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[Guidelines for the management of chronic cough in adults]. Rev Mal Respir 2023; 40:432-452. [PMID: 37080877 DOI: 10.1016/j.rmr.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/03/2023] [Indexed: 04/22/2023]
Abstract
Patients with chronic cough experience major alteration in their quality of life. Given its numerous etiologies and treatments, this disease is a complex entity. To help clinicians involved in patient management of patients, guidelines have been issued by a group of French experts. They address definitions of chronic cough and initial management of patients with this pathology. We present herein the second-line tests that might be considered in patients whose coughing has persisted, notwithstanding initial management. The experts have also put forward a definition of unexplained or refractory chronic cough (URCC), the objective being to more precisely identify those patients whose cough persists despite optimal management. Lastly, these guidelines indicate the pharmacological and non-pharmacological interventions of use in URCC. Amitriptyline, pregabalin, gabapentin or morphine combined with speech and/or physical therapy are mainstays in treatment strategies. Other treatment options, such as P2X3 antagonists, are being developed and have generated high hopes among physicians and patients alike.
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La kinésithérapie respiratoire en 2022 : une approche multimodale. Rev Mal Respir 2022; 39:319-320. [DOI: 10.1016/j.rmr.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 10/18/2022]
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High-flow nasal cannula therapy, factors affecting effective inspired oxygen fraction: an experimental adult bench model. J Clin Monit Comput 2021; 36:1441-1448. [PMID: 34877626 PMCID: PMC8651462 DOI: 10.1007/s10877-021-00784-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 11/25/2021] [Indexed: 12/02/2022]
Abstract
Oxygenation through High Flow Delivery Systems (HFO) is described as capable of delivering accurate FiO2. Meanwhile, peak inspiratory flow \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I ) of patients with acute hypoxemic respiratory failure can reach up to 120 L/min, largely exceeding HFO flow. Currently, very few data on the reliability of HFO devices at these high \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I are available. We sought to evaluate factors affecting oxygenation while using HFO systems at high \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I in a bench study. Spontaneous breathing was generated with a mechanical test lung connected to a mechanical ventilator Servo-i®, set to volume control mode. Gas flow from a HFO device was delivered to the test lung. The influence on effective inspired oxygen fraction of three parameters (FiO2 0.6, 0.8, and 1, \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I from 28 to 98.1 L/min, and HFO Gas Flows from 40 to 60 L/min) were analyzed and are reported. The present bench study demonstrates that during HFO treatment, measured FiO2 in the lung does not equal set FiO2 on the device. The substance of this variation (ΔFiO2) is tightly correlated to \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I (Pearson’s coefficient of 0.94, p-value < 0.001). Additionally, set FiO2 and Flow at HFO device appear to significatively affect ΔFiO2 as well (p-values < 0.001, adjusted to \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I ). The result of multivariate linear regression indicates predictors (\documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I , Flow and set FiO2) to explain 92% of the variance of delta FiO2 through K-Fold Cross Validation. Moreover, adjunction of a dead space in the breathing circuit significantly decreased ΔFiO2 (p < 0.01). The present bench study did expose a weakness of HFO devices in reliability of delivering accurate FIO2 at high \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I as well as, to a lesser extent, at \documentclass[12pt]{minimal}
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\begin{document}$$\dot{V}_{{\text{I}}}$$\end{document}V˙I below equivalent set HFO Flows. Moreover, set HFO flow and set FIO2 did influence the variability of effective inspired oxygen fraction. The adjunction of a dead space in the experimental set-up significantly amended this variability and should thus be further studied in order to improve success rate of HFO therapy.
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The 3 Minute Step Test is a validated field test to evaluate the functional exercise capacity in children aged 6 to 12. Respir Med Res 2021; 80:100833. [PMID: 34147867 DOI: 10.1016/j.resmer.2021.100833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/10/2021] [Accepted: 05/26/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Field tests are useful to assess the functional exercise capacity. The 6minute walking test (6MWT) is the most common field test even if alternatives are needed. The main aim of the study was to verify if the 3minute step test (3MST) is a valid tool to measure the functional exercise capacity and can surrogate the 6MWT in healthy children from 6- to 12-years-old. METHODS This randomized cross-over trial recruited 30 healthy children from 6 to 12 years. One 6MWT and two 3MST (3MST1 and 3MST2) were performed randomly on 3 consecutive days. The variables were the distance (6MWT), the number of steps (3MST) and the cardiorespiratory parameters. RESULTS The distance walked during 6MWT was very strongly correlated to the number of steps during the 3MST (3MST1: rho=0.833; P<0.001 and 3MST2: rho=0.868; P<0.001). Heart rate (HR) was lower than the theoretical maximal HR at the end of both tests. The change in HR and perceived fatigue were significantly higher after the 3MST. A learning effect was observed in the 3MST (+8 steps; P<0.001). CONCLUSIONS The 3MST is validated and can be a surrogate for the 6MWT in healthy children population between 6 and 12 years old. A training test is required in these children.
