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Jornal Brasileiro de Pneumologia :... 2016To evaluate the level of self-reported adherence to physical therapy recommendations in pediatric patients (6-17 years) with cystic fibrosis (CF) and to ascertain...
OBJECTIVE
To evaluate the level of self-reported adherence to physical therapy recommendations in pediatric patients (6-17 years) with cystic fibrosis (CF) and to ascertain whether the different levels of adherence correlate with pulmonary function, clinical aspects, and quality of life.
METHODS
This was a cross-sectional study. The patients and their legal guardians completed a questionnaire regarding adherence to physical therapy recommendations and a CF quality of life questionnaire. We collected demographic, spirometric, and bacteriological data, as well as recording the frequency of hospitalizations and Shwachman-Kulczycki (S-K) clinical scores.
RESULTS
We included 66 patients in the study. Mean age, FEV1 (% of predicted), and BMI were 12.2 ± 3.2 years, 90 ± 24%, and 18.3 ± 2.5 kg/m2, respectively. The patients were divided into two groups: high-adherence (n = 39) and moderate/poor-adherence (n = 27). No statistically significant differences were found between the groups regarding age, gender, family income, and total S-K clinical scores. There were statistically significant differences between the high-adherence group and the moderate/poor-adherence group, the latter showing lower scores for the "radiological findings" domain of the S-K clinical score (p = 0.030), a greater number of hospitalizations (p = 0.004), and more days of hospitalization in the last year (p = 0.012), as well as lower scores for the quality of life questionnaire domains emotion (p = 0.002), physical (p = 0.019), treatment burden (p < 0.001), health perceptions (p = 0.036), social (p = 0.039), and respiratory (p = 0.048).
CONCLUSIONS
Low self-reported adherence to physical therapy recommendations was associated with worse radiological findings, a greater number of hospitalizations, and decreased quality of life in pediatric CF patients.
Topics: Adolescent; Child; Cross-Sectional Studies; Cystic Fibrosis; Female; Hospitalization; Humans; Male; Patient Compliance; Quality of Life; Respiratory Therapy; Self Report; Spirometry; Statistics, Nonparametric; Treatment Outcome
PubMed: 26982038
DOI: 10.1590/S1806-37562016000000068 -
Revue Des Maladies Respiratoires Apr 2022
Topics: Humans; Physical Therapy Modalities; Respiratory Therapy
PubMed: 35589189
DOI: 10.1016/j.rmr.2022.04.009 -
Pneumologie (Stuttgart, Germany) Apr 2022Inhalation therapy is a cornerstone especially in pulmonary diseases or comorbidities, either in invasive or noninvasive mechanical ventilation. In pediatric patients,...
Inhalation therapy is a cornerstone especially in pulmonary diseases or comorbidities, either in invasive or noninvasive mechanical ventilation. In pediatric patients, mainly in respiratory failure of the premature born child inhalation of surfactant is crucial in the therapy. Additional drugs given by inhalation are antibiotics, mucoactive substances and drugs that treat pulmonary hypertension. This article describes main deposition mechanisms of inhalation therapies and presents recommendations for correct performance of inhalation therapy in invasively as well as noninvasively ventilated patients in ICU. Also safety aspects for patients and medical staff during aerosol therapy in the Corona pandemic era are discussed.
Topics: Administration, Inhalation; Aerosols; Child; Humans; Intensive Care Units; Respiration, Artificial; Respiratory Therapy
PubMed: 35453166
DOI: 10.1055/a-1652-5960 -
Respiratory Care Jun 2017This article reviews the common pulmonary complications seen in the pediatric oncology population and our approach to diagnosis, management, and therapy considerations... (Review)
Review
This article reviews the common pulmonary complications seen in the pediatric oncology population and our approach to diagnosis, management, and therapy considerations in this specialized population, including patients receiving chemotherapy, radiation, and hematopoietic stem cell transplantation. Although infections cause the most significant complications in this population, non-infectious complications, including acute lung injury from chemotherapy or radiation, idiopathic interstitial pneumonia, diffuse alveolar hemorrhage, bronchiolitis obliterans, and cryptogenic organizing pneumonia, also occur commonly. With improvements in survival of childhood cancer, there are now a growing number of adults who are childhood cancer survivors who may be encountered by therapists in adult hospitals. We also review the growing literature on the emerging late pulmonary findings in these adult childhood cancer survivors.
Topics: Adult; Cancer Survivors; Child; Humans; Long Term Adverse Effects; Neoplasms; Respiration Disorders; Respiratory Therapy
PubMed: 28546377
DOI: 10.4187/respcare.05223 -
Respiratory Care Mar 2017
Topics: Delivery of Health Care; Humans; Respiratory Therapy
PubMed: 28246282
DOI: 10.4187/respcare.05484 -
The Kaohsiung Journal of Medical... Oct 2020Mechanical ventilation (MV) is a common life support system in intensive care units. Accurate identification of patients who are capable of being extubated can shorten...
