Respiratory Therapy

Let’s read an article a month – October 2021

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

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.

The objective of this paper is to “evaluate respiratory function 4 months after diagnosis in patients who survive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the difference between patients with or without initial lung involvement” (p1).

Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life

By: Fabio Anastasio, Sarah Barbuto, Elisa Scarnecchia, Paolo Cosma, Alessandro Fugagnoli, Giulio Rossi, Mirco Parravicini, and Pierpaolo Parravicini.

European Respiratory Journal 2021 58: 2004015; DOI: 10.1183/13993003.04015-2020

Link to the article: https://erj.ersjournals.com/content/58/3/2004015?etoc

Reasons I liked this article

  • The age range for this study was 18 to 80 years old (p2).  Also, a detailed assessment was attained from the subjects, of course post infection, which included SF-12 and IPAQ questionnaires, 6MWT,  and a comprehensive PFT (p2).
  • This study shows “a reduction of respiratory function and exercise capacity secondary to SARS-CoV-2 pneumonia, mostly in patients who developed ARDS during the acute phase” (p9). 
  • The authors suggest that the data may indicate that “respiratory evaluation does not appear to be necessary in patients without pneumonia and without symptoms. DLCO, 6MWT and plethysmography could be avoided in patients without pneumonia, performing only spirometry with bronchodilator responsiveness testing…In contrast, in patients who developed ARDS, DLCO, 6MWT and complete spirometry could uncover presence of residual pulmonary and functional impairment, with need for respiratory rehabilitation and gradual physical activity “ (p10). 

As always, take the time to read this study. There is a lot of information and data covered in the study which I cannot cover here.  As a disclaimer, continue to follow guidelines for ordering PFTs and providing patient care as recommended by your employer and regulatory body.

Happy reading and learning,

Farzad Refahi

October 6th, 2021

https://respiratory.blog/lets-read-an-article-a-month-october-2021/

Let’s read an article a month – September 2021

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

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 piece on cardiopulmonary exercise capacity and COVID19 recovery. The objective of this paper is to “determine cardiopulmonary function during exercise 3–4 months after hospital discharge for COVID-19 compared with a reference population and to describe the characteristics of participants with exercise limitations. ” p2.

Cardiopulmonary exercise capacity and limitations 3 months after COVID-19 hospitalisation

By: Ingunn Skjørten, Odd Andre Wathne Ankerstjerne, Divna Trebinjac, Eivind Brønstad, Øystein Rasch-Halvorsen, Gunnar Einvik, Tøri Vigeland Lerum, Knut Stavem, Anne Edvardsen, and Charlotte Björk Ingul

European Respiratory Journal 2021 58: 2100996; DOI: 10.1183/13993003.00996-2021

Link to the article: https://erj.ersjournals.com/content/58/2/2100996?etoc

The reasons I found this article interesting 

  • Regaining exercise capacity after COVID-19 is an important finding (p7).
  • Brings more weight to self-reported dyspnea as it was “associated with lower ventilatory efficiency and lower V′O2peak·kg−1 due to higher BMI” (p7).
  • In order of relevance: deconditioning, circulatory factors, and ventilatory limitation were the top three exercise limitations (p7).

This is a great article so I encourage you to take the time to read it.  

Happy learning and reading!

Farzad Refahi

September 30, 2021

https://respiratory.blog/lets-read-an-article-a-month-september-2021/

Let’s read an article a month – August 2021

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

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.

The objective of this paper is to use the “data from the INMARK trial to assess the feasibility and validity of home spirometry as a measure of lung function decline in subjects with IPF “ p2.

Home spirometry in patients with idiopathic pulmonary fibrosis: data from the INMARK trial

By: Imre Noth, Vincent Cottin, Nazia Chaudhuri, Tamera J. Corte, Kerri A. Johannson, Marlies Wijsenbeek, Stephane Jouneau, Andreas Michael, Manuel Quaresma, Klaus B. Rohr, Anne-Marie Russell, Susanne Stowasser and Toby M. Maher

Eur Respir J 2021 58:2001518; published ahead of print 2021,

doi:10.1183/13993003.01518-2020 OPEN ACCESS ARTICLE

Link to the article: http://erj.ersjournals.com/content/58/1/2001518?etoc

Reasons you may find this article interesting 

  • I like the idea of patients with chronic conditions being able to perform spirometry at home.  I value the time and technology advancement to make these tests available at home, and having the ability to remotely tracking patients’ progress. This empowers patients to be more aware of their health status and to be more conscious of their well being.
  • Authors conclude that there is a “strong correlation where observed between FVC measurements abstain at home and in clinic at individual time-points, but correlations between changes in FVC measurements over time estimated using home and clinic spirometry were weak, mainly due to variability in the measurements obtained using home spirometry” p8. (side note: researchers did provide re-training as required). I encourage you to read the full article to view all the details.

