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Respiratory day hospital: a novel approach to acute respiratory care

Schwartzman, Kevin; Duquette, Guylaine; Zaoudé, May; Dion, Marie-Josée; Lagacé, Marie-Annie; Poitras, Jacinthe; Cosio, Manuel G.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em 16/10/2001 EN
Relevância na Pesquisa
46.09%
IN 1996 WE ESTABLISHED A DAY HOSPITAL DEDICATED to acute respiratory care, as an alternative to emergency department and inpatient treatment. The unit is staffed by respirologists, family physicians and specialized nurses; patients have access to all standard inpatient treatments and services. Between 1996/97 and 1998/99 the annual number of admissions to the day hospital increased from 658 to 922. By 1998/99 more than 75% of patients were referred for acute treatment, with a mean stay of 2.3 days. The most common diagnoses were asthma and chronic obstructive pulmonary disease, which accounted for 58% and 32% respectively of treatment-related admissions. Treatment most often involved intravenous corticosteroid therapy and inhaled bronchodilator therapy. Between 1996/97 and 1998/9 the proportion of patients requiring transfer to overnight care decreased from 22% to 14%; complications and unscheduled return visits were rare. We believe that a respiratory day hospital provides a useful alternative to emergency department and inpatient care.

Use of protein profiles to identify Acinetobacter calcoaceticus in a respiratory care unit.

Dijkshoorn, L; Wubbels, J L; Beunders, A J; Degener, J E; Boks, A L; Michel, M F
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /08/1989 EN
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45.89%
The presence of acinetobacters in a respiratory care unit was prospectively studied because of an increase in the number of isolations of Acinetobacter calcoaceticus. Cell envelope protein electrophoresis was used to distinguish strains. Eleven protein patterns were observed in isolates from patients and their environment. One pattern (pattern 1) was seen in several patients and environmental samples. Another pattern (pattern 2) was identified repeatedly in samples from skin and mucous membranes of patients in the same ward. After thorough cleaning was undertaken throughout the unit, the pattern 1 strain was no longer cultivated from clinical samples. It is concluded that cell envelope protein electrophoresis is a useful method for tracing epidemic strains of A calcoaceticus.

Effect of educational outreach to nurses on tuberculosis case detection and primary care of respiratory illness: pragmatic cluster randomised controlled trial

Fairall, Lara R; Zwarenstein, Merrick; Bateman, Eric D; Bachmann, Max; Lombard, Carl; Majara, Bosielo P; Joubert, Gina; English, Rene G; Bheekie, Angeni; van Rensburg, Dingie; Myers, Pat; Peters, Annatjie C; Chapman, Ronald D
Fonte: BMJ Publishing Group Ltd. Publicador: BMJ Publishing Group Ltd.
Tipo: Artigo de Revista Científica
Publicado em 01/10/2005 EN
Relevância na Pesquisa
46.05%
Objectives To develop and implement an educational outreach programme for the integrated case management of priority respiratory diseases (practical approach to lung health in South Africa; PALSA) and to evaluate its effects on respiratory care and detection of tuberculosis among adults attending primary care clinics.

The Intensive Respiratory Care Unit—An Approach to the Care of Acute Respiratory Failure

Petty, Thomas L.; Bigelow, D. Boyd; Nett, Louise M.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /11/1967 EN
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46.19%
An organized approach for the management of acute respiratory failure in an intensive general care unit utilizes a team of consultants including a general physician, a surgeon, respiratory care nurses, physical therapists and a blood gas technician. Because this team provides consultation and technical assistance in respiratory care and provides the equipment as well as the monitoring of care, this approach is suitable for any hospital interested in the management of acute respiratory emergencies.