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[Which physical tests for which objectives in pulmonary rehabilitation?]. Rev Mal Respir 2021; 38:646-663. [PMID: 33895033 DOI: 10.1016/j.rmr.2021.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/25/2021] [Indexed: 11/19/2022]
Abstract
Chronic respiratory disease is a major cause of morbidity and mortality worldwide and an important cause of disability including a reduction of exercise, functional and muscle capacity contributing to a decreased quality of life. In the context of pulmonary rehabilitation, a thorough patient-centered outcome assessment, including not only measures of lung function, but also exercise functional and muscle capacity, is imperative for a comprehensive disease management. Assessment of these impairments and dysfunctions with appropriate and change-sensitive procedures is thus necessary for personalizing the physical interventions and assessing the short- and long-term effectiveness of the intervention. The clinician currently has a wide variety of tests and measurements available to assess the physical and functional capacity of people with chronic respiratory disease. The aim of this review is to provide a pragmatic synthesis of the physical, functional and muscle capacity tests most commonly used in pulmonary rehabilitation. Ultimately, it should help the clinician to identify the relevant evaluations according to the objectives of the patients but also according to the available resources, the setting of pulmonary rehabilitation and the specific qualities of each test.
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[Good practice for aerosol therapy by nebulization in 2020]. Rev Mal Respir 2020; 38:171-176. [PMID: 33288396 DOI: 10.1016/j.rmr.2020.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 07/21/2020] [Indexed: 11/16/2022]
Abstract
Nebulization is a drug delivery mode whose prescription and application remain uncertain. A guide to good practice has been proposed by the work group on aerosol therapy of the French Society for Respiratory Diseases, so-called GAT. The previous recommendations date from 2007. In addition to an update of data on nebulization, these expert recommendations aim to be of real help to the prescriber.
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Nebulization: A potential source of SARS-CoV-2 transmission. Respir Med Res 2020; 78:100778. [PMID: 32763845 PMCID: PMC7399661 DOI: 10.1016/j.resmer.2020.100778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/11/2020] [Accepted: 06/14/2020] [Indexed: 01/22/2023]
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One-minute sit-to-stand test as an alternative tool to assess the quadriceps muscle strength in children. Respir Med Res 2020; 78:100777. [PMID: 32623309 DOI: 10.1016/j.resmer.2020.100777] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/02/2020] [Accepted: 06/05/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND Clinical tools for assessment of the skeletal muscle strength are scarce and have rarely been validated in children. The aims of this study were to verify the construct validity of the one-minute sit-to-stand test (1-MSTST) to evaluate the quadriceps strength in healthy children between 12 and 18 years old and to correlate these outcomes with the anthropometric parameters. METHODS Healthy children were recruited and consecutively performed 1-MSTST and maximal voluntary contraction of the quadriceps (QMVC). RESULTS Eighty-three children (15±2 years old) were analyzed. Contrarily to the QMVC, neither the number of 1-MSTST repetitions nor the sit-to-stand work (1-MSTST expressed as the product of body weight) differed between genders. The QMVC was not correlated with the number of repetitions (rho=-0.056; P=0.617) but correlated with 1-MSTST when expressed as a product of body weight (r=0.491; P<0.001). The QMVC was also correlated with age (r=0.314; P=0.004), height (r=0.672; P<0.001), weight (r=0.721; P<0.001) and BMI (r=0.451; P<0.001) whereas 1-MSTST did not correlate with any of these parameters. The leg length was related to the results of both tests. CONCLUSION We demonstrated that the one-minute sit-to-stand test can be considered as a valid and valuable alternative to evaluate the muscle strength when expressed as the product of body weight.
