Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
�
ORIGINAL ARTICLE
EFFECTS OF CPAP ON THE PHYSICAL EXERCISE TOLERANCE OF MODERATE TO
SEVERE CHRONIC OBSTRUCTIVE PULMONARY DISEASE
!
MICHEL SILVA REIS1,2, HUGO VALVERDE REIS1,2, DANIEL TEIXEIRA SOBRAL1,2, APARECIDA MARIA
CATAI3, AUDREY BORGHI-SILVA4
!
1Research Group in Cardiorespiratory Physical Therapy (GECARE), Department of Physical Therapy, Faculty of
Medicine, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
2Physical Education Undergraduation Program, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
3Laboratory of Cardiovascular Physical Therapy, Department of Physical Therapy, UFSCar, São Carlos, SP, Brazil
4Laboratory of Cardiopulmonary Physical Therapy, Department of Physical Therapy, Universidade Federal de São
Carlos (UFSCar), São Carlos, SP, Brazil
!
!
Received September 21, 2016; accepted April 18, 2017
Objective: The aim of this study was to evaluate the effect of continuous positive airway pressure
(CPAP) on the exercise tolerance of patients with moderate to severe chronic obstructive pulmonary
disease (COPD). Methods: ten men with COPD (69 ± 9 years), FEV1/FVC (58.90 ± 11.86%) and FEV1
(40.98 ± 10.97% of predict) were submitted to a symptom-limited incremental exercise test (IT) on
the cyclo ergometer. Later, on another visit, they were randomized to perform a constant load
exercise protocol until maximal tolerance with and without CPAP (5cmH2O) in the following
conditions: i) 50% of the peak workload; and ii) 75% of the peak workload. Heart rate (HR), arterial
pressure (AP) and peripheral oxygen saturation were obtained at rest and during the exercise
protocols. For statistical procedures, Shapiro-Wilk normality test and two-way ANOVA with Tukey
post hoc (p<0.05) were performed. Results: There was a signi`icant improvement in exercise time
tolerance during the 75% of the peak workload protocol with CPAP when compared with
spontaneous breath (SB) (438±75 vs. 344±73ms, respectively). Conclusion: CPAP with 5 cmH2O
seems to be useful to improve exercise tolerance in patients with COPD.
!
!
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!
Corresponding Author
Michel Silva Reis ([email protected])
!
Journal of Respiratory and CardioVascular Physical Therapy
KEYWORDS:
Noninvasive
ventilation;
COPD;
exercise
tolerance;
CPAP
mailto:[email protected]
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
INTRODUCTON
Patients with chronic obstructive pulmonary disease
(COPD) present a reduced physical exercise tolerance that
can be determined by ventilatory and/or peripheral
mechanism1,2. Progressive increase in the expiratory
air`low resistance, which limits the tidal volume gain
beyond the expiratory and inspiratory reserve volumes,
may be accentuated because these patients ventilate ...
Effect of Inspiratory Muscle Training on Muscle Strength and Quality of Life ...kacm20
Effect of Inspiratory Muscle Training on Muscle Strength and
Quality of Life in Patients With Chronic Airflow Limitation:
a Randomized Controlled Trial
Title: A Study to Evaluate the Hemodynamic Effects of Swiss Ball Exercise in Post-Operative Coronary Artery Bypass Graft Patients
Introduction:
Coronary artery bypass graft (CABG) surgery is a common procedure to restore blood flow to the heart in patients with coronary artery disease.
Post-operative cardiac rehabilitation is crucial for optimizing recovery and improving overall cardiovascular health.
Swiss ball exercises have gained popularity as a rehabilitation tool due to their potential to improve balance, core stability, and functional capacity.
Objective:
To assess the hemodynamic effects of Swiss ball exercise in patients undergoing post-operative coronary artery bypass graft surgery.
Methods:
Study Design: A prospective, randomized controlled trial.
Participants: Patients who underwent coronary artery bypass graft surgery and met inclusion criteria.
Randomization: Patients will be randomly assigned to either the intervention group (Swiss ball exercise) or the control group (standard cardiac rehabilitation).
Intervention: The intervention group will perform supervised Swiss ball exercises as part of their cardiac rehabilitation program.
Control Group: The control group will receive standard cardiac rehabilitation without Swiss ball exercises.
Outcome Measures: Hemodynamic parameters, including heart rate, blood pressure, cardiac output, stroke volume, and systemic vascular resistance, will be measured at baseline and at specified time intervals during the study period.
Data Analysis: Statistical analysis will be performed to compare the hemodynamic parameters between the intervention and control groups.
Expected Results:
Improved Hemodynamic Parameters: It is hypothesized that the Swiss ball exercise group will exhibit improved hemodynamic parameters compared to the control group.
Increased Cardiac Output and Stroke Volume: Swiss ball exercises may enhance cardiac performance, leading to increased cardiac output and stroke volume.
Decreased Systemic Vascular Resistance: Swiss ball exercises may result in improved vascular function, leading to reduced systemic vascular resistance.
Enhanced Functional Capacity: Patients in the intervention group may experience improved functional capacity, as reflected by increased exercise tolerance and reduced exertional symptoms.
Significance:
Clinical Application: The findings of this study may provide evidence supporting the inclusion of Swiss ball exercises in post-operative cardiac rehabilitation programs for CABG patients.
Rehabilitation Guidelines: The study results may contribute to the development of guidelines for incorporating Swiss ball exercises into standard cardiac rehabilitation protocols.
Improved Patient Outcomes: If Swiss ball exercises are found to have positive hemodynamic effects, their implementation in post-operative rehabilitation
Outcome study of pulmonary telerehab - respirehab for post COVID patientsSubodh Gupta
Respirehab's case paper of telerehab of post COVID patients for improving breathing capacity, physical endurance and patient well being. The online pulmonary rehab delivered excellent gains on various parameters like SGRQ, MMRC and SPO2. This would be very helpful for COPD patients suffering from shortness of breath (Dyspnea).
