BackgroundTeaching mechanical ventilation at the bedside with real patients is difficult with many logistic limitations. Mechanical ventilators virtual simulators (MVVS) may have the potential to facilitate mechanical ventilation (MV) training by allowing Web-based virtual simulation.ObjectiveWe aimed to identify and describe the current available MVVS, to compare the usability of their interfaces as a teaching tool and to review the literature on validation studies.MethodsWe performed a comparative evaluation of the MVVS, based on a literature/Web review followed by usability tests according to heuristic principles evaluation of their interfaces as performed by professional experts on MV.ResultsEight MVVS were identified. They showed marked heterogeneity, mainly regarding virtual patient's anthropomorphic parameters, pulmonary gas exchange, respiratory mechanics and muscle effort configurations, ventilator terminology, basic ventilatory modes, settings alarms, monitoring parameters, and design. The Hamilton G5 and the Xlung covered a broader number of parameters, tools, and have easier Web-based access. Except for the Xlung, none of the simulators displayed monitoring of arterial blood gases and alternatives to load and save the simulation. The Xlung obtained the greater scores on heuristic principles assessments and the greater score of easiness of use, being the preferred MVVS for teaching purposes. No strong scientific evidence on the use and validation of the current MVVS was found.ConclusionsThere are only a few MVVS currently available. Among them, the Xlung showed a better usability interface. Validation tests and development of new or improvement of the current MVVS are needed.

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BACKGROUND: Although the internet is an important tool for entertainment, work, learning, shopping, and communication, it is also a possible source for information on health and disease. The aim of this study was to evaluate the proportion of subjects with COPD in São Paulo, Brazil, who use the internet to obtain information about their disease. METHODS: Subjects (N ‫؍‬ 382) with COPD answered a 17-question survey, including information regarding computer use, internet access, and searching for sites on COPD. Our sample was distributed according to the socioeconomic levels of the Brazilian population (low, 17.8%; medium, 66.5%; and high, 15.7%). RESULTS: Most of the subjects in the sample were male (62.6%), with a mean age of 67.0 ؎ 9.9 y. According to Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages, 74.3% of the subjects were in stage II or III. In addition, 51.6% of the subjects had a computer, 49.7% accessed the internet, and 13.9% used it to search for information about COPD. The internet was predominantly accessed by male (70.3%) and younger (64.6 ؎ 9.5 y of age) subjects compared with female (29.7%, P ‫؍‬ .04) and older (67.5 ؎ 9.6 y of age, P < .007) subjects. Searching for information about COPD on the internet was associated with having a computer (5.9-fold), Medical Research Council dyspnea level 1 (5.3-fold), and high social class (8.4-fold). The search for information on COPD was not influenced by GOLD staging. CONCLUSIONS: A low percentage of subjects with COPD in São Paulo use the internet as a tool to obtain information about their disease. This search is associated with having a computer, low dyspnea score, and high socioeconomic level.

There are no studies that have evaluated energy cost for COPD patients accomplishing the most common activities of daily Rationale living (ADL) Our aim was to develop a table with the energy and ventilatory costs of COPD patients accomplishing several common ADL.. Eighty COPD patients were analyzed by a portable ergoespirometer (K4 Cosmed) while performing 18 ADLs, during 5 minutes Methods: each: lateral lying, dorsal lying, sitting, standing, morning hygiene, bathing, put on and off clothes, put on and off shoes, domestic and office activities, going up and down a flight of stairs, walking for five minutes holding 2.5 Kg in each hand, walking for five minutes holding 5.0 Kg in one hand and go up and down a ramp.: Patient characteristics: mean age of 64.1±10.2 yrs, FEV /FVC of 0.48±0.12 and Results 1 FEV of 55.9±23.2%. 1 *p<0.05, pre vs. post activity.: Simple activities of daily living performed by COPD patients lead to a high ventilation (up to 65% of the ventilatory reserve), Conclusion cardiac requirement (up to72% of the cardiac reserve) and energy cost (up to 50% of maximum estimated VO2 or 2-4 times the rest value).