INTRODUCTION: Chest physiotherapy (CPT) may benefit children aged below five years who suffer from lower respiratory tract infection (LRTI). However, its effects depend on the technique used. This study aimed to determine whether mechanical CPT using the LEGA-Kid® mechanical percussion device is superior to manual CPT in children with LRTI. METHODS: Children aged five months to five years who were admitted and referred for CPT from January to April 2017 were randomised to either manual CPT or mechanical CPT with LEGA-Kid. Outcomes measured before intervention and two hours after intervention were respiratory rate (RR), oxygen saturation and modified Respiratory Distress Assessment Instrument (mRDAI) score. RESULTS: All 30 enrolled patients showed significant reduction in post-intervention RR and mRDAI scores. There was an 8% reduction in RR for the manual CPT group (p = 0.002) and a 16.5% reduction in the mechanical CPT group (p = 0.0001), with a significantly greater reduction in the latter (p = 0.024). mRDAI scores decreased by 2.96 in the manual group (p = 0.0001) and 3.62 in the mechanical group (p = 0.002), with no significant difference between the groups. There was no significant improvement in oxygen saturation, and no adverse events were observed after CPT. CONCLUSION Children receiving both manual and mechanical CPT showed improvements in respiratory distress symptoms, with no adverse effects. A combined strategy of nebulised hypertonic saline followed by CPT for LRTI removes airway secretions and results in improvements in moderately severe respiratory distress. The LEGA-Kid mechanical CPT method is superior to manual CPT in reducing the RR.
Child ; Humans ; Percussion/methods* ; Physical Therapy Modalities ; Respiratory Distress Syndrome ; Respiratory Therapy/methods* ; Respiratory Tract Infections ; Single-Blind Method

Administration, Sublingual ; Humans ; Immunotherapy ; methods ; Inflammation ; Respiratory Hypersensitivity ; therapy

Acute Disease ; Humans ; Intubation, Intratracheal ; methods ; Length of Stay ; Positive-Pressure Respiration ; methods ; Respiratory Insufficiency ; therapy

Recent clinical trials have shown that electrical stimulation has beneficial effects in obstructive sleep apnea syndrome (OSAS). The purpose of this study was to evaluate the efficacy of electrical stimulation therapy for OSAS with a meta-analysis. The meta-analysis of all relative studies was performed through searching international literature, including PUBMED, CNKI, and EMBASE databases. This literature analysis compared all patients undergoing electrical stimulation therapy with respect to the respiratory disturbance index (RDI) and changes in sleep structure. Six studies were selected involving a total of 91 patients. The meta-analysis indicated that electrical stimulation therapy reduced RDI, longest apnea time, and improved the minimum SaO2. Based on the evidence found, electrical stimulation may be a potential therapy for OSAS, warranting further clinical trials.
Electric Stimulation Therapy ; methods ; Humans ; Respiratory Mechanics ; physiology ; Sleep ; physiology ; Sleep Apnea, Obstructive ; physiopathology ; therapy

Adolescent ; Asthma ; therapy ; Child ; Humans ; Quality of Life ; Respiratory Therapy ; methods ; Surveys and Questionnaires ; Treatment Outcome

This paper introduces the adjusting principles of APV mechanical ventilation.
Equipment Design ; Humans ; Lung Diseases ; therapy ; Positive-Pressure Respiration ; instrumentation ; methods ; Respiration, Artificial ; instrumentation ; methods ; Respiratory Insufficiency ; therapy ; Respiratory Mechanics ; Tidal Volume

OBJECTIVETo observe the effects of neurally adjusted ventilatory assist (NAVA) on the patient-ventilator synchrony, gas exchange, and ventilatory parameters in preterm infants with respiratory distress syndrome (RDS) during mechanical ventilation.

METHODSTen preterm infants with RDS received mechanical ventilation in NAVA mode for 60 minutes and in synchronized intermittent mandatory ventilation (SIMV) mode for 60 minutes, and the two modes were given in a random order. The vital signs, patient-ventilator synchrony, blood gas values, and ventilatory parameters were compared between the two ventilation modes.

RESULTSInspiratory trigger delay was significantly shorter with NAVA than with SIMV (P<0.05). There were no significant differences in arterial pH, PaCO2, PaO2 and PaO2/FiO2 between the two modes. The spontaneous respiratory rate, peak inspiratory pressure (PIP), electrical activity of the diaphragm and work of breathing were significantly lower in NAVA than in SIMV (P<0.05).