Effect of Inspiratory Muscle Training on Muscle Strength and Quality of Life ...kacm20
Effect of Inspiratory Muscle Training on Muscle Strength and
Quality of Life in Patients With Chronic Airflow Limitation:
a Randomized Controlled Trial
Title: A Study to Evaluate the Hemodynamic Effects of Swiss Ball Exercise in Post-Operative Coronary Artery Bypass Graft Patients
Introduction:
Coronary artery bypass graft (CABG) surgery is a common procedure to restore blood flow to the heart in patients with coronary artery disease.
Post-operative cardiac rehabilitation is crucial for optimizing recovery and improving overall cardiovascular health.
Swiss ball exercises have gained popularity as a rehabilitation tool due to their potential to improve balance, core stability, and functional capacity.
Objective:
To assess the hemodynamic effects of Swiss ball exercise in patients undergoing post-operative coronary artery bypass graft surgery.
Methods:
Study Design: A prospective, randomized controlled trial.
Participants: Patients who underwent coronary artery bypass graft surgery and met inclusion criteria.
Randomization: Patients will be randomly assigned to either the intervention group (Swiss ball exercise) or the control group (standard cardiac rehabilitation).
Intervention: The intervention group will perform supervised Swiss ball exercises as part of their cardiac rehabilitation program.
Control Group: The control group will receive standard cardiac rehabilitation without Swiss ball exercises.
Outcome Measures: Hemodynamic parameters, including heart rate, blood pressure, cardiac output, stroke volume, and systemic vascular resistance, will be measured at baseline and at specified time intervals during the study period.
Data Analysis: Statistical analysis will be performed to compare the hemodynamic parameters between the intervention and control groups.
Expected Results:
Improved Hemodynamic Parameters: It is hypothesized that the Swiss ball exercise group will exhibit improved hemodynamic parameters compared to the control group.
Increased Cardiac Output and Stroke Volume: Swiss ball exercises may enhance cardiac performance, leading to increased cardiac output and stroke volume.
Decreased Systemic Vascular Resistance: Swiss ball exercises may result in improved vascular function, leading to reduced systemic vascular resistance.
Enhanced Functional Capacity: Patients in the intervention group may experience improved functional capacity, as reflected by increased exercise tolerance and reduced exertional symptoms.
Significance:
Clinical Application: The findings of this study may provide evidence supporting the inclusion of Swiss ball exercises in post-operative cardiac rehabilitation programs for CABG patients.
Rehabilitation Guidelines: The study results may contribute to the development of guidelines for incorporating Swiss ball exercises into standard cardiac rehabilitation protocols.
Improved Patient Outcomes: If Swiss ball exercises are found to have positive hemodynamic effects, their implementation in post-operative rehabilitation
Outcome study of pulmonary telerehab - respirehab for post COVID patientsSubodh Gupta
Respirehab's case paper of telerehab of post COVID patients for improving breathing capacity, physical endurance and patient well being. The online pulmonary rehab delivered excellent gains on various parameters like SGRQ, MMRC and SPO2. This would be very helpful for COPD patients suffering from shortness of breath (Dyspnea).
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Autologous mononuclear and mesenchymal stromal cells infusion in COPD patients: impact on pulmonary capacity and quality of life in a Phase I randomized clinical trial
Assessment of preoperative exercise capacity in hepatocellular carcinoma pati...Enrique Moreno Gonzalez
Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma (HCC) patients with chronic liver injury who underwent hepatectomy.
Randomized controlled trial of 12-week yoga therapy as lifestyle intervention...Yogacharya AB Bhavanani
Randomized controlled trial of 12-week yoga therapy as lifestyle intervention in patients of essential hypertension and cardiac autonomic function tests
This study aims at exploring the eff ect of a 4-week hypoxic training on some physiological and biochemical parameters in the 400-m competing athletes of the Palestinian athletics team. Twelve trained male athletes were divided into two groups, normoxic training (n = 6) and hypoxic training (n = 6) for residing at sea-level.The training period was 90min, 3 days per week for 4 weeks.Therefore,physiological measurements showed (Vital Capacity (VC), Maximal Oxygen Consumption (VO2max) and Heart-Rate (HR)); Biochemical measurements (Erythropoietin (EPO), Hemoglobin (Hb), Hematocrit (Hct) and Partial Oxygen Pressure PO2); the numerical level of running 400m.
Currently, athletes with the aim of improving their physical performance or even those into functional rehabilitation programs have had the benefits of resistance training (RT). The suitable adjustment of variables during their prescription, such as the type of muscle contraction, weight, and number of exercises repetitions and the recovering time between one set and another must be considered to achieve the aimed adaptations. Studies which have evaluated those variables about the impact on cardiovascular system have brought out some questions referring to changes in the kinds of contractions, dynamics or statics, on hemodynamic parameters. Comprehending the hemodynamics repercussions of those exercise modalities is determinant for a safe and efficient prescription.
•Reflective Log•Your reflective log should include the.docxtawnyataylor528
•
Reflective Log
•
Your
reflective
log
should include the following
•
What was your role within the business simulation company?
Demonstrate how you used the resources critically to make decisions
while you were running the company.
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•The philosophers Thomas Hobbes and John Locke disagreed on the un.docxtawnyataylor528
•The philosophers Thomas Hobbes and John Locke disagreed on the understanding of political authority, with Locke taking what is commonly called the “liberal” view. Choose a side (be brave perhaps; take a side you actually disagree with). Using the writings of each given in our class text or at the Websites below, make your case for the side you chose and against the other side. Identify one (1) modern situation in the world where these issues are significant.
Philosophers Debate Politics
•Chapter 24 (pp. 768-9)
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http://oregonstate.edu/instruct/phl302/texts/hobbes/leviathan-contents.html
;
Summary at http://plato.stanford.edu/entries/hobbes-moral/; also
http://jim.com/hobbes.htm
•Locke: text at http://www.thenagain.info/Classes/Sources/Locke-2ndTreatise.html; General
background of the concept at
http://www.digitalhistory.uh.edu/teachers/lesson_plans/pdfs/unit1_12.pdf
.