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Concordance between superficial swab and deep sampling in post-sternotomy mediastinitis: Single center experience. J Infect Chemother 2019; 25:589-593. [PMID: 31005566 DOI: 10.1016/j.jiac.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 12/23/2018] [Accepted: 03/04/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES Deep sampling (DS) is the gold standard for microbiological diagnosis of post-sternotomy mediastinitis (PSM), however superficial swab (SS) are frequently performed in some centers and antibiotherapy initiated base on their results. We analysed the concordance between superficial swab and deep sampling in PSM. MATERIALS AND METHODS We analysed retrospectively patients with a PSM between 2010 and 2014 at Saint-Luc University hospital (Belgium). We considered that there was a concordance between SS and DS when the same microorganism was found in the two sampling method in each patient. Patients were stratified in six groups according to microbiology results as Staphylococcus Aureus (SA) sensitive or resistant, coagulase negative Staphylococcus (CoNS), Gram negative bacilli (GNB), other Gram positive bacteria (GPB) and fungi. RESULTS Thirty-six patients were included. Twenty-five men (69%) and a mean age of 66 years old. The overall concordance between SS and DS was 57%. SA and GNB showed high concordance (100% and 85.7% respectively). For the other groups the concordance was low. The sensitivity and specificity of SS was 97% and 33% respectively. The PPV and NPV of superficial swab was 96% and 50% respectively. CONCLUSION Microbiological results from SS, even with flocked swabs, except for SA and GNB have low concordance with those obtained from deep sampling. Our data confirm that in PSM, deep sampling is the gold standard for microbiological assessment.
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Efficacy of yoga, tai chi and qi gong on the main symptoms of chronic obstructive pulmonary disease: A systematic review. Respir Med Res 2019; 75:13-25. [PMID: 31235453 DOI: 10.1016/j.resmer.2019.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/19/2019] [Accepted: 04/08/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The aim of this systematic review was to summarize the effects of yoga, qi gong or tai chi in COPD patients. METHODS Studies evaluating effects of the selected complementary therapies on lung function, dyspnea, quality of life or functional exercise capacity in COPD patients were identified and reviewed from three databases. RESULTS Eighteen studies were included. Six studies evaluated the effects of yoga and the others focused on tai chi or qi gong separately or combined. The duration of the programs ranged from 6 weeks to 6 months and the frequency from 2 to 7 times a week. Each session reached 30 to 90 minutes. Benefits were observed on lung function and functional exercise capacity but benefit was clearly stated neither on quality of life nor on dyspnea. CONCLUSION This systematic review highlights the potential of these therapies as complementary therapeutic approach in COPD patients.
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WS04.2 Immediate effects of autogenic drainage on ventilatory mechanics in CF adult patients. J Cyst Fibros 2017. [DOI: 10.1016/s1569-1993(17)30176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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[Non-pharmacological management in acute COPD exacerbations]. Rev Mal Respir 2017; 34:477-486. [PMID: 28495297 DOI: 10.1016/j.rmr.2017.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Management of acute exacerbations of chronic obstructive pulmonary disease (COPD). Guidelines from the Société de pneumologie de langue française (summary). Rev Mal Respir 2017; 34:282-322. [DOI: 10.1016/j.rmr.2017.03.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 08/31/2016] [Indexed: 11/25/2022]
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37th International Symposium on Intensive Care and Emergency Medicine (part 1 of 3). Crit Care 2017. [PMCID: PMC5374603 DOI: 10.1186/s13054-017-1628-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Effets à court terme du drainage autogène sur la mécanique ventilatoire de patients adultes atteints de mucoviscidose. Rev Mal Respir 2017. [DOI: 10.1016/j.rmr.2016.10.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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WS21.3 Short-term effects of hypertonic saline nebulization combined with oscillatory positive expiratory pressure in cystic fibrosis: randomised crossover trial. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30178-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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ePS04.2 The importance of the mundane-effect of a new simplified hygiene standard on nebulizer contamination. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30215-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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[Impact of physical exercise in cystic fibrosis patients: A systematic review]. Rev Mal Respir 2016; 33:573-82. [PMID: 27209116 DOI: 10.1016/j.rmr.2015.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/20/2015] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Beneficial effects of physical exercise have been previously demonstrated in patients with chronic obstructive pulmonary disease. The aim of this systematic review was to summarize the evidence supporting physical exercise to improve on lung function, exercise capacity and quality of life in cystic fibrosis patients. METHODS Medline database was used to search clinical studies from 2000 to 2015. We also analyzed the bibliographic section of the included studies, in order to identify additional references. RESULTS A total of 17 studies were identified. A great disparity was found in the results of the different studies. No systematic benefit was found on lung function, exercise capacity or quality of life. No relationship between the type of program and the benefits achieved was observed. CONCLUSIONS Evidence that physical exercise benefits lung function, exercise capacity and quality of life in cystic fibrosis patient is inconsistent and evidence does not support a particular standardized program for all patients.
