第1篇
Our Editor’s Choice paper examines respiratory therapists』 experiences and attitudes regarding terminal extubations and end-of-life care. Grandhige and colleagues surveyed RTs at 2 academic medical centers about their experiences caring for patients with terminal extubations. They found that RTs are rarely involved in end-of-life discussions despite a desire to be, and they experience situations that generate discomfort. Strickland suggests that integrating content regarding ethical decision-making, end-of-life care, withdrawal of life support, and palliative care not only into the entry-to-practice curriculum, but also into post-graduate continuing education for RTs, as this is vital to improving the RT’s ability to participate and contribute to higher quality care for the patient at the end of life. RT integration into care teams focused on palliative care and end-of-life care, as well as into primary care teams in the ICU, will not only enhance collaboration but also improve patient care.
文摘主要探討了呼吸治療師對於末期拔管和臨終照護的經歷和態度。Grandhige等人調查了2個學術醫療中心呼吸治療師對末期拔管患者的照護經歷。結果發現，儘管他們有參與的意願，但是呼吸治療師很少參與臨終的討論，參與過程也使他們感覺不適。斯特裡克蘭(Strickland)認為，末期拔管和臨終照護的內容涉及倫理決策、臨終照護、生命支持撤除和臨終關懷，不僅要作為一個整體課程融入學生在校的臨床實習課程中，也要成為學生畢業後呼吸治療師的繼續教育課程，因為這是呼吸治療師提高實踐能力、提供更優質照護的關鍵。呼吸治療師加入臨終關懷和臨終照護的團隊，以及加護病房的初級治療團隊，不僅能增進協作還能提高患者照護質量。
第2篇
The purpose of the study by Burnett et al was to investigate the prevalence of exercise-induced bronchoconstriction by a self-report questionnaire, and the perceived impact of exercise-induced bronchoconstriction in college athletes. A majority of athletes reported a history or current symptoms related to exercise-induced bronchoconstriction or asthma, many were not taking any asthma medication, and they reported concern about exercise-induced bronchoconstriction adversely affecting their sports performance. As pointed out by DeJuilio, signs and symptoms of exercise-induced bronchoconstriction should be taken seriously, and Burnett and others have shown that this is not always the case. This study supports the need for future educational programs that should include athletes, families, trainers, coaches, and teachers.
文摘中Burnett等人通過自陳式問卷調查了大學生運動員中運動誘導性支氣管痙攣的患病率和認知影響。結果發現，大多數運動員曾經發生過或現在患有運動誘發的支氣管痙攣或哮喘，其中許多人未服用任何哮喘治療藥物。他們擔心運動誘發的支氣管痙攣會影響他們的運動表現。DeJuilio指出，我們應該高度重視運動誘導性支氣管痙攣的臨床表徵和症狀，但Burnett等人表示並非總是如此。這項研究支持並表明，未來的教育對象還應包括運動員、家庭、訓練員、教練和教師等人。
第3篇
McConnell et al conducted an observational study to assess the proportion of subjects with an arterial blood gas result within 60 min of mechanical ventilation initiation. A post-intubation checklist and time out improved the timeliness of mechanical ventilation monitoring through more rapid assessment of ABGs. Unfortunately, however, there was only moderate adoption of the checklist. The authors propose that implementing this peri-intubation procedure may reduce the risks associated with transitioning to mechanical ventilation. Poon and Kritek suggest that perhaps a simpler checklist needs to be developed. Maybe clinical champions of the checklist need to be identified. The answer to creating and sustaining a program that assures timely completion of routine processes after intubation remains to be found, but we can learn from the experiences of this study.
McConnell等人評估機械通氣開始60分鐘內受試者動脈血氣分析值的比例變化的觀察性研究，他們製作了一份插管後的檢查表並計時經由動脈血氣分析值的快速評估來改善機械通氣監測的及時性。然而，遺憾的是，該檢查表只有中度被採用。作者認為，實施這樣一個插管期間監測，可能減少過度使用機械通氣的相關風險，Poon和Kritek認為需要開發更簡單有效的檢查清單，也許需更加權威的人來確認有效性。如何設計和維持一個計劃來確保插管後及時完整的日常流仍需要繼續探索，但我們可以從中學習到經驗。
第4篇
In their study, Berlinski and Cooper hypothesized that using a soft mist inhaler and changing the delivery route from tracheostomy to oronasal will increase lung dose. They found that, in general, a soft mist inhaler delivers higher lung dose than a pMDI when using a metallic spacer during oronasal and tracheostomy route with the latter providing higher lung dose.
Berlinski和Cooper的研究，他們假設，使用柔性氣霧吸入器，並將路徑從氣切口改到口鼻將增加肺內沉積量。結果發現，在一般情況下，經由口鼻吸入時柔性的氣霧器並用金屬輔助器在肺沉積劑量比加壓型定劑量吸入器高，而加壓型定劑量吸入器經由氣切口路徑提供則有較高的肺沉積劑量。
第5篇
To develop normal values, Carrillo and colleagues evaluated diaphragm thickness measurements with a two-dimensional B-mode ultrasound at rest in healthy subjects. They found that real time ultrasound of the diaphragm is a simple, inexpensive and portable imaging technique that can provide qualitative anatomical information.