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International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
Autologous mononuclear and mesenchymal stromal cells infusion in COPD patients: impact on pulmonary capacity and quality of life in a Phase I randomized clinical trial
Assessment of preoperative exercise capacity in hepatocellular carcinoma pati...Enrique Moreno Gonzalez
Cardiopulmonary exercise testing measures oxygen uptake at increasing levels of work and predicts cardiopulmonary performance under conditions of stress, such as after abdominal surgery. Dynamic assessment of preoperative exercise capacity may be a useful predictor of postoperative prognosis. This study examined the relationship between preoperative exercise capacity and event-free survival in hepatocellular carcinoma (HCC) patients with chronic liver injury who underwent hepatectomy.
Randomized controlled trial of 12-week yoga therapy as lifestyle intervention...Yogacharya AB Bhavanani
Randomized controlled trial of 12-week yoga therapy as lifestyle intervention in patients of essential hypertension and cardiac autonomic function tests
This study aims at exploring the eff ect of a 4-week hypoxic training on some physiological and biochemical parameters in the 400-m competing athletes of the Palestinian athletics team. Twelve trained male athletes were divided into two groups, normoxic training (n = 6) and hypoxic training (n = 6) for residing at sea-level.The training period was 90min, 3 days per week for 4 weeks.Therefore,physiological measurements showed (Vital Capacity (VC), Maximal Oxygen Consumption (VO2max) and Heart-Rate (HR)); Biochemical measurements (Erythropoietin (EPO), Hemoglobin (Hb), Hematocrit (Hct) and Partial Oxygen Pressure PO2); the numerical level of running 400m.
Currently, athletes with the aim of improving their physical performance or even those into functional rehabilitation programs have had the benefits of resistance training (RT). The suitable adjustment of variables during their prescription, such as the type of muscle contraction, weight, and number of exercises repetitions and the recovering time between one set and another must be considered to achieve the aimed adaptations. Studies which have evaluated those variables about the impact on cardiovascular system have brought out some questions referring to changes in the kinds of contractions, dynamics or statics, on hemodynamic parameters. Comprehending the hemodynamics repercussions of those exercise modalities is determinant for a safe and efficient prescription.
•Reflective Log•Your reflective log should include the.docxtawnyataylor528
•
Reflective Log
•
Your
reflective
log
should include the following
•
What was your role within the business simulation company?
Demonstrate how you used the resources critically to make decisions
while you were running the company.
.
•The philosophers Thomas Hobbes and John Locke disagreed on the un.docxtawnyataylor528
•The philosophers Thomas Hobbes and John Locke disagreed on the understanding of political authority, with Locke taking what is commonly called the “liberal” view. Choose a side (be brave perhaps; take a side you actually disagree with). Using the writings of each given in our class text or at the Websites below, make your case for the side you chose and against the other side. Identify one (1) modern situation in the world where these issues are significant.
Philosophers Debate Politics
•Chapter 24 (pp. 768-9)
•Hobbes: text at
http://oregonstate.edu/instruct/phl302/texts/hobbes/leviathan-contents.html
;
Summary at http://plato.stanford.edu/entries/hobbes-moral/; also
http://jim.com/hobbes.htm
•Locke: text at http://www.thenagain.info/Classes/Sources/Locke-2ndTreatise.html; General
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• This summative assessment can be completed in class or at any .docxtawnyataylor528
• This summative assessment can be completed in class or at any other convenient location.
• Students are required to complete this task using digital tools and ensure to submit in an acceptable format, e.g. .docx, .pdf, .pptx, or as advised by your assessor.
• Please use the following formatting guidelines to complete this assessment task:
• Font Size: 12; Line Spacing: Double; Font Style: Times New Roman
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Instruction to Assessors:
https://zealtutors.com/2021/05/11/assuming-your-organization-was-awarded-the-following-tender-atm-id-naa-rft-20xx-105/
• You must assess student’s assessment according to the provided Marking Criteria.
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Assuming your organization was awarded the following tender:
ATM ID: NAA RFT 20xx/1058
Agency: National Archives of Australia
Category: 81110000 – Computer services
Close Date & Time: 15-Aug-20xx 2:00 pm (ACT Local Time)
Publish Date: 15-Jul-20xx
Location: ACT Canberra
ATM Type: Request for Tender
APP Reference: NAA20XX-1
Multi Agency Access: No
Panel Arrangement: No
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https://4assignmenthelpers.com/assuming-your-organization-was-awarded-the-following-tender-atm-id-naa-rft-20xx-105/
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• 2 pages• APA• how the airport uses sustainability at the o.docxtawnyataylor528
• 2 pages
• APA
•
h
ow the airport uses sustainability at the operational side/airside (everything behind the gate and basically where the airplanes are) at an airport
• e.g. use of electric cars at the airfield, like buses for passengers etc.
• Due 6 PM (NY Time)
Thank you so much!
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¿Lógico o ilógicoIndicate whether each of the doctors statemen.docxtawnyataylor528
¿Lógico o ilógico?
Indicate whether each of the doctor's statements is
lógico
or
ilógico
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"En este hospital se prohíben exámenes médicos."
"Esta mañana se me rompió la mano; tuve que cancelar todas las citas de esta semana."
"Se necesitan medicinas porque hay pacientes enfermos."
"En mi consultorio se regalan radiografías."
"A un enfermero se le cayeron unas botellas; por eso el paciente se quitó los zapatos."
Oraciones con
se
Rewrite the sentences using
se
.
Modelo
Buscamos médicos bilingües.
Se buscan médicos bilingües.
No pueden hablar por teléfono.
Mariela sufre muchos dolores de cabeza. Debe trabajar más.
Fiebre
se escribe así: efe - i - e - be - ere - e.
A Felipe no le gustan mucho las películas; va al cine constantemente.
Conversaciones
Choose the correct adverbs to complete the conversations.
—Éstas son las pastillas que usted debe tomar. Recuerde, son cuatro pastillas al día; debe tomarlas...
—Perdone, doctora, ¿puede hablar más ? Es que con este dolor de cabeza escucho.
—¿Te enfermas ?
— , me enfermo una vez al año.
—¿Qué te dijo el médico?
—Que debo nadar una hora, tres veces por semana porque siento dolor en los huesos. La natación es muy buena para la circulación y no lastima los huesos.
Adverbios
Fill in the blanks with words from the list. Two words will not be used.
a tiempo
casi
muchas veces
poco
rápido
tarde
Mi amigo Onofre y yo estudiamos medicina. A nuestra profesora de biología le importa mucho la puntualidad. Si los estudiantes llegan
(1) [removed],
ella está de buen humor; pero si no, ¡ojo (
watch out
)!
(2) [removed]
Onofre y yo llegamos
(3) [removed]
a clase, y ahora bajaron nuestras notas (
grades
). ¡Vamos a tener que caminar
(4) [removed]
a clase!
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·Which of the following is considered a hybrid organizational fo.docxtawnyataylor528
·
Which of the following is considered a hybrid organizational form?
·
sole proprietorship
·
corporation
·
limited liability partnership
·
partnership
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·
Write aresearch paper of three (3) body pages on a narrow aspect of the topic
“
how a specific innovation or discovery from the past has impacted or changed some aspect of human history.”
The paper may be either an argumentative or analytical essay. Utiliz
e
at least three
high-quality academic references that you access through FDU on-line or physical libraries.
At least one must be a scholarly/peer reviewed article.
Use of Wikipedia, blogs, .com websites of people not known as experts in their fields, and similar sources do
not
meet this “high-quality” requirement.
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·
Your paper will be written in APA format and must include:
·
Title page
·
Abstract
·
Fully researched body with appropriate in text citations
·
References
·
Appendices (if appropriate)
Cover, Abstract/Prefatory Information, References, Appendix, Illustrations and other support materials
are in addition
to the three body pages noted above.
Your paper
must
be double space, 12 pt. Times New Roman, with paragraph indents, no extra spaces between paragraphs, on US letter paper. Margins must be 1 inch top, bottom and
both sides, with alignment flush left and uneven, or
ragged
, on right.
·
In-text citations (including secondary source citations) and references must follow APA guidelines as covered in class and in handouts that are distributed to you.
Your OUTLINE/graphic organizer will be graded separately and will be worth 10 points. Your paper will be worth 90 points, for a total of 100 points on this assignment.
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·InterviewConduct an interview and document it.During this c.docxtawnyataylor528
·
Interview
Conduct an interview and document it.
During this course we have learned about organizational culture and structure, we have spoken of feedback and job types. As project that pulls together all concepts from this course you will conduct an interview. Document the interview and draw a conclusion in a short four to five sentence summary of the experience.
1.
create 8 to 10 professional and quality interview questions
2.
decide how you are going to document the interview (audio, video or type)
3.
conduct the interview
4.
confirm that the interview was documented
5.
write the summary paragraph
6.
submit your assignment
The topic and interviewee are to be of your choice and should allow you to learn something that will help in pursuit of your career.
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·Submit a 50- to 100-word response to each of the followin.docxtawnyataylor528
·
Submit
a 50- to 100-word response to
each of
the following questions:
o
Understanding a Will
1.
What is
a will and what is
the benefit of having
one
?
2.
Why is it important to also have a living revocable trust with a will?
o
Creating a Durable Power of Attorney for Health Care
What is a Durable Power of Attorney for Healthcare? What information does the document provide? How is this document related to an advance directive (aka living will)?
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Understanding the Purpose of the Must-Have Documents
4.
Why might these forms need to be
updated?
How would you go about making these updates to ensure they are valid?
5.
In what ways did you find any of these forms to be difficult to complete? What did you learn as a result of completing these forms?
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·Section 3·Financial management, quality and marketing asp.docxtawnyataylor528
·
Section 3
·
Financial management, quality and marketing aspects of the organization
·
Financial
·
Analysis of the service reimbursement for the organization (State, Federal, Insurance and Private Pay)
·
Methods of funding
·
Research issues
·
Quality and Ethics
·
Accreditation
·
Awards
·
Regulation
·
Ethical issues regarding who receives care at the organization
·
Marketing
·
Strategies
·
Branding
·
Community and employee involvement
·
Section 4
·
Impact of economic and outside influences to the organization
·
National and world economy impact
·
Explanation of the sustainability of this organizational care model
·
Healthcare reform
·
Regulations
·
Section 5
·
Conclusion for your paper and combine all the sections into a project paper
·
Recap the info regarding organization
·
Glimpse into the future for the organization based on your learning
·
Combine all parts into a APA formatted product
.
·Why is the effort to standardize the language used in reporti.docxtawnyataylor528
·
Why is the effort to standardize the language used in reporting clinical trials (MedDRA) important to harmonization throughout the world?
IMPORTANCE OF STANDARDIZING THE LANGUAGE USED IN
(MedDRA)
Reason for standardizing the language used in MedDRA)
.
·Humans belong to the genus Homo and chimpanzees to the genus .docxtawnyataylor528
·
Humans belong to the genus Homo and chimpanzees to the genus Pan, yet studies of primate genes show that chimpanzees and humans are more closely related to one another than each is to any other animals. In light of this result, some researchers suggest that chimpanzees should be renamed as members of the genus Homo. Discuss at least three (3) practical, scientific, and / or ethical issues that might be raised by such a change in naming. aleast 400 words.
.
·Crash House II and add resources and costs—remember, only crash.docxtawnyataylor528
·
Crash House II and add resources and costs—remember, only crash tasks on the critical path and start with the lowest cost.
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Perform resource allocation and crash House II for House III homework.
I need an Email address to send the attachment I can't uploade it here.
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·What is the main difference between the approaches of CONFLICT .docxtawnyataylor528
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What is the main difference between the approaches of CONFLICT THEORY and FUNCTIONALIST THEORY about the nature of crime and criminality? Elaborate with examples.
D DO you agree or disagree with the premise that the media portrays women as sexual objects.
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Describe the boundaries you think that the media should adhere to when it comes to issues of sexuality.
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·What is the work of art’s historical and cultural context·.docxtawnyataylor528
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What is the work of art’s historical and cultural context?
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Does the work adhere to the conventions of the style movement / artistic period, or does it go against those conventions?
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How are the two works of art similar? How are they different?
o
What can we conclude from those similarities and differences?
