Increased Respiratory Secretion

AbstractBackgroundAspiration is a serious side effect of delayed gastric emptying and increased residual volume in intensive care patients. Aspiration can increase the risk of pneumonia and death. Currently, pharmaceutical methods are the most commonly used techniques for decreasing aspiration, but non-pharmaceutical methods may also be effective in reducing aspiration. One of these methods is an abdominal massage. The present study aimed to examine the effect of abdominal massage on aspiration incidence in intensive care patients with an endotracheal tube.MethodsThis study was a randomized controlled clinical trial. Seventy intensive care patients with an endotracheal tube were chosen by convenience sampling and allocated to an intervention or a control group by the minimization method. The intervention group was provided with a 15-min abdominal massage twice a day for 3 days, while the control group received only routine cares. The patients’ respiratory secretion was suctioned before and after the intervention, and immediately after suctioning, the incidence of the aspiration was assessed using special strips which are sensitive to respiratory secretion pH and glucose. SPSS 18 was used to analyze data. Descriptive statistics were used. T independent, Mann-Whitney U, χ2, and Fisher exact tests were used to compare two groups.ResultsThe incidence rates of the aspiration were 5.7% (confidence interval: 0.0–14.3%) and 20% (confidence interval: 8.6–34.3%) in the abdominal massage and the control groups, respectively. The incidence of aspiration differed between two groups, but it was not statistically significant (p=0.07).ConclusionAlthough the low rate of aspiration in the abdominal massage group did not differ significantly with that of the control group, it can be clinically important. It is suggested that further studies be conducted to confirm the effect of abdominal massage on the prevention of aspiration in intensive care patients with an endotracheal tube.

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Microparticle and anti-influenza activity in human respiratory secretion

PLoS ONE ◽

10.1371/journal.pone.0183717 ◽

2017 ◽

Vol 12 (8) ◽

pp. e0183717 ◽

Cited By ~ 5

Author(s):

Ornpreya Suptawiwat ◽

Kanyarat Ruangrung ◽

Chompunuch Boonarkart ◽

Pilaipan Puthavathana ◽

Kittipong Maneechotesuwan ◽

...

Keyword(s):

Respiratory Secretion ◽

Influenza Activity

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Benefits of interventions for respiratory secretion management in adult palliative care patients—a systematic review

BMC Palliative Care ◽

10.1186/s12904-016-0147-y ◽

2016 ◽

Vol 15 (1) ◽

Cited By ~ 7

Author(s):

Juliano Ferreira Arcuri ◽

Ebun Abarshi ◽

Nancy J. Preston ◽

Jenny Brine ◽

Valéria Amorim Pires Di Lorenzo

Keyword(s):

Systematic Review ◽

Palliative Care ◽

Respiratory Secretion

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Clinician Roles in Symptoms and Signs Improvement among Advanced Cancer Patients

10.21203/rs.3.rs-93325/v1 ◽

2020 ◽

Author(s):

Jae Ho Chung ◽

Sun Hyun Kim ◽

Sang-Yeon Suh ◽

Shao-Yi Cheng ◽

Masanori Mori ◽

...

Keyword(s):

Cancer Patients ◽

Hospice Care ◽

Terminally Ill ◽

Palliative Care Service ◽

Care Physician ◽

Care Group ◽

Respiratory Secretion ◽

Terminally Ill Cancer Patients ◽

Physician Group ◽

Symptoms And Signs

Abstract Background: We, study and research how to improve terminally ill cancer patients’ symptoms and signs to ease their pain. Furthermore we also seek how the dedicated palliative care service effects on the cancer patients’ results.Methods: We analyzed 334 physician-diagnosed terminally ill cancer patients and categorized them into non-dedicated hospice care group of 234 and dedicated hospice care group of 100.Results: Symptoms improvement of dyspnea, fatigue, drowsiness, and dry mouth during the first week of admission were respectively 298 (89.2%), 25 (7.5%), 204 (61.1%), 76 (22.8%). Signs improvement of myoclonus, respiratory secretion, leg edema, and ascites between admission and a week after were 5 (1.5%), 41 (12.3%), 47 (14.1%), 12 (3.6%). Significant differences between dedicated hospice care physician group and non-dedicated hospice care physician group were shown in drowsiness (67.5% vs 46 %, p < 0.001) and respiratory secretion (15% vs 6%, p < 0.028).Conclusions:In conclusion, terminally ill cancer patients who received palliative or hospice service showed significant improvement in symptoms and illness signs. Moreover, family doctors (dedicated hospice physician group) performed better than oncologist (non-dedicated physician group).

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Macrolide combination therapy for patients hospitalised with community-acquired pneumonia? An individualised approach supported by machine learning

European Respiratory Journal ◽

10.1183/13993003.00824-2019 ◽

2019 ◽

Vol 54 (6) ◽

pp. 1900824 ◽

Cited By ~ 3

Author(s):

Rainer König ◽

Xueqi Cao ◽

Marcus Oswald ◽

Christina Forstner ◽

Gernot Rohde ◽

...

Keyword(s):

Machine Learning ◽

Combination Therapy ◽

Decision Tree ◽

Controlled Trial ◽

Community Acquired Pneumonia ◽

Moderate Severity ◽

Respiratory Secretion ◽

Hospitalised Patients ◽

Atypical Pathogens ◽

Leukocyte Counts

BackgroundThe role of macrolide/β-lactam combination therapy in community-acquired pneumonia (CAP) of moderate severity is a matter of debate. Macrolides expand the coverage to atypical pathogens and attenuate pulmonary inflammation, but have been associated with cardiovascular toxicity and drug interactions. We developed a decision tree based on aetiological and clinical parameters, which are available ex ante to support a personalised decision for or against macrolides for the best clinical outcome of the individual patient.MethodsWe employed machine learning in a cross-validation scheme based on a well-balanced selection of 4898 patients after propensity score matching to data available on admission of 6440 hospitalised patients with moderate severity (non-intensive care unit patients) from the observational, prospective, multinational CAPNETZ study. We aimed to improve the primary outcome of 180-day survival.ResultsWe found a simple decision tree of patient characteristics comprising chronic cardiovascular and chronic respiratory comorbidities as well as leukocyte counts in the respiratory secretion at enrolment. Specifically, we found that patients without cardiovascular or patients with respiratory comorbidities and high leukocyte counts in the respiratory secretion benefit from macrolide treatment. Patients identified to be treated in compliance with our treatment suggestion had a lower mortality of 27% (OR 1.83, 95% CI 1.48–2.27; p<0.001) compared to the observed standard of care.ConclusionStratifying macrolide treatment in patients following a simple treatment rule may lead to considerably reduced mortality in CAP. A future randomised controlled trial confirming our result is necessary before implementing this rule into the clinical routine.

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