Knowledge brokering: An innovative model for supporting evidence-informed practice in respiratory care

Hoens, Alison M; Reid, W Darlene; Camp, Pat G
Fonte: Pulsus Group Inc Publicador: Pulsus Group Inc
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
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46.09%
The process of adopting research findings in the clinical setting is challenging, regardless of the area of practice. One strategy to facilitate this process is the use of knowledge brokering. Knowledge brokers (KBs) are individuals who work to bridge the gap between researchers and knowledge users. In the health care setting, KBs work closely with clinicians to facilitate enhanced uptake of research findings into clinical practice. They also work with researchers to ensure research findings are translatable and meaningful to clinical practice. The present article discusses a KB’s role in a respiratory care setting. Working closely with both researchers and clinicians, the KB has led teams in the process of conceptualizing, developing, testing, disseminating and evaluating several projects related to respiratory care, including projects related to mobility in critical care settings and acute exacerbations of chronic obstructive pulmonary disease; inspiratory muscle training; and the use of incentive spirometry in postsurgical populations. The KB role has provided an important communication link between researcher and knowledge user that has facilitated evidence-informed practice to improve patient care.

Phosphate metabolism in intensive care patients with acute respiratory failure

Moran, J.; Solomon, P.; Yeung, V.; Pannall, P.; John, G.; Eliseo, A.
Fonte: Australasian Academy of Critical Care Medicine Publicador: Australasian Academy of Critical Care Medicine
Tipo: Artigo de Revista Científica
Publicado em //2002 EN
Relevância na Pesquisa
46.16%
Objective: To determine the variables predicting the change of plasma phosphate over the first 24 hr period in intensive care in patients with acute respiratory failure Methods: Fifty-seven patients were studied prospectively in a university teaching hospital intensive care unit (ICU). Thirty two patients were classified as having acute respiratory failure and a primary respiratory system diagnosis (group I), 10 were classified as having acute cardiogenic pulmonary oedema (group II) and 15 were general ICU patients (group III). Arterial blood specimens at intensive care unit admission (T0) and at 24 hr post-admission (T24) were assayed for multiple plasma biochemical parameters including phosphate (PO4) and red blood cell 2,3-diphosphoglycerate (2,3-DPG). Timed urine collections were used to determine 24 hr urine phosphate loss and renal phosphate threshold concentration (RTP). During the measurement period glucose-free fluids only were infused. Results: Fifty seven patients had a mean (± SD) age of 67 ± 12 years and Apache II score of 22 ± 6. The plasma PO4 at T0 was 1.55 ± 0.71 mmol/L and showed a significant 24 hr decrease of 0.55 mmol/L (p < 0.0001) at T24. Hypophosphataemia at T0 was observed in 26% of patients. Red blood cell 2...

Chronic Respiratory Failure and Neuromuscular Disease

Kennedy, J.; Martin, A.
Fonte: W B Saunders Co Publicador: W B Saunders Co
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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46.03%
The outlook for children with respiratory complications of neuromuscular disease has improved significantly in the past 15 years. This has been the result of many advances in clinical care, including improved monitoring of lung function and hypoventilation during sleep; coordinated respiratory care by experienced physicians with access to specialized respiratory services, especially physiotherapy; and, most importantly, the widespread introduction of noninvasive ventilation.; J. Declan Kennedy and A. James Martin

Outcomes of patients admitted to tertiary intensive care units after interhospital transfer: comparison with patients admitted from emergency departments.