Your draft should be 2 – 3 pages long and include at least
four
scholarly sources (two for each work of art). Check out these databases from the
Shapiro Library website
to help you get started:
·
JSTOR: you can search by subject; “Art & Art History” is your best bet here
·
Project MUSE: you can search for articles by subject here as well; look for articles under “Art and Architecture”
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·Review the steps of the SDLC. Explain why quality service deliv.docxtawnyataylor528
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Review the steps of the SDLC. Explain why quality service delivery depends on the execution of the service delivery life cycle. Discuss the aspects of the SDLC that are critical to quality service management. Explain your answer.
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From the e-Activity, explain how the service delivery model used within an organization impacts an IT organization at the enterprise level.
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Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
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Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
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This is a presentation by Dada Robert in a Your Skill Boost masterclass organised by the Excellence Foundation for South Sudan (EFSS) on Saturday, the 25th and Sunday, the 26th of May 2024.
He discussed the concept of quality improvement, emphasizing its applicability to various aspects of life, including personal, project, and program improvements. He defined quality as doing the right thing at the right time in the right way to achieve the best possible results and discussed the concept of the "gap" between what we know and what we do, and how this gap represents the areas we need to improve. He explained the scientific approach to quality improvement, which involves systematic performance analysis, testing and learning, and implementing change ideas. He also highlighted the importance of client focus and a team approach to quality improvement.
1. Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
�
ORIGINAL ARTICLE
EFFECTS OF CPAP ON THE PHYSICAL EXERCISE
TOLERANCE OF MODERATE TO
SEVERE CHRONIC OBSTRUCTIVE PULMONARY
DISEASE
!
MICHEL SILVA REIS1,2, HUGO VALVERDE
REIS1,2, DANIEL TEIXEIRA SOBRAL1,2,
APARECIDA MARIA
CATAI3, AUDREY BORGHI-SILVA4
!
1Research Group in Cardiorespiratory Physical
Therapy (GECARE), Department of Physical
Therapy, Faculty of
Medicine, Universidade Federal do Rio de Janeiro
(UFRJ), Rio de Janeiro, RJ, Brazil
2Physical Education Undergraduation Program,
Universidade Federal do Rio de Janeiro
(UFRJ), Rio de Janeiro, RJ, Brazil
3Laboratory of Cardiovascular Physical Therapy,
Department of Physical Therapy, UFSCar, São Carlos,
SP, Brazil
4Laboratory of Cardiopulmonary Physical Therapy,
2. Department of Physical Therapy, Universidade
Federal de São
Carlos (UFSCar),São Carlos, SP, Brazil
!
!
Received September 21, 2016; accepted April
18, 2017
Objective: The aim of this study was to
evaluate the effect of continuous positive
airway pressure
(CPAP) on the exercise tolerance of patients with
moderate to severe chronic obstructive
pulmonary
disease (COPD). Methods: ten men with COPD (69 ±
9 years), FEV1/FVC (58.90 ± 11.86%)
and FEV1
(40.98 ± 10.97% of predict) were submitted to a
symptom-limited incremental exercise test (IT) on
the cyclo ergometer. Later, on another visit,
they were randomized to perform a
constant load
exercise protocol until maximal tolerance with and
without CPAP (5cmH2O) in the following
conditions: i) 50% of the peak workload; and ii)
75% of the peak workload. Heart rate (HR),
arterial
3. pressure (AP) and peripheral oxygen saturation
were obtained at rest and during the
exercise
protocols. For statistical procedures, Shapiro-Wilk
normality test and two-way ANOVA with Tukey
post hoc (p<0.05) were performed. Results: There
was a signi`icant improvement in exercise
time
tolerance during the 75% of the peak workload
protocol with CPAP when compared with
spontaneous breath (SB) (438±75 vs. 344±73ms,
respectively). Conclusion: CPAP with 5 cmH2O
seems to be useful to improve exercise
tolerance in patients with COPD.
!
!
!
!
!
!
Corresponding Author
Michel SilvaReis ([email protected])
!
Journal of Respiratory and CardioVascular
Physical Therapy
4. KEYWORDS:
Noninvasive
ventilation;
COPD;
exercise
tolerance;
CPAP
mailto:[email protected]
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
INTRODUCTON
Patients with chronic obstructive pulmonary disease
(COPD) present a reduced physical exercise
tolerance that
can be determined by ventilatory and/or
peripheral
mechanism1,2. Progressive increase in the expiratory
air`low resistance, which limits the tidal
volume gain
beyond the expiratory and inspiratory reserve
volumes,
may be accentuated because these patients
ventilate in
5. higher pulmonary volumes at rest. Thus, they
reach the
maximal pulmonary capacity during physical
exercise
early3. Nowadays, peripheral muscular dysfunction
has
gained evidence, mainly its in`luence on the
premature
physical exercise interruption4. Facts such as
chronic
hypoxemia, oxidative stress, nutritional depletion,
peripheral muscular disuse, medicament effects and
vagal-
sympathetic imbalance contribute to this
peripheral
muscular dysfuction4. Beyond these factors,
another
limiting capacity aspect of physical exercise is
the blood
`low redistribution to peripheral muscles despite
the
ventilatory muscles, especially in high intensity
exercises5.
6. Hence, thereare known forms to decrease the
ventilatory
overload with repercussion on physical exercise
tolerance
such as oxygen supplementation6,7, the use of
bronchodilators8, heliox9,10,11,12,13 and non-invasive
ventilation (NIV)1,9,14,15. NIV improves the
functional
residual capacity by reducing the pulmonary shunt,
generating a higher ventilatory reserve16.
Furthermore, it
reduces the work of breathing and it has been
explored in
recent study during physical activity with COPD
patients5
and otherchronic diseases17, sincethereis a
reduction in
sympathetic response in peripheral musculature,
which
promotes a higher blood `low with higher
tolerance on
physical exercise5,17.
7. Therefore, our study has the objective to
evaluate acute
effects of continuous positive airway pressure
(CPAP) on
physical exercise capacity of COPD subjects.
!
