Chest
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Comparative Study
Lung scanning and exercise testing for the prediction of postoperative performance in lung resection candidates at increased risk for complications.
To analyze the value of preoperative lung scanning and exercise testing for the prediction of postoperative complications and of the short- as well as long-term performance in lung resection candidates at increased risk for complications. ⋯ Radionuclide-based calculations of postoperