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The New England Journal of Medicine Jul 1986
Topics: Cost Control; Humans; Respiratory Therapy; United States
PubMed: 3724823
DOI: 10.1056/NEJM198607313150510 -
The Veterinary Clinics of North... Sep 2007Effective respiratory therapy depends on obtaining a definitive diagnosis and following established recommendations for treatment. Unfortunately, many respiratory... (Review)
Review
Effective respiratory therapy depends on obtaining a definitive diagnosis and following established recommendations for treatment. Unfortunately, many respiratory conditions are idiopathic in origin or are attributable to nonspecific inflammation. In some situations, disorders are controlled rather than cured. Recent advances in pulmonary therapeutics include the use of new agents to treat common diseases and application of local delivery of drugs to enhance drug effect and minimize side effects.
Topics: Animals; Cat Diseases; Cats; Combined Modality Therapy; Dog Diseases; Dogs; Drug Delivery Systems; Respiratory Therapy; Respiratory Tract Diseases; Treatment Outcome
PubMed: 17693209
DOI: 10.1016/j.cvsm.2007.05.009 -
Effects of the use of respiratory physiotherapy in children admitted with acute viral bronchiolitis.Archives de Pediatrie : Organe Officiel... Aug 2018To evaluate the effects of the use of respiratory physiotherapy in children admitted with acute viral bronchiolitis (AVB). (Review)
Review
OBJECTIVE
To evaluate the effects of the use of respiratory physiotherapy in children admitted with acute viral bronchiolitis (AVB).
METHODS
A literature review was done searching the Pubmed, LILACS, PEDro, and Scielo databases. The following key words were used: bronchiolitis, physiotherapy, techniques, physical therapy, and chest physiotherapy. Both controlled and uncontrolled clinical trials, without limits as to date, were selected.
RESULTS
Fifteen articles were included and the use of different techniques of respiratory physiotherapy showed positive results in eight studies. Most (11) were controlled clinical trials, and only two had a double-blind design. Of the 14 studies with a control group, in six this group was submitted to nasopharyngeal aspiration. The most widely used techniques were manual vibration and postural drainage (eight studies), and then tapping/percussion (seven studied). The maneuvers considered as current, e.g., prolonged slow expiration, expiratory flow acceleration, and rhinopharyngeal retrograde clearance, were used in four, four, and two studies, respectively.
CONCLUSIONS
The use of respiratory physiotherapy in children with AVB remains controversial. The heterogeneity of techniques evaluated in the studies limits the interpretation of efficacy, although its use was considered safe. Recent findings indicating a reduction in the length of the hospital stay remain to be confirmed.
Topics: Bronchiolitis, Viral; Child; Hospitalization; Humans; Respiratory Therapy; Treatment Outcome
PubMed: 30064712
DOI: 10.1016/j.arcped.2018.06.004 -
Chest Aug 2021
Topics: Clinical Competence; Education, Graduate; Humans; Lung Diseases; Professional Role; Respiratory Therapy; United States
PubMed: 33819470
DOI: 10.1016/j.chest.2021.03.053 -
Der Anaesthesist Apr 1989The optimal methods of prophylaxis and therapy of postoperative respiratory complications in surgical patients are still open to discussion. In spite of numerous recent... (Review)
Review
The optimal methods of prophylaxis and therapy of postoperative respiratory complications in surgical patients are still open to discussion. In spite of numerous recent clinical investigations, there is still no specific and universally acceptable therapeutic concept. In our department, we identify patients at risk of pulmonary complications by adequate screening, i.e. medical history, physical examination, chest X-ray, and spirometry. In the postoperative period there are a sequence of stages starting with early mobilization, respiratory therapy (including incentive spirometry and IPPB), and when necessary, controlled mechanical ventilation. We have measured and documented the flows and volumes required of patients using various types of incentive spirometer. In addition, we review on the literature and describe our experience with the technique, handling, and organization of sustained maximal inspiration (SMI). After thoracic or major upper abdominal surgery, all lung volumes decrease due to impairment of rib cage movement, changes in chest wall muscle tone, an increase in lung recoil, and airway closure. At the end of each expiration some of the smallest airways collapse either partly or totally. This process continues to some extent until, normally, a deep breath recruits the alveoli. Sighs to the limit of total lung capacity or oscillations of the expiratory baseline ought to be responsible for this effect in healthy humans; the same purpose is intended in incentive spirometry. For this therapy, it is mandatory that the central airways are not occluded by mucus and that the patient is able to breath volumes exceeding his normal tidal volume.(ABSTRACT TRUNCATED AT 250 WORDS)
Topics: Humans; Motivation; Postoperative Complications; Respiration Disorders; Respiratory Therapy; Spirometry
PubMed: 2658675
DOI: No ID Found -
Home Respiratory Therapy: Technological Innovations in Severe Chronic Obstructive Pulmonary Disease.Archivos de Bronconeumologia Nov 2015
Topics: Disease Progression; Early Diagnosis; Home Care Services; Home Nursing; Humans; Inventions; Oximetry; Patient Admission; Program Evaluation; Pulmonary Disease, Chronic Obstructive; Quality of Life; Respiratory Therapy; Self Care; Telemedicine; Triage
PubMed: 25812920
DOI: 10.1016/j.arbres.2015.01.002 -
Pulmonology 2019Chronic Obstructive Pulmonary Disease (COPD) history is characterized by episodes of exacerbation of varying severity, featured by acute worsening of respiratory...