Flabouris, A.; Hart, G.; George, C.
Fonte: Australasian Academy of Critical Care Medicine Publicador: Australasian Academy of Critical Care Medicine
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
45.88%
OBJECTIVES: To compare outcomes of patients admitted to tertiary-level intensive care units after interhospital transfer (IHT) with those of similar patients admitted from the emergency department (ED). DESIGN: Historical case-control study using data from the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD), a quality-assurance dataset. PARTICIPANTS AND SETTING: 28882 patients aged 16 years or older admitted to an adult tertiary ICU in Australia or New Zealand between 1 January 1994 and 31 December 2003 with one of the eight most common diagnoses for IHT patients. Patients admitted directly to the ICU from another hospital (DIHT group) (n=9203) were matched by age, sex, APACHE II score and diagnosis with non-IHT patients admitted from the ED (ED group). RESULTS: Hospital mortality was higher in the DIHT group than in the ED group for patients with a diagnosis of multiple trauma (11.0% v 5.1%; odds ratio [OR], 2.3; 95% CI, 1.6- 3.34), respiratory infection (28.1% v 19.1%; OR, 1.66; 95% CI, 1.34-2.05), sepsis (38.7% v 28.7%; OR, 1.57; 95% CI, 1.34-1.83), intracranial haemorrhage (49.9% v 42.6%; OR, 1.34; 95% CI, 1.14-1.58), head injury alone (16.9% v 13.7%; OR, 1.28; 95% CI, 1.01-1.62), and cardiac arrest (59.3% v 53.2%; OR...

Models of chronic disease management in primary care for patients with mild-to-moderate asthma or COPD: a narrative review

Cranston, J.; Crockett, A.; Moss, J.; Pegram, R.; Stocks, N.
Fonte: Australasian Med Publ Co Ltd Publicador: Australasian Med Publ Co Ltd
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
46.13%
Objective: To review the literature for any promising strategies for the primary care management of mild-to-moderate asthma and chronic obstructive pulmonary disease (COPD) in adults. Methods: Using “MeSH” terms for COPD, asthma and primary health care, we conducted an extensive literature search for relevant meta-analyses, systematic reviews, narrative reviews, reports and individual studies. Grey literature was also included. We chose a narrative review approach because of substantial heterogeneity of study designs in the literature. Results: 1119 articles of potential relevance were retained, of which 246 were included in our review. There was insufficient evidence to determine whether general practitioners with a special interest (GPwSI) in respiratory care improved the diagnosis and management of mild-to-moderate COPD. An asthma service involving GPwSI increased respiratory drug costs but reduced the costs for less specific drugs. No clear benefit has been shown for practice nurse-run asthma clinics in primary care compared with usual care in altering asthma morbidity, quality of life, lung function or medication use. Evidence to determine the effectiveness of practice nurse-run COPD clinics could not be found. Self-management education...

Observational study of patients admitted to intensive care units in Australia and New Zealand after interhospital transfer.

Flabouris, A.; Hart, G.; George, C.
Fonte: Australasian Academy of Critical Care Medicine Publicador: Australasian Academy of Critical Care Medicine
Tipo: Artigo de Revista Científica
Publicado em //2008 EN
Relevância na Pesquisa
45.9%
OBJECTIVE: To describe the demographics, illness categories and outcomes of adult intensive care unit patients who underwent interhospital transfer (IHT). DESIGN: Retrospective review of data from the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD), a binational intensive-care quality-assurance dataset. PARTICIPANTS AND SETTING: 332 009 patients from 125 Australian and New Zealand adult ICUs, who were aged 16 years or older, and had a known hospital and ICU source of admission between 1 January 1994 and 31 December 2003. RESULTS: Tertiary ICUs contributed 47.9% of patients, metropolitan 20.9%, private 16.7% and rural/regional 14.5%. Patients admitted to an ICU after IHT had more severe illness, longer hospital stay, and a higher intubation rate, mortality and rate of discharge to another hospital. Over 10 years, the proportion of IHTs increased for rural/regional (R2=0.639; P=0.006) and tertiary (R2=0.703; P=0.002) hospitals, and for the diagnoses of sepsis (R2=0.877; P<0.001) and respiratory infection (R2=0.679, P=0.003); decreased for trauma (R2=0.612; P=0.007); and was associated with fewer ICU admissions after elective surgery (Beta=-1.47; 95% CI, -2.19 to -0.74; P<0.001) and from the operating theatre (Beta=-0.78; 95% CI...

