The clinical respiratory journal
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Randomized Controlled Trial
Acetazolamide improves oxygenation in patients with respiratory failure and metabolic alkalosis.
Coexistent respiratory failure and metabolic alkalosis is a common finding. Acidotic diuretics cause a fall in pH that may stimulate respiration. ⋯ Acetazolamide may constitute a useful adjuvant treatment mainly to be considered in selected patients with respiratory failure combined with prominent metabolic alkalosis or where non-invasive ventilation is insufficient or infeasible.
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The cause for shortness of breath among systemic sclerosis (SSc) patients is often lacking. We sought to characterize the hemodynamics of these patients by using simple isotonic arm exercise during cardiac catheterization. ⋯ Exercise during catheterization elucidates the pathophysiology of dyspnea and distinguishes EIPAH from the more common DD in SSc patients.
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The reduction in the ratio between forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) is used for the diagnosis of chronic obstructive pulmonary disease (COPD). The choice between a simple fixed cut-off ratio (FEV1/FVC <0.70) and the use of lower limit of normal (LLN) is eagerly discussed. The aim of this paper was to examine the impact of these two diagnostic measures on the prevalence of COPD using data from the fourth examination of The Copenhagen City Heart Study (CCHS4). ⋯ Using the fixed ratio for diagnosing COPD in an epidemiological setting results in a higher prevalence than if the LLN is used. Time seems ripe for studying if the same is seen when diagnosing COPD in the clinical setting.
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Randomized Controlled Trial
Training on a new, portable, simple simulator transfers to performance of complex bronchoscopy procedures.
Virtual-reality (VR) simulation provides a safe and effective learning environment prior to practicing on patients. However, existing bronchoscopy simulators are expensive and not easily portable. ⋯ The effect of a brief, self-directed training session using a portable, simple simulator was substantial and transferred to performance of more complex skills.
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Even if hyperglycaemia is often identified as an independent risk factor for developing respiratory tract infection, only few studies have investigated this relationship. The aim of this study is to investigate if plasma glucose on admission is related with in-hospital mortality among patients with pneumonia and to identify the glycaemic range with significant reductions of mortality risks in non-intensive care patients. ⋯ Our observations suggest that in non-intensive care patients, hypoglycaemia, as hyperglycaemia, is associated with in-hospital mortality.