American Association for Respiratory Care
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AARC Diagnostics Section

May 2012

AARC Congress 2012: Registration Underway Now

Registration is underway now for AARC CONGRESS 2012, Nov. 10–13 in New Orleans, LA. Don’t miss this great opportunity to learn the latest in respiratory care in a city that’s proud to show off its remarkable recovery from the devastating effects of Hurricane Katrina in 2005. The diagnostics offerings at the meeting promise to deliver the state of the art information you need to stay on the cutting edge of your practice.

Speaking of the Congress, it’s a great place to share your clinical research too, through the annual Open Forum. The deadline to SUBMIT AN ABSTRACT is June 1.

3-Minute Constant Rate Shuttle Walking Protocol Detects Improvements in Exertional Dyspnea

Canadian investigators publishing ahead of print in COPD on April 18 find a 3-minute constant rate shuttle walking protocol can detect improvements in exertional dyspnea following bronchodilation in COPD patients. The study was conducted among 39 patients with moderate-to-severe COPD who were asked to walk on a flat corridor for three minutes at a speed internally imposed by an audio signal. Dyspnea was graded using the 10-point modified Borg scale following the administration of saline placebo and the administration of 500 μg nebulized ipratropium bromide. Respiratory rate and tidal volume improved with ipratropium bromide compared to placebo, and statistically and clinically significant reductions in Borg dyspnea scores were seen as well. READ ABSTRACT

Unpleasant Stimuli May Contribute to Bronchoconstriction in Asthma

A new study out of Southern Methodist University suggests unpleasant stimuli may induce bronchoconstriction in patients with asthma. The research involved 15 asthma patients and 14 healthy controls who were subjected to unpleasant and neutral films ranging between 3–5 minutes in length. Oscillatory resistance (R(os)), respiratory rate, tidal volume, and minute ventilation were measured as the subjects watched. Unpleasant films, including those depicting surgery, resulted in a uniform pattern of initial increases in R(os), with peaks within the first 1–2 minutes, followed by a gradual decline. These increases were more pronounced in the asthma patients and during surgery films. The temporal course of R(os) change was not influenced by the addition of the other respiratory parameters. Participants who experienced greater arousal by the films or reported more shortness of breath had a slower rate of decline in R(os) after the initial increase, as did those who were more susceptible to psychological triggers in daily life. The authors conclude, “More sustained constriction in emotion-induced asthma could be a risk factor for developing asthma exacerbation in daily life.” The study was published ahead of print in Biological Psychology on April 2. READ ABSTRACT

Jury Still Out on Closed System for MBW

University of North Carolina researchers who studied the validity and sensitivity of a commercially available device that uses a closed (rebreathing) setup with photoacoustic spectroscopy for multiple breath wash-out (MBW) testing stopped their trial early after noting a significant degree of intra-subject variability. The trial involved cystic fibrosis patients between the ages of 5–21, along with healthy controls. Seventeen subjects attempted a total of 76 MBW maneuvers; 80% were completed and 60% met criteria for acceptability. Among the results:

  • Most of the unacceptable maneuvers were unacceptable due to errors in the tracer gas curve.
  • Substantial intra-subject variability for the lung clearance index and functional residual capacity were noted.
  • Subjects were noted to have significant increases in exhaled CO2 and tidal volume during MBW testing.

The authors conclude, “Further studies are needed to better understand the closed system MBW setup.” The study was published ahead of print in Pediatric Pulmonology on Mar. 29. READ ABSTRACT

Sensory Hyperreactivity Patients Bear Some Similarity to those with COPD

Patients with “sensory hyperreactivity” (SHR) often suffer from airway environmental sensitivity, chronic cough, and dyspnea. Swedish researchers compared 35 SHR patients with 19 COPD patients, 32 asthma patients, and 28 healthy controls to determine how their symptoms may be different or the same. Results showed SHR patients had an increased respiratory rate and reduced abdominal movement during deep breathing when compared to asthma patients and controls, but not when compared to COPD patients. A lower pain threshold was seen in all of the patient groups vs. the controls. The authors conclude, “Patients with SHR have evident signs of dysfunctional breathing and appeared to be most similar to the COPD group except for lung function.” The study was published ahead of print in Respiratory Medicine on April 15. READ ABSTRACT

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