The clinical respiratory journal
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Randomized Controlled Trial
A randomized double-blind controlled trial comparing three sedation regimens during flexible bronchoscopy: Dexmedetomidine, alfentanil and lidocaine.
No standardized sedation protocol is available for flexible bronchoscopy (FB). ⋯ No consistent differences were present between the three regimens; however, each was more appropriate in certain patient profiles. We consequently proposed a protocol as a first step towards standardizing sedation practice in FB in a patient-tailored manner. A more comprehensive and detailed protocol including other sedative agents with their corresponding doses should be developed.
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Community-acquired pneumonia (CAP) in adults is an infectious disease with high morbidity in China and the rest of the world. With the changing pattern in the etiological profile of CAP and advances in medical techniques in diagnosis and treatment over time, Chinese Thoracic Society of Chinese Medical Association updated its CAP guideline in 2016 to address the standard management of CAP in Chinese adults. Extensive and comprehensive literature search was made to collect the data and evidence for experts to review and evaluate the level of evidence. ⋯ This guideline is only applicable for the immunocompetent CAP patients aged 18 years and older. The recommendations on selection of antimicrobial agents and the dosing regimens are not mandatory. The clinicians are recommended to prescribe and adjust antimicrobial therapies primarily based on their local etiological profile and results of susceptibility testing, with reference to this guideline.
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Multicenter Study
The safety and efficacy of different methods for obtaining transbronchial lung cryobiopsy in diffuse lung diseases.
Most data on transbronchial lung cryobiopsy (TBLC) are from single centers, with little evidence on the outcome of different methods for performing TBLC. ⋯ Transbronchial lung cryobiopsy was found to offer a reasonable yield in the diagnosis of DPLDs. The incidence of pneumothorax and moderate-to-severe bleeding was lower with the use of fluoroscopy and an occlusion balloon, respectively.
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Multicenter Study
A survey of knowledge and application of mechanical thromboprophylaxis among the medical staff of intensive care units in North China.
Mechanical prophylaxis with graduated compression stockings (GCS) or intermittent pneumatic compression (IPC) is suggested for patients who are bleeding or at high risk for major bleeding. ⋯ A wide gap exists with regards to the knowledge and application of mechanical thromboprophylaxis for venous thromboembolism (VTE) between the medical staff of our country and abroad. Strengthened standardized training may help medical staff improve their understanding and application of mechanical thromboprophylaxis. Amelioration of concerns regarding IPC and GCS could help increase the rate of mechanical thromboprophylaxis for VTE, reduce the occurrence of VTE in ICUs and improve the prognosis of these critically ill patients.
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Observational Study
Emergencies and outcome in invasive out-of-hospital ventilation: An observational study over a 1-year period.
The number of ventilated patients is further increasing which leads to an increasing number of patients with weaning failure. In Germany, the treatment of patients with invasive out-of-hospital becomes more and more common. The aim of the study was to observe the outcome, the frequency and character of emergencies of patients with invasive out-of-hospital ventilation. ⋯ In patients with invasive home mechanical ventilation survival for more than 1 year seems to be common. Only the rate of emergencies affected survival.