Respiratory care clinics of North America最新文献

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Basic principles of control of breathing. 控制呼吸的基本原则。
Respiratory care clinics of North America Pub Date : 2005-06-01 DOI: 10.1016/j.rcc.2005.02.011
Stephen Corne, Zoheir Bshouty
{"title":"Basic principles of control of breathing.","authors":"Stephen Corne,&nbsp;Zoheir Bshouty","doi":"10.1016/j.rcc.2005.02.011","DOIUrl":"https://doi.org/10.1016/j.rcc.2005.02.011","url":null,"abstract":"<p><p>The metabolic demands of the body, including consumption of oxygen and removal of carbon dioxide, vary widely in health and disease. Ventilation must adjust to meet these demands and accommodate volitional and behavioral activities. Control of breathing depends on a complex and intricate feedback control system that integrates these automatic and volitional aspects of ventilation. Sensors, including chemoreceptors and lung volume receptors, relay information to a central controller located primarily in the medulla. The central controller integrates this information and determines the level of activation of the effectors (the respiratory motoneurons and muscles), which affects ventilation and gas exchange. Inputs from suprapontine structures, including the cerebral cortex, are also important in integrating volitional aspects of breathing into the control system.</p>","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"11 2","pages":"147-72"},"PeriodicalIF":0.0,"publicationDate":"2005-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rcc.2005.02.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40947788","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}
引用次数: 10
Functional principles of positive pressure ventilators: implications for patient-ventilator interaction. 正压呼吸机的功能原理:对患者-呼吸机相互作用的影响。
Respiratory care clinics of North America Pub Date : 2005-06-01 DOI: 10.1016/j.rcc.2005.02.002
Richard D Branson
{"title":"Functional principles of positive pressure ventilators: implications for patient-ventilator interaction.","authors":"Richard D Branson","doi":"10.1016/j.rcc.2005.02.002","DOIUrl":"https://doi.org/10.1016/j.rcc.2005.02.002","url":null,"abstract":"<p><p>Ventilator performance can be tied to the individual systems that control delivery of pressure, volume, and flow. Clinician's need not be engineers but should understand how individual device mechanics and algorithms can affect patient ventilator synchrony.</p>","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"11 2","pages":"119-45"},"PeriodicalIF":0.0,"publicationDate":"2005-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rcc.2005.02.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40947787","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}
引用次数: 11
Do guidelines guide pneumonia practice? A systematic review of interventions and barriers to best practice in the management of community-acquired pneumonia. 肺炎实践有指南吗?对社区获得性肺炎管理最佳实践的干预措施和障碍的系统回顾。
Respiratory care clinics of North America Pub Date : 2005-03-01 DOI: 10.1016/j.rcc.2004.10.001
Scot H Simpson, Thomas J Marrie, Sumit R Majumdar
{"title":"Do guidelines guide pneumonia practice? A systematic review of interventions and barriers to best practice in the management of community-acquired pneumonia.","authors":"Scot H Simpson,&nbsp;Thomas J Marrie,&nbsp;Sumit R Majumdar","doi":"10.1016/j.rcc.2004.10.001","DOIUrl":"https://doi.org/10.1016/j.rcc.2004.10.001","url":null,"abstract":"<p><p>Successful guideline implementation programs need to understand local barriers, incorporate multiple component interventions, and proceed within a framework of continuous quality improvement. We found few intervention studies to improve CAP guideline adherence and no controlled studies that used certain practice changes strategies that have proven effective for other conditions, such as face-to-face educational outreach, use of local opinion leaders, and individualized audit with peer-comparison feedback. Future studies in CAP management need to use rigorous study designs, use multiple evidence-based strategies to change practice, and convincingly demonstrate to front-line health care providers that the suggested interventions are safe and improve patient outcomes. Paper does not change practice, and the creation and mailing out of a practice guideline for the treatment of CAP is only the first necessary step in translating good evidence into everyday clinical practice.</p>","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"11 1","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rcc.2004.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25002306","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}
引用次数: 53
Community-acquired pneumonia: new facets of an old disease--Hantavirus pulmonary syndrome. 社区获得性肺炎:一种老病的新方面——汉坦病毒肺综合征
Respiratory care clinics of North America Pub Date : 2005-03-01 DOI: 10.1016/j.rcc.2004.10.003
