393 results match your criteria Respiratory Care Clinics of North America[Journal]


Indirect calorimetry: relevance to patient outcome.

Respir Care Clin N Am 2006 Dec;12(4):635-50, vii

Department of Medicine, Division of Gastroenterology/Hepatology, University of Louisville School of Medicine, 550 S. Jackson St., Louisville, KY 40202, USA.

Indirect calorimetry provides an important adjunctive monitor for the provision of nutrition support in the critically ill patient. Accuracy in determining caloric requirements may serve to optimize benefit from nutrition therapy and improve patient outcome. A number of strategies in nutrition management in the intensive care setting (eg, dosing of enteral nutrition, monitoring cumulative caloric balance, and deliberate but "permissive" underfeeding) necessitate the determination of a fairly specific goal for caloric provision. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.09.008DOI Listing
December 2006
4 Reads

Indirect calorimetry: applications in practice.

Respir Care Clin N Am 2006 Dec;12(4):619-33

Clinical Nutrition/Pharmacy, St. Joseph Mercy Hospital, 5301 East Huron River Drive, Ann Arbor, MI 48106, USA.

IC is the standard for determining energy expenditure in critically ill patients. The measured REE is an objective, patient-specific caloric reference that serves as the most accurate method of determining energy expenditure. Protocols addressing IC methodology are necessary to ensure technical accuracy and clinically useful results. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.09.005DOI Listing
December 2006
6 Reads

Strategies to prevent aspiration-related pneumonia in tube-fed patients.

Authors:
Norma A Metheny

Respir Care Clin N Am 2006 Dec;12(4):603-17

School of Nursing, Saint Louis University, 3525 Caroline Mall, St. Louis, MO 63104, USA.

It is improbable that aspiration and aspiration-pneumonia can be entirely prevented, but application of one or more of the strategies described in this article probably can reduce these potentially life threatening conditions. Fortunately, many of these strategies are relatively easy and inexpensive to incorporate into routine care. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.09.007DOI Listing
December 2006
6 Reads

Feeding the critically ill obese patient: the role of hypocaloric nutrition support.

Respir Care Clin N Am 2006 Dec;12(4):593-601

Mount Carmel Health System, 793 West State Street, Columbus, OH 43222, USA.

Obesity and its many metabolic and physiologic comorbidities are becoming more common. Thus, a strategy to approach the nutritional needs of obese critically ill patients is warranted. The adverse effect of obesity on the respiratory system is well established. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.09.002DOI Listing
December 2006
4 Reads

Nutrition support for the long-term ventilator-dependent patient.

Respir Care Clin N Am 2006 Dec;12(4):567-91, vi

Surgical Nutrition Service, Department of Surgery, Medical College of Georgia, Augusta, GA 30912, USA.

This article discusses issues related to nutrition support for the critically ill (CCI), especially those who are dependent on ventilators for long periods. A large and growing population of patients survives acute critical illness only to become CCI with profound debilitation, weeks to months of hospitalization, and often permanent dependence on mechanical ventilation and other life-sustaining modalities. Despite resource-intensive treatment, outcomes for CCI remain poor. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.09.003DOI Listing
December 2006
14 Reads

A nutritional strategy to improve oxygenation and decrease morbidity in patients who have acute respiratory distress syndrome.

Respir Care Clin N Am 2006 Dec;12(4):547-66, vi

Strategic and International R & D, Ross Products Division, Abbott Laboratories, 625 Cleveland Avenue, Columbus, OH 43215, USA.

Enteral nutrition is increasingly becoming the standard of care for critically ill patients with the goal of providing nutritional support that prevents nutritional deficiencies and reduces morbidity. Furthermore, the development of nutritional strategies that dampen inflammation is an encouraging advance in the management of patients who have acute respiratory distress syndrome. This article discusses evidence from randomized, controlled studies that the use of a specialized nutritional formula containing eicosapentaenoic acid plus gamma-linolenic acid and elevated antioxidants offer physiologic and anti-inflammatory benefits over standard formulas. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.09.006DOI Listing
December 2006
2 Reads

Nutrition support in the acutely ventilated patient.