MATERIALS ANDMETHODS
Subject
Ten men with a clinical diagnosis of COPD
volunteered to
participate in this cross-sectional study.
Subjects were
recruited from a public primary health care facility
and to
be included in the study presented with the
following
characteristics: stable pulmonary function with forced
!
expiratoryvolume in the `irst second/forced vital
capacity
(FEV1/FVC) < 70%18, ex-smokers, and presenting
dyspnea
and symptoms with minor or moderate efforts19.
8. Exclusion
criteria were: consumption of alcoholic beverages,
usersof
addicting drugs, and regular physical activity in
the past six
months. All subjects were submitted to clinical
evaluation
and pulmonary function tests, functional
capacity
evaluation according to the British Modi`ied
Medical
Research Council (MRC)19, biochemical tests,
electrocardiogram (ECG) and a symptom-limited
physical
exercise test prior to the study. All of them
signed an
informed consent form, and the protocol was
approved by
the Ethics Committee from Universidade
Federal de São
Carlos (UFSCar),São Carlos, SP, Brazil (protocol
238/06).
Experimental protocol
9. The research was conducted in an acclimatized
laboratory
at temperatures between
22 °C and 24 °C and relative humidity between
50% and
60%,during the same period of the day (between 8
a.m.
and 12 p.m.). Prior to and on the day of
the test, each
subject was asked to ensure they avoided
consumption of
stimulating beverages and physical activity for
24 hours,
and consumed light meals and slept for at least eight
hours.
Initially, the subjects were familiarized with the
experimental equipment and environment and the
researchers involved in the study. Prior to the
tests, they
were evaluated and examined to ensure that the
directions
given had been strictly followed. In addition, systolic
and
10. diastolic blood pressure, lungauscultation and
peripheral
saturation of Oxigen (SpO2) were assessed.
Pulmonary function
Spirometry was performed using a
Vitalograph®
spirometer (Hand-Held 2021 instrument. Ennis,
Ireland).
The FVC test was conducted to determine
the FEV1 and
FEV1/FVC ratio. Technical procedures, criteria
for
acceptability and reproducibility, were performed
according to the guidelinesrecommended by the
American
Thoracic Society20. The reference values used were
those
suggested by Knudson et al. 21.
Incremental physical exercise protocol
The assessment was performed by a cardiologist
to
determine the maximum load the patients were
11. able to
achieve. In addition, this step was considered
important to
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
assess clinical and functional conditions of
the
cardiovascular and peripheral muscular systems of
the
subjects and to identify evidence of cardiorespiratory
comorbidities elicited by physical exercise. Initially,
the
patients were evaluated using an ECG with the
standard 12-
lead ECG, followed by the evaluation of the
electrocardiographicsignal from the derivations
MC5, DII
modi`ied and V2 in the following conditions: supine,
sitting,
apnea (15 s) and hyperventilated (15 s). The
exercise test
was performedon a cycloergometerwith electromagnetic
12. brakes (Quinton 400 Corival Ergometer, Groningen,
Netherlands) and power increments externally
controlled
by a microprocessor model Workload
Program (Quinton,
Groningen, Netherlands). The subjects remained seated
with the knees `lexed at 5-10°. Initially, a 2-
minute warm up
period was performed with no load,
corresponding to 4
watts (W). Following the warm up, the subjects
performed
increments of 5W every 3 minutes at 60
rpm, until physical
exhaustion or it was impossible for them to
maintain the
pedaling speed. The test was stopped on the `irst
indications of signs and/or symptoms such
as dizziness,
nausea, cyanosis, complex arrhythmias, excessive
sweating,
13. angina and peripheral oxygen desaturation. During
the test,
they were monitored from the MC5 derivation, DII
modi`ied
and V2. Measurements of heartrate (HR), blood
pressure
(auscultation method) and electrocardiographicrecordings
were performedin the 30 `inal seconds of each power
level
and at the 1st, 3rd, 6th and 9th minutes of
recovery. At the end
of the recovery period, with the subject in the
supine
position, the standard 12-lead ECG was performed.
In
addition to the aforementioned variables, using
formulae
recommended by the American Heart Association
(which
considers peak load and body mass), peak
oxygen
consumption (VO2 peak) achieved by the
subjects was
14. obtained. Throughout the test, peripheral oxygen
saturation (SpO2) was measured using pulse
oximetry
(Oxyfast, Takaoka, Brazil).
Protocol of constant load in spontaneous breath
and during
CPAP application
All tests were performedin four or two days (two tests
per
day) with an interval of 48 hours between the
days. For the
implementation of this protocol, initially, the
subjects were
kept at rest in the sitting position for about 10
minutes,
aiming to achieve basalvalues for HR. At the
same time,
instantaneous HR was obtained at rest in the sitting
position for 15 minutes. Subsequently, subjects were
randomized by drawing to perform submaximal
exercise at
15. a constant load until maximum tolerance, with and without
application of continuous positive airway
pressure (CPAP –
5 cm H2O, Breas PV101, Sweden) using a
Confortgel nasal
mask (Respironics, Murrysville, PA) under the
following
conditions: i) 50% of the peak load of the
incremental test
and ii) 75% of the peak load of the incremental
test.
Subjects were positioned in the horizontal
electronically
braked cyclo ergometer (Quinton 400 Corival
Ergometer,
Groningen, Netherlands) with knees `lexed
between 5° and
10°. Initially, they remained seated on the cycle
ergometer
at rest for 1 minute and then were instructed to
pedal at a
cadence of 60 rpm until maximum tolerance,
that was
16. de`ined when the subject could not keep the
cadence. SpO2
(Oxyfast, Takaoka, Brazil) and ECG (Eca`ix 500, São
Paulo,
Brazil), in leads MC5, DII modi`ied and V2,
were
continuously monitored throughout the
experimental
protocol. Blood pressure and the modi`ied BORG
scale(CR
– 10) were carefully veri`ied every two minutes to
avoid
interference in the collection of the variables.
