrinolytic therapy appeared to be a reasonable nonsurgical management option for patients in poor overall condition. Conclusion For an aging population, we think that the combination of repeated pleural cavity drainage procedures and fibrinolytic therapy is a reasonable nonsurgical strategy for the management of patients with acute empyema.","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"143-146"},"PeriodicalIF":0.0,"publicationDate":"2021-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1f/f2/cjrt-2021-032.PMC8527924.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39609937","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":"Evaluation of a novel endotracheal tube suctioning system incorporating an inflatable sweeper.","authors":"John D Davies,&nbsp;Yuh Chin Huang,&nbsp;Neil R MacIntyre","doi":"10.29390/cjrt-2021-026","DOIUrl":"https://doi.org/10.29390/cjrt-2021-026","url":null,"abstract":"<p><strong>Introduction: </strong>Accumulation of secretions in an endotracheal tube can increase the resistance to flow resulting in an increased patient work of breathing when the patient is interacting with the ventilator. Retained secretions can also serve as an infection risk. Standard suction catheters are limited in their ability to keep the lumen of the endotracheal tube clear. A novel closed-suction catheter has been introduced that incorporates a balloon at its distal end that, when inflated, physically scrapes secretions out of the endotracheal tube (CleanSweep catheter (CSC), Teleflex, Morrisville NC). We hypothesized that the CSC would be more efficient at removing secretions from inside the endotracheal tube than a standard suction catheter (SSC).</p><p><strong>Methods: </strong>We performed a bench study examining resistive pressures across different sizes of endotracheal tubes when cleaned by the CSC as compared with an SSC. This study was followed by a prospective crossover study again comparing the CSC with an SSC in intubated intensive care unit patients receiving mechanical ventilation and requiring frequent suctioning.</p><p><strong>Results: </strong>For the bench study the CSC was significantly better in reducing airway resistive pressures (<i>P</i> < 0.001). In the prospective crossover study the CSC over 2 h also removed significantly more secretions than the SSC (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Both our bench and crossover clinical study demonstrated improved clearance of secretions with the CSC vs an SSC. Further research is needed to ascertain the clinical outcome benefits of enhanced secretion removal.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"138-142"},"PeriodicalIF":0.0,"publicationDate":"2021-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d5/0e/cjrt-2021-026.PMC8509580.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39589466","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":"Exploring the professionalization of respiratory therapy in Canada.","authors":"Marco Zaccagnini,&nbsp;André Bussières,&nbsp;Peter Nugus,&nbsp;Andrew West,&nbsp;Aliki Thomas","doi":"10.29390/cjrt-2021-046","DOIUrl":"https://doi.org/10.29390/cjrt-2021-046","url":null,"abstract":"<p><strong>Introduction: </strong>A recurrent challenge facing respiratory therapists (RTs) is their legitimacy as professionals. RTs are often referred to as technologists, vocationalists, or technicians and must often justify their status as full professionals rather than \"professional technicians\". There is currently little exploration of what it means to be a profession and the process of professionalization in respiratory therapy.</p><p><strong>Approach: </strong>Drawing from sociological theory, the purpose of this paper is to discuss the professionalization of respiratory therapy in Canada using Andrew Abbott's theory, the \"system of professions\". We will use this theory as a lens to propose areas of consideration for professional development regarding two pervasive themes in the respiratory therapy community, RTs' specialized body of knowledge and professional autonomy.</p><p><strong>Findings: </strong>Abstract knowledge is believed to be essential in the evolution from occupation to profession and is valuable to a profession in three ways: it can influence the profession's legitimacy, it can be used for conducting research, and it promotes higher education. RTs possess jurisdictional professional autonomy within Canada. The privilege of self-regulation allows RTs to act according to their knowledge and judgement without direct oversight from other professions.</p><p><strong>Conclusion: </strong>Based on Abbott's theoretical position, RTs can rightly justify their position as professionals. However, RTs need to acknowledge that professionalization is a dynamic and continuous process that requires creative changes to innovate within the profession and support future efforts to reinforce their position as professionals. Throughout this paper, we offer suggestions for how RTs can contribute to the ongoing professionalization of respiratory therapy.</p>","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"129-137"},"PeriodicalIF":0.0,"publicationDate":"2021-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/d8/cjrt-2021-046.PMC8500402.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39561450","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":"Call for emergency action to limit global temperature increases, restore biodiversity, and protect health.","authors":"Lukoye Atwoli,&nbsp;Abdullah H Baqui,&nbsp;Thomas Benfield,&nbsp;Raffaella Bosurgi,&nbsp;Fiona Godlee,&nbsp;Stephen Hancocks,&nbsp;Richard Horton,&nbsp;Laurie Laybourn-Langton,&nbsp;Carlos Augusto Monteiro,&nbsp;Ian Norman,&nbsp;Kirsten Patrick,&nbsp;Nigel Praities,&nbsp;Marcel Gm Olde Rikkert,&nbsp;Eric J Rubin,&nbsp;Peush Sahni,&nbsp;Richard Smith,&nbsp;Nick Talley,&nbsp;Sue Turale,&nbsp;Damián Vázquez","doi":"10.29390/cjrt-2021-056","DOIUrl":"https://doi.org/10.29390/cjrt-2021-056","url":null,"abstract":"","PeriodicalId":39373,"journal":{"name":"Canadian Journal of Respiratory Therapy","volume":"57 ","pages":"126-128"},"PeriodicalIF":0.0,"publicationDate":"2021-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/6a/cjrt-2021-056.PMC8509575.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39589465","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}