Shallow Breathing Research Articles

Risk factors for postoperative adverse airway events in patients with primary oral cancer undergoing reconstruction without prophylactic tracheostomy

ObjectiveTo identify risk factors associated with adverse airway events (AAEs) in primary oral cancer patients undergoing tumor ablation followed by free tissue transfer without prophylactic tracheostomy. MethodsWe retrospectively collected primary oral cancer patients who underwent tumor ablation surgery following free-tissue transfer without prophylactic tracheostomy during February 2017 to June 2019 in Chang Gung Memorial Hospital, Linkou Medical Center, Taiwan. 379 patients were included. Data were analysed from 2020 to 2021. Demographics, comorbidities, intraoperative variables and postoperative respiration profile were obtained from the medical record. Main outcome was postoperative AAEs, including requirement of endotracheal intubation after extubation and tracheostomy after prolonged intubation. ResultsOf the 379 patients, postoperative AAEs happened in 29 patients (7.6 %). In reintubation group, patients were older with more diabetes mellitus, hypertension and cerebrovascular disease. These patients had lower preoperative hemoglobin, creatinine, and albumin level with more intraoperative blood transfusion. In postoperative respiration profile, rapid shallow breathing index (RSBI) and PaO2/FiO2 (PF) ratio were poorer. On multivariate analysis, patient's age, tumor location, and cross-midline segmental mandibulectomy and a lower PF ratio were independent risk factors for postoperative AAEs. ConclusionsIn head and neck cancer patients that underwent tumor ablation followed by free tissue transfer without prophylactic tracheostomy, patient's age, tumor location, cross-midline segmental mandibulectomy and P/F ratio are associated with postoperative AAEs.

Answered by Madame Marchesi: A Department Devoted to the Questions of Vocal Students, Part 2

Abstract: In 1907–1908, the Ladies Home Journal published a series of articles in which people could send questions to the famous voice teacher Mathilda Marchesi (1821–1913) to be answered in print. These articles are a rare glimpse at first-person, uninterpreted information. To the author’s knowledge, this collection of articles had not been previously re-published in its entirety until this three-part series within Provenance , of which this installment is Part Two. While Marchesi fields a range of questions, a persistent theme in this installment involves the appropriate age to begin serious study of voice, as well as Marchesi’s opinion of diaphragmatic, “lateral” and clavicular breathing.

Investigation on acceptor-donor co-doped SnO2 nanoparticles enriched with oxygen vacancies: a capacitive humidity sensor for respiration detection.

In this work, we develop a novel capacitive humidity sensor based on Al-Si acceptor-donor co-doped SnO2 for real-time monitoring of ambient humidity and human respiration. XRD measurements reveal that all samples exhibit a tetragonal rutile phase and the crystallite size of SnO2 decreases with increasing Al-Si content. The high intensity of the Raman peak at 762 cm-1 confirms the presence of bridging mode oxygen vacancies in (Al + Si)0.02Sn0.98O2. The EPR results show that the amount of singly ionized oxygen vacancies increases after the introduction of Al-Si. Both types and amounts of oxygen vacancy defects are particularly sensitive to the adsorption of water molecules. Moreover, according to DFT calculations, the contribution of the Si 3s orbital and Al 3s orbital to the band edge verifies the formation of acceptor-donor complexes in Al-Si co-doped SnO2. The humidity sensing results reveal that the (Al + Si)0.02Sn0.98O2 humidity sensor shows high sensitivity (S = 839), low hysteresis (1.94%) and fast response/recovery times (25 s/5 s). The respiratory intervals during shallow, medium and deep breathing states of (Al + Si)0.02Sn0.98O2 were measured at 2.8 s, 3.8 s and 4.5 s, respectively. The chemical mechanism for the enhancement of humidity sensing performance corresponding to the oxygen vacancy defects induced by Al-Si interplay is proposed.

Effects of an 8-Week Corrective Dance Exercises Intervention on Thoracic Hyperkyphosis, Scapular Position, Respiratory Function, and Happiness in Girls Aged 10-12Years.