Lil Miedzinski
{"title":"Community-acquired pneumonia: new facets of an old disease--Hantavirus pulmonary syndrome.","authors":"Lil Miedzinski","doi":"10.1016/j.rcc.2004.10.003","DOIUrl":"https://doi.org/10.1016/j.rcc.2004.10.003","url":null,"abstract":"<p><p>It seems that with climatic and geoecologic changes, Hantaviruses have re-emerged as human pathogens related to increases in interaction between humans and rodent reservoirs. Infection with SNV in North America and the Andes virus in South America can produce infection manifest initially as a flu-like illness. In the setting of a history of possible exposure to rodents or their excreta, clinical symptoms and laboratory clues such as thrombocytopenia should raise the suspicion of HPS. Clinical deterioration can be rapid, so patients should be hospitalized and transported to tertiary care centers where mechanical ventilation is available if necessary. Presumptive treatment for other forms of sepsis should be considered before confirmation of diagnosis. Survival seems to be determined in part by viral and host factors. Canadian and South American data suggest that there may be species variations influencing clinical manifestations and course of disease. Because the pathogenesis seems to be based on immunologic injury, future treatments will likely focus on interventions other than antiviral medications. Prevention strategies should be emphasized, particularly when recognized climatic conditions favor rodent abundance. Physicians should remain alert to the possibility of such a diagnosis when evaluating a patient with CAP and should request appropriate serology while supporting the patient in a closely monitored setting. The declining mortality rates seen over the past decade may be a consequence of improved medical management or better recognition of cases, including those less severe than originally described.</p>","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"11 1","pages":"45-58"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rcc.2004.10.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25170640","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}
引用次数: 12
Community-acquired Pneumonia: An Illness with Great Diversity 社区获得性肺炎:一种多样性很强的疾病
Respiratory care clinics of North America Pub Date : 2005-03-01 DOI: 10.1016/j.rcc.2004.10.009
T. Marrie
{"title":"Community-acquired Pneumonia: An Illness with Great Diversity","authors":"T. Marrie","doi":"10.1016/j.rcc.2004.10.009","DOIUrl":"https://doi.org/10.1016/j.rcc.2004.10.009","url":null,"abstract":"","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"369 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72434601","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}
引用次数: 0
Management of community-acquired pneumonia in the emergency room. 社区获得性肺炎的急诊室管理。
Respiratory care clinics of North America Pub Date : 2005-03-01 DOI: 10.1016/j.rcc.2004.10.004
Thomas J Marrie, Sumit R Majumdar
{"title":"Management of community-acquired pneumonia in the emergency room.","authors":"Thomas J Marrie,&nbsp;Sumit R Majumdar","doi":"10.1016/j.rcc.2004.10.004","DOIUrl":"https://doi.org/10.1016/j.rcc.2004.10.004","url":null,"abstract":"<p><p>Many patients with CAP are seen in the ER and treated as outpatients.History, physical examination, selected lab tests, and chest radiography must be routinely undertaken in patients with \"presumptive\" pneumonia to make the diagnosis and allow for appropriate risk stratification. There is wide disagreement among physicians on the presence or absence of CAP on chest radiographs, and a chest radiograph that shows \"no pneumonia\" may not be sufficient to rule out the diagnosis. Furthermore, even patients with \"ambulatory\" pneumonia may have important laboratory abnormalities and a moderate risk of hypoxemia. Diabetes mellitus and stress hyper-glycemia are important comorbidities and must be accounted for in any rational discharge plan. All of the aforementioned observations need to be understood in the context of an increasingly older and frailer patient population that may still be eligible for appropriate outpatient treatment. It is likely that guidelines and clinical pathways for outpatient treatment of CAP that standardize medical care and mandate careful and regular follow-up of patients discharged home will decrease unnecessary practice variation while improving the overall quality of care.</p>","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"11 1","pages":"15-24"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rcc.2004.10.004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25002307","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}
引用次数: 12
Community-acquired pneumonia: An illness with great diversity 社区获得性肺炎:一种多种疾病
Respiratory care clinics of North America Pub Date : 2005-03-01 DOI: 10.1016/J.RCC.2004.10.010