Authors:
Mark H Oltermann

Respir Care Clin N Am 2006 Dec;12(4):533-45

Department of Internal Medicine, Division of Critical Care, John Peter Smith Hospital, 1500 South Main Street, Fort Worth, TX 76104, USA.

Although the nutrition support literature is limited and therefore does not provide robust evidence to promote grade A or strong recommendations, there is a "signal" from all of these studies taken a a whole that critically ill patients may benefit from nutritional manipulation. The acutely ventilated patient that is likely to still be intubated by day three is a classic example of the critically ill patient who has the potential to achieve positive outcomes with nutritional support. Initiating nutrition support early improves the chances of benefit. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.09.004DOI Listing
December 2006
6 Reads

Malnutrition in chronic obstructive pulmonary disease.

Respir Care Clin N Am 2006 Dec;12(4):521-31

Providence Saint Joseph Medical Center, 501 S. Buena Vista, Burbank, CA 91505, USA.

Malnutrition in patients with COPD is associated with an impaired pulmonary status, reduced diaphragmatic mass, lower exercise capacity, and higher mortality rate when compared with adequately nourished individuals with COPD. Deterioration in patients with COPD may be the result of malnutrition. In addition, malnutrition could be a sign of other factors directly altered by the disease. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.09.001DOI Listing
December 2006
10 Reads

Do all mechanically ventilated pediatric patients require continuous capnography?

Respir Care Clin N Am 2006 Sep;12(3):501-13

Pediatric Critical Care Medicine, Duke Children's Hospital, Box 3046, Durham, NC 27710, USA.

With most patients in modern ICUs requiring mechanical ventilation, any technology that may lead to more optimal ventilatory strategies would be invaluable in the management of critically ill patients. The focus of most ventilator strategies is protecting the lung from the deleterious effects of mechanical ventilation. Every effort is made to minimize the duration of mechanical ventilation while optimizing the potential for successful extubation. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.05.006DOI Listing
September 2006
5 Reads

The role of inhaled nitric oxide and heliox in the management of acute respiratory failure.

Respir Care Clin N Am 2006 Sep;12(3):489-500, ix

Division of Pulmonary Medicine, Duke University Medical Center, Durham, NC 27710, USA.

The application of positive-pressure mechanical ventilation is one of the cornerstones of support for patients with acute respiratory failure. Unfortunately, the clinical condition of some patients does not improve, despite escalating ventilatory support. Adjunctive therapies to mechanical ventilation such as nitric oxide and heliox have been explored for the purposes of minimizing injurious settings and supporting adequate gas exchange. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.06.006DOI Listing
September 2006
6 Reads

What is the role of airway pressure release ventilation in the management of acute lung injury?

Respir Care Clin N Am 2006 Sep;12(3):483-8

Children's Healthcare of Atlanta, Egleston Campus, Cardiac Intensive Care Unit, 1405 Clifton Road NE, Atlanta, GA 30322, USA.

The lack of published evidence supporting the use of APRV in the pediatric critical care patient population may diminish its effective application in respiratory failure. The effect of APRV on the number of ventilator days, ICU stay, and mortality still remains to be studied. Further application of APRV in the role of rest settings for ECMO especially in the pediatric cardiac patient population needs to be investigated. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.06.004DOI Listing
September 2006
6 Reads

Extubation criteria in infants and children.

Respir Care Clin N Am 2006 Sep;12(3):469-81

Critical Care Medicine, Children's National Medical Center, George Washington University, 111 Michigan Avenue NW, Suite 3-West 100, Washington, DC 20010, USA.

Predictors of extubation outcome attempt to provide objective data that may help to modify clinical decision making at the bedside. This article reviews the subjective and objective extubation readiness predictors tested in the pediatric medical literature. An understanding of the predictive capacity of the extubation criteria is vital for the critical care physician. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.05.005DOI Listing
September 2006
32 Reads

High-frequency jet and oscillatory ventilation for neonates: which strategy and when?

Respir Care Clin N Am 2006 Sep;12(3):453-67

Division of Neonatology, Schneider Children's Hospital, North Shore Long Island Jewish Health System, 269-01 76th Avenue, New Hyde Park, NY 11040, USA.