This study examined the impact of an 8-week corrective dance intervention on thoracic hyperkyphosis, scapular position, breathing, and happiness in girls aged 10-12years. Sixty participants were randomly assigned to either an experimental (EX) or control (CO) group. The intervention involved rhythmic and corrective movements conducted 3 times a week. Measurements were taken before and after the intervention for thoracic hyperkyphosis angle, scapular position, lung function, and happiness levels. EX showed greater improvements (P = .001) than CO for the decrement of thoracic hyperkyphosis angle (48.20-42.80°) than in CO (47.66°-46.59°), and scapular position improved more (P = .003) in EX (1.48°-1.20°) than in CO (1.44°-1.42°). Forced vital capacity (P = .001) and forced expiratory volume in 1second (P = .001) significantly increased in EX (FVC: 2.65-3.40L; FEV1: 2.32-2.74L), while they remained stable in CO. Happiness levels significantly improved (P = .001) in EX (42.20-49.79) and slightly decreased in CO (41.80-40.15). The 8-week dance program improved posture, scapular position, breathing, and happiness in girls aged 10-12years. It enhances physical health, emotional well-being, and social skills in children and adolescents.

Evaluation of the combined predictive value of multiple indicators based on diaphragmatic ultrasound using logistic regression and ROC curve in weaning from mechanical ventilation in pediatric patients.

Conventional single indicators have low sensitivity and specificity for predicting weaning from mechanical ventilation in pediatric patients, necessitating the establishment of a combined prediction model for predicting weaning outcomes. To explore the combined predictive value of PaO2/FiO2 Ratio (P/F ratio), diaphragm excursion-rapid shallow breathing index (DE-RSBI), diaphragm thickening fraction-rapid shallow breathing index (DTF-RSBI), and Pediatric Critical Illness Score (PCIS) in weaning from mechanical ventilation in pediatric patients. Sixty critically ill pneumonia pediatric patients requiring mechanical ventilation treatment from July 2022 to June 2023 at the Second Affiliated Hospital of Jiaxing University were selected. They all underwent a spontaneous breathing trial (SBT) and were divided into the weaning success group (42 cases) and weaning failure group (18 cases) based on the weaning outcome. Parameters including total duration of illness, mechanical ventilation duration, heart rate (HR), P/F ratio, diaphragm excursion (DE), DE-RSBI, diaphragm thickening fraction (DTF), DTF-RSBI, and PCIS were included in univariate and multivariate logistic regression analyses to determine independent factors affecting pediatric weaning success. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of P/F ratio, DE-RSBI, DTF-RSBI, PCIS alone or in combination for weaning success. Comparing P/F ratio, DE, DE-RSBI, DTF, DTF-RSBI and PCIS, there were statistically significant differences (P < 0.05). Through collinearity analysis and binary logistic regression analysis,P/F ratio [OR = 0.777, 95% CI (0.641,0.941)], DE-RSBI [OR = 1.694, 95% CI (1.172, 2.447)], DTF-RSBI [OR = 1.057, 95% CI (1.002, 1.114)], and PCIS [OR = 0.661, 95% CI (0.445, 0.982)] were identified as independent factors affecting successful weaning(P < 0.05).The regression equation was: LogitP = 73.299-0.253 P/F ratio + 0.525DE-RSBI + 0.055DTF-RSBI-0.43PCIS.The sensitivity of the combined indicator Logit(P) in predicting successful weaning from mechanical ventilation in pediatric patients was 88.9%, with a specificity of 95.2% (optimal cutoff value of 0.511), and the area under the ROC curve (AUC) was 0.960 [95% CI (0.915, 1.000)]. The AUC of the combined prediction model for predicting pediatric weaning was greater than that of P/F ratio, DE-RSBI, DTF-RSBI and PCIS alone (Z values = 9.129, 2.061, 2.075, 8.326, P < 0.05). In mechanically ventilated pediatric patients, the combined prediction model has better predictive value for weaning success compared to using P/F ratio, DE-RSBI, DTF-RSBI, or PCIS alone.

Predicting extubation in patients with traumatic cervical spinal cord injury using the diaphragm electrical activity during a single maximal maneuver