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An evaluation of different steam disinfection protocols for cystic fibrosis nebulizers. J Cyst Fibros 2016; 15:78-84. [DOI: 10.1016/j.jcf.2015.07.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 07/16/2015] [Accepted: 07/16/2015] [Indexed: 10/23/2022]
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Non-invasive ventilation: evaluation of CO2 washout by intentional leaking in three recent oronasal masks. A pilot study. Minerva Anestesiol 2015; 81:526-532. [PMID: 25317575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Many types of interfaces with intentional leaks exist for Non Invasive Ventilation. The purpose of intentional leaks is to remove CO2 from the interface, however the calibration does not allow a sufficiently large flow and rebreathing of CO2 can occur. The aim of this study was to compare the CO2 rinsing capacities of three new generation oronasal masks with intentional leaks (A: Quattro®, [Resmed]; B: Amara® [Respironics]; C: Forma® [Fisher&Paykel]) in healthy subjects. METHODS Seventeen healthy volunteers were included in this prospective cross-sectional, randomized, double-blinded trial. Each subject underwent ventilation with a home ventilator (IPAP: 14 cmH2O; EPAP: 4 cmH2O) with each mask consecutively. Transcutaneous capnography (PtcCO2) recordings were carried out throughout the trial and ventilator data (tidal volume, respiratory rate, minute ventilation and unintentional leaks) were also analyzed. Mask comfort was assessed using a visual analog scale (0 to 10). RESULTS The results showed no differences in PtcCO2 between masks (P=0.82). There were no significant differences in respiratory parameters (tidal volume, P=0.79; respiratory rate, P=0.65; minute ventilation, P=0.12) between masks. The rate of unintentional leaks were significantly lower for Mask A (P=0.016). Subjects rated Mask A and Mask C as more comfortable than Mask B (P=0.041). CONCLUSION There was no effect of mask on PtcCO2 in healthy subjects. The mask with the highest comfort rating had not the lowest rate of unintentional leaks.
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LUNG DEPOSITION OF A RADIOLABELED AEROSOL WITH TWO VENTILATION MODALITIES DURING INVASIVE MECHANICAL VENTILATION: A RANDOMIZED COMPARATIVE STUDY. Intensive Care Med Exp 2015. [PMCID: PMC4796313 DOI: 10.1186/2197-425x-3-s1-a10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Évaluation des paramètres cardio-respiratoires pendant le test de montée d’escalier et le test de marche de 6min. Rev Mal Respir 2015. [DOI: 10.1016/j.rmr.2014.10.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Quelle kinésithérapie de désencombrement pour demain ? Rev Mal Respir 2014; 31:691-2. [PMID: 25391503 DOI: 10.1016/j.rmr.2014.07.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 07/28/2014] [Indexed: 11/27/2022]
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Effect of Drug Targeting Nebulization on Lung Deposition: A Randomized Crossover Scintigraphic Comparison Between Central and Peripheral Delivery. Respir Care 2014; 59:1501-7. [DOI: 10.4187/respcare.03068] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Mucoviscidose et traitements inhalés : quoi de neuf en 2013 ? Rev Mal Respir 2014; 31:336-46. [DOI: 10.1016/j.rmr.2013.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 10/13/2013] [Indexed: 10/25/2022]
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[Inhalation therapy: inhaled corticosteroids in ENT, development and technical challenges of powder inhalers, nebulisers synchronized with breathing and aerosol size distribution. GAT aerosolstorming, Paris 2012]. Rev Mal Respir 2013; 30:657-68. [PMID: 24182652 DOI: 10.1016/j.rmr.2013.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2013] [Accepted: 04/17/2013] [Indexed: 11/17/2022]
Abstract
The working group on aerosol therapy (GAT) of the Société de Pneumologie de Langue Française (SPLF) has organized its third Aerosolstorming in 2012. During one single day, different aspects of inhaled therapies have been treated and are detailed in two articles, this one being the second. This text deals with the indications of inhaled corticosteroids in ENT, the development and technical challenges of powder inhalers, the advantages and disadvantages of each type of technologies to measure the particle sizes of inhaled treatments.