Mechanical ventilation (MV) is a common life support system in intensive care units. Accurate identification of patients who are capable of being extubated can shorten the MV duration and potentially reduce MV-related complications. Therefore, prediction of patients who can successfully be weaned from the mechanical ventilator is an important issue. The electronic medical record system (EMRs) has been applied and developed in respiratory therapy in recent years. It can increase the quality of critical care. However, there is no perfect index available that can be used to determine successful MV weaning. Our purpose was to establish a novel model that can predict successful weaning from MV. Patients' information was collected from the Kaohsiung Medical University Hospital respiratory therapy EMRs. In this retrospective study, we collected basic information, classic weaning index, and respiratory parameters during spontaneous breathing trials of patients eligible for extubation. According to the results of extubation, patients were divided into successful extubation and extubation failure groups. This retrospective cohort study included 169 patients. Statistical analysis revealed successful extubation predictors, including sex; height; oxygen saturation; Glasgow Coma Scale; Acute Physiology and Chronic Health Evaluation II score; pulmonary disease history; and the first, 30th, 60th, and 90th minute respiratory parameters. We built a predictive model based on these predictors. The area under the curve of this model was 0.889. We established a model for predicting the successful extubation. This model was novel to combine with serial weaning parameters and thus can help intensivists to make extubation decisions easily.
Topics: Aged; Aged, 80 and over; Electronic Health Records; Female; Humans; Intensive Care Units; Male; Middle Aged; Respiration, Artificial; Retrospective Studies; Ventilator Weaning
PubMed: 32729992
DOI: 10.1002/kjm2.12269 -
Seminars in Respiratory and Critical... Aug 2015Delivery of medication to sites of action through airways has been used for centuries but has gained momentum in recent decades. Currently available modes of aerosol... (Review)
Review
Delivery of medication to sites of action through airways has been used for centuries but has gained momentum in recent decades. Currently available modes of aerosol delivery offer advantages but still there are shortcomings. Delivery of active agents to sites of action is affected by many factors beyond the characteristics of the delivery devices, including the coordination between inhalation and actuation and dependence on the patient's inspiratory flow and breathing pattern. Recent advances in drug delivery focus around changes in the generation of particle size with better penetration to the targeted sites, easier activation of the device with inspiratory flow, ease of use including fewer steps in using the device, and better portability. Availability of computer chips allows for smart delivery devices to tailor delivery to the patient's breathing pattern and lung function. Further, smart devices can provide feedback to patients. Novel inhaler technologies, separately or in combination with new therapeutic agents, are in development not only for respiratory diseases but also for diseases of other systems. This article reviews some of the recent clinically relevant advances in aerosol delivery devices.
Topics: Administration, Inhalation; Aerosols; Drug Delivery Systems; Equipment Design; Humans; Nebulizers and Vaporizers; Particle Size; Respiration Disorders; Respiratory System Agents; Respiratory Therapy
PubMed: 26238640
DOI: 10.1055/s-0035-1555612 -
Expert Review of Respiratory Medicine Mar 2017Inhalation therapy has become a popular procedure for the treatment of patients with tracheostomy. However, clinicians are faced with many challenges during inhalation... (Review)
Review
Inhalation therapy has become a popular procedure for the treatment of patients with tracheostomy. However, clinicians are faced with many challenges during inhalation therapy because of the many factors affecting aerosol therapy to this patient population, and the lack of literature providing guidance in this area of research. Areas covered: The purpose of this paper is to describe the factors affecting aerosol drug delivery to patients with tracheostomy and to explain how to optimize inhalation therapy through device selection, interface selection and delivery technique in this patient population. Expert commentary: Many factors affect inhalation therapy in this patient population and without understanding the impact of these factors on aerosol drug delivery, clinicians will not be able to provide the treatment properly and patients may not benefit from prescribed medications. In the next 5 years, aerosol medicine will continue to experience tremendous growth with new devices and drug/device combinations. However, these advances will have minimal impact on inhalation therapy in patients with tracheostomy unless we provide guidance and training to clinicians on optimizing aerosol drug delivery to this patient population.
Topics: Administration, Inhalation; Aerosols; Humans; Nebulizers and Vaporizers; Respiratory Therapy; Tracheostomy
PubMed: 28228052
DOI: 10.1080/17476348.2017.1289843 -
Respiratory Medicine Oct 2023
Topics: Humans; Artificial Intelligence; Respiratory Therapy
PubMed: 37380092
DOI: 10.1016/j.rmed.2023.107342 -
Neurodegenerative Disease Management Apr 2016In amyotrophic lateral sclerosis, the onset of respiratory muscle weakness is silent, but survival following symptom recognition may only be a few weeks. Consequently,... (Review)
Review
In amyotrophic lateral sclerosis, the onset of respiratory muscle weakness is silent, but survival following symptom recognition may only be a few weeks. Consequently, respiratory function and symptoms should be assessed every 2-3 months. Noninvasive ventilation improves symptoms, quality of life and survival, without increasing carer burden. Lung volume recruitment helps to reverse and prevent atelectasis, improving gas exchange, while techniques to enhance sputum clearance reduce the risk of mucus plugging and lower respiratory tract infections. When noninvasive support fails, often due to severe bulbar impairment, tracheostomy ventilation prolongs life. Most patients receiving tracheostomy ventilation at home report satisfactory quality of life, but at the expense of high carer burden. Diaphragmatic pacing is associated with an increased risk of death.
Topics: Amyotrophic Lateral Sclerosis; Disease Management; Evidence-Based Medicine; Humans; Muscle Weakness; Respiratory Insufficiency; Respiratory Therapy
PubMed: 27033240
DOI: 10.2217/nmt-2015-0010