Both HFOV and HFJV are important adjuncts to the ventilatory care of sick infants and children. Today, it is important that neonatologists, pediatric intensivists, and respiratory care practitioners understand these ventilators and the options they provide. It is no longer necessary to continue the use of damaging pressures and volumes with CV simply because no other option is available. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.06.005DOI Listing
September 2006
22 Reads

Is high-frequency ventilation more beneficial than low-tidal volume conventional ventilation?

Respir Care Clin N Am 2006 Sep;12(3):437-51

Division of Pediatric Pharmacology and Critical Care, Rainbow Babies and Children's Hospital, Case School of Medicine, 11100 Euclid Avenue Cleveland, OH 44106, USA.

The ventilator goals of the ICU clinician faced with caring for a critically ill child who has ALI/ARDS remain relatively simple: provide adequate ventilation and oxygenation without overdistending alveoli or furthering lung injury. How one obtains these goals is much less simple. The current use of CV calls for the use of relatively low V(T)s and limiting peak inspiratory pressure and plateau pressure while accepting a certain degree of respiratory acidosis. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.05.004DOI Listing
September 2006
6 Reads

The role of noninvasive ventilation for acute respiratory failure.

Respir Care Clin N Am 2006 Sep;12(3):421-35

Pediatric Critical Care Medicine, Duke Children's Hospital, Box 3046, Durham, NC 27710, USA.

The use of NIV has been shown to facilitate discontinuing ventilatory dependence as well as provide support for adult patients with chronic lung disease without the need for endotracheal intubation. In fact, NIV has recently described as a potential support strategy following extubation failure. Therefore, using NIV as a bridge to liberation from mechanical ventilation may decrease many of the complications associated with long-term use of invasive airway devices as well complications from reinsertion of an artificial airway. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.06.007DOI Listing
September 2006
5 Reads

To stop or not to stop: how much support should be provided to mechanically ventilated pediatric bone marrow and stem cell transplant patients?

Authors:
Paul L Martin

Respir Care Clin N Am 2006 Sep;12(3):403-19

Pediatric Blood and Marrow Transplant Division, Duke University Medical Center, 2400 Pratt Street, Suite 1400, Durham, NC 27705, USA.

Every publication to date reporting the outcome of intensive care support for pediatric SCT patients must be viewed with caution because all are single-institution, retrospective reports. Nevertheless, some of the conclusions made by these investigators appear to be clinically relevant. First, an SCT patient who requires intensive care support does not automatically have a dismal chance of survival. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.06.002DOI Listing
September 2006
3 Reads

Ventilator management protocols in pediatrics.

Respir Care Clin N Am 2006 Sep;12(3):389-402

Department of Pediatrics, Division of Pediatric Critical Care, Oregon Health & Science University, Mail Code CDRC-P, 707 SW Gaines Street, Portland, OR 97239-2901, USA.

Management of mechanical ventilation is a complex process with outcomes affected by multiple patient and caregiver variable. Well-constructed protocols represent the synthesis of best available evidence regarding ventilator management. In adults, protocols improve important outcomes such as duration of mechanical ventilation, length of stay, and complication rates; however, protocols are not uniformly successful. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.05.002DOI Listing
September 2006
6 Reads

Is permissive hypercapnia a beneficial strategy for pediatric acute lung injury?

Respir Care Clin N Am 2006 Sep;12(3):371-87

University of Texas Medical Branch at Galveston, USA.

It is clear that mechanical ventilation strategies influence the course of lung disease, and the choice of a ventilation strategy that avoids volutrauma and atelectrauma is firmly based on experimental literature and clinical experience. The application of a lung-protective strategy with reduced tidal volumes, effective lung recruitment, adequate PEEP to minimize alveolar collapse during expiration, and permissive hypercapnia has been shown to be advantageous in adult patients who have ARDS, although it has not been systematically studied in children. A significant body of literature confirms the beneficial effects of hypercapnic acidemia in the setting of acute lung injury. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.06.001DOI Listing
September 2006
7 Reads

Is permissive hypoxemia a beneficial strategy for pediatric acute lung injury?

Respir Care Clin N Am 2006 Sep;12(3):359-69, v-vi

Pediatric Critical Care Medicine, Pediatric Intensive Care, Duke Children's Hospital, Duke University Medical Center, Box 3046, Durham, NC 27710, USA.