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Influence de la musique à tempo rapide sur le test de marche de 6minutes chez les patients bpco. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ergothérapie et réadaptation pulmonaire dans la broncho-pneumopathie chronique obstructive (BPCO). Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Influence de la musique sur la dyspnée pendant une séance de revalidation pulmonaire. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Occupational therapy (OT) and pulmonary rehabilitation (PR) of COPD patients. Ann Phys Rehabil Med 2013. [DOI: 10.1016/j.rehab.2013.07.376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Comparison of an entirely automated ventilation mode, Intellivent-ASV, with conventional ventilation in ARDS patients: a 48-hour study. Crit Care 2013. [PMCID: PMC3643158 DOI: 10.1186/cc12036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Aerosol delivery to the lung is more efficient using an extension with a standard jet nebulizer than an open-vent jet nebulizer. J Aerosol Med Pulm Drug Deliv 2013; 26:208-14. [PMID: 23286829 DOI: 10.1089/jamp.2012.0994] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Open-vent jet nebulizers are frequently used to promote drug deposition in the lung, but their clinical efficacy and indications are not clear. Our study compared lung deposition of amikacin using two different configurations of a jet nebulizer (Sidestream(®)): one vented (N1) and one unvented with a corrugated piece of tubing (N2). METHODS In vitro nebulizer performance was assessed by laser diffraction and filtering. Lung delivery was evaluated by scintigraphy in baboons as a child model, and by amikacin urinary drug concentration in seven healthy spontaneously breathing volunteers. Subjects were randomly assigned to the two nebulizer systems (N1 and N2). RESULTS AND CONCLUSIONS In vitro results showed a higher efficiency of N2 than N1 in terms of lung deposition prediction (95±3 mg vs. 70±0 mg; p<0.0001). Radioactivity deposition in the baboons' lungs was lower with N1 than with N2 (1.8% vs. 4.7% of nebulizer charge; p<0.05). The total daily amount of amikacin urinary excretion was lower with N1 than with N2 (29.5 mg vs. 40.1 mg; p<0.01). Conversely, in vivo drug output rate was higher with N1 than with N2 (3.1 mg/min vs. 2.2 mg/min; p<0.05). Using a corrugated piece of tubing with standard jet nebulizers delivers higher doses to the lungs than open-vent jet nebulizers. The open-vent jet nebulizer might be recommended for rapid administration of a lower dose to the lungs and the standard jet nebulizer with corrugated piece of tubing for a higher dose in the lungs.
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[Inhalation therapy: provocation tests, infectious risks, acute bronchiolitis and ENT diseases. GAT aerosolstorming, Paris 2011]. Rev Mal Respir 2012; 29:1186-97. [PMID: 23228677 DOI: 10.1016/j.rmr.2011.11.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 11/29/2011] [Indexed: 11/29/2022]
Abstract
Communications from the 2011 meeting of the GAT are reported in this second article on the practical management of bronchial provocation tests and infectious risks associated with the use of nebulization. Recent advances on the role of nebulized hypertonic saline in the treatment of acute bronchiolitis in infants and of the nebulization in sinusal diseases are also reported.
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Sonic aerosol therapy to target maxillary sinuses. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129:244-50. [PMID: 22921302 DOI: 10.1016/j.anorl.2011.09.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Revised: 08/30/2011] [Accepted: 09/06/2011] [Indexed: 10/28/2022]
Abstract
AIM Intranasal aerosol administration of drugs is widely used by ENT specialists. Although clinical evidence is still lacking, intranasal nebulization appears to be an interesting therapeutic option for local drug delivery, targeting anatomic sites beyond the nasal valve. The sonic nebulizer NL11SN associates a 100Hertz (Hz) sound to the aerosolization to improve deposition in the nasal/paranasal sinuses. The aim of the present study was: to evaluate in vivo the influence of associating a 100Hz sound on sinus ventilation and nasal and pulmonary aerosol deposition in normal volunteers, and; to quantify in vitro aerosol deposition in the maxillary sinuses in a plastinated head model. MATERIAL AND METHODS Scintigraphic analysis of (81m)Kr gas ventilation and of sonic aerosol ((99m)Tc-DTPA) deposition using the NL11SN was performed in vivo in seven healthy volunteers. In parallel, NL11SN gentamicin nebulization was performed, with or without associated 100Hz sound, in a plastinated human head model; the gross amount of gentamicin delivered to the paranasal sinuses was determined by fluorescence polarization immunoassay. RESULTS Associating the 100Hz sound to (81m)Kr gas ensured paranasal sinus ventilation in healthy volunteers. (99m)Tc-DTPA particles nebulized with the NL11SN were deposited predominantly in the nasal cavities (2/3, vs 1/3 in the lungs). In vitro, the use of NL11SN in sonic mode increased gentamicin deposition threefold in the plastinated model sinuses (P<0.002); the resulting antibiotic deposit would be sufficient to induce a local therapeutic effect. CONCLUSION The NL11SN nebulizer ensured preferential nasal cavity aerosol deposition and successfully targeted the maxillary sinuses.
