May 2008

Open Forum Deadline Extended Till June 15
If you’ve attended an AARC Congress, you know the Open Forum is one of the highlights of the event. Nowhere else will you find as many reports of original research performed by your colleagues in respiratory care. Hopefully, we’ll have lots of presentations from section members this December – and now you have more time to submit your abstracts. The AARC has just extended the deadline from June 1 to June 15. GO TO EASY STREET TO SUBMIT ONLINE

Controversies in Mechanical Ventilation Covered in June Issue of Journal
The June issue of Clinics in Chest Medicine zeroes in on controversies in mechanical ventilation, with papers on everything from setting tidal volume for mechanical ventilatory support, to protocol-driven ventilator weaning, to how best to deliver aerosol medications to mechanically ventilated patients. AARC member and leading pulmonologist Neil MacIntyre served as guest editor for the edition and authored several of the papers. Respiratory Care Editor Dean R. Hess also has a paper in the issue, as do several other prominent RTs. READ ABSTRACTS

Mechanical Ventilation Leads to Diaphragmatic Muscle Atrophy
University of Pennsylvania researchers have shown for the first time that mechanical ventilation causes muscle atrophy in the human diaphragm in as little as 18 hours. The study was conducted among 14 brain dead donors between the ages of 18 and 58 who had undergone mechanical ventilation for between 18 and 69 hours. They were compared to 8 similar people who were mechanically ventilated for under 3 hours each. The prolonged ventilation group had significant signs of muscle atrophy when compared to the control group. “Disuse atrophy of human diaphragm myofibers could be a major contributor to the weaning problems that occur in some of our patients,” study author Sanford Levine was quoted as saying. “Therefore, we believe fiber atrophy of the magnitude noted in our case diaphragms could have clinical significance.” The study appeared in the March 27 edition of The New England Journal of Medicine. READ PRESS RELEASE READ ABSTRACT

RTs Included in Survey Aimed at Identifying Decannulation Factors
Oregon researchers who surveyed experienced physicians and respiratory therapists on managing airway decannulation identify several clinical factors that can be used to select patients for tracheostomy tube removal. They further suggest these factors can be used to design clinical trials of tracheostomy decannulation, which they believe are needed to shore up the evidence base for this procedure. “An important implication of the study is that care providers should recognize our knowledge deficit and develop systematic protocols for improving patient care using quality improvement techniques,” write the authors. “Such models exist in the literature for adult patients and for children with tracheostomies who are managed by expert teams with requisite knowledge and skills.” The paper was published in the March 31 edition of Critical Care.  READ ABSTRACT

Measuring FRC Using the Oxygen Washout Technique
Functional residual capacity (FRC) can be used at the bedside to help guide respiratory therapy, but high repeatability has not been demonstrated in ventilated patients. German investigators tested the repeatability of FRC measurements and the impact of different DeltaFiO2’s on this repeatability in 20 postoperative cardiac surgery patients using a system that employs the oxygen washout technique. Results showed no difference between repeated measurements of FRC using a DeltaFiO2 of 0.1, 0.2, or 0.6; coefficients of variation were 6.6%, 5.6%, and 6.6%, respectively. The authors conclude, “FRC can be measured in ventilated patients using the oxygen washout technique with a clinically acceptable repeatability.” The study appears in this month’s Anesthesia and Analgesia. READ ABSTRACT