The adverse effects of high oxygen levels have been widely reported, and clinicians have struggled for many years to find the ideal balance between inspired oxygen levels and acceptable arterial oxygen saturation. However, when asked "what is an acceptable oxygen saturation," one is hard pressed to find a definitive answer. Permissive hypoxemia is a concept similar to the well-described strategy of permissive hypercapnia. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.06.003DOI Listing
September 2006
5 Reads

Application of the acute respiratory distress syndrome network low-tidal volume strategy to pediatric acute lung injury.

Respir Care Clin N Am 2006 Sep;12(3):349-57

PICU Offices, Children's Hospital & Research Center Oakland, 747 52nd Street, Oakland, CA 94609, USA.

In summary, most of the available data suggest that pediatric patients should be ventilated with low tidal volumes. The 6-mL/kg IBW tidal volume strategy as used in the ARDSNet studies is a reasonable target, having since been rigorously tested in several large, clinical trials (adult and pediatric). The mortality associated with ALI in these studies has never been lower, certainly supporting continued use of the 6 mL/kg target tidal volume as the "gold standard" and, thus, eliminating any equipoise in designing a pediatric trial comparing 6 mL/kg to a larger tidal volume. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.05.003DOI Listing
September 2006
4 Reads

Humidification of respired gases in neonates and infants.

Respir Care Clin N Am 2006 Jun;12(2):321-36

Pediatric Cardiology, Neonatal and Pediatric Intensive Care Medicine, Department of Pediatrics, Georg-August-Universität Göttingen, Robert-Koch-Strasse 40, D-37099 Göttingen, Germany.

Which temperature and humidity is optimal and can be recommended to the clinician? Some authors advocate the delivery of gas at body temperature and 100% relative humidity, which is equivalent to a water content of 44 mg/L [5,88,89]. They argue that energy neutrality is the best indicator of optimum humidity and that the intubated airway cannot be equated with the natural airway. Water loss as well as temperature and humidity gradients along the airway are necessary for mucociliary clearance and maintenance of the liquid layer of the airway epithelium, however [3]. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.002DOI Listing
June 2006
14 Reads

The use of filters with small infants.

Respir Care Clin N Am 2006 Jun;12(2):307-20

Department of Anaesthesia, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, UK.

The use of breathing system filters may be particularly beneficial in small infants, compared with older children and adults, because of their greater need for warming and humidification of inspired gases as well as their increased susceptibility to lower respiratory tract contamination. The only evidence available regarding the safety and efficacy of breathing system filters in small infants comes from a few small studies conducted on intensive care patients, however. These studies have suggested that the use of HME filters may be effective in preserving body temperature and airway humidity while decreasing fluid build-up in the breathing system and therefore reducing breathing system contamination. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.006DOI Listing
June 2006
6 Reads

The impact of severe acute respiratory syndrome on the use of and requirements for filters in Canada.

Authors:
Ron J Thiessen

Respir Care Clin N Am 2006 Jun;12(2):287-306

Royal Columbian Hospital, 330 East Columbia Street, New Westminster, British Columbia, V4R 2V1, Canada.

This article begins with a brief look at the epidemiology of SARS in Canada and then discusses barrier use and potential containment strategies that could be applied to the respiratory equipment and supportive procedures that have been implicated in the spread of SARS or other respiratory infections. The article ends with a discussion of how practice and regulations have changed in Canada since SARS and some suggestions on how practice or regulations could further improve. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.003DOI Listing
June 2006
2 Reads

The reuse of breathing systems in anesthesia.

Authors:
John A Carter

Respir Care Clin N Am 2006 Jun;12(2):275-86

Department of Anaesthesia, Frenchay Hospital, Frenchay Park Road, Bristol BS16, UK.

The cheap manufacture of plastics compared with the relatively expensive labor-intensive cost of decontaminating medical equipment encourages the use of disposable single-use equipment. Although the manufacture and disposal of single-use equipment superficially would seem to have more environmental impact than reusable equipment, the processes of cleaning and decontaminating reusable items may impose an even greater cost on the environment. In a recent study at two United States hospitals, anesthetic tubing accounted for less than 10% of medical waste, about half the amount of the plastic waste generated by the cafeterias at the same two hospitals [34]. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.008DOI Listing
June 2006
4 Reads

The effect of humidification on the incidence of ventilator-associated pneumonia.