Constant
workload tests were performedon a single day and at
the
same time to avoid circadian in`luenceswith an interval
of
30 minutes or until cardiovascular variables
returned to
baseline values. A team of trained researchers
conducted
the tests and carefully monitored the signs
and/or
17. symptoms of exercise intolerance and who could
determine
when to immediately stop the test. Data analysis
The maximum time for completion of the physical
exercise
during the protocol of constant workload was
identi`ied by
tolerance time. The HR, subjective sensation of
effort for
dyspnea, and discomfort of the lower limb
variables were
assessed at baseline and at the peak of the
protocol.
Statistical analysis
Data were subjected to a normality test (Shapiro-Wilk)
and
homogeneity test (Levene test).Since a normal
distribution
was observed, parametric statistical tests were used.
Next,
a two-way ANOVA test with Tuckey post hoc was
applied for
18. comparisons in the two exercise load conditions,
spontaneous breath and with CPAP. Analyses were
performed with GraphPad Instat 3 (San Diego,
CA, USA),
with a signi`icance level of p<0.05. All data were
presented
as means and standard deviation.
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
RESULTS
We had 24 COPD patients, from which 12
were excluded
and two abandoned the current study, resulting in
10
analyzed patients, as shown in Figure 1.
In Table 1 we can observe age, anthropometric
data, clinical
characteristics and incremental cardiopulmonary data of
the subjects. All individuals of the study were
mild to
19. moderate in Global initiative for chronic obstructive
lung
disease (GOLD)18 classi`ication, functional class
of MRC
between I and III and were with optimized drug
therapy.
Additionally, the incremental cardiopulmonary test
showed
that COPD patients present low functional
capacity (VO2
<15 ml/kg/min).
!
!
!
Table 2 exposes the cardiorespiratory data at
rest and
constant work load physical exercises with and
without
CPAP on the intensitiesof 50 and 75% of the
incremental
test. We noted a higher improve in the
physical exercise
time tolerance when the patients were with CPAP in
the
20. intensity of 75% of the incremental test compared
with the
condition without CPAP.
Figure 2 shows the time of tolerance to
physical exercise of
patients in the intensity of 75% of the incremental
test
without CPAP (SB) and with CPAP, in which
we can see
signi`icantly higher values with the use of CPAP
compared
with the spontaneous breath condition. (p<0.05).
!
!
!
Figure 1. Flowchart of the study.
!
!
!
!
!
!
!
!
21. !
24 eligible patients
12 patients
10 patients included
Two excluded
!
Abandoned the protocol (n=1)
Mobility issues by severe dyspnea (n=1)
12 excluded
!
Uncontrolled arterial blood pressure (n=4)
Current smokers (n=3)
Suspected cancer (n=2)
Refusal of participant (n=2)
Consumption of alcoholic beverage (n=1)
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
Table 1. Anthropometrics and clinical
characteristics of Chronic Obstructive Pulmonary
Disease (COPD) Subjects.
22. Values are means ± SD. FEV1: forced
expiratoryvolume in the `irst second; FEV1/FVC:
forced expiratoryvolume in the `irst
second and forced vital capacity ratio; SpO2:
peripheral oxygen saturation; RR: respiratory
rate; SAP: systolic arterial
pressure; DAP: diastolic arterial pressure; HR: heart
rate. MRC: Medical Research Council.
!
!
!
!
COPD (n=10)
Age (years) 69 ± 9
Height (cm) 167 ± 8.96
Weight (Kg) 64.44 ± 8.96
Body mass index (kg/m²) 23.21 ± 3.33
Spirometrics
FEV1 (L) 0.8 ± 0.2
FEV1 (% predict) 40.98 ± 10.97
FEV1/FVC (%) 58.90 ± 11.86
FVC (% predict) 68 ± 13
23. MRC
Class I n=1
Class II n=3
Class III n=6
Clinical characteristics
SpO2 (%) 92 ± 3
RR (ipm) 15 ± 4
Drugs
Short-acting bronchodilator 6
Long-acting bronchodilator 10
Incremental test
At rest
SAP (mmHg) 124 ± 11
DAP (mmHg) 75 ± 5
HR (bpm) 70 ± 12
Peak
SAP (mmHg) 171 ± 17
DAP (mmHg) 80 ± 9
24. HR (bpm) 110± 20
VO2peak (mL.kg.min) 10.15 ± 3.19
Power (watts) 27 ± 18
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
Table 2. Cardiopulmonary variables and Borg during
exercise
Values are means and SD. SB: spontaneous breath;
CPAP: continuous positive airway pressure;
RF: respiratory frequency in
incursionsper minute; HR: heartrate in beat per minute;
SAP:systolic arterial pressure; DAP: diastolic
arterial pressure;*
p<0.05: rest vs. exercise (t student paired test);Ϯ
p<0.05: SB vs. CPAP in 75% of incremental
test (two-way ANOVA with Tukey
post hoc).
�
Figure 2. Tolerance time for Chronic Obstructive
Pulmonary Disease Subjects during submaximal
exercise at 75% of
incremental test. SB: spontaneous breath. Median
(bold line).
26. Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
DISCUSSION
The main `inding of this study is the increase in
the time of
tolerance of physical exercise in the intensity of
75% of the
incremental test with CPAP compared with the
condition of
spontaneous breath.
The patients were eutrophic, with level of obstruction
of
expiratory air`low from mild to moderate;
all of them
maintained the use of medications during the
study
protocol. During the incremental test, all subjects
showed
an increase in the hemodynamic variables reaching a
mean
of the estimated VO2 in the peak of exercise of
10.15ml/kg/
min.
27. Regarding the increase in the time of tolerance in
the
condition of 75% of incremental test with CPAP,
our data
corroborate literature `indings. In another study
that
evaluated the time of tolerance of physical exercise of
patients with COPD from mild to moderate
with use of
proportional assisted ventilation with titled `lows
and
volumes of 5.8±0.9 cm H2O/l and 3.5±0.8 cm
H2O/l/s,
respectively, Borghi-Silva et al.5 observed a higher
tolerance
in the conditions with the ventilatory support in
higher
exercise intensities. In the same way,
Bianchi et al.22
showed that 15 patients with COPD presented higher
physical capacity with the association of proportional
assist
28. ventilation (PAV) (8.6±3.6 cm H2O/l and 3±1.3
cm H2O/l)
and high intensity physical exercise (80% of peak
workload). Dyer et al.14 , who studied hospitalized
patients
with COPD by acute exacerbation of the disease
without
hypercapnia, observed a mean increase of 147
seconds in
the pedal capacity with `ixedload of 20 watts of
patients
when submitted to NIV with two pressure levels
(Pressure
support ventilation of 10 cm H2O and PEEP of
5 cm H2O).