CONCLUSIONSCompared with SIMV, NAVA appears to improve patient-ventilator synchrony, decrease PIP, and reduce diaphragmatic muscle load and work of breathing in preterm infants with RDS during mechanical ventilation.

Diaphragm ; physiology ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; Respiration, Artificial ; methods ; Respiratory Center ; physiology ; Respiratory Distress Syndrome, Newborn ; therapy

Extracorporeal membrane oxygenation (ECMO) is a kind of technique that uses extracorporeal circulation system to draw patients' blood into the circuit, and then oxygenate the blood when it passes along the membrane, followed by returning the blood into patients. At present, ECMO is mainly used in treating patients with respiratory failure and circulatory failure, for whom the conventional treatment such as mechanical ventilation and vasoactive drugs are invalid. ECMO can provide cardiopulmonary support for burn patients with respiratory failure or circulatory failure, and put the heart and lung at rest. The purpose of this paper is to review the application of ECMO in the treatment of severe burn.
Burns ; therapy ; Critical Care ; methods ; Extracorporeal Membrane Oxygenation ; methods ; trends ; Humans ; Respiration, Artificial ; Respiratory Insufficiency ; therapy ; Severity of Illness Index

Objective: To compare the efficacy of high-flow nasal cannula oxygen therapy (HFNC) and non-rebreather face mask (NRFM) in the treatment of mild acute carbon monoxide poisoning (ACOP) in reducing carboxyhemoglobin (COHb) , and to explore the feasibility of HFNC in the treatment of ACOP. Methods: Patients with mild ACOP with COHb >10% who were admitted to the emergency department of Northern Jiangsu People's Hospital from January 2015 to December 2020 were analyzed, and those with altered consciousness, mechanical ventilation and those requiring hyperbaric oxygen therapy were excluded. The patients were divided into HFNC group and NRFM group according to the oxygen therapy used in the emergency department. The COHb decline value and COHb half-life in the two groups were observed. Results: Seventy-one patients were enrolled, including 39 in the NRFM group and 32 in the HFNC group. The baseline COHb in the HFNC group was 24.8%±8.3%, and that in the NRFM group was 22.5%±7.1%, with no significant difference between the two groups (t=1.27, P=0.094) . At 60 min, 90 min and 120 min of treatment, COHb in both groups decreased, but the COHb in HFNC group was lower than that in NRFM group at the same time point (P<0.05) . After 1 h of treatment, the COHb decrease in the HFNC group (16.9%±4.5%) was significantly higher than that in the NRFM group (10.1%±7.8%) (t=4.32, P=0.013) . The mean half-life of COHb in the HFNC group (39.3 min) was significantly lower than that in the NRFM group (61.4 min) (t=4.69, P=0.034) . Conclusion: HFNC treatment of mild ACOP can rapidly reduce blood COHb level, it is a potential oxygen therapy method for clinical treatment of ACOP.
Humans ; Carbon Monoxide Poisoning/therapy* ; Cannula ; Respiration, Artificial ; Masks ; Oxygen Inhalation Therapy/methods* ; Carboxyhemoglobin ; Oxygen/therapeutic use* ; Respiratory Insufficiency/therapy*

The goal of mechanically ventilating patients with acute respiratory distress syndrome (ARDS) is to ensure adequate oxygenation and minimal ventilator-associated lung injury. Non-invasive ventilation should be cautiously used in patients with ARDS. Protective ARDS mechanical ventilation strategies with low tidal volumes can reduce mortality. Driving pressure is the most reasonable parameter to optimize tidal volume. Available evidence does not support the routine use of higher positive end expiratory pressure (PEEP) in patients with ARDS. The optimal level of PEEP may be titrated by the inflection point obtained from static pressure-volume curve. Promising therapies include prone position ventilation, high frequency oscillatory ventilation and extracorporeal membrane oxygenation as salvage treatment. While mechanically ventilating, it is also important for ARDS patients to maintain spontaneous breathing via assisted ventilation mode such as bilevel positive airway pressure, pressure support ventilation and neurally adjusted ventilation assist. Exogenous surfactant, inhaled nitric oxide, bronchodilators, airway pressure release ventilation and partial liquid ventilation are not recommended therapies.
Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; methods ; Respiratory Distress Syndrome, Adult ; therapy ; Tidal Volume