Respir Care Clin N Am 2006 Jun;12(2):263-73

Intensive Care Medicine, Paris VII Medical School, Paris, France.

Breathing systems used with heated humidifiers are associated with a rapid and high level of bacterial colonization. This colonization is considerably reduced with the use of HMEs. Breathing systems do not need to be changed during the entire ventilation period of a given patient unless they are visibly soiled or mechanically malfunctioning. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.007DOI Listing
June 2006
6 Reads

Humidification of respired gases during mechanical ventilation: mechanical considerations.

Respir Care Clin N Am 2006 Jun;12(2):253-61

Division of Trauma/Critical Care, Department of Surgery, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267, USA.

Humidification of inspired gases during mechanical ventilation remains a standard of care. Optimal humidity is an elusive target and is not clearly defined in the literature. The choice of a humidification device cannot be made solely on the basis of moisture output, however. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.011DOI Listing
June 2006
50 Reads

Consequences of under- and over-humidification.

Respir Care Clin N Am 2006 Jun;12(2):233-52

Intensive Care Unit, Thierry Sottiaux Clinique Notre-Dame de Grâce, Gosselies Hospital, 212 Chaussée de Nivelles, B-6041-Gosselies, Belgium.

Respiratory mucosal and lung structures and functions may be severely impaired in mechanically ventilated patients when delivered gases are not adequately conditioned. Although under- and over-humidification of respiratory gases have not been defined clearly, a safe range of temperature and humidity may be suggested. During mechanical ventilation, gas entering the trachea should reach at least physiologic conditions (32 degrees C-34 degrees C and 100%relative humidity) to keep the ISB at its normal location. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.010DOI Listing
June 2006
56 Reads

Standards for humidification and filtration devices.

Authors:
John Stevens

Respir Care Clin N Am 2006 Jun;12(2):203-32

London W4 3UR, United Kingdom.

This synopsis of the background to the standardization of medical devices allows a comparison of the functional operation of two regulatory authorities, the FDA and the European Commission. It can be seen that with time they have developed many common features. However, there remains a significant difference with the older style of regulation imposed by the FDA, in particular the obligation to comply with USA Federal Law and Federal Codes of Regulation. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.004DOI Listing
June 2006
5 Reads

Filtration of respired gases: theoretical aspects.

Authors:
Ron J Thiessen

Respir Care Clin N Am 2006 Jun;12(2):183-201

Royal Columbian Hospital, New Westminster, British Columbia, V3L 3W7, Canada.

The filtration of aerosols and the behavior of aerosolized particles are less intuitive and more complex than commonly indicated in the medical literature, but once the basic principles are presented, they are not difficult to understand or apply. Particles with diameters close to the most penetrating particle size are clearly the particles of greatest concern, interest, and value in considering the performance of different filtration devices, and this size has been identified as the standard particle size for testing respirators and breathing system filters. Although almost every level of health care now mandates the N95 (NIOSH rating) as the minimum rating for medical respirators, there is no such mandate regarding minimum efficiencies of breathing system filters. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.001DOI Listing
June 2006
5 Reads

Devices used to humidify respired gases.

Authors:
Jörg Rathgeber

Respir Care Clin N Am 2006 Jun;12(2):165-82

Department of Anaesthesiology and Intensive Care Medicine, Albertinen-Hospital, Süntelstrasse 11 A, D-22 457 Hamburg, Germany.

The efficiency of HMEs decreases with increasing tidal volumes. HMEs always result in an elevation of the inspiratory and expiratory airway resistances; this should be considered especially in cases that involve spontaneous respiration. The pressure drop across HMEs should be less than 2 hPa for a flow of 60 L/min, a level that also has been measured for cascade humidifiers. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.012DOI Listing
June 2006
14 Reads

Humidification: measurement and requirements.

Authors:
Klaus Züchner

Respir Care Clin N Am 2006 Jun;12(2):149-63

Department of Anesthesiology, Emergency and Intensive Care Medicine, University of Göttingen, Bereich Humanmedizin Georg-August-Universität, Stiftung öffentlichen Rechts Robert-Koch-Str, 40 D-37099 Göttingen, Germany.

Humidification measurement is now feasible, but it is cumbersome and costly for routine use. The user therefore may rely on data supplied with the humidification device and obtained according to ISO standards. For comparison purposes it would be extremely helpful if both standards used to describe humidification properties quoted performance values in the same manner, preferably as moisture loss measured as milligrams of water per liter at the maximum tidal volume. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.005DOI Listing
June 2006
5 Reads

The humidification and filtration functions of the airways.

Authors:
Maire P Shelly

Respir Care Clin N Am 2006 Jun;12(2):139-48

Acute Intensive Care Unit, Wythenshawe Hospital, Southmoor Road, Manchester, M23 9LT, United Kingdom.

The mucociliary elevator is a highly evolved organ that humidifies inspired gases and protects the lungs from particulate, chemical, and microbiologic matter. Studies of disorders mucus and ciliary function have improved the understanding of this forgotten organ. The clinical implications of this understanding have yet to be explored. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.03.009DOI Listing
June 2006
3 Reads

Accreditation of sleep disorders programs.

Authors:
Bonnie Robertson

Respir Care Clin N Am 2006 Mar;12(1):121-4, ix-x

REM Medical Corp., 505 5th Avenue South, Suite 350, Seattle, WA 98104, USA.

The accreditation of a sleep program ensures a high quality of care for the patient who has a sleep disorder. With more sleep laboratories becoming available, accreditation may be the best single way for a consumer to determine the adequacy of the facility. The process for accreditation requires the sleep program to develop policies and procedures that meet rigorous national and local standards. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.005DOI Listing
March 2006
2 Reads

Sleep medicine management: clinic-based, laboratory testing, and durable medical equipment.

Authors:
Bonnie Robertson

Respir Care Clin N Am 2006 Mar;12(1):111-9, ix

REM Medical Corp., 505 5th Avenue South, Suite 350, Seattle, WA 98104, USA.

The patient who is suffering from a sleep disorder is seeking help for one of the basic necessities of life: a good night's sleep. For all those who have developed a problem in sleeping, whether it is physiologic or psychologic, the sleep medicine profession can be literally a lifesaver. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.006DOI Listing
March 2006
5 Reads

Safety in the sleep laboratory.

Authors:
Mary Kay Hobby

Respir Care Clin N Am 2006 Mar;12(1):101-10, ix

Sleep Health Management Resources, Inc., 5818 North Hales Corner Road, Stillman Valley, IL 61084, USA.

The importance of workplace safety cannot be understated. The safety of employees affects morale, attendance, and workman's compensation. Federal organizations and agencies have provided guidelines to help ensure the health and safety of the technician and the patients who visit the sleep center. Read More

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http://dx.doi.org/10.1016/j.rcc.2006.02.001DOI Listing
March 2006
5 Reads

The effect of medication on sleep.

Authors:
W David Brown

Respir Care Clin N Am 2006 Mar;12(1):81-99, ix

The Woodlands Sleep Evaluation Center, The Woodlands, TX, USA.

Understanding the role that medication has on sleep is difficult for many reasons. Most medications have not been sufficiently studied to determine their primary effects on sleep and waking behavior. Because of the increased awareness of the importance of sleep to health and well being, the effects of a new drug on sleep and waking behavior should be a mandatory element of the clinical trials process. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.008DOI Listing
March 2006
6 Reads

Psychiatric and neurologic disorders that affect sleep.

Authors:
Jeremy Dozier

Respir Care Clin N Am 2006 Mar;12(1):71-80, viii

Sleep Diagnostics of Texas, Woodlands Sleep Evaluation Center, 4840 W. Panther Creek Drive, Suite 101, The Woodlands, TX 77381, USA.

Neurologic and psychiatric disorders that affect sleep are linked by a common symptom: insomnia. For this reason the overnight attended polysomnogram is a vital diagnostic tool for the clinician who wishes to determine the cause of the sleep disturbance. The role of a well-trained and competent polysomnographer is vital to the collection of reliable diagnostic data. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.007DOI Listing
March 2006
5 Reads

Medical disorders and their effects on sleep.

