No abstract

An integrating pneumotachograph designed for use in neonates and small children was described by Lunn, Molyneux & Pask in 1965,' and later evaluated by OwenThomas.2 A Greer defocusing manometer was used to measure the differential pressure across an airflow resistance, and this response was electrically integrated with respect to time to read minute volume; the electrical circuit was arranged to respond to flow in one direction only.In our hands this instrument was found to have some disadvantages when used clinically.The principal problems were zero drift which resulted in progressive errors in calibration of the instrument and condensation in the flowhead.The effects of this condensation were demonstrated experimentally using a 'dummy-lung' and ventilator system. When dry gas at ambient temperature was passed through the pneumotachograph whilst the head was also at ambient temperature, the readings remained stable. However, if the gas was saturated with water vapour at 37°C and passed through the head at ambient temperature, considerable inaccuracies were seen after 5 min. Stability was restored when the pneumotachograph head was maintained at 37°C (Fig. 1).Accordingly the electrical circuit and flowhead have been redesigned to eliminate these disadvantages, and the instrument will be described in its modified form. The pneumotachograph assemblyThe pneumotachograph head In principle the head is similar to a Fleisch head, but using a strip of corrugated copper rolled into a cylinder as the airflow resistance (Fig. 2). The head is encased in a water jacket through which water circulates at a temperature which maintains the interior of the head at 37-38°C. It has a dead space of 6 ml.A pressure transducer, calibrated with an inclined water manometer and linked to an oscillographic (U.V.) recorder, was used to measure the resistance.

An introduction: (comprising context and problem statement) The prevalence of obesity in adults with COPD and asthma is up to 40%. Obesity has been associated with increased dyspnoea, exercise limitation and decreased lung-function. This is compounded by physical inactivity. Interventions with a combined dietary and physical activity component are the most effective in delivering health related outcomes. Consequently, a multidisciplinary approach was employed to develop a targeted weight management programme for individuals referred from a respiratory rehab unit.Short description of practice change implemented: A collaborative approach between dietetics and physiotherapy was utilised to develop a group weight management programme, promoting self efficacy and self management. Input was received from other members of the MDT such as Social Work, Pharmacy and Occupational Therapy.Aim and theory of change: Develop a dietetic and physiotherapy co-lead group programme aimed at improving physical activity, anthropometric status and overall quality of life of individuals with obesity and respiratory disease. Targeted population and stakeholders: Individuals with asthma or COPD with a BMI ≥30kg/m2Timeline: Participants attended physiotherapy for 30 minutes and dietetics for 90 minutes once a week for 8 weeks, with follow up at 6 weeks, 3 months, 6 months and 12 months.Highlights: (innovation, Impact and outcomes) This is the first programme of its kind in Ireland.It encompassed behaviour change strategies empowering self-efficacy and self monitoring, with a multidisciplinary approach at the core. The programme was tailored to the specific needs of the participant group.Qualitative and quantitative outcomes were measured, using weight, BMI, waist circumference, EQ-5D-3L, 6 Minute Walk Test (6MWT), COPD Assessment Test (CAT) and HAD scale.Comments on sustainability: This model required significant time in development and set up, ≥7 hours per week. Once the framework was developed, approximately 0.1WTE Physiotherapy, 0.3WTE Dietetics and 0.1WTE admin were required per group.

No abstract

No abstract