Histogram analysis for bedside respiratory monitoring in not critically ill preterm neonates: a proposal for a new way to look at the monitoring data
Author(s) Sur A.; Paria A.
Source European Journal of Pediatrics; 2020
Publication Date 2020
Despite robust evidence in favour of maintaining optimal oxygen saturation targets in the preterm infants, the titration of oxygen is largely dependent on manual observations and transcription. Similarly, notwithstanding the gaining popularity of non-invasive modalities like high-flow nasal therapy, the practices of weaning and escalating support are largely individualized and based on point of care observations. These are often erroneous and lack objectivity. Histogram analysis from patient monitors is an easy and objective way of quantifying vital parameters and their trends. We review the technology and evidence available behind this practice. .
Author(s) Donovan T.; Milan S.J.; Wang R.; Banchoff E.; Bradley P. et al.
Source The Cochrane database of systematic reviews; Dec 2020; vol. 12
Publication Date Dec 2020
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) are a major cause of hospital admissions, disease-related morbidity and mortality. COPD is a heterogeneous disease with distinct inflammatory phenotypes, including eosinophilia, which may drive acute exacerbations in a subgroup of patients. Monoclonal antibodies targeting interleukin 5 (IL-5) or its receptor (IL-5R) have a role in the care of people with severe eosinophilic asthma, and may similarly provide therapeutic benefit for people with COPD of eosinophilic phenotype.
Spirometry performed as part of the Manchester community-based lung cancer screening programme detects a high prevalence of airflow obstruction in individuals without a prior diagnosis of COPD
Author(s) Balata H.; Harvey J.; Barber P.V.; Duerden R.; Evison M. et al.
Source Thorax; May 2020
BACKGROUND: COPD is a major cause of morbidity and mortality in populations eligible for lung cancer screening. We investigated the role of spirometry in a community-based lung cancer screening programme.
Intra-pleural fibrinolytic therapy versus placebo, or a different fibrinolytic agent, in the treatment of adult parapneumonic effusions and empyema
Author(s) Altmann E.S.; Crossingham I.; Wilson S.; Davies H.R.
Source Cochrane Database of Systematic Reviews; Oct 2019; vol. 2019 (no. 10)
Background Pleural infection, including parapneumonic effusions and thoracic empyema, may complicate lower respiratory tract infections. Standard treatment of these collections in adults involves antibiotic therapy, effective drainage of infected fluid and surgical intervention if conservative management fails. Intrapleural fibrinolytic agents such as streptokinase and alteplase have been hypothesised to improve fluid drainage in complicated parapneumonic effusions and empyema and therefore improve treatment outcomes and prevent the need for thoracic surgical intervention. Intrapleural fibrinolytic agents have been used in combination with DNase, but this is beyond the scope of this review.
Training opportunities in thoracic ultrasound for respiratory trainees: Are current guidelines practical?
Author(s) Stanton A.E.; Evison M.; Roberts M.; Latham J.; Clive A.O. et al.
Source BMJ Open Respiratory Research; Sep 2019; vol. 6 (no. 1)
Introduction: Respiratory trainees in the UK face challenges in meeting current Royal College of Radiologists (RCR) Level 1 training requirements for thoracic ultrasound (TUS) competence, specified as attending 'at least one session per week over a period of no less than 3 months, with approximately five scans per session performed by the trainee (under supervision of an experienced practitioner)'. We aimed to clarify where TUS training opportunities currently exist for respiratory registrars.
Method(s): Data were collected (over a 4-week period) to clarify the number of scans (and therefore volume of training opportunities) within radiology departments and respiratory services in hospitals in the South West, North West deaneries and Oxford.
Result(s): 14 hospitals (including three tertiary pleural centres) provided data. Of 964 scans, 793 (82.3%) were conducted by respiratory teams who performed a mean of 17.7 scans per week, versus 3.1 TUS/week in radiology departments. There was no radiology session in any hospital with >=5 TUS performed, whereas 8/14 (86%) of respiratory departments conducted such sessions. Almost half (6/14) of radiology departments conducted no TUS scans in the period surveyed.
Conclusions The currently recommended exposure of regularly attending a list or session to undertake five TUS is not achievable in radiology departments. The greatest volume of training opportunities exists within respiratory departments in a variety of scheduled and unscheduled settings. Revision of the competency framework in TUS, and where this is delivered, is required.Copyright © 2019 Author(s) (or their employer(s)).
Author(s) Donovan T.; Crossingham I.; Bradley P.; Milan S.J.; Wang R.
Source Cochrane Database of Systematic Reviews; Sep 2019; vol. 2019 (no. 9)
Publication Date Sep 2019
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the efficacy and safety of monoclonal antibody therapies targeting IL-5 signalling (anti-IL-5 or anti-IL-5Ralpha) compared with placebo in the treatment of adults with COPD.Copyright © 2019 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
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