R. Branson, N. MacIntyre
{"title":"Community-acquired pneumonia: An illness with great diversity","authors":"R. Branson, N. MacIntyre","doi":"10.1016/J.RCC.2004.10.010","DOIUrl":"https://doi.org/10.1016/J.RCC.2004.10.010","url":null,"abstract":"","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72786346","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}
引用次数: 0
Tuberculosis: still overlooked as a cause of community-acquired pneumonia--how not to miss it. 结核病:作为社区获得性肺炎的原因仍然被忽视——如何不错过它。
Respiratory care clinics of North America Pub Date : 2005-03-01 DOI: 10.1016/j.rcc.2004.10.007
Dennis Kunimoto, Richard Long
{"title":"Tuberculosis: still overlooked as a cause of community-acquired pneumonia--how not to miss it.","authors":"Dennis Kunimoto,&nbsp;Richard Long","doi":"10.1016/j.rcc.2004.10.007","DOIUrl":"https://doi.org/10.1016/j.rcc.2004.10.007","url":null,"abstract":"<p><p>Tuberculosis (TB) is often mistaken for community-acquired pneumonia (CAP). To avoid missing the diagnosis, we recommend that any CAP patient with upper lobe infiltrate, cavitation, miliary pattern, hemoptysis or >1 month of any of cough, fever, malaise,weakness, night sweats, or significant weight loss, should have sputa submitted for Mycobacterium tuberculosis smear and culture. Any CAP patient failing or relapsing after empiric therapy should be investigated for TB. In the presence of HIV with low CD4 count (< or = 200 cells/mL), the presentation may be atypical, and therefore sputa should be submitted for M tuberculosis. Any HIV patient, regardless of CD4 count, with a known history of positive tuberculin skin test, previous TB, or recent exposure to TB, who presents with CAP, should be investigated for TB.</p>","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"11 1","pages":"25-34"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rcc.2004.10.007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25170638","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}
引用次数: 22
Multicenter, multinational observational studies: a new approach to studying community-acquired pneumonia. 多中心、多国观察性研究:研究社区获得性肺炎的新方法。
Respiratory care clinics of North America Pub Date : 2005-03-01 DOI: 10.1016/j.rcc.2004.10.011
Julio Ramirez
{"title":"Multicenter, multinational observational studies: a new approach to studying community-acquired pneumonia.","authors":"Julio Ramirez","doi":"10.1016/j.rcc.2004.10.011","DOIUrl":"https://doi.org/10.1016/j.rcc.2004.10.011","url":null,"abstract":"<p><p>Using the Internet, it is possible to perform multicenter international projects easier, faster, and less expensive than in the past. Making large international databases available to investigators from around the world will greatly expand the possibilities to obtain new knowledge in the areas of community-acquired pneumo-nia (CAP) research and quality. By closing the gap between clinical research and clinical practice, the management of patients with CAP will improve worldwide.</p>","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"11 1","pages":"35-44"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rcc.2004.10.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25170639","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}
引用次数: 7
Hendra and Nipah viruses: new zoonotically-acquired human pathogens. 亨德拉病毒和尼帕病毒:新的人畜共患性病原体。
Respiratory care clinics of North America Pub Date : 2005-03-01 DOI: 10.1016/j.rcc.2004.10.006
Joseph G McCormack
{"title":"Hendra and Nipah viruses: new zoonotically-acquired human pathogens.","authors":"Joseph G McCormack","doi":"10.1016/j.rcc.2004.10.006","DOIUrl":"https://doi.org/10.1016/j.rcc.2004.10.006","url":null,"abstract":"<p><p>Some of the key features of Hendra and Nipah viruses are summarized in Table 1. The appearance of these new viruses over the last 10 years emphasizes a number of issues. (1) Epidemics of human infectious diseases can occur unexpectedly and with high impact in terms of morbidity and mortality. (2) We do not know what epidemiologic factors conspire to allow these viruses to stray out of their bat reservoirs into the two different intermediate hosts (horses and pigs) and then into humans. (3) We do not know how long these viruses have been present in the bat population, where they originated from, or if they are present in other parts of the world. (4)There may be other viruses waiting for similar opportunities to cross species.(5) It is unlikely that we have seen the last of these and related viruses.</p>","PeriodicalId":79530,"journal":{"name":"Respiratory care clinics of North America","volume":"11 1","pages":"59-66"},"PeriodicalIF":0.0,"publicationDate":"2005-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rcc.2004.10.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25170641","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}
引用次数: 14
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