Respir Care Clin N Am 2006 Mar;12(1):55-69, viii

National Jewish Medical and Research Center, 1400 Jackson Street, Room J232, Denver, CO 80206, USA.

Disturbances of sleep can be encountered in many medical disorders. Conversely, sleep impairment can adversely affect the symptoms of a variety of medical conditions, including respiratory, cardiac, gastrointestinal, renal, rheumatologic, and infectious disorders. More than one sleep pathology may be present in a particular patient, and these disorders may interact to increase the severity or prolong the duration of sleep disturbance. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.009DOI Listing
March 2006
3 Reads

Overview of sleep disorders.

Respir Care Clin N Am 2006 Mar;12(1):31-54, viii

California Institute of Sleep Medicine, 500 East Remington Drive, Suite 18, Sunnyvale, CA 94087, USA.

Sleep disorders are common and can affect anyone, from every social class and every ethnic background. It is estimated that more than 70 million Americans are afflicted by chronic sleep disorders. Currently about 88 sleep disorders are described by the International Classification of Sleep Disorders as established by The American Academy of Sleep Medicine. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.001DOI Listing
March 2006
5 Reads

Actigraphy.

Respir Care Clin N Am 2006 Mar;12(1):23-30, viii

Sleep and Chronobiology Research Laboratory, Department of Psychiatry and Human Behavior, E.P. Bradley Hospital/Brown Medical School, 1011 Veterans Memorial Parkway, East Providence, RI 02915, USA.

Actigraphy is a methodology for recording and analyzing activity (movement) from small, computerized devices worn on the body. Published reports on the reliability and validity of actigraph measures, although not comprehensive, generally indicate that sleep estimated by scoring algorithms is relatively consistent with PSG-scored sleep for normal individuals across the lifespan and for some patient groups. Accuracy is often greatly decreased when sleep is disordered or disrupted. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.010DOI Listing
March 2006
6 Reads

Multiple sleep latency test and maintenance of wakefulness test.

Authors:
Jill M Slinkard

Respir Care Clin N Am 2006 Mar;12(1):17-22, viii

Sleep Disorders Center, National Jewish Medical and Research Center, 1400 Jackson Street, Denver, CO 80206, USA.

In addition to overnight polysomnography, there are two special tests with which every sleep technologist should be familiar: the multiple sleep latency test and the maintenance of wakefulness test. These two tests classify excessive daytime sleepiness using objective data. The role of the sleep technologist is to understand and perform an accurate test so that sleep clinicians can use that data in diagnosing and treating their patients. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.012DOI Listing
March 2006
3 Reads

Sleep report parameters and calculations.

Authors:
Cynthia Mattice

Respir Care Clin N Am 2006 Mar;12(1):11-5, vii

AccuHealth, Inc. Sleep Disorders Center, 5100 North Brookline, Suite 325, Oklahoma City, OK 73112, USA.

Accurate interpretation of a polysomnogram is based on a sleep parameters report generated from the scored sleep stages and clinical events. Understanding the calculations necessary to verify the accuracy of the digitally produced PSG evaluation report ensures that the interpreting physician has the necessary information to formulate an impression and make recommendations. This chapter provides definitions of the sleep report parameters and the calculations to verify accuracy. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.011DOI Listing
March 2006
7 Reads

Infant and toddler polysomnography.

Respir Care Clin N Am 2006 Mar;12(1):1-10

Division of Pulmonary Medicine, The University of Colorado & Health Sciences Center, 4200 E. 9th Avenue, Denver, CO 80262, USA.

The acquisition process for infant and toddler polysomnography requires pediatric-specific equipment and specially trained personnel. Pediatric laboratories must keep in mind the importance of including the parent through-out the process. The demand for infant and pediatric polysomnography continues to grow as new research increasingly demonstrates the value of studying physiologic variables collected during the study. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.11.002DOI Listing
March 2006
20 Reads

Event scoring in polysomnography: scoring arousals, respiratory events, and leg movements.

Respir Care Clin N Am 2005 Dec;11(4):709-30, ix

Michael E. DeBakey Veteran Affairs Medical Center, Sleep Disorders Clinic, Houston, TX 77030, USA.

