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SLEEP SUCTIONING CPAP ASTHMA BLOOD GAS SPIROMETRY COPD Ad Page 2 Finally, the First Complete Bubble CPAP System That Is Safe, Effective Andad Easy to Use Volume 7 Number 6 December 2012-January 2013 The Journal of Pulmonary Technique SLEEP SUCTIONING CPAP ASTHMA BLOOD GAS SPIROMETRY COPD Ad page 2 Finally, the first complete Bubble CPAP System that is safe, effective andAd easy to use. page 3 Providing world-leading humidification technology while delivering reliable respiratory support. (800) 446-3908 [email protected] For more information on the F&P Bubble CPAP System and FlexiTrunk™ Interface please contact your local Fisher & Paykel Healthcare representative. www.fphcare.com Bubble CPAP Advert.indd 1 14/02/2012 9:05:07 a.m. Volume 7 Number 6 December 2012-January 2013 The Journal of Pulmonary Technique Editorial Hacked and App’d SLEEP SUCTIONING Here’s some interesting items in the news regarding medical devices and CPAP ASTHMA BLOOD GAS information technology: Torie Bosch reports via Slate.com that the GAO has asked SPIROMETRY COPD the FDA to develop a strategy to address information security risks for medical devices. This comes after hackers demonstrated the vulnerability of such devices by hacking into an insulin pump. According to the GAO report, “A denial-of-service attack could be launched using computer worms or viruses that overwhelm a device by excessive communication attempts, making the device unusable by either slowing or blocking functionality or draining a device’s battery.” Medical Vol. 7 No. 6 data generated by the devices could be wiped or stolen and therapies could be December 2012-January 2013 altered. The Slate article noted that most medical devices don’t require passwords, likely because a good security system could slow down medical treatment in case of an emergency. The website PopSci reported that a computer expert at a security conference demonstrated the hacking of a pacemaker, sending 800 volts of electricity across Table of Contents 30 feet. He also showed how a virus could be passed into the pacemaker that could spread and infect other pacemakers nearby. DEPARTMENTS In related news, a bill has been proposed that would establish an Office of Mobile 4 Editorial Health under the auspices of the FDA that would evaluate apps that claim to provide healthcare info. Jennie Gold reports in Kaiser Health News that “it can News 12 be hard to know which [apps] deliver on their health claims and provide accurate 16 Sleep News information.” The KHN article points out, however, that apps are being developed at such a fast pace, it would be hard for the FDA to keep up. 17 Products Gold writes: “The Healthcare Innovation and Marketplace Technologies Act 21 Sleep Products (HIMTA) would establish a special Office of Mobile Health at the FDA to provide 22 Spotlight on Blood Gas/Spirometry recommendations on mobile health app issues and create a mobile health developer support program at the Department of Health and Human Services to 23 Sleep Roundtable help app developers make sure they are operating within privacy regulations, including the federal law HIPAA that sets privacy standards.” The proposed bill has met opposition, with app developers protesting that typical governmental ARTICLES regulatory protocols are too hard to navigate, and hoped that a dedicated FDA office for mobile health would streamline the process. 25 Applying Transpulmonary Pressure The agency has already begun to regulate a handful of medical apps, but 27 Sleep Apnea Diagnostics developers are complaining that the typical six to 20 month approval process 29 Sleep Recording is too slow, and would kill off innovation. The FDA’s Safety and Innovation Act, currently signed into law, has been charged with setting up a strategy for mobile 30 Nasotracheal Suctioning Alternative app regulation, but the report on its work won’t be due until the spring of 2013. It’s estimated that by 2015, 500 million smartphone users will be using medical apps. 32 CPAP for OSA 35 Abdominal Adiposity, Asthma, IR, SDB 43 Blood Hemoglobin, Blood Gases, COPD 48 Arterial Oxygen Saturation Les Plesko, Editor by Pulse Oximetry 52 Non Drowsy OSA and Hypertension 4 Respiratory Therapy Vol. 7 No. 6 n December 2012-January 2013 Ad page 5 Proven option for all OSA patients Get more of your patients on treatment Amazingly simple, advanced treatment for the entire OSA patient spectrum Provent® Sleep Apnea Therapy successfully treats mild, moderate and severe OSA patients. Because Provent is well tolerated with excellent compliance, more OSA patients get on treatment and stay treated. • Demonstrated efficacy across all patient severities • Clinically proven in multiple studies • Treated OSA patients have significantly lower risk of comorbidities Therapy that sticks. ProventTherapy.com / HCP 1-888-SLP-WELL (1-888-757-9355) © 2012 