Identifying unusual performance in Australian and New Zealand intensive care units from 2000 to 2010

Solomon, P.J.; Kasza, J.; Moran, J.L.; Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation (CORE)
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
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45.88%
BACKGROUND: The Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD) collects voluntary data on patient admissions to Australian and New Zealand intensive care units (ICUs). This paper presents an in-depth statistical analysis of risk-adjusted mortality of ICU admissions from 2000 to 2010 for the purpose of identifying ICUs with unusual performance. METHODS: A cohort of 523,462 patients from 144 ICUs was analysed. For each ICU, the natural logarithm of the standardised mortality ratio (log-SMR) was estimated from a risk-adjusted, three-level hierarchical model. This is the first time a three-level model has been fitted to such a large ICU database anywhere. The analysis was conducted in three stages which included the estimation of a null distribution to describe usual ICU performance. Log-SMRs with appropriate estimates of standard errors are presented in a funnel plot using 5% false discovery rate thresholds. False coverage-statement rate confidence intervals are also presented. The observed numbers of deaths for ICUs identified as unusual are compared to the predicted true worst numbers of deaths under the model for usual ICU performance. RESULTS: Seven ICUs were identified as performing unusually over the period 2000 to 2010...

Current issues in the respiratory care of patients with amyotrophic lateral sclerosis

Orsini,Marco; Lopes,Agnaldo José; Menezes,Sara Lucia Silveira de; Oliveira,Acary Bulle; Freitas,Marcos Raimundo Gomes de; Nascimento,Osvaldo Jose Moreira do; Guimarães,Fernando Silva
Fonte: Academia Brasileira de Neurologia - ABNEURO Publicador: Academia Brasileira de Neurologia - ABNEURO
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/10/2015 EN
Relevância na Pesquisa
56.08%
Amyotrophic lateral sclerosis is a progressive neuromuscular disease, resulting in respiratory muscle weakness, reduced pulmonary volumes, ineffective cough, secretion retention, and respiratory failure. Measures as vital capacity, maximal inspiratory and expiratory pressures, sniff nasal inspiratory pressure, cough peak flow and pulse oximetry are recommended to monitor the respiratory function. The patients should be followed up by a multidisciplinary team, focused in improving the quality of life and deal with the respiratory symptoms. The respiratory care approach includes airway clearance techniques, mechanically assisted cough and noninvasive mechanical ventilation. Vaccination and respiratory pharmacological support are also recommended. To date, there is no enough evidence supporting the inspiratory muscle training and diaphragmatic pacing.

Effecting change in primary care management of respiratory conditions : a global scoping exercise and literature review of educational interventions to inform the IPCRG's E-Quality initiative

McDonnel, Juliet; Williams, Sian; Chavannes, Niels H.; Sousa, Jaime Correira de; Fardy, H. John; Fletcher, Monica; Stout, James; Tomlins, Ron; Yusuf, Osman M.; Pinnock, Hilary
Fonte: Primary Care Respiratory Society Publicador: Primary Care Respiratory Society
Tipo: Artigo de Revista Científica
Publicado em //2012 ENG
Relevância na Pesquisa
56.16%
This discussion paper describes a scoping exercise and literature review commissioned by the International Primary Care Respiratory Group (IPCRG) to inform their E-Quality programme which seeks to support small-scale educational projects to improve respiratory management in primary care. Our narrative review synthesises information from three sources: publications concerning the global context and health systems development; a literature search of Medline, CINAHL and Cochrane databases; and a series of eight interviews conducted with members of the IPCRG faculty. Educational interventions sit within complex healthcare, economic, and policy contexts. It is essential that any development project considers the local circumstances in terms of economic resources, political circumstances, organisation and administrative capacities, as well as the specific quality issue to be addressed. There is limited evidence (in terms of changed clinician behaviour and/or improved health outcomes) regarding the merits of different educational and quality improvement approaches. Features of educational interventions that were most likely to show some evidence of effectiveness included being carefully designed, multifaceted, engaged health professionals in their learning...

La ventilación no invasiva con presión positiva en la insuficiencia respiratoria aguda hipercápnica: diez años de experiencia clínica de una unidad de terapia semiintensiva respiratoria; Non-Invasive Positive Pressure Ventilation in Acute Hypercapnic Respiratory Failure: Ten-Year’s Clinical Experience of a Respiratory Semi-Intensive Care Unit

Scala, Raffaele; Naldi, Mario
Fonte: Universidade do Rosário Publicador: Universidade do Rosário
Tipo: Artigo de Revista Científica Formato: application/pdf
Publicado em 18/05/2010 SPA
Relevância na Pesquisa
46.16%
Premisa: Si bien numerosos estudios prospectivos, controlados y aleatorizados han demostrado el éxito de la ventilación no invasiva con presión positiva (VNI) en casos seleccionados de insuficiencia respiratoria aguda (IRA) hipercápnica, en contexto con intensidad de cuidado diferente, los datos de práctica clínica relativos al uso de la VNI en escenarios reales son limitados.Objetivo: Reportar los resultados de nuestra experiencia clínica sobre la VNI en la IRA aplicada en la Unidad de Terapia Semiintensiva Respiratoria (UTSIR), de la Unidad Operativa de Neumología de Arezzo, entre 1996-2006, en términos de tolerabilidad, efectos sobre los gases arteriales, tasa de éxito y factores predictivos del fracaso.Métodos: Trescientos cincuenta de los 1.484 pacientes (23,6%) ingresados consecutivamente por IRA en nuestra Unidad Operativa de Neumología, durante el periodo de estudio, recibieronla VNI asociada a la terapia estándar, posterior al cumplimiento de criterios predefinidos, empleados de rutina.Resultados: Ocho pacientes (2,3%) no toleraron la VNI por incomodidad producida por la máscara, mientras los 342 restantes (M: 240; F: 102; edad: mediana [intercuartiles] 74,0 años [68,0-79,3]; enfermedad pulmonar obstructiva crónica (EPOC) [69...

Análisis del cuidado respiratorio en cinco regiones del país: ¿dónde está y hacia dónde vamos?; Analysis Respiratory Care in Five Regions of the Country: Current Status and Future Tendencies

Durán Palomino, Diana; Wilches, Esther Cecilia
Fonte: Universidade do Rosário Publicador: Universidade do Rosário
Tipo: Artigo de Revista Científica Formato: application/pdf
Publicado em 18/05/2010 SPA
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66.14%
El presente estudio analiza la práctica del cuidado respiratorio en cinco regiones del país, por medio de una investigación de carácter descriptivo-exploratoria, que busca revisar las tendencias de formación, las condiciones laborales, los roles que ejercen sus practicantes, los dilemas del ejercicio profesional y la caracterización de las funciones de los fisioterapeutas y terapeutas respiratorios. La información se obtuvo mediante encuesta a fisioterapeutas, terapeutas respiratorios, entrevista a profesionales de enfermería y médicos intensivistas que trabajan en instituciones de salud de tercer y cuarto nivel de complejidad en las ciudades seleccionadas para el estudio. La información recopilada incluye desde el quehacer diario, los conocimientos y las preferencias respecto a la práctica de los profesionales, hasta los aspectos relacionados con las condiciones laborales y las características de su ejercicio profesional. El estudio permitió concluir que hay una idealización de los roles, vacíos conceptuales para ejercer eficientemente el cuidado respiratorio sin una formación adicional tipo posgrado o cursos de entrenamiento en el área, debilidad en las funciones administrativas, investigativas, de atención domiciliaria y de evaluación social del entorno...

