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Let’s read an article a month – April 30, 2020

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Every month I try to read an open-access article. After reading the article, I share the tittle and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

I found an article on April 25th, 2020. I spent a few days with it, and now I share it with you.

Endotracheal cuff pressures in the PICU: Incidence of underinflation and overinflation

Richard W. Wettstein MMEd, RRT, FAARC, Donna D. Gardner DrPH, RRT, FAARC, Sadie Wiatrek MSRC, RRT, Kristina E. Ramirez MPH, RRT, CHES, Ruben D. Restrepo MD, RRT, FAARC
Published online January 21, 2020 https://bit.ly/2VRHC0E

Top 3 reasons why I enjoyed reading this article

I enjoyed reading this submission to Canadian Journal of Respiratory Therapy (CJRT) as it was a quick read, and served as a nice review of reasons for using cuffed versus uncuffed ETT in paediatric population. Also, it reviewed possible benefits and drawbacks of using cuffed ETT in paeds. MOV, MLT versus pressure manometer techniques were discussed.

What you can expect from this study

In this study rate of under- or over-inflation was assessed. Also, if CP was outside of norm, possible association with gender, age, ETT size and number of days intubated prior to CP measurement was evaluated (second goal of the study. P2).

Considerations

The main limitation to this study was its small size (n=20).

Thoughts?

Happy reading. Let me know about your personal opinion on using cuffed versus uncuffed ETT in paediatric patients. Also, what’s your preferred way to monitor cuff pressures?

Farzad Refahi
http://respiratory.blog/lets-read-an-article-a-month-april-30-2020/
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Let’s read an article a month – March 11, 2020

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Screenshot of the first page of the article by Morgan et al. Ready by Farzad Refahi and shared on www.Respiratory.Blog

An Article A Month

Every month I try to read an open-access article. After reading the article, I share the tittle and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

I found an article on March 9th, 2020. I spent a few days with it, and now I share it with you.

Variability In Expiratory Flow Requirements Among Oscillatory Positive Expiratory Pressure Devices 


by Sherwin E. Morgan, RRT, Steven Mosakowski, RRT, MBA, Brenda L. Giles, MD, Edward Naureckas, MD, Avery Tung, MD, FCCM
Published online March 4, 2020. Available on The Canadian Journal of Respiratory Therapy (CJRT) : https://www.cjrt.ca/wp-content/uploads/cjrt-2019-025.pdf

Top 3 Reasons Why I enjoyed this Article

Firstly, this article is quick and easy to read.

Secondly, I had forgotten about the various Oscillatory Positive Expiratory Pressure (OPEP) devices on the market. This article was a nice introduction to various flows and pressures required to operate the units. The authors provide a recommendation for which units to be used by which population (small vs. larger patients) on page 10.

Thirdly, in the introduction the authors discuss the proper technique for using these devices (referencing Olsen et. al). You can find this description on pages 7 and 8.

Once again, you can view this article by visiting CJRT (which is owned by Canadian Society of Respiratory Therapists): https://www.cjrt.ca/wp-content/uploads/cjrt-2019-025.pdf

Happy Reading! Let me know what you think.

Farzad Refahi
http://respiratory.blog/lets-read-an-article-a-month-march-11-2020/
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Let’s read an article a month – March 06, 2020

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Snapshot of the first page of the article.

Every month I try to read an open-access article. After reading the article, I share the tittle and associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and continue to grow.

I found an article on Feb 27th, 2020. I spent a few days with it, and now I share it with you.

A spatially restricted fibrotic niche in pulmonary fibrosis is sustained
by M-CSF/M-CSFR signalling in monocyte-derived alveolar macrophages by Nikita Joshi et al.
 
 Eur Respir J 2020 55:1900646; published ahead of print 2019, doi: 10.1183/13993003.00646-2019 https://erj.ersjournals.com/content/erj/55/1/1900646.full.pdf

This article is well written and easy to follow. I must admit that it is too specialized and technical for my comfort level, but I still enjoyed it.

What this study demonstrates? Many elements were discussed but here is a very simple summary to get you interested:

“Our findings suggest that inhibition of M-CSFR (macrophage colony-stimulating factor receptor) signalling during fibrosis disrupts an essential fibrotic niche that includes monocyte-derived alveolar macrophages and fibroblasts during asbestos-induced fibrosis.” p1

Happy reading!

Farzad Refahi

Let’s read an article a month –Feb. 21, 2020

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Photo of the article’s first page.

Every month I try to read an open access article. After reading the article, I share the tittle and associated link with my followers. This is to encourage clinicians to reads articles, stay up to date and continue to grow.

The article I read on Friday was:

Bilateral hypoglossal nerve stimulation for treatment of adult obstructive sleep apnoea by Peter R. Eastwood et al.

Eur Respir J 2020 55:1901320; published ahead of print 2019, doi:10.1183/13993003.01320-2019 OPEN ACCESS ARTICLE http://erj.ersjournals.com/content/55/1/1901320?etoc

I am not here to endorse this technology or this approach to manage Obstructive Sleep Apnea (OSA). I am learning about it and sharing it with you. It did open my eyes to another approach which apparently has been around for some time. I appreciated the innovations. Compliance with CPAP units, the current gold stands, is low. The authors do mention that, and I have personally witnessed it when I worked for a CPAP company (casually for around 2 years).

I don’t need to express my personal thoughts on this as the authors have done a great job of describing the technology (GEnio system), what’s make it unique, the limitation of the study, and also the opportunities it brings.

It is a small study, n=22, with few participants. There is no control group.

This approach did open up the discussion to devices that deliver bilateral stimulation of hypoglossal nerve, includes minimal incision, and lacks an implanted battery (p10).

What are your thoughts and take on this?

Let’s read an article a month – April 3 2019

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An Article A Month

Every month I try to read an open-access article.  After reading the article, I share the tittle and associated link with my followers.  This is to encourage clinicians to read articles, stay to up to date, and continue to grow.

This morning I read this recent editorial piece on ERS:

The new haemodynamic definition of pulmonary hypertension: evidence prevails, finally!

By Marius M. Hoeper and Marc Humbert.

https://erj.ersjournals.com/content/erj/53/3/1900038.full.pdf

I wanted to review the noninvasive ways of measuring for pulmonary hypertension and came across this useful resource: https://www.123sonography.com/book/352

Happy Reading!

Farzad Refahi
April 3 2019 
https://respiratory.blog/rvsp/

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