BackgroundThe unsuccessful extubation in patients with traumatic cervical spinal cord injuries (CSCI) may result from impairment diaphragm function and monitoring of diaphragm electrical activity (EAdi) can be informative in guiding extubation. We aimed to evaluate whether the change of EAdi during a single maximal maneuver can predict extubation outcomes in CSCI patients.MethodsThis is a retrospective study of CSCI patients requiring mechanical ventilation in the ICU of a tertiary hospital. A single maximal maneuver was performed by asking each patient to inhale with maximum strength during the first spontaneous breathing trial (SBT). The baseline (during SBT before maximal maneuver), maximum (during the single maximal maneuver), and the increase of EAdi (ΔEAdi, equal to the difference between baseline and maximal) were measured. The primary outcome was extubation success, defined as no reintubation after the first extubation and no tracheostomy before any extubation during the ICU stay.ResultsAmong 107 patients enrolled, 50 (46.7%) were extubated successfully at the first SBT. Baseline EAdi, maximum EAdi, and ΔEAdi were significantly higher, and the rapid shallow breathing index was lower in patients who were extubated successfully than in those who failed. By multivariable logistic analysis, ΔEAdi was independently associated with successful extubation (OR 2.03, 95% CI 1.52–3.17). ΔEAdi demonstrated high diagnostic accuracy in predicting extubation success with an AUROC 0.978 (95% CI 0.941–0.995), and the cut-off value was 7.0 μV.ConclusionsThe increase of EAdi from baseline SBT during a single maximal maneuver is associated with successful extubation and can help guide extubation in CSCI patients.

Predictive Power of XGBoost_BiLSTM Model: A Machine-Learning Approach for Accurate Sleep Apnea Detection Using Electronic Health Data

Sleep apnea is a common disorder that can cause pauses in breathing and can last from a few seconds to several minutes, as well as shallow breathing or complete cessation of breathing. Obstructive sleep apnea is strongly associated with the risk of developing several heart diseases, including coronary heart disease, heart attack, heart failure, and stroke. In addition, obstructive sleep apnea increases the risk of developing irregular heartbeats (arrhythmias), which can lead to low blood pressure. To prevent these conditions, this study presents a novel machine-learning (ML) model for predicting sleep apnea based on electronic health data that provides accurate predictions and helps in identifying the risk factors that contribute to the development of sleep apnea. The dataset used in the study includes 75 features and 10,765 samples from the Swedish National Study on Aging and Care (SNAC). The proposed model is based on two modules: the XGBoost module assesses the most important features from feature space, while the Bidirectional Long Short-Term Memory Networks (BiLSTM) module classifies the probability of sleep apnea. Using a cross-validation scheme, the proposed XGBoost_BiLSTM algorithm achieves an accuracy of 97% while using only the six most significant features from the dataset. The model’s performance is also compared with conventional long-short-term memory networks (LSTM) and other state-of-the-art ML models. The results of the study suggest that the proposed model improved the diagnosis and treatment of sleep apnea by identifying the risk factors.

Penatalaksanaan Fisioterapi Pada Kasus Bronkopneumonia Anak di Rumah Sakit Wijaya Kusuma Lumajang

Bronchopneumonia is an infection that affects the airways entering the lungs, also known as the bronchi. Symptoms that arise are cough, fever, restlessness, dyspnea, rapid and shallow breathing, and cyanosis around the nose and mouth. Physiotherapy measures in the form of breathing exercises (deep breathing exercise and coughing) and postural drainage are appropriate interventions for this condition. The aim of the research was to determine the effect of physiotherapy interventions in the form of breathing exercise (deep breathing exercise and coughing) and postural drainage on children's brochopneumonia conditions at Wijaya Kusuma Lumajang Hospital. The research instrument used the Dalhousie Dyspnea Scales. The results of the study showed a decrease in the degree of shortness of breath from 5 to 2 with 8 treatments. So it can be concluded that breathing exercise and postural drainage are effective in reducing the degree of shortness of breath in bronchopneumonia patients&#x0D;

Inferior T wave inversion in young individuals: should we be worried

Abstract Introduction Cardiac screening in young individuals may identify individuals at risk of sudden cardiac death (SCD). The ECG is crucial to identify individuals who harbour pre-clinical/clinical phenotypes. T wave inversion (TWI) are often found at screening. Outcomes and clinical implications of individuals with TWI are dependent on demographic variables and territory involved. However, the implications of inferior TWI in young individuals are poorly understood. Aim This study was carried out to ascertain prevalence and outcomes of adolescent individuals with inferior TWI. Methodology Cardiac screening (questionnaire/ECG) was carried out in 2672 students (14-17 years) attending year 11 classes during the 2017/2018 scholastic year (3991 eligible citizens) as part of a national cardiac screening program (BEAT-IT). Cases with contiguous TWI in ≥2 leads in the inferior (II/III/aVF) leads were included (isolated and those extending into the lateral leads). ECGs with inferior TWI were repeated (in shallow breathing) to ensure appropriate lead placement. An athlete was defined as an individual who participated in organized sport and/or engaged in &amp;gt;4 hours of physical activity weekly. Results 2672 adolescents gave consent (mean, 50.4% were female). 1042 (39.0%) were athletes. Most were of Caucasian ethnicity (95.8%). Inferior TWI were present in 15 (0.6%), all were Caucasian and 9 of these were non-athletic individuals. 4 had symptoms (26.7%) and 1 (6.7%) had a positive family history [HCM]. Inferior TWI (n=15) was more frequent in females (n=13 [1.0%] vs n=2 [0.2%] vs 0.2%, p=0.037). The prevalence was similar in athletes and non-athletes (n=6 [0.6%] vs n=9 [0.6%], p=0.858). 11 (0.4%) had isolated inferior TWI. Only 1 (9.1%) had TWI involving all three inferior leads. Another 4 (0.1%) had inferior TWI extending into the lateral leads. Borderline/other pathological ECG patterns were as likely in both groups (p=0.770). Two participants with inferior TWI (22.2%) had other abnormal ECG patterns (P mitrale [n=1] and ST segment depression [n=2]). One participant (24.0%) from the inferolateral TWI group had ST segment depression. Two patients (13.3% of all participants with inferior TWI) were given a clinical diagnosis (one HCM [inferolateral TWI] and one MVP [inferior TWI]). Both were asymptomatic. The yield was similar for inferolateral (25.0%) and isolated inferior (11.1%) TWI [2 leads] (p=0.523). Most participants with isolated inferior TWI (n=5, 55.6%) were discharged after referral vs 0% in those with inferolateral TWI. Some (n=6) are under surveillance (mean±SD 1897±9 days). Two refused further evaluation. Conclusion Inferior TWI is an infrequent finding in young individuals and may be a marker of pathology in a small group of subjects. The number of leads with TWI (inferior [2 leads], inferior [3 leads] and inferolateral TWI) did not influence the diagnostic yield. Further evaluation is warranted in such cases.

Methods for measuring respiratory rate based on the analysis of chest wall movements

Aim of the review to discuss the respiratory rate (RR) measurement methods that use sensors for analyzing chest wall movements. Strain and movement sensors can be successfully used in real clinical practice, since they can be easily integrated into clothes and garments (electronic textiles) for measuring the respiratory rate in both inpatients and outpatients. Meanwhile, magnetometers, gyroscopes and accelerometers must be located in specific places. One of the main limitations of strain and motion sensors is their sensitivity to patient's breathing-unrelated movements. In order to reduce this limitation, the sensors should most often be placed in the upper part of the chest and integrated into mechanical supports. In addition, it is recommended to use hybrid systems consisting of multiple different sensors. Such systems allow separate analysis of the thoracic and abdominal breathing patterns, providing for wide opportunities to use these sensors for scientific purposes. The use of special polymers and protective materials in a piezoresistive sensors design will allow to overcome their other drawback the possible influence of environmental factors (for example, temperature or humidity). Conclusion. All types of the sensors presented in this review showed generally good quality of respiratory curves at rest during normal breathing. However, in most cases, the bias increased in physical activity. The choice of a certain type of sensor for RR assessment should obviously be based on the specific clinical situation, monitoring duration, monitoring conditions (intensive care unit, inpatient, outpatient department), taking into consideration the advantages and disadvantages.

Errors in Metered Dose Inhaler Use Amongst Pediatric Asthma Patients.

The aim of this paper is to use easily accessible smartphones as a straightforward means for physicians to objectively check Medical Device Inhaler (MDI) technique, without the need for additional devices. Additionally, we seek to assess the frequency of inhaler technique errors and their impact on asthma control. Thirty-two children between the ages of 5 and 18 receiving asthma therapy through MDIs were included. Three surveys were administered to all participants to gauge device history, asthma control, and patient characteristics. Patient technique was scored using inhaler audio signals recorded with a smartphone. For subjects that were able, forced oscillation technique (FOT) was performed during tidal breathing conditions before and after corticosteroid administration. 81% (25/31) of participants used their MDIs incorrectly with the most common errors being rapid shallow breathing, inadequate breath-holding, and excessive actuations. Poor inhaler technique correlated with poorly controlled asthma symptoms. The use of smartphone recordings can a convenient way to evaluate technique errors and could allow patients to demonstrate and refine their technique and usage without a doctor's visit, ensuring proper technique and enhancing treatment effectiveness.

Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial

BackgroundThe results of clinical and weaning readiness tests and the spontaneous breathing trial (SBT) are used to predict the success of the weaning process and extubation.MethodsWe evaluated the capacity of the cuff leak test, rate of rapid and shallow breathing, cough intensity, and diaphragmatic contraction velocity (DCV) to predict the success of the SBT and extubation in a prospective, multicenter observational study with consecutive adult patients admitted to four intensive care units. We used receiver operating characteristic (ROC) curves to assess the tests’ predictive capacity and built predictive models using logistic regression.ResultsWe recruited 367 subjects who were receiving invasive mechanical ventilation and on whom 456 SBTs were performed, with a success rate of 76.5%. To predict the success of the SBT, we derived the following equation: (0.56 × Cough) − (0.13 × DCV) + 0.25. When the cutoff point was ≥ 0.83, the sensitivity was 91.5%, the specificity was 22.1%, and the overall accuracy was 76.2%. The area under the ROC curve (AUC-ROC) was 0.63. To predict extubation success, we derived the following equation: (5.7 × SBT) + (0.75 × Cough) − (0.25 × DCV) − 4.5. When the cutoff point was ≥ 1.25, the sensitivity was 96.8%, the specificity was 78.4%, and the overall accuracy was 91.5%. The AUC-ROC of this model was 0.91.ConclusionObjective measurement of cough and diaphragmatic contraction velocity could be used to predict SBT success. The equation for predicting successful extubation, which includes SBT, cough, and diaphragmatic contraction velocity values, showed excellent discriminative capacity.

Analisis Teknik Vokal Onang Onang Dalam Ende Gordang Sambilan Pada Grup Kumala Huta Siantar Panyabungan Kabupaten Mandailing Natal

This study examines the Onang onang Vocal Technique Analysis in Ende Gordang Sambilan in the Kumala Huta Siantar Panyabungan group, Mandailing Natal Regency. The purpose of this study was to determine the vocal techniques of onang onang by parende/group singers, using qualitative methods through a descriptive analysis approach. Using musicology theory, supported by vocal techniques in western music science. Data collection techniques through field observa-tions, interviews, and documentation. The application of vocal techniques seen from the posture in a standing position, dominant articulation using the letters A and O, breathing through chest breathing in medium and low tones and abdominal breathing at the beginning of high-pitched lyrics, onang onang intonation according to the original melody, head resonance and a distinc-tive nose, improvisation with the addition of ornaments in some of the lyrics, vibrato at the end of the lyrics, the spontaneity of the vocal lyrics in relation to the dialect of everyday language, and the miking technique by holding the mic with two hands. In terms of vocal techniques in western music, parende's vocal techniques cannot be forced. Onang onang as a traditional musical art, and has its own characteristics.

ASSESSMENT OF THE RATE OF CHANGE IN THE RAPID SHALLOW BREATHING INDEX AND ITS IMPACT ON EXTUBATION OUTCOMES IN MECHANICALLY VENTILATED PATIENTS

Mechanical ventilation is a crucial intervention in critical care, but weaning and extubation can be complex. Extubation failure poses significant risks, including increased morbidity and mortality. The Rapid Shallow Breathing Index (RSBI) has been explored to predict extubation outcomes. Still, recent research suggests that assessing the rate of change of RSBI over time (ΔRSBI) could enhance prediction accuracy. In this prospective observational study, we analyzed data from patients with respiratory failure, including those with airway diseases and those without documented respiratory conditions. RSBI was measured at the 5th and 120th minutes of spontaneous breathing trials (SBT), and the ΔRSBI was calculated. Patients were categorized into extubation failure and success groups based on their post-extubation outcomes. Receiver-operating characteristic (ROC) curves were generated to determine optimal RSBI thresholds for predicting extubation failure. Out of 119 patients, 23 were excluded due to intolerance to the 120-minute SBT. The remaining 96 patients were divided into normal and airway groups. In the overall analysis, ΔRSBI had an AUC of 0.943, with a threshold of 26% ΔRSBI predicting extubation failure (sensitivity 96%, specificity 91%, overall accuracy 89%). RSBI 120 had an AUC of 0.837, with an optimal threshold of 71 (sensitivity 86%, specificity 78%, overall accuracy 82%). In the normal group, ΔRSBI (AUC 0.785) with a threshold of 24% (sensitivity 86%, specificity 92%, overall accuracy 88%) outperformed RSBI-120 (AUC 0.931) with a threshold of 70 (sensitivity 86%, specificity 91%, overall accuracy 86%). In the airway group, ΔRSBI (AUC 0.893) with a threshold of 26% ΔRSBI (sensitivity 88%, specificity 84%, overall accuracy 88%) and RSBI 120 (AUC 0.863) with a threshold of 76 (sensitivity 88%, specificity 84%, overall accuracy 84%) showed strong predictive capabilities.&#x0D; Assessing the rate of change of RSBI during a 120-minute SBT offers superior predictive value for extubation outcomes compared to a single RSBI measurement. This approach is particularly valuable in patients with airway diseases. Accurate extubation prediction can reduce reintubation rates and associated complications, ultimately improving patient care.