Approaches to chronic disease management for asthma and chronic obstructive pulmonary disease: strategies through the continuum of care

Hart, Mary K.; Millard, Mark W.
Fonte: Baylor Health Care System Publicador: Baylor Health Care System
Tipo: Artigo de Revista Científica
Publicado em /07/2010 EN
Relevância na Pesquisa
46.11%
Investigator-initiated research in both asthma and chronic obstructive pulmonary disease conducted at the Baylor Martha Foster Lung Care Center has sought to improve management throughout the continuum of respiratory care using a multidisciplinary approach. Respiratory care therapists employed in the primary care setting were shown to improve the quality of asthma care: rescue inhaler use decreased by 75% and respiratory symptom score decreased by 49% in patients who were seen by this midlevel specialty provider. In addition to similar results in a geriatric population, patients' diagnosis was changed in 48% of cases and treatment was changed in 76% of cases after the intervention. For pulmonary rehabilitation, an activity of daily living assessment form was created, and rehabilitation—whether traditional or water-based—was shown to improve patients' ability to perform activities of daily living and improve quality of life scores. The Rules of Two®, developed by Baylor University Medical Center at Dallas to simplify understanding of good asthma control, continues to be taught, and patient education has also been offered through asthma summer camps for children. Finally, a multidisciplinary team worked to develop a protocol for treatment of asthma patients in the emergency department and...

Characterization and sensitivity to antibiotics of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units

Medell,Manuel; Medell,Mariana; Martínez,Alicia; Valdés,Rodolfo
Fonte: Brazilian Society of Infectious Diseases Publicador: Brazilian Society of Infectious Diseases
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2012 EN
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46.09%
OBJECTIVE: This observational study described the characterization of bacteria isolated from the lower respiratory tract of ventilated patients hospitalized in intensive care units. The demonstration of isolated microorganism resistance to antibiotics and a time-trend analysis of infection comparing a 48-month period were also other objectives. METHOD: Semi-quantitative assays of 1254 samples taken from 741 ventilated patients were performed, while pathogens were identified using the Enterotube II assay and VITEK 2 Compact equipment. Bacterial resistance to antibiotics was assessed by the Kirby-Bauer disc diffusion method and time-trend analysis of infection was based on data recorded by hospital microbiology laboratories. RESULTS: The most prevalent isolated bacteria from the patient's lower respiratory tract were with Gram-negative bacteria (67.8%) mostly represented by: Acinetobacter spp. (25.2%), Pseudomonas spp. (18.3%) and Klebsiellas spp. (9.4%). Acinetobacter spp. showed moderate high to very high resistance to ceftriaxone (CRO), gentamicin (CN), amikacin (AK), meropenem (MRP), aztreonam (ATM) and piperacillin/tazobactam (TZP). Some isolates of Acinetobacter spp. resistant to colistin (CS) were identified in this patient population. Pseudomonas spp. and Klebsiella spp. were very highly resistant to ampicillin/sublactam (AMS) and with moderate or low resistance to CRO...

Efeito da continuidade da fisioterapia respiratória até a alta hospitalar na incidência de complicações pulmonares após esofagectomia por câncer; Effect of sustained respiratory care until hospital discharge on the incidence of pulmonary complications following esophagectomy for cancer