Polysomnographic events comprise a wide variety of phenomena,including episodes of apnea, episodes of hypopnea, leg movements, transient central nervous system arousals, and eye movements. The process of event scoring involves pattern recognition and provides a description of potentially pathophysiologic activity occurring during sleep. The rules for scoring sleep-related events continue to be developed. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.08.007DOI Listing
December 2005
4 Reads

Sleep stage scoring in the adult population.

Respir Care Clin N Am 2005 Dec;11(4):691-707, ix

Michael E. DeBakey Veteran Affairs Medical Center, Sleep Disorders Clinic, Houston, TX 77030, USA.

Sleep stage scoring is a system-based classification procedure requiring knowledge and understanding of brainwave electrical potentials and their patterns in different cortical areas. Monitoring precise scalp locations requires standardized electrode placements. The electroencephalogram is recorded concurrently with eye movement potentials (electro-oculogram) and submentalis muscle activity (electromyogram). Read More

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http://dx.doi.org/10.1016/j.rcc.2005.08.009DOI Listing
December 2005
6 Reads

Positive airway pressure and oxygen therapy in the sleep laboratory.

Authors:
James T Hundley

Respir Care Clin N Am 2005 Dec;11(4):679-89

Sleep Medicine Program, Raleigh Neurology Associates, P.A., Raleigh, NC 27607, USA.

Adequate titration of PAP and oxygen therapy depends on intuitive, observant, and highly skilled acquisition technicians. Sleep laboratories must have a variety of equipment to ensure that technicians have adequate resources during manual titrations. Titration policies and procedures must be determined and written by sleep laboratory staff to ensure compliance with third-party payers, provide guidance to technical staff, and enable ongoing quality improvement processes. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.08.010DOI Listing
December 2005
5 Reads

Monitoring respiration during sleep.

Respir Care Clin N Am 2005 Dec;11(4):663-78

National Jewish Medical and Research Center, Denver, CO 80206, USA.

Monitoring of respiration during sleep allows the assessment of physiologic variables that are required to characterize SRBD events. The patency of the upper airway, the pattern of breathing, oxygenation, and ventilation usually can be inferred from simultaneous measurements of airflow, respiratory effort, thoracic volume, and blood gases. As new techniques of respiratory monitoring emerge, the respiratory therapist and sleep technologist must be familiar with the advantages and shortcomings of each modality. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.08.008DOI Listing
December 2005
3 Reads

Cardiac arrhythmias.

Authors:
Jon W Atkinson

Respir Care Clin N Am 2005 Dec;11(4):635-61, viii

Ohio Sleep Consulting and Recording Services, Lancaster, OH 43130, USA.

This article presents an overview of common cardiac arrhythmias. Interventions for severe and potentially severe arrhythmias are discussed. Tips for recording and viewing the electrocardiogram as employed in polysomnography are presented. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.08.006DOI Listing
December 2005
4 Reads

Troubleshooting and elimination of artifact in polysomnography.

Authors:
Bretton Beine

Respir Care Clin N Am 2005 Dec;11(4):617-34, viii

Sleep Center at National Jewish Medical and Research Center, Denver, CO, USA.

A sleep technician who runs a sleep study without understanding the basis of the signals being acquired can spend a lot of time and energy trying to improve poor signal quality without success. Poor signal quality often results in an image that cannot be interpreted or is difficult to interpret, and extensive troubleshooting often results in a very disrupted sleep study. This article addresses trouble-shooting and elimination of artifact in polysomnography. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.08.005DOI Listing
December 2005
29 Reads

Instrumentation and electrode placement.

Authors:
James A Munday

Respir Care Clin N Am 2005 Dec;11(4):605-15, viii

Sleep Disorders Center, HealthOne Swedish Medical Center, Englewood, CO 80110, USA.

The field of sleep diagnostics and polysomnography has increased significantly in the past 2 decades, and the need for expertly trained and qualified technologists has never been greater. This article instructs the therapist in the importance of proper patient hookup, reviews the 10-20 international system of electrode placement, considers accurate placement of electrodes and sensors, and discusses the use of various instrumentation. Read More

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http://dx.doi.org/10.1016/j.rcc.2005.08.004DOI Listing
December 2005
3 Reads