Dean Hess
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View article: Maximizing Extubation Outcomes Through Educational and Organizational Research (METEOR) Trial: protocol for a batched, stepped-wedge, cluster-randomised, type 2 hybrid effectiveness–implementation trial
Maximizing Extubation Outcomes Through Educational and Organizational Research (METEOR) Trial: protocol for a batched, stepped-wedge, cluster-randomised, type 2 hybrid effectiveness–implementation trial Open
Introduction Many patients who are extubated after receiving mechanical ventilation for acute respiratory failure experience extubation failure (ie, require reintubation hours to days after extubation). High-quality evidence shows that ext…
View article: Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation
Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation Open
Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared co…
View article: Pulse Oximetry: 2023 Year in Review
Pulse Oximetry: 2023 Year in Review Open
Pulse oximetry is arguably the most impactful monitor ever introduced into respiratory care practice. Recently there has been increased attention to the problem of occult hypoxemia in which patients are hypoxemic despite an acceptable SpO2…
View article: AARC Clinical Practice Guideline: Patient-Ventilator Assessment
AARC Clinical Practice Guideline: Patient-Ventilator Assessment Open
Given the important role of patient-ventilator assessments in ensuring the safety and efficacy of mechanical ventilation, a team of respiratory therapists and a librarian used Grading of Recommendations, Assessment, Development, and Evalua…
View article: AARC Clinical Practice Guideline: Spontaneous Breathing Trials for Liberation From Adult Mechanical Ventilation
AARC Clinical Practice Guideline: Spontaneous Breathing Trials for Liberation From Adult Mechanical Ventilation Open
Despite prior publications of clinical practice guidelines related to ventilator liberation, some questions remain unanswered. Many of these questions relate to the details of bedside implementation. We, therefore, formed a guidelines comm…
View article: How to Write an Effective Discussion
How to Write an Effective Discussion Open
Explaining the meaning of the results to the reader is the purpose of the discussion section of a research paper. There are elements of the discussion that should be included and other things that should be avoided. Always write the discus…
View article: Observational Studies
Observational Studies Open
Studies can be observational or experimental. With an observational study, the investigator does not determine the assignment of subjects, and there might not be a control group. If there is a control group, assignment of the independent v…
View article: Respiratory Care Management of COPD Exacerbations
Respiratory Care Management of COPD Exacerbations Open
A COPD exacerbation is characterized by an increase in symptoms such as dyspnea, cough, and sputum production that worsens over a period of 2 weeks. Exacerbations are common. Respiratory therapists and physicians in an acute care setting o…
View article: Using S<sub>pO<sub>2</sub></sub>: Not as Simple as It Seems
Using S<sub>pO<sub>2</sub></sub>: Not as Simple as It Seems Open
The use of pulse oximetry (SpO2) is ubiquitous. In the United States, it is used continuously for all critically ill patients. Moreover, pulse oximeters can be purchased at any pharmacy and at large mail order consumer sites. Few practicin…
View article: Research and Publication in Respiratory Care
Research and Publication in Respiratory Care Open
The evidence that informs respiratory care practice arises from research that generates facts based on the scientific method. A simple definition of research is that it is a method for finding answers to questions. The Common Rule establis…
View article: Symptom Assessment for Mechanically Ventilated Patients: Principles and Priorities: An Official American Thoracic Society Workshop Report
Symptom Assessment for Mechanically Ventilated Patients: Principles and Priorities: An Official American Thoracic Society Workshop Report Open
Mechanically ventilated patients experience many adverse symptoms, such as anxiety, thirst, and dyspnea. However, these common symptoms are not included in practice guideline recommendations for routine assessment of mechanically ventilate…
View article: Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation
Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation Open
Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared co…
View article: Noninvasive respiratory support for COVID-19 patients: when, for whom, and how?
Noninvasive respiratory support for COVID-19 patients: when, for whom, and how? Open
The significant mortality rate and prolonged ventilator days associated with invasive mechanical ventilation (IMV) in patients with severe COVID-19 have incited a debate surrounding the use of noninvasive respiratory support (NIRS) (i.e., …
View article: Exploring the Patient Experience with Noninvasive Ventilation: A Human-Centered Design Analysis to Inform Planning for Better Tolerance
Exploring the Patient Experience with Noninvasive Ventilation: A Human-Centered Design Analysis to Inform Planning for Better Tolerance Open
Background: This study brings a human-centered design (HCD) perspective to understanding the patient experience when using noninvasive ventilation (NIV) with the goal of creating better strategies to improve NIV comfort and tolerance. Meth…
View article: Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation
Analysis of shared cognitive tasks in the application of non-invasive ventilation to patients with COPD exacerbation Open
Interprofessional teamwork plays a key role in the uptake of evidence-based interventions, such as noninvasive ventilation (NIV) for patients with exacerbated Chronic Obstructive Pulmonary Disease (COPD). We aimed to identify the shared co…
View article: Update to the study protocol for an implementation-effectiveness trial comparing two education strategies for improving the uptake of noninvasive ventilation in patients with severe COPD exacerbation
Update to the study protocol for an implementation-effectiveness trial comparing two education strategies for improving the uptake of noninvasive ventilation in patients with severe COPD exacerbation Open
Background There is strong evidence that noninvasive ventilation (NIV) improves the outcomes of patients hospitalized with severe COPD exacerbation, and NIV is recommended as the first-line therapy for these patients. Yet, several studies …
View article: Using Evidence to Adjust Productivity: Bringing Respiratory Care into the 21st Century
Using Evidence to Adjust Productivity: Bringing Respiratory Care into the 21st Century Open
On July 30, 1965, President Lyndon B. Johnson signed Medicare into law, providing medical insurance for Americans aged 65 years or older. In 1972, eligibility for the program was extended to Americans aged less than 65 years with certain d…
View article: Enhancing Implementation of Complex Critical Care Interventions through Interprofessional Education
Enhancing Implementation of Complex Critical Care Interventions through Interprofessional Education Open
Background: Many critical care interventions that require teamwork are adopted slowly and variably despite strong evidence supporting their use. We hypothesize that educational interventions that target the entire interprofessional team (r…
View article: Remembering the Explorers: Robert M. Kacmarek, PhD, RRT, FCCM
Remembering the Explorers: Robert M. Kacmarek, PhD, RRT, FCCM Open
Robert ('Bob') M. Kacmarek, PhD, RRT, FCCM, Director of Respiratory Care at Massachusetts General Hospital and Professor of Anesthesiology at Harvard, died April 1, 2021, at the age of 72. Bob was a prolific author, investigator and teache…
View article: Loss of a Legend: Remembering Robert M. Kacmarek
Loss of a Legend: Remembering Robert M. Kacmarek Open
On April 1, 2021, we lost our longest serving Editorial Board member, Robert M Kacmarek PhD RRT FAARC ([Fig. 1][1]). Bob joined the Editorial Board in 1985. Over the subsequent years, Bob contributed to the evolution of the Journal in many…
View article: Evidence-Based Respiratory Care
Evidence-Based Respiratory Care Open
Evidence-based medicine is the integration of individual clinical expertise with the best available research and the patient's values and expectations. The efficient approach to finding the best evidence is to identify systematic reviews o…
View article: A nomogram for use of non-invasive respiratory strategies in COVID-19
A nomogram for use of non-invasive respiratory strategies in COVID-19 Open
Non-invasive respiratory strategies (NIRS) include non-invasive ventilation (NIV) and high-flow nasal cannula (HFNC). Although neither are invasive, the physiological effects of NIV and HFNC differ. The maturity of evidence supporting the …
View article: AARC Clinical Practice Guidelines: Phase 4
AARC Clinical Practice Guidelines: Phase 4 Open
As we complete the first 20 years of the 21st century, the words "evidence-based medicine" are indelibly etched into practice. What does this mean? This approach to practice is based on using the highest level of evidence. It means that we…
View article: Endogenous Carbon Monoxide Production and Diffusing Capacity of the Lung for Carbon Monoxide in Sepsis-Induced Acute Respiratory Distress Syndrome
Endogenous Carbon Monoxide Production and Diffusing Capacity of the Lung for Carbon Monoxide in Sepsis-Induced Acute Respiratory Distress Syndrome Open
Low-dose inhaled carbon monoxide is a novel therapeutic under investigation in acute respiratory distress syndrome. The Coburn-Forster-Kane equation is a well-validated model of carbon monoxide uptake that can accurately predict carboxyhem…
View article: Long-Term Noninvasive Ventilation in Chronic Stable Hypercapnic Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guideline
Long-Term Noninvasive Ventilation in Chronic Stable Hypercapnic Chronic Obstructive Pulmonary Disease. An Official American Thoracic Society Clinical Practice Guideline Open
Background: Noninvasive ventilation (NIV) is used for patients with chronic obstructive pulmonary disease (COPD) and chronic hypercapnia. However, evidence for clinical efficacy and optimal management of therapy is limited.Target Audience:…