Flutter Valve™ increases sputum removal during treatment and diminishes total and peripheral airway resistance in hypersecretive patients with bronchiectasis. Impulse oscillometry is a user-friendly tool to evaluate the effects of airway clearance techniques on respiratory mechanics.
The application of hyperinflation using pressure support ventilation in mechanically ventilated patients with pulmonary infection improves secretion clearance and increases static compliance of the respiratory system.
BACKGROUND: Expiratory rib cage compression (ERCC) has been empirically used by physiotherapists with the rationale of improving expiratory flows and therefore the airway clearance in mechanically ventilated patients. This study evaluates the acute mechanical effects and sputum clearance of an ERCC protocol in ventilated patients with pulmonary infection. METHODS: In a randomized crossover study, sputum production and respiratory mechanics were evaluated in 20 mechanically ventilated subjects submitted to 2 interventions. ERCC intervention consisted of a series of manual bilateral ERCCs, followed by a hyperinflation maneuver. Control intervention (CTRL) followed the same sequence, but instead of the compressive maneuver, the subjects were kept on normal ventilation. Static (C st ) and effective (C eff ) compliance and total (R tot ) and initial (R init ) resistance of the respiratory system were measured pre-ERCC (
Background: Complaints of peripheral muscle weakness are quite common in patients with
systemic sclerosis (SSc). It is likely that the muscle impairments may reduce the
patients' exercise performance, which in turn may decrease their functional
capacity and exert a direct impact on their quality of life. Objectives:To assess the peripheral and respiratory muscle strength in individuals with SSc
and to investigate their correlation with the 6-min walk distance (6MWD) and
quality of life measurements. Moreover, we aimed to characterize their nutritional
status, pulmonary function, functional capacity, and quality of life compared to
the controls. Method:The present cross-sectional study included 20 patients with SSc and 20 control
subjects. All of the participants were subjected to isometric dynamometry, surface
electromyography, bioelectrical impedance analysis, pulmonary function testing,
and the 6-min walk test. Patients with SSc also responded to the Medical Outcomes
Study 36-Item Short-Form Health Survey (SF-36) and the Health Assessment
Questionnaire Disability Index (HAQ-DI). Results:The individuals with SSc exhibited a reduction in quadriceps strength (p=0.0001),
increased quadriceps fatigability (p=0.034), impaired pulmonary function, and a
reduced 6MWD (p=0.0001) compared to the controls. Quadriceps strength was
significantly correlated with the 6MWD (Rho=0.719; p=0.0004) and
the HAQ-DI (Rho=-0.622; p=0.003). We also found significant
correlations between quadriceps fatigability and maximal inspiratory
(Rho=0.684; p=0.0009) and maximal expiratory
(Rho=0.472; p=0.035) pressure. Conclusions:Patients with SSc exhibited reduced respiratory muscle and quadriceps strength and
an increase in its fatigability. In these individuals, there was a relationship
between quadriceps strength, functional capacity, and quality of life.
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