Chronic Obstructive Pulmonary Disease (COPD) history is characterized by episodes of exacerbation of varying severity, featured by acute worsening of respiratory symptoms, commonly precipitated by respiratory tract infection. The recent ERS/ATS clinical practice guidelines strongly recommend the application of non invasive ventilation (NIV) for patients with acute respiratory failure (ARF) leading to acute or acute-on-chronic respiratory acidosis (pH 7.35) and not for those patients with acute exacerbation of COPD (AECOPD) and hypercapnia who are not acidotic. In recent years, High-Flow through Nasal Cannula (HFNC) has been introduced in the clinical practice. We designed the present systematic review of the literature to assess all effects of HFNC use reported in exacerbated COPD patients. In this setting, HFNC is able to keep PaCO2 unmodified, while oxygenation slightly deteriorates as opposed to NIV. Furthermore, the work of breathing is reduced with HFNC by a similar extent to NIV, while it increases by 40-50% during conventional oxygen therapy (COT). HFNC is also reported to be more comfortable than COT and NIV. Despite these results, little and limited evidence for improved clinical outcomes is currently available.
Topics: Acidosis, Respiratory; Blood Gas Analysis; Disease Progression; Humans; Hypercapnia; Noninvasive Ventilation; Positive-Pressure Respiration; Pulmonary Disease, Chronic Obstructive; Respiratory Insufficiency; Respiratory Rate; Respiratory Therapy; Treatment Outcome; Work of Breathing
PubMed: 31591056
DOI: 10.1016/j.pulmoe.2019.08.001 -
Chest Apr 2023Respiratory therapists (RTs) are credentialed health professionals who specialize in assessment of pulmonary conditions, performing assessment of pulmonary function and... (Review)
Review
Respiratory therapists (RTs) are credentialed health professionals who specialize in assessment of pulmonary conditions, performing assessment of pulmonary function and delivering pulmonary therapeutics including aerosol therapy, and noninvasive and invasive mechanical ventilation. Respiratory therapists work closely with various clinicians including physicians, nurses, and therapy staff in a number of different settings including outpatient clinics, long-term facilities, EDs, and ICUs. RTs are integral in the treatment of patients with several acute and chronic conditions. In this review, we outline the importance, the elements of, and an approach to building a comprehensive RT program that allows delivery of high-quality care while ensuring RTs practice at the full scope of their licensure. Over the last two decades, we have implemented a suite of changes to the training, functioning, deployment, continuing education, and capacity building in our Lung Partners Program practice, under the supervision of a medical director, that have allowed us to create an effective inpatient and outpatient model of primary respiratory care.
Topics: Humans; Respiratory Therapy; Respiration, Artificial; Administration, Inhalation; Lung; Intensive Care Units
PubMed: 36906506
DOI: 10.1016/j.chest.2022.12.024 -
Respiratory Care May 2017The purpose of this retrospective medical record review was to report on recidivism to the ICU among adult postoperative cardiac and thoracic patients managed with a...
BACKGROUND
The purpose of this retrospective medical record review was to report on recidivism to the ICU among adult postoperative cardiac and thoracic patients managed with a respiratory therapy assess-and-treat (RTAT) protocol. Our primary null hypothesis was that there would be no difference in all-cause unexpected readmissions and escalations between the RTAT group and the physician-ordered respiratory care group. Our secondary null hypothesis was that there would be no difference in primary respiratory-related readmissions, ICU length of stay, or hospital length of stay.
METHODS
We reviewed 1,400 medical records of cardiac and thoracic postoperative subjects between January 2015 and October 2016. The RTAT is driven by a standardized patient assessment tool, which is completed by a registered respiratory therapist. The tool develops a respiratory severity score for each patient and directs interventions for bronchial hygiene, aerosol therapy, and lung inflation therapy based on an algorithm. The protocol period commenced on December 1, 2015, and continued through October 2016. Data relative to unplanned admissions to the ICU for all causes as well as respiratory-related causes were evaluated.
RESULTS
There was a statistically significant difference in the all-cause unplanned ICU admission rate between the RTAT (5.8% [95% CI 4.3-7.9]) and the physician-ordered respiratory care (8.8% [95% CI 6.9-11.1]) groups ( = .034). There was no statistically significant difference in respiratory-related unplanned ICU admissions with RTAT (36% [95% CI 22.7-51.6]) compared with the physician-ordered respiratory care (53% [95% CI 41.1-64.8]) group ( = .09). The RTAT protocol group spent 1 d less in the ICU ( < .001) and in the hospital ( < .001).
CONCLUSIONS
RTAT protocol implementation demonstrated a statistically significant reduction in all-cause ICU readmissions. The reduction in respiratory-related ICU readmissions did not reach statistical significance.
Topics: Aged; Clinical Protocols; Critical Care; Female; Health Plan Implementation; Humans; Intensive Care Units; Male; Middle Aged; Patient Readmission; Respiratory Therapy; Retrospective Studies
PubMed: 28223463
DOI: 10.4187/respcare.05269 -
Journal of the Royal Society of Medicine Nov 1980
Topics: Humans; Respiratory Therapy
PubMed: 7241433
DOI: 10.1177/014107688007301103