Knowledge regarding Metabolic Syndrome and adherence to NCEP-ATP III clinical practice guidelines among physicians in New Providence, The Bahamas

P4430Physical activity in leisure time: complying with the recommendations of clinical practice guidelines increases maximum oxygen consumption

European Heart Journal ◽

10.1093/eurheartj/ehz745.0832 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

L Tojal Sierra ◽

S Garcia Mancebo ◽

M Torres Fernandez ◽

I Juanes Dominguez ◽

E Saez De Buruaga ◽

...

Keyword(s):

Physical Activity ◽

Metabolic Syndrome ◽

Oxygen Consumption ◽

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Leisure Time ◽

Health Study ◽

Maximum Oxygen Consumption ◽

Cross Sectional

Abstract Introduction/Objectives The promotion of physical activity is a universal recommendation for prevention of cardiovascular diseases. Clinical practice guidelines recommend at least 150 min/week of moderate or severe physical activity or ≥75 min of severe intensity.Our objective was to analyze whether reaching the physical activity levels recommended in the clinical practice guidelines evaluated by validated questionnaires and accelerometry, is associated with higher level of VO2 max. Methods We conducted a prospective cross-sectional study of 243 participants in the PREDIMED PLUS study (site: Vitoria-Gasteiz), (82 women), 65±4,9 years old, with metabolic syndrome and overweight/obesity. They performed a maximum exercise testing with expired gas analyses. Physical activity in leisure time was evaluated using subjective methods: self-reported questionnaires REGICOR and RAPA 1 and objective methods: chair test and accelerometry (91 subjects). Sedentarism was analyzed with the Nurses Health Study questionnaire and accelerometry Results Subjects who claimed to comply with the recommendations of the PA guidelines in the REGICOR questionnaire achieved higher maximum oxygen consumption (21.3±4.6 vs 18±4.4 ml/kg/min; P<0.001) and those who reported more physical activity in the RAPA 1 test showed a maximum oxygen consumption 18% higher than the less active group (P < . 001). However, those who performed ≥150 min/week of moderate/intense physical activity by accelerometry did not differ significantly from those who did not (21.1±4.7 vs 19.9±4.7 ml/kg/min; P: 0.644). Conclusions Subjects with metabolic syndrome and overweight/obesity who claim to meet PA recommendations in the REGICOR and RAPA tests achieve higher máximum oxygen consumption

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High Flow Oxygen Therapy and the Pressure to Feed Infants With Acute Respiratory Illness

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-19-00158 ◽

2020 ◽

Vol 5 (4) ◽

pp. 1006-1010

Author(s):

Jennifer Raminick ◽

Hema Desai

Keyword(s):

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Oxygen Therapy ◽

Respiratory Illness ◽

High Flow ◽

Oral Feeding ◽

Respiratory Support ◽

Acute Respiratory Illness ◽

High Flow Oxygen

Purpose Infants hospitalized for an acute respiratory illness often require the use of noninvasive respiratory support during the initial stage to improve their breathing. High flow oxygen therapy (HFOT) is becoming a more popular means of noninvasive respiratory support, often used to treat respiratory syncytial virus/bronchiolitis. These infants present with tachypnea and coughing, resulting in difficulties in coordinating sucking and swallowing. However, they are often allowed to feed orally despite having high respiratory rate, increased work of breathing and on HFOT, placing them at risk for aspiration. Feeding therapists who work with these infants have raised concerns that HFOT creates an additional risk factor for swallowing dysfunction, especially with infants who have compromised airways or other comorbidities. There is emerging literature concluding changes in pharyngeal pressures with HFOT, as well as aspiration in preterm neonates who are on nasal continuous positive airway pressure. However, there is no existing research exploring the effect of HFOT on swallowing in infants with acute respiratory illness. This discussion will present findings from literature on HFOT, oral feeding in the acutely ill infant population, and present clinical practice guidelines for safe feeding during critical care admission for acute respiratory illness. Conclusion Guidelines for safety of oral feeds for infants with acute respiratory illness on HFOT do not exist. However, providers and parents continue to want to provide oral feeds despite clinical signs of respiratory distress and coughing. To address this challenge, we initiated a process change to use clinical bedside evaluation and a “cross-systems approach” to provide recommendations for safer oral feeds while on HFOT as the infant is recovering from illness. Use of standardized feeding evaluation and protocol have improved consistency of practice within our department. However, further research is still necessary to develop clinical practice guidelines for safe oral feeding for infants on HFOT.

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