scholarly journals Influence of total face, facial and nasal masks on short-term adverse effects during noninvasive ventilation

2009 ◽  
Vol 35 (2) ◽  
pp. 164-173 ◽  
Author(s):  
Marcelo Alcantara Holanda ◽  
Ricardo Coelho Reis ◽  
Georgia Freire Paiva Winkeler ◽  
Simone Castelo Branco Fortaleza ◽  
José Wellington de Oliveira Lima ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Noninvasive Ventilation ◽  
Crossover Trial ◽  
Positive Airway Pressure ◽  
Ventilator Circuit ◽  
Short Term ◽  
Air Leaks ◽  
Randomized Crossover Trial ◽  
Bilevel Positive Airway Pressure ◽  
Mask Type

OBJECTIVE: Failure of noninvasive ventilation (NIV) has been associated with short-term adverse effects related to the use of masks. The aim of this study was to compare the incidence, type and intensity of adverse effects, as well as the comfort, of total face masks (TFMs), facial masks (FMs) and nasal masks (NMs) during NIV. METHODS: This was a randomized crossover trial involving 24 healthy volunteers submitted to six sessions of NIV in bilevel positive airway pressure mode using the TFM, FM and NM masks at low and moderate-to-high pressure levels. A written questionnaire was applied in order to evaluate eleven specific adverse effects related to the use of the masks. Comfort was assessed using a visual analog scale. The CO2 exhaled into the ventilator circuit was measured between the mask and the exhalation port. RESULTS: The performance of the TFM was similar to that of the NM and FM in terms of comfort scores. Higher pressure levels reduced comfort and increased adverse effects, regardless of the mask type. When the TFM was used, there were fewer air leaks and less pain at the nose bridge, although there was greater oronasal dryness and claustrophobia. Air leaks were most pronounced when the FM was used. The partial pressure of exhaled CO2 entering the ventilator circuit was zero for the TFM. CONCLUSIONS: The short-term adverse effects caused by NIV interfaces are related to mask type and pressure settings. The TFM is a reliable alternative to the NM and FM. Rebreathing of CO2 from the circuit is less likely to occur when a TFM is used.

Randomized Trial of 2 Self-Titrated Oral Appliances for Airway Management

2020 ◽  
pp. 002203452095697
Author(s):  
E. Schneiderman ◽  
P. Schramm ◽  
J. Hui ◽  
P. D. Wilson ◽  
P. Moura ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Positive Airway Pressure ◽  
Mouth Opening ◽  
Oral Appliance ◽  
Oral Appliances ◽  
Pressure Therapy ◽  
Randomized Crossover Trial ◽  
Obstructive Sleep ◽  
Respiratory Event ◽  
Test Population

The effectiveness and predictability of 2 different oral appliance (OA) designs to reduce the respiratory event index (REI) in moderate and severe obstructive sleep apnea (OSA) patients requires elucidation. The primary aim of the trial was to determine if 2 widely used midline-traction and bilateral-thrust OA designs differ in effectiveness to reduce the REI within a single test population categorized by OSA severity. Moderate and severe adult OSA patients, who were previously prescribed continuous positive airway pressure therapy (CPAP) but were dissatisfied with it ( n = 56), were studied by home-polygraphy in a randomized crossover trial using either midline-traction with restricted mouth opening (MR) or bilateral thrust with opening permitted (BP) design OAs. OAs were used nightly for 4 wk (T2) followed by a 1-wk washout period, then 4 wk (T4) using the alternate OA. REI and oxygen saturation (SaO2) were primary outcomes, while predictability and efficacy comparison of the 2 OAs were secondary outcomes. Thirty-six participants had used MR and BP OAs during both 4-wk study legs. Twenty (55.6%) MR OA-using participants, 25 (69.4%) BP OA-using participants, and 16 (44.4%) participants using both OAs had significant REI reductions. Overall baseline (T0) median REI (interquartile range) of 33.7 (20.7–54.9) was reduced to 18.0 (8.5–19.4) at T2 and to 12.5 (8.2–15.9) at T4 ( P < 0.001). Comparison of the 2 sequence groups’ (MR-BP and BP-MR) REI showed the median differences between T0 and T2 and T4 were highly significant ( P < 0.001). Regression analysis predicted about half of all users will have REIs between 8 and 16 after 2 mo. Baseline overjet measures >2.9 mm predicted greater OA advancement at T4. Mean and minimum SaO2 did not change significantly from T0 to T2 or T4. MR and BP OA designs similarly attenuated REI in moderate and severe OSA individuals who completed the 8-wk study protocol with greater REI reduction in those with severe OSA (ClinicalTrials.gov NCT03219034).

scholarly journals A Pilot Randomized Crossover Trial Assessing the Safety and Short-Term Effects of Pomegranate Supplementation in Hemodialysis Patients

2015 ◽  
Vol 25 (1) ◽  
pp. 40-49 ◽  
Author(s):  
Matthew B. Rivara ◽  
Rajnish Mehrotra ◽  
Lori Linke ◽  
John Ruzinski ◽  
T. Alp Ikizler ◽  
...  
Keyword(s):  
Crossover Trial ◽  
Hemodialysis Patients ◽  
Short Term ◽  
Randomized Crossover Trial ◽  
Short Term Effects

scholarly journals Short-Term Intake of Yellowstripe Scad versus Salmon Did Not Induce Similar Effects on Lipid Profile and Inflammatory Markers among Healthy Overweight Adults despite Their Comparable EPA+DHA Content

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3524
Author(s):  
Wei Lin Chang ◽  
Azrina Azlan ◽  
Sabariah Md Noor ◽  
Irmi Zarina Ismail ◽  
Su Peng Loh
Keyword(s):  
Lipid Profile ◽  
Inflammatory Markers ◽  
Crossover Trial ◽  
Atherogenic Index ◽  
Short Term ◽  
Atherogenic Index Of Plasma ◽  
Randomized Crossover Trial ◽  
Vldl Cholesterol ◽  
Before And After ◽  
Overweight Adults

Yellowstripe scad (YSS) have comparable eicosapentaenoic acid and docosahexaenoic acid (EPA+DHA) content to salmon. We aimed to compare the effects of YSS and salmon on lipid profile and inflammatory markers. A randomized crossover trial with two diet periods was conducted among healthy overweight (with BMI 23.0–27.4 kg/m2) Malaysian adults aged 21–55 years. Steamed whole YSS fish (≈385 g whole fish/day) or salmon fillets (≈246 g fillet/day) were given for eight weeks (3 days per week), retaining approximately 1000 mg EPA+DHA per day. Diets were switched after an 8-week washout period. Fasting blood samples were collected before and after each diet period. A total of 49 subjects participated in the intervention (35% male and 65% female; mean age 29 (7) years). YSS did not induce any significant changes in outcome measures. However, the consumption of salmon as compared with YSS was associated with reduction in triglycerides (between-group difference: −0.09 mmol/1, p = 0.01), VLDL-cholesterol (between-group difference: −0.04 mmol/1, p = 0.01), atherogenic index of plasma (between-group difference: −0.05 mmol/1, p = 0.006), and IL-6 (between-group difference: −0.01 pg/mL, p = 0.03). Despite their comparable EPA+DHA content, short-term consumption of salmon but not YSS induced significant changes in lipid profile and inflammatory markers. Larger clinical trials are needed to confirm the findings.

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