Carrillo等人利用B超測量正常人的膈肌的厚度。結果發現，即時超聲對於膈肌的測量是一種簡單、廉價和便攜的成像技術，可以提供定性解剖信息。
第6篇
The purpose of the study by Efstathiou et al was to examine the relationship between handgrip strength and maximum inspiratory pressure in healthy young and middle-aged individuals. Their results showed significant correlation between hand flexor force and strength of inspiratory muscles in healthy individuals. This study should be viewed as hypothesis-generating and further studies are required in critically ill or difficult-to-wean patients.
Efstathiou等人的研究，他們比較健康年輕人和中年人的手握力和最大吸氣壓力之間的關係。結果發現：健康人的手握力和吸氣肌的強度之見有顯著的相關性。這項研究可被當作產生假設，對重症或脫機困難病人進一步研究是必需的。
第7篇
De Vito and colleagues determined the carbon dioxide rebreathing response in subjects with late-onset Pompe disease. They found that subjects with late-onset Pompe disease had an impaired hypercapnic respiratory drive response. The clinical impact of this phenomenon in this patient subset warrants further investigation
文摘是De Vito等人研究遲發性龐貝式症受試者對二氧化碳重吸入的反應。結果發現，遲發性龐貝式症受試者碳酸血症使其呼吸驅動反應受損。這些人群中的這種臨床現象需要進一步研究。
第8篇
The aim of the study by Reychler et al was to observe the reproducibility sputum color identification by different categories of health caregivers using a sputum color chart. They found that, even if a sputum color chart is a useful tool for the clinician in the context of a clinical deterioration, it presents a non-uniform reliability regarding the caregivers and their category.
文摘是Reychler等人的研究，其目的是用痰液顏色圖標來觀察不同病人痰液顏色再現性。他們發現，即使痰液顏色的變化對於臨床人員判斷臨床狀況惡化是一項有用的工具，但對於不同種類的病人無法呈現一致的可靠性。
第9篇
The purpose of the study by Jacobsen and colleagues was to examine socioeconomic variations in use of prescription medicines among elderly subjects with COPD. They found that there were no systematic socioeconomic differences in the use of relevant prescription medicines in elderly subjects diagnosed with COPD in hospital settings. Their findings do indicate a gap between guideline recommendations and observed use of long-acting bronchodilators, and thus suboptimal quality-of-treatment in the elderly COPD patient population.
Jacobsen 等人的研究，目的是檢驗慢性阻塞性肺疾病(COPD)受試老人所使用處方與社會經濟的關係。結果發現，住院COPD老人所使用處方與社會經濟地位之間沒有明顯差異。研究顯示，治療指南的建議和使用長效支氣管擴張劑之間沒有明顯差異，因此對於老年COPD病人群體的治療沒有達到最佳品質。
第10篇
Cystatin C is a biomarker of renal function, and an independent risk factor for all-cause and cardiovascular mortality among elderly persons. The aim of the study by Hu et al was to examine the prognostic role of cystatin C for mortality of COPD exacerbations. They found that cystatin C was a strong and independent risk factor for hospital mortality in COPD exacerbations.
我們都知道胱蛋白C是腎功能的生物標誌，也是預測所有老年人心血管死亡率與其他因素之間的獨立危險因素。本研究探討胱蛋白C在預測COPD急性加重的死亡率的預後因子的角色。結果發現，胱蛋白C是在COPD急性加重的住院死亡率的強而獨立的危險因素。
第11篇
The study by Lee and colleagues used the National Health Insurance Research Database in Taiwan to examine the risk factors for tracheostomy in infants with congenital heart disease and to evaluate the associated mortality risk in those who received a tracheostomy. Infants with congenital heart disease had an increased risk of undergoing tracheostomy. The mortality risk was significantly increased in infants with congenital heart disease and tracheostomy, and the risk increases progressively with time.
Lee及其同事根據臺灣的健康保險資料庫分析先天性心臟病嬰幼兒做氣管切開的危險因素和評定相關的死亡風險。研究顯示，先天性心臟病增加了嬰幼兒接受氣管切開術後的風險。同時存在先天性心臟病和氣管切開的嬰幼兒死亡率明顯增加，並且風險隨著時間的推移逐步增加。
第12篇
Tang et al evaluated prognostic factors for acute organophosphorus pesticide poisoning. High 6-hour post-admission blood lactate levels, low blood pH, and low post-admission 6-hour lactate clearance rates were independent prognostic factors identified by multivariate logistic regression analysis.
Tang等人評估了關於急性有機磷農藥中毒預後因素的研究。經多種因素回歸分析確定，入院後6小時血液中高乳酸值、低pH值和低乳酸清除率是獨立的預後因素。
第13篇
This month we publish the paper by Needham and his colleagues from the 3rd Thomas L Petty Memorial Lecture, entitled, 「Early Mobilization and Rehabilitation in the Intensive Care Unit: Moving Back to the Future」
本月，我們發表的論文是Needham及其同事在第三屆託馬斯Thomas L Petty紀念演講的內容，題為「ICU中早期的活動和康復，讓患者更好得擁抱未來」。