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Abstract
BACKGROUND Our study investigated the influence of the cannula's inner diameter (ID) and of its removal on the expected respiratory dose of amikacin, using three different jet nebulizer configurations (Sidestream(®)): vented (N1), unvented with a piece of corrugated tubing attached to the expiratory limb of the T attachment (N2), and unvented alone (N3). METHODS The jet nebulizer was filled with amikacin (500 mg/4 mL) and was attached to the tracheostomy tube. A lung model simulating spontaneous breathing was connected to the tracheostomy tube. A filter was connected between the nebulizer and the tracheostomy tube to measure the inhaled dose, and between the tracheostomy tube and the lung model to measure the respiratory dose. Different cannula IDs were tested (6.5, 8, 8.5, and 10 mm), and aerosol lost in the cannulas was determined. RESULTS AND CONCLUSIONS Respiratory dose varied between 96±1 mg and 44±3 mg, with higher values observed with N2. The aerosol lost in the cannula was significant and represented up to 63% of the inhaled dose. There was a negative correlation between the cannula's ID and the aerosol lost in the cannula. After removal of the internal cannula, an increase in the respiratory dose of up to 31.3% was observed. We recommend removing the inner tracheostomy cannula to nebulize a larger amount of drug through a tracheostomy tube. Among the three jet nebulizer configurations studied, we recommend the unvented one with a piece of corrugated tubing attached to the expiratory limb of the T attachment.
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WS24.3 Evaluation of the performance of sonic nebuliser to target maxillary sinuses. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60166-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mucoviscidose : les techniques instrumentales de désencombrement des voies aériennes. Rev Mal Respir 2012; 29:128-37. [DOI: 10.1016/j.rmr.2011.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 04/19/2011] [Indexed: 10/14/2022]
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L’incidence du délai de la consommation du tabac sur les valeurs mesurées lors d’une épreuve fonctionnelle respiratoire chez les BPCO. Rev Mal Respir 2012. [DOI: 10.1016/j.rmr.2011.10.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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73 Deposition of aerosol in healthy volunteer with a nasal sonic jet nebulizer. J Cyst Fibros 2011. [DOI: 10.1016/s1569-1993(11)60091-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Inhaled phosphodiesterase type 5 inhibitors restore chloride transport in cystic fibrosis mice. Eur Respir J 2010; 37:72-8. [DOI: 10.1183/09031936.00013510] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Exophiala dermatitidis: can it chronically colonize and infect airways of patients with CF? J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Peripherally Inserted Central Catheter (PICC) for home IV therapy: a Belgian CF center experience. J Cyst Fibros 2009. [DOI: 10.1016/s1569-1993(09)60365-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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272 Satisfaction survey concerning vibrating mesh-nebulizer in CF patients. J Cyst Fibros 2007. [DOI: 10.1016/s1569-1993(07)60252-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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267 Hygiene of the inhalation equipment: what about vibrating-mesh nebulizers? J Cyst Fibros 2007. [DOI: 10.1016/s1569-1993(07)60247-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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268 Hygiene of the inhalation equipment: a Belgian national survey. J Cyst Fibros 2007. [DOI: 10.1016/s1569-1993(07)60248-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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A specific database for providing local and national level of integration of clinical data in cystic fibrosis. J Cyst Fibros 2007; 6:187-93. [PMID: 17027346 DOI: 10.1016/j.jcf.2006.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2006] [Revised: 07/06/2006] [Accepted: 07/17/2006] [Indexed: 11/27/2022]
Abstract
It has recently been stated that a database is an essential tool in the management of CF. The purpose of this work is to create a specific database allowing optimal performance of storage, search and retrieval functions on patients with CF. A specific database was developed using a Windev licence, for application via Microsoft supported platforms or Intranet system. The database allows real-time point of care data management of medical, investigational and administrative data. It is currently being used in the 6 Belgian reference centres. It represents a useful tool for gathering information on routine clinical and lab data, bacteriology, treatments, complications and specific outcomes for clinical and research purposes. The ongoing evolution of the database includes enhancements toward research data orientation including comparison of patient data between different centres and completeness of the National CF registry questionnaire. A complimentary copy of the software can be provided to multidisciplinary accredited CF centres worldwide upon request.
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