Happy reading and learning!

Farzad Refahi

August 25, 2021
https://respiratory.blog/lets-read-an-article-a-month-august-2021/

Let’s read an article a month – July 2021

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

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 narrative review to share with you.  The objective of this paper is to “  to review detached opinions and provide strategies for the safe and effective delivery of aerosolized medications through HFNC in the era of COVID-19 and beyond.” [p22].

How to deliver aerosolized medications through high flow nasal cannula safely and effectively in the era of COVID-19 and beyond: A narrative review

By: Arzu Ari, PhD, RRT, PT, CPFT, FAARC, FCCP, Gerald B. Moody, BSRC, RRT-NPS

Can J Respir Ther 2021;57:22–25. doi: 10.29390/cjrt-2020-041.

Link to the article: https://www.cjrt.ca/wp-content/uploads/cjrt-2020-041.pdf

The reason you may enjoy this article

  • The authors have put together a nice summary of suggestions with regards to:
    •  Nebulizer selection, 
    • Nebulizer placement and use, 
    • HFNC cannula prongs, 
    • Gas flow, 
    • Delivery technique, and 
    • Unit dose vs. continuous nebulization with an infusion pump.

      Checkout Table 1 on page 24.

Happy reading and learning,

Farzad Refahi

July 27, 2021
https://respiratory.blog/lets-read-an-article-a-month-july-2021/

Let’s read an article a month – June 2021

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

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’s article falls under infection and lung function. The objective of this paper is to “systematically evaluating the persisting cardiopulmonary damage of COVID-19 patients 60 days and 100 days after COVID-19 onset” (p2).

Cardiopulmonary recovery after COVID-19: an observational prospective

  multicentre trial

By:  Thomas Sonnweber, Sabina Sahanic, Alex Pizzini, Anna Luger, Christoph

  Schwabl, Bettina Sonnweber, Katharina Kurz, Sabine Koppelstätter, David

  Haschka, Verena Petzer, Anna Boehm, Magdalena Aichner, Piotr Tymoszuk,

  Daniela Lener, Markus Theurl, Almut Lorsbach-Köhler, Amra Tancevski, Anna

  Schapfl, Marc Schaber, Richard Hilbe, Manfred Nairz, Bernhard Puchner,

  Doris Hüttenberger, Christoph Tschurtschenthaler, Malte Aßhoff, Andreas

  Peer, Frank Hartig, Romuald Bellmann, Michael Joannidis, Can

  Gollmann-Tepeköylü, Johannes Holfeld, Gudrun Feuchtner, Alexander Egger,

  Gregor Hoermann, Andrea Schroll, Gernot Fritsche, Sophie Wildner, Rosa

  Bellmann-Weiler, Rudolf Kirchmair, Raimund Helbok, Helmut Prosch, Dietmar

  Rieder, Zlatko Trajanoski, Florian Kronenberg, Ewald Wöll, Günter Weiss,

  Gerlig Widmann, Judith Löffler-Ragg and Ivan Tancevski.

  Eur Respir J 2021 57:2003481; published ahead of print 2020,

  doi:10.1183/13993003.03481-2020 OPEN ACCESS ARTICLE

Link to the ERS article page  http://erj.ersjournals.com/content/57/4/2003481?etoc

Reasons you may find this article interesting 

  • I have noticed a trend of increased referrals for patients with past diagnoses of COVID19.  As the local rates for the virus decreases, patients and ordering physicians have felt more confident sending patient to the outpatient PFT lab of the hospital.  This is another useful article to better plan and look after such patients. 
  • While this study has its limitations such as 
    • being specific to Austria, 
    • includes individuals with existing comorbidities, and 
    • lacks pre-infection diagnostic testing, 

      However, it still delivers a lot of useful information.  The study includes questionnaires, PFT, cap. Gas samples, TEE, CT and other routine lab examinations (p3).  I strongly recommend that you look over each component in the results section: Clinical Evaluation at follow-up, Cardiopulmonary evaluation at follow-up, Serological Markers, and Pulmonary Imaging (pp 4-6).

Happy learning and reading!

Farzad Refahi

https://respiratory.blog/lets-read-an-article-a-month-june-2021/