Ventus Medical, Inc. Provent, Ventus Medical and the V logo are registered trademarks or trademarks of Ventus Medical, Inc., in the U.S. and other countries. The Provent device is covered by U.S. Patent Numbers 7,506,649, 7,735,492, 7,735,491, 7,856,979 and other pending U.S. and foreign patents. MSM0404-01_A Editorial advisory Board Mohammed Al Ahmari, PhD, MSc, RRT Dr. Miguel Goncalves Nawal M. Mofarreh AARC Intl Fellow Pulmonology Department and ICU and MBBS, Arab Board-Internal ISSN 2152-355X Director, Respiratory Care Program Emergency Department Medicine I, Cardiac Center- Published six times each year by King Fahd Military Medical Complex & University Hospital of S. João School Al-Thawra General Modern Hospital, Goldstein and Associates, Inc. Prince Sultan College of Health Faculty of Medicine CPR Instructor & Co-Ordinator 10940 Wilshire Blvd., Suite 600 Sciences University of Porto, Portugal Saudi Heart Association in affiliation Los Angeles, CA 90024 USA Al-Khobar, Saudi Arabia Joshua F. Gonzales, MHA, RRT-NPS with American Heart Association, CPR Tel: 310-443-4109 · Fax: 310-443-4110 Prof. Nicolino Ambrosino, Head, Assistant Professor Center, Al-Thawra Hospital E-mail: [email protected] Pulmonary Unit, Cardio-Thoracic Department of Respiratory Care Sana’a-Yemen Website: www.respiratorytherapy.ca Department Texas State University-San Marcos Richard J. Morishige, MS, RRT, RCP, Publisher Steve Goldstein University Hospital, Pisa; Head, Rik Goselink , PT, PhD RAC Editor Les Plesko Pulmonary Rehabilitation and Professor, Rehabilitation Sciences Director, Clinical Affairs Associate Editor Jordana Hammeke Weaning Unit Dean, Faculty of Kinesiology and Breathe Technologies, Inc., Assistant Editor Laszlo Sandor Auxilium Vitae, Volterra, Italy Rehabilitation Sciences Irvine, CA Design & Production Muhammad Aslam, MD Universitaire Ziekenhuizen Leuven/ Pavlos M. Myrianthefs, MD, PhD www.accugraphics.net Clinical Fellow in Newborn Medicine Katholieke Uniersiteit Leuven, Belgium Assistant Professor Harvard Neonatal-Perinatal Charles J. Gutierrez, PhD, RRT, FAARC Athens University Circulation, Coverage, Advertising Fellowship Program Assistant Chief Critical Care Department Rates: Complete details regarding Children’s Hospital Boston Neurorespiratory Care Program– KAT Hospital circulation, coverage, advertising rates, Instructor in Pediatrics, Spinal Cord Injury Center Athens space sizes, and similar information are Harvard Medical School James A. Haley Veterans Hospital Cheryl Needham, BA, RRT available to prospective advertisers. Boston, MA Tampa, FL Clinical Education Manager Closing date is 45 days preceding date Eliezer Be’eri, MD Ken D. Hargett, MHA, RRT, RCP, FAARC, Philips Respironics of issue. Director, Respiratory Rehabilitation Unit FCCM Monroeville, PA Change of Address notices should be Alyn Hospital Director, Respiratory Care Services, Paul Nuccio, MS, RRT, FAARC sent promptly to Circulation Department. Founder and CSO Pulmonary Diagnostic Laboratory, Director of Pulmonary Services Provide old mailing label as well as new Innovent Medical Systems Digestive Disease Endoscopy Brigham and Women’s Hospital & address. Allow two months for change. Jerusalem, Israel The Methodist Hospital Dana-Farber Cancer Institute Melissa K. Brown, BS, RRT-NPS, RCP Houston, TX Boston, MA Editorial Contributions will be Faculty, Respiratory Therapy Program Surinder K. Jindal, MD Lisa Pappas, RRT, BS handled with reasonable care. However, Grossmont College Postgraduate Institute of Medical Respiratory Clinical Coordinator, NICU publishers assume no responsibility for El Cajon, CA Education & Research University of Utah Hospital the safety of artwork, photographs or Prof. Andrea Calkovksa, MD, PhD Chandigarh, India Salt Lake City, UT manuscripts. All submissions may be Department of Physiology, Jessenius Brent D. Kenney, BSRT, RRT, RCP Hossein Razavi, MD, FCCP emailed to [email protected]. Every Faculty of Medicine Supervisor of Care Coordinators, Pulmonary, Critical Care & precaution is taken to ensure accuracy, Comenius University Respiratory Care Department Sleep Medicine but the publish ers cannot accept Mala Hora, Slovakia St. John’s Regional Health Center St. Helena, CA responsibility for the correctness or Prof. Enrico M. Clini Springfield, MO Dr. John H. Riggs, PhD, RCP, FAARC accuracy of information supplied herein Clinica di Malattie Apparato Prof. Dr. Naomi Kondo Nakagawa Director of Respiratory Services or for any opinion expressed. Editorial Respiratorio Department of Physiotherapy, Mission Hospitals closing date is the first day of the month Dipartimento di Oncologia Communication Science and Disorders Asheville, NC preceding month of issue. Ematologia e Pneumologia and Occupational Therapy Daniel D. Rowley, MSc, RRT-NPS, RPFT, ©2012 by Goldstein & Associates, Inc. All Universita Studi
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