Our Editor's Choice paper investigates the effects of nasal cycling on FIO2 by nasal cannula in an anatomic model com-paring right and left prong oxygen flow delivery. Marshall and colleagues found that oxygen delivery might be inefficient in the presence of nasal cycle. Delivered oxygen concentrations decreased when bilateral nasal patency changed to unilateral nasal patency. Wettstein reminds us that bench studies do not predictably translate into clinical practice, but this study raises interesting questions requiring further research.
Comini et al evaluated the impact of clinical and quality of life outcomes of survivors with prolonged ICU stay who are recovering from rehabilitation on caregivers' burden. Al-though subjects' clinical status improved over time, caregiv-ers' burden remained high, suggesting the need to monitor and support caregivers. Liang and Choi recommend that, to best understand how to assist in recovery, it is important to enroll both ICU survivors and family caregivers in future studies to investigate relationships between burden and recovery in both.
An observational study was conducted by Mascoll-Robert-son et al to evaluate the objective use of pulse oximetry to predict respiratory support transition in preterm infants. Their hypothesis was that infants with ≥15% of time spent with SpO2 <86% prior to transitioning from CPAP or high-flow na-sal cannula to low-flow nasal cannula, oxyhood, or room air are more likely to fail transitioning. Their results suggest that SpO2 histograms may be useful in assessing support transition readiness. Mense and Waitz suggest that frequent assessment of SpO2, including the percentage of time infants spent within their desired target SpO2 range and the number of prolonged hypoxemic events, could be a valuable strategy to adapt the intensity of therapeutic interventions.
In another study related to pulse oximetry, Amalakanti et al assessed the performance of pulse oximetry in acute respirato-ry failure of subjects with COPD. They found that pulse ox-imetry performed poorly in comparison with arterial blood gas analysis. The variability of the readings was greater in the sub-jects with chronic bronchitis than in those with emphysema.
Ruiz and colleagues evaluated transcutaneous carbon diox-ide (PtcCO2) in subjects with acute respiratory failure and se-vere hypercapnia. They report an overall acceptable agreement between PtcCO2 and PaCO2. However, PtcCO2 underestimated PaCO2 and was not suitable for subjects with severe hypercap-nia.
Turan et al assessed smoking-related behaviors and effec-tiveness of tobacco cessation therapy in prison. Factors like stress and being in prison may provoke smoking. A smoking ban did not seem to be a solution for preventing tobacco use in the prisons. Tobacco cessation programs may be a better option, and cost-free cessation medications may increase quit rates among prisoners.
Boubaker and colleagues tested whether finger plethys-mography waveform change during a Valsalva maneuver could help the distinction between subjects with COPD exac-erbation, with and without left ventricular dysfunction (LVD). They found that an increased plethysmographic pulse ampli-tude ratio associated with COPD exacerbation is a good pre-dictor of LVD.
The aim of the study by McCaleb et al was to describe the respiratory microbiology of children with long-term tracheos-tomies. Interestingly, specific organisms were not related to the level of chronic respiratory support or likelihood of receiv-ing antibiotics.
Freire and colleagues verified the effects of passive smok-ing on mucociliary clearance and the autonomic nervous sys-tem, and investigated the influence of frequency and time of passive exposure on these systems. Passive smokers had worse mucociliary clearance and there was a correlation between passive exposure load and damage to the hemodynamic behav-ior, pulmonary function, and the autonomic nervous system.
The aim of the study by Carlucci et al was to investigate the technical aspects that can influence setting the ventilator during mouthpiece ventilation (MPV) and to give a practical setting to avoid alarm activation. They found that an appropri-ate alarm setting, and combination of tidal volume and inspi-ratory time, allowed the majority of the tested ventilators to be used for MPV without alarm activation.
Sgariboldi and Pazzianotto-Forti developed predictive equations for maximal respiratory pressures of women consid-ering their anthropometric characteristics. They suggest that the predictive equations developed in this study can be used in the interpretation of the assessment of respiratory muscle strength in morbidly obese women ages 25 to 65 y. Lee et al evaluated the clinical utility of measurement of total lung capacity in diagnosing obstructive lung disease in subjects with a restrictive pattern of spirometry. They found that the measurement of total lung capacity was more useful than FEF25-75%, peak expiratory flow, and post-bronchodilator response for diagnosis of obstructive lung disease in subjects with a restrictive pattern of spirometry when obstructive lung disease is clinically suspected.
This study of Karadallı and colleagues investigated the ef-fects of inspiratory muscle training in subjects with sarcoid-osis. Inspiratory muscle training improved functional and maximal exercise capacity and respiratory muscle strength, decreased severe fatigue and dyspnea perception in subjects with early stage of sarcoidosis.
In the study by Bellani and colleagues, the authors describe an index, PEI, defined as the ratio between the inspiratory muscle pressure and the electrical activity of the diaphragm (EAdi). They found that PEI remained constant in each subject over time, although the inter-individual variability was high. Neither the PEI nor its trends appeared to be associated with ventilatory variables or clinical outcome.
Bohács et al evaluated the relationship of circulating C5a and complement factor H levels with disease control in preg-nant subjects with asthma. They found that asthma during pregnancy increases the circulating level of proinflammatory C5a, which was accompanied by impaired lung function, and partly counteracted by the gestation specific elevation of regu-latory complement factor H level.
The aim of the study by Smith et al was to investigate clinical and quantitative measures of balance in people with chronic respiratory disease following participation in outpa-tient pulmonary rehabilitation (PR). Participation in an 8-week outpatient PR program improved balance. Detailed analysis of force plate measures demonstrated improvements primarily with respect to medial-lateral balance control.
Retory and colleagues aimed to develop a method to accu-rately monitor ventilation with respiratory inductive plethys-mography in subjects with high body mass index (BMI) during a 6-min walk test (6MWT). They found that this respiratory monitoring method is sufficiently sensitive to indicate differ-ences between rest and exercise, as well as locomotor and ven-tilatory differences relative to BMI during the 6MWT.
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