Lastly, a meta-analysis about NIV and COPD
performedby
Shi et al.23 showed that from `ive selected
studies24,25,26,27,
two of them had a positive association
between NIV and
physical exercise.
The use of NIV has been shown to be effective
29. for patients
with other chronic diseases that curse with
peripheral
dysfunction and consequently reduces the physical
exercise
tolerance. Reis et al.17 observed an increase in
time of
tolerance of physical exercise in patients with chronic
heart
failure with reduced left ventricular ejection fraction
when
submitted to CPAP of 5 cm H2O in the
intensity of 75% of
the incremental test.
!
The rational for these`indings base on the bene`its of
NIV
on the increase in functional residual capacity
with the
maintenance of expanded alveoli and consequent
increase
in ventilatory reserve and decrease in ventilatory
workload5,14,17. This effect is especially important
30. when NIV
is associated with physical exercise, since these
patients
may early interrupt the exercise by the increase in
the
expiratory air`low resistance and consequent
dynamic
hyperin`lation28. Additionally, we may also consider
that
the lower the ventilatory work demands, the
lower the
relative cardiac output to ventilatory muscles
decreasing
the sympathetic response of the peripheral
muscles and
consequently increasingthe blood `low and oxygen
supply
to this area, thus increasing the time of
physical
tolerance29,30.
Even though blood `low has not been directly
evaluated in
this study, our data allow to infer about the
possibility of
31. lower blood `low redistribution to the peripheral
muscles,
sincethe use of CPAP of 5 cm H2O was able to
signi`icantly
increase the time of tolerance in physical exercise in
a
constant workload protocol with high intensity (75% of
the
incremental test). Although the PEEP titration
was
recommended, the use of 5cm H2O already was
able to
generate a satisfactory response on the time of
tolerance of
thesepatients.
Curiously, the results of 75% of the incremental
test were
not reproduced with 50%.Probably, the imposed load on
the constant load protocol with 50% of the incremental
test
was insuf`icient to generate a high enough
metabolic
32. demand to increase the overload on ventilatory
muscles
and consequently earlyinterrupt the physical exercise.
The limitation of the study is the absence of
whole-body
plethysmography to measure the static volumes as
well as
the echocardiography to remove the possibility of
coexisting chronic heart failure and arterial blood
gas
analysis to separate the hypoxic and hypercapnic
patients.
As well as the small sample size, the recruitment
of men
only, and the participation of subjects only with mild
to
moderate severity disease.
!
!
!
!
Jour Resp Cardiov Phy Ther. 2016; 5(1): 12-20.
33. CONCLUSION
As exposed, our study observed improve in the
time
tolerance of physical exercise of patients with COPD
from
mild to moderate with CPAP with 5 cm H2O supply
during
the constant load protocol with 75% of the incremental
test.
!
ACKNOWLEDGMENTS
To Fundação Carlos Chagas de Apoio da
Pesquisa do Estado
do Rio de Janeiro (FAPERJ – protocol: E-
26/110.827/2012)
and to Conselho Nacional de Desenvolvimento
Cientí`ico e
Tecnológico (CNPq – protocol: 487375/2012-2),
for
`inancial support. Additionally, we thank our
colleagues
from the Research Group in Cardiorespiratory
34. Physical
Therapy (GECARE) from the Department of
Physical
Therapy, Universidade Federal do Rio de Janeiro
(UFRJ), Rio
de Janeiro, RJ, Brazil.
!
REFERENCES
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Journal Article Analysis
Choose a peer reviewed journal article.
Reference: (In AMA format)
Fedora M. The influence of early application of HFOV on
outcomes in pediatric acute respiratory distress syndrome. Scr
Med. 2010;74(4):233-244.
Overview of Article:
This article focuses on the effects of high frequency oscillatory
ventilation (HFOV) on infants with RDS. In RDS the gas
44. exchange is compromised which leads to poor oxygenation and
inflammation in the lungs. Patients with RDS will end up on a
ventilator and it’s important to use a mode of ventilation that
will be beneficial and give the best results. Because high
frequency oscillatory ventilation delivers smaller tidal volumes
at a faster rate, it increases the gas exchange and CO2
elimination which could be beneficial in treating RDS.
Major Points/Findings:
Through this study the researchers found that infants with RDS
showed a better recovery rate and decreased mortality rate by
using HFOV as an early treatment, instead of trying to use it as
a salvage therapy after other modes have failed. The researchers
discussed that by applying this therapy early, the process of
reversing the problem starts earlier, giving a better chance of
recovery. Smaller tidal volumes are more manageable for some
babies and HFOV is a protective mode that decreased secondary
issues due to RDS. With RDS the alveoli are collapsed, so it
required more pressure to open them up and keep them open. In
this mode, lower pressure was more effective, which resulted in
lower derecruitment of the alveoli.
Limitations of Research:
The study was done on 26 patients, 17 males and 9 females, in
one medical center, so these results were only tested on a small
group and mostly on one sex. This limits the applicability of the
results. Further testing is needed.
Application to Your Practice of Respiratory Therapy and/or the
overall impact to the field of Respiratory Care:
If this is proven to be true, it could change respiratory protocols
across the country in the treatment of RDS in infants. Even if
not in that magnitude, a therapist can still attempt to use the
mode in their personal practice to yield better results for their
patients. Every patient case is different and it is a critical skill
for the therapist to be able to evaluate their patient’s situation
45. and be able to problem solve and find a solution. This article
gives insight into a technique that can be used in infants with
RDS.
Reference: (In AMA format)
Overview of Article:
Major Points/Findings:
Limitations of Research:
46. Application to Your Practice of Respiratory Therapy and/or the
overall impact to the field of Respiratory Care: