Respiratory Care Year in Review 2010: Part 1. Asthma, COPD, Pulmonary Function Testing, Ventilator-Associated Pneumonia

Abstract

The purpose of this paper is to review the recent literature related to asthma, COPD, pulmonary function testing, and ventilator-associated pneumonia. Topics covered related to asthma include genetics and epigenetics; exposures; viruses; diet, obesity and exercise; exhaled nitric oxide; and drug therapy (␤ agonists, macrolides, tiotropium and monteleukast). Topics covered related to COPD include childhood disadvantage factors and COPD; vitamin D deficiency and COPD; ␤-blockers and COPD; corticosteroid therapy during COPD exacerbations; oxygen administration during 488RESPIRATORY CARE • APRIL 2011 VOL 56 NO 4 pre-hospital transport of patients with COPD exacerbation; and prognosis of patients admitted to the hospital for COPD exacerbation. Topics related to pulmonary function testing include methods and techniques; predicted values; natural history, pulmonary function in health and disease; and the COPD controversy. Finally, the paper includes the following topics related to ventilator-associated pneumonia: the tube, the intubation route, and the cuff; mechanical ventilation; the bundle; and cost. These topics were chosen and reviewed in a manner that is most likely to have interest to the readers of RESPIRATORY CARE.

A 2015 Update on Ventilator-Associated Pneumonia: New Insights on Its Prevention, Diagnosis, and Treatment

“…ETTs are associated with significant impairment of mucociliary clearance of secretions, the formation of bacterial biofilms upon the ETT polymer, microaspiration and leakage of oropharyngeal secretions around the inflated ETT cuff (Fig. 1) [10][11][12]. These are exacerbated in the context of positive pressure ventilation, which combines with gravity to move secretions and microorganisms into the distal respiratory tract.…”

Respiratory Care Year in Review 2012: Invasive Mechanical Ventilation, Noninvasive Ventilation, and Cystic Fibrosis

“…Using a cutoff of 25 mL/V, neuroventilatory efficiency measured at 5 min into the SBT had the highest predictive value for successful extubation (area under the receiver operating characteristic curve 0.84, P Ͻ .001). The breathing pattern of patients who failed had a more pronounced and sustained drop in both minute ventilation and V T , along with a rise in P aCO 2 . In other words, despite a very high degree of neuromuscular excitation, the diaphragm was unable to adapt to the increased work load.…”

“…At the American Association for Respiratory Care Congress 2012, RESPIRATORY CARE presented a series of lectures on the theme of "Year in Review." As done twice before, [1][2][3] topics were chosen that are likely to have special interest to the readers of RESPIRATORY CARE. In this paper we review topics related to invasive mechanical ventilation, noninvasive ventilation, and cystic fibrosis (CF).…”

Convergence in the Epidemiology and Pathogenesis of COPD and Pneumonia

“…Childhood pneumonia is particularly prevalent in lowincome countries and is regarded as one of the so-called "childhood disadvantage factors" that leads to ongoing impaired lung function (59,60). In one study, five childhood disadvantage factors, identified as maternal asthma, paternal asthma, childhood asthma, maternal smoking and childhood respiratory infections were prevalent in the general population and had a significant impact on lung function and development of COPD (59).…”