Acupuncture for ventilator-dependent patients at a hospital-based respiratory care center: A randomized controlled trial

BackgroundIn intensive care units, mechanical ventilation is an important therapy to help patients with dyspnea. However, long-term ventilator dependence would consume huge medical resources and increase the risk of morbidity and mortality. The aim of the study was to examine the efficacy of the acupuncture combined with western medical care on ventilator parameters in ventilator-dependent patients. MethodsIn this clinical trial, 80 ventilator-dependent patients aged 20 to 80 years old were randomly assigned to acupuncture group and control group in the respiratory care center (RCC) of Changhua Christian Hospital. Besides regular medical care and therapy, participants in the acupuncture group received acupuncture therapy at the same 17 acu-points for 20 minutes once a day, a total of 12 sessions. The ventilator parameters were recorded to evaluate the respiratory efficiency for all participants. The primary outcome was rapid shallow breathing index (RSBI), and secondary outcomes were respiratory rate (RR), tidal volume (TV) and ventilation per minute (MV), ResultsThough there was no significant difference in the parameter between the acupuncture group and the control group, we found the trend of decreasing RSBI in the acupuncture group. In subgroup analyses, the mean of RSBI significantly decreased 16.02 (with the SD in 60.84) in acupuncture group, while it increased 17.84 (with the SD in 39.38) in control group (p=0.036) after 12 sessions. ConclusionAcupuncture treatment can improve breathing ability of patients with respirator dependence in respiratory care center.

RETRACTED: Analysis of respiratory properties using the low-frequency piezoelectric sensor in patients undergoing intravenous sedation: A prospective observational study

BackgroundPatients who undergo general anesthesia may experience respiratory failure postoperatively because of respiratory depression or upper airway obstruction. AimWe investigated whether a piezoelectric sensor (AYA-P sensor) can be used to detect upper airway obstruction in patients undergoing intravenous sedation. MethodsThis prospective observational study included 26 patients who underwent dental treatment under sedation at a dental clinic. Participants were evaluated using a newly defined airway obstruction score (AOS). The AYA-P sensors were attached to the suprasternal notch and the midpoint between the umbilicus and xiphoid process. The patient's respiratory status was classified into four categories based on thoracic movements, capnography, and breathing sounds from recorded data (S1: no airflow, S2: hypoventilation, S3: normal breathing, and S4: artifact). The data obtained from the AYA-P sensors were processed using a 0.4-Hz low-pass filter, calculated using the moving standard deviation (MSD) method, and further processed using a 0.1-Hz low-pass filter (fMSD). Next, these data were differentiated (D-fMSD). We defined the positive predictive value (PPV) as fMSD or D-fMSD values higher than a threshold α in categories S1 and S2. PPV(αMAX) was defined as the maximum PPV, and the negative predictive value (NPV[αMAX]) was defined using the same αMAX. ResultsWe compared each of the apnea-hypopnea time ratio (AHT%) and AOS with PPV(αMAX) and NPV(αMAX). The AHT% and AOS were correlated with PPV(αMAX) and NPV(αMAX) in the neck and abdomen, respectively. These findings suggest that an AYA-P sensor attached to the neck and abdomen can detect a patient's respiratory status. ConclusionProcessed data obtained from AYA-P sensors can predict upper airway obstruction in patients, and the predicted data may be dependent on individual anatomical differences. Clinical trial registrationThis study was registrated in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) clinical trial: Unique ID: UMIN000047007.

