August 2007

Three Great Ways to Promote Respiratory Care
We’d all like more people to know who respiratory therapists are and what they do. The AARC has three great ways to get the job done, and they’re all heating up right now: we’ve just launched a new web page for National Respiratory Care Week, the ARCF’s Ventilator 5K is seeking participants, and the brand new AARC Life & Breath video is up for preview and purchase in the AARC Store. Check them out and see how you can use these great events and tools to let more people in on the best kept secret in health care today (your profession!). RC WEEK VENTILATOR 5K LIFE & BREATH

Inhaled Steroids Linked to Pneumonia in COPD
Canadian researchers who analyzed hospitalization and drug prescription information for 175,906 patients with COPD find having a prescription for an inhaled steroid increased the risk for a pneumonia hospitalization by 70%. Among patients taking these medications, pneumonia deaths within 30 days of hospitalization went up by 53%. The authors note inhaled steroid use among COPD patients increased from 13.2% of the population in 1987 to 41.4% in 1995. The study appeared in the second July issue of the American Journal of Respiratory and Critical Care Medicine. READ PRESS RELEASE

Study Touts Asthma Education in the ED
A new meta-analysis suggests asthma education in the emergency department can improve health outcomes for those with the condition. Canadian investigators pooled the results from 12 randomized controlled trials conducted among 1,954 patients who had come to the ED for a severe asthma attack. While the type of education provided and the health professional delivering the education varied, education reduced the need for another hospitalization, and people who received education were also more likely to attend regularly scheduled medical appointments. The report appeared in the July issue of The Cochrane Library. READ PRESS RELEASE

Stress Index Strategy Reveals Alveolar Hyperinflation
Italian investigators find adjusting the positive end-expiratory pressure level using a stress index strategy reveals alveolar hyperinflation during application of the ARDSnet strategy. The study was conducted in 15 patients who were assessed in random order during both the standard ARDSnet strategy or the stress index strategy. “In all patients the stress index revealed alveolar hyperinflation during application of the ARDSnet strategy and consequently positive end-expiratory pressure was significantly decreased in order to normalize the stress index value.” they write. The study appeared in the July 26 Epub edition of the American Journal of Respiratory and Critical Care Medicine. READ ABSTRACT

APCV Better Than PSV for COPD Patients
Assisted pressure-controlled ventilation (APCV) outperforms pressure-support ventilation (PSV) in hypercapnic COPD patients, report researchers from Turkey. They compared the two ventilatory modes in 34 patients with similar baseline values. Results showed:

• Partial arterial carbon dioxide pressure and pH levels improved significantly in the APCV group when compared with baseline.
• Cardiac output and cardiac index decreased in both groups but more significantly in the PSV group.
• The decreases in stroke volume index and increases in arterial oxygen content after NIV were also considerable in both groups.
• Central venous pressure and systemic vascular resistance index values increased notably only after PSV.

The researchers conclude, “From these data, we deduce that APCV can be a better alternative to PSV for NIV in COPD patients with AHRF owing to its more beneficial physiological effects.” The study appeared in the July 11 Epub edition of Respiration. READ ABSTRACT