Lunardi, Adriana Claudia; Resende, Juliana Mantovani; Cerri, Olívia Maio; Carvalho, Celso Ricardo Fernandes de
Fonte: Universidade de São Paulo. Faculdade de Medicina Publicador: Universidade de São Paulo. Faculdade de Medicina
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; ; ; ; ; ; Formato: application/pdf
Publicado em 01/01/2008 POR
Relevância na Pesquisa
45.94%
O presente estudo avaliou os efeitos na incidência de complicações pulmonares do cuidado contínuo de fisioterapia respiratória no pós-operatório de esofagectomia, até a alta hospitalar. Examinaram-se retrospectivamente 40 prontuários de pacientes de esofagectomia consecutivos (nenhuma exclusão), que foram divididos em dois grupos: um dos que receberam fisioterapia respiratória apenas na unidade de tratamento intensivo (gUTI, n=20) e outro dos que a receberam até a alta hospitalar (gALTA, n=20). Foram coletadas informações referentes ao pré, intra e pós-operatório. Os resultados mostram que gUTI e gALTA, respectivamente, apresentaram-se similares (média±dp) quanto a idade (55,5±9,9 e 57,1±10,8 anos), IMC (22,5±3,3 e 18±4 kg/m²), tempo de cirurgia (400±103,8 e 408,5±142 min), tempo de anestesia (498,3±107,3 e 516±148,9 min) e número de atendimentos de fisioterapia na UTI (9,6±14,9 e 8,3±7,6). Apesar de o gALTA apresentar história de tabagismo superior (35,7±17,6 vs 26,1±18,4 maços-ano, p; This study assessed the effects of chest physical therapy all through hospital stay until discharge onto the incidence of pulmonary complications in patients having undergone esophagectomy for cancer. Medical records of esophagectomy patients were examined and 40 subsequent ones selected (none excluded)...

Primary care spirometry

Derom, E.; Van Weel, Chris; Liistro, G.; Buffels, J.; Schermer, Tjard R.J.; Lammers, E.; Wouters, Emiel; Decramer, M.
Fonte: European Respiratory Society Publicador: European Respiratory Society
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
46.06%
Primary care spirometry is a uniquely valuable tool in the evaluation of patients with respiratory symptoms, allowing the general practitioner to diagnose or exclude chronic obstructive pulmonary disease (COPD), sometimes to confirm asthma, to determine the efficacy of asthma treatment and to correctly stage patients with COPD. The use of spirometry for case finding in asymptomatic COPD patients might become an option, once early intervention studies have shown it to be beneficial in these patients. The diagnosis of airway obstruction requires accurate and reproducible spirometric measurements, which should comply with the American Thoracic Society (ATS)/European Respiratory Society (ERS) guidelines. Low acceptability of spirometric manoeuvres has been reported in primary care practices. This may hamper the validity of the results and affect clinical decision making. Training and refresher courses may produce and maintain good-quality testing, promote the use of spirometric results in clinical practice and enhance the quality of interpretation. Softening the stringent ATS/ERS criteria could enhance the acceptability rates of spirometry when used in a general practice. However, the implications of potential simplifications on the quality of the data and clinical decision making remain to be investigated. Hand-held office spirometers have been developed in recent years...

Parameter estimation of an artificial respiratory system under mechanical ventilation following a noisy regime

Victor Júnior,Marcus Henrique; Forgiarini Junior,Luiz Alberto; Kinjo,Toru Miyagi; Amato,Marcelo Britto Passos; Yoneyama,Takashi; Tanaka,Harki
Fonte: Sociedade Brasileira de Engenharia Biomédica Publicador: Sociedade Brasileira de Engenharia Biomédica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2015 EN
Relevância na Pesquisa
45.92%
Abstract Introduction: This work concerns the assessment of a novel system for mechanical ventilation and a parameter estimation method in a bench test. The tested system was based on a commercial mechanical ventilator and a personal computer. A computational routine was developed do drive the mechanical ventilator and a parameter estimation method was utilized to estimate positive end-expiratory pressure, resistance and compliance of the artificial respiratory system. Methods The computational routine was responsible for establishing connections between devices and controlling them. Parameters such as tidal volume, respiratory rate and others can be set for standard and noisy ventilation regimes. Ventilation tests were performed directly varying parameters in the system. Readings from a calibrated measuring device were the basis for analysis. Adopting a first-order linear model, the parameters could be estimated and the outcomes statistically analysed. Results Data acquisition was effective in terms of sample frequency and low noise content. After filtering, cycle detection and estimation took place. Statistics of median, mean and standard deviation were calculated, showing consistent matching with adjusted values. Changes in positive end-expiratory pressure statistically imply changes in compliance...