A Single 10-Minute E-cigarette Vapor Exposure Reduces Tidal Volume and Minute Ventilation in Normoxia and Normobaric Hypoxia in Adult Rats.

The present study investigated the effects of a single 10-minute exposure to e-cigarette vapor on ventilation in adult male Long-Evans rats. Ventilation was recorded using awake, unrestrained whole-body plethysmography. Baseline recordings were taken the day before full-body exposure to either room air (n = 9; air control group) or e-cigarette vapor (n = 9; treatment group). Post-exposure recordings were taken immediately after the 10-minute room air or vapor exposure. As part of the ventilation protocol, in addition to recording the subject's ventilation in room air, the subjects were also exposed to 10% oxygen (balanced with nitrogen) to assess the effects of e-cigarette vapor on an increased drive to breathe. Ventilation data were analyzed using a 2x2x2 mixed-model ANOVA measuring treatment (vape vs. air) x time (baseline vs. post-treatment) x condition (normoxia vs. hypoxia) for breathing frequency, tidal volume, and minute ventilation. Breathing frequency increased in both treatment groups (air and vape) with exposure to normobaric hypoxia (p < 0.001), with no effect of time (baseline vs. post-treatment) for either group. Tidal volume increased in both treatment groups (air and vape) with exposure to normobaric hypoxia (p < 0.001), and an effect of time (baseline vs. post-treatment) was observed (p = 0.010) for the vape group. Minute ventilation increased in both treatment groups (air and vape) with exposure to normobaric hypoxia (p < 0.001), and an effect of time (baseline vs. post-treatment) was observed (p < 0.001) for the vape group. In conclusion, immediately following a single 10-minute e-cigarette vapor exposure, both tidal volume and minute ventilation were reduced during normoxia and normobaric hypoxia, indicating a decrease in ventilation after a single 10-minute e-cigarette vapor exposure. Furthermore, this exposure also blunted the physiological response to acute hypoxia exposure. Subjects in the vape group, while breathing more rapidly as expected, experienced shallower breathing than the air group during hypoxia. The findings in this study confirm that vaping could result in reduced lung function.

Preterm birth and exercise capacity: what do we currently know?

The long-term cardiopulmonary outcomes following preterm birth during the surfactant era remain unclear. Respiratory symptoms, particularly exertional symptoms, are common in preterm children. Therefore, cardiopulmonary exercise testing may provide insights into the pathophysiology driving exertional respiratory symptoms in those born preterm. This review aims to outline the current knowledge of cardiopulmonary exercise testing in the assessment of children born preterm in the surfactant era. This study is a narrative literature review. Published manuscripts concerning the assessment of pulmonary outcomes using cardiopulmonary exercise testing in preterm children (aged <18 years) were reviewed. Search terms related to preterm birth, bronchopulmonary dysplasia, and exercise were entered into electronic databases, including Medline, PubMed, and Google Scholar. Reference lists from included studies were scanned for additional manuscripts. Preterm children have disrupted lung development with significant structural and functional lung disease and increased respiratory symptoms. The association between these (resting) assessments of respiratory health and exercise capacity is unclear; however, expiratory flow limitation and an altered ventilatory response (rapid, shallow breathing) are seen during exercise. Due to the heterogeneity of participants, treatments, and exercise protocols, the effect of the aforementioned limitations on exercise capacity in children born preterm is conflicting and poorly understood. Risk factors for reduced exercise capacity in those born preterm remain poorly understood; however, utilizing cardiopulmonary exercise testing to its full potential, the pathophysiology of exercise limitation in survivors of preterm birth will enhance our understanding of the role exercise may play. The role of exercise interventions in mitigating the risk of chronic disease and premature death following preterm birth has yet to be fully realized and should be a focus of future robust randomized controlled trials.

41 Analysis of an Emergency Department Extubation Protocol Using Readiness-To-Wean and Rapid Shallow Breathing Index

41 Analysis of an Emergency Department Extubation Protocol Using Readiness-To-Wean and Rapid Shallow Breathing Index

Effect of Thoracic Joint Mobilization and Breathing Exercise on The Thickness of The Diaphragm, Expansion of The Chest, Respiratory Function, and Endurance in Chronic Stroke Patients

Effect of Thoracic Joint Mobilization and Breathing Exercise on The Thickness of The Diaphragm, Expansion of The Chest, Respiratory Function, and Endurance in Chronic Stroke Patients