Measurement of thoraco-abdominal synchrony using respiratory inductance plethysmography: technical aspects and a proposal to overcome its limitations.

Background: Thoraco-abdominal asynchrony (TAA) is usually assessed by respiratory inductance plethysmography. The main parameter used for its assessment is the calculation of the phase angle based on Lissajous plots. However, there are some mathematical limitations to its use.

Ventilators, Settings, Autotitration Algorithms.

The choice of a ventilator model for a single patient is usually based on parameters such as size (portability), presence or absence of battery and ventilatory modes. However, there are many details within each ventilator model about triggering, pressurisation or autotitration algorithms that may go unnoticed, but may be important or may justify some drawbacks that may occur during their use in individual patients. This review is intended to emphasize these differences.

Higher mortality and intubation rate in COVID-19 patients treated with noninvasive ventilation compared with high-flow oxygen or CPAP.

The effectiveness of noninvasive respiratory support in severe COVID-19 patients is still controversial. We aimed to compare the outcome of patients with COVID-19 pneumonia and hypoxemic respiratory failure treated with high-flow oxygen administered via nasal cannula (HFNC), continuous positive airway pressure (CPAP) or noninvasive ventilation (NIV), initiated outside the intensive care unit (ICU) in 10 university hospitals in Catalonia, Spain. We recruited 367 consecutive patients aged ≥ 18 years who were treated with HFNC (155, 42.

Does the Efficacy of High Intensity Ventilation in Stable COPD Depend on the Ventilator Model? A Bench-to-Bedside Study.

Purpose: The European Task Force for chronic non-invasive ventilation in stable COPD recommends the use of high pressure-support (PS) level to maximize the decrease in PaCO2. It is possible that the ventilator model can influence the need for higher or lower pressure levels.

Research Question: To determine the differences between ventilators in a bench model with an increased inspiratory demand; and to compare the degree of muscular unloading measured by parasternal electromyogram (EMGpara) provided by the different ventilators in real patients with stable COPD.

A bench-to-bedside study about trigger asynchronies induced by the introduction of external gas into the non-invasive mechanical ventilation circuit.

Treatments that require the introduction of external gas into the non-invasive ventilation (NIV) circuit, such as aerosol and oxygen therapy, may influence the performance of the ventilator trigger system. The aim of the study was to determine the presence and type of asynchronies induced by external gas in the NIV circuit in a bench model and in a group of patients undergoing chronic NIV. Bench study: Four ventilators (one with two different trigger design types) and three gas sources (continuous flow at 4 and 9 l/min and pulsatile flow at 9 l/min) were selected in an active simulator model.

Integrated 3D printing solution to mitigate shortages of airway consumables and personal protective equipment during the COVID-19 pandemic.

Background: To cope with shortages of equipment during the COVID-19 pandemic, we established a nonprofit end-to-end system to identify, validate, regulate, manufacture, and distribute 3D-printed medical equipment. Here we describe the local and global impact of this system.

Methods: Together with critical care experts, we identified potentially lacking medical equipment and proposed solutions based on 3D printing.

Relationship between the respiratory microbiome and the severity of airflow limitation, history of exacerbations and circulating eosinophils in COPD patients.

Background: The respiratory microbiome is altered in COPD patients but its relationship with core components of the disease, such as the severity of airflow limitation, the frequency of exacerbations or the circulating levels of eosinophils, is unclear.

Methods: Cross-sectional study comprising 72 clinically stable COPD patients (mean age 68 [SD 7.9] years; FEV1 48.

Basic Concepts for Tidal Volume and Leakage Estimation in Non-Invasive Ventilation.

Non-invasive ventilation (NIV) aims to maintain sufficient alveolar ventilation, improve pulmonary gas exchange, assist respiratory muscles, and decrease work of breathing. Monitoring variables such as leaks, tidal volume, and minute ventilation during therapy is crucial to assess the effectiveness of NIV. However, most of the time, leaks and tidal volume are not measured but estimated by NIV devices.

Titration of Mechanical Insufflation-Exsufflation Optimal Pressure Combinations in Neuromuscular Diseases by Flow/Pressure Waveform Analysis.

Introduction: The aim of this study was to assess several air-pressure settings for MI-E to determine their effect on peak cough flow (PCF), and to compare the best pressures with those are more common used in the literature (±40cmHO) in patients with neuromuscular disorders (NMD).

Methods: Adults with NMD in whom MI-E was indicated were recruited. Assisted PCF was measured by an external pneumotachograph.

Effect of a rehabilitation-based chronic disease management program targeting severe COPD exacerbations on readmission patterns.

Background: Pulmonary rehabilitation (PR) is recommended after a severe COPD exacerbation, but its short- and long-term effects on health care utilization have not been fully established.

Aims: The aims of this study were to evaluate patient compliance with a chronic disease management (CDM) program incorporating home-based exercise training as the main component after a severe COPD exacerbation and to determine its effects on health care utilization in the following year.

Materials And Methods: COPD patients with a severe exacerbation were included in a case-cohort study at admission.