Let’s read an article a month – July, 2020

Screenshot of the first page of the printed 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.

This month I found a great case-study in Canadian Journal of Respiratory Therapy (CJRT) .

Helmet CPAP revisited in COVID-19 pneumonia: A case series

by Aniket S. Rali, Christopher Howard, Rachel Miller, Christopher K. Morgan, Dennis Mejia, John Sabo, James P. Herlihy, Sunjay R. Devarajan
Published online on July 21, 2020.
https://www.cjrt.ca/wp-content/uploads/cjrt-2020-019.pdf

Reasons you may find this article interesting:

  • It’s a nice and quick read.
  • We all have seen photos of Helmet CPAPs being used in Italy. If you haven’t had the chance to look into them, this article will provide you will some useful information!
  • It is published in a Canadian Journal so why not! Side note, the authors’ affiliations is in Houston, TX, USA.
  • The authors talk about three cases with various backgrounds and outcomes (pp. 1-2).
  • The authors discuss the benefits and shortcoming of Helmet CPAPs (e.g. “prevention of functional and neuromuscular complications”, minimization of aerosolization, requirement for high flow rates, difficulty with resting the head, and other details pp. 2-3).

This article shares the experience on only 3 cases, so set your expectations accordingly when picking up this article.

Happy learning and reading!

Farzad Refahi
July 24 2020
https://respiratory.blog/lets-read-an-article-a-month-july-2020/

Let’s read an article a month– June 2020

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

This month I found a great article on June 20th, 2020. I spent a few days with it, and now I share it with you.

Predictors of progression in systemic sclerosis patients with interstitial lung disease

  Oliver Distler, Shervin Assassi, Vincent Cottin, Maurizio Cutolo, Sonye

  K. Danoff, Christopher P. Denton, Jörg H.W. Distler, Anna-Maria

  Hoffmann-Vold, Sindhu R. Johnson, Ulf Müller Ladner, Vanessa Smith,

  Elizabeth R. Volkmann and Toby M. Maher

  Eur Respir J 2020 55:1902026; published ahead of print 2020,

  doi:10.1183/13993003.02026-2019 OPEN ACCESS

https://erj.ersjournals.com/content/erj/55/5/1902026.full.pdf

Top 3 reasons why I enjoyed reading this article:

-A well-written review of key pathways implicated in systemic sclerosis-associated interstitial lung disease (pp2-4 ). Inflammatory pathways are complex and while I enjoy reviewing them, I never tend to be able to memorize them. There is also a nice diagram that goes along with the description (i.e. Figure 1 on page 3).  

-An insider and expert view of the challenges involved with the disease diagnosis. When it comes to interstitial lung disease, there is so much for me to read and learn about. I am involved with the Pulmonary Diagnostic side of respiratory care, and mostly I see patients with confirmed diagnosis of interstitial lung disease (usually in the later stages). Occasionally I do see patients who have some indications in an imaging test, CXR or Chest-CT, and are visiting the PFT lab for additional information. “One potential barrier to diagnosis a lack of awareness within primary care of SSc, which can lead to late referrals” (p.5). 

-If you are involved with pulmonary diagnostics, you will enjoy this article as there are references to lung function values (with some references to 6MWTs) (found on pp 7-8).

Happy Learning!

Farzad Refahi
June 25, 2020

http://respiratory.blog/let’s-read-an-article-a-month–june-2020/

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

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.

This month I found a great editorial post on May 15th, 2020. I spent a few days with it, and now I share it with you.

Will children reveal their secret? The coronavirus dilemma
Luca Cristiani, Enrica Mancino, Luigi Matera, Raffaella Nenna, Alessandra Pierangeli, Carolina Scagnolari, Fabio Midulla
European Respiratory Journal 2020
55: 2000749; DOI: 10.1183/13993003.00749-2020 https://erj.ersjournals.com/content/55/4/2000749

You will be presented by suggestions, ideas and theories such as high angiotensin-converting enzyme 2 (ACE2) receptor concentration, innate immune response as both protective and a destructive mechanism, and constitutional elevated lymphocytes.

Happy Learning!

Farzad Refahi
http://respiratory.blog/lets-read-an-article-a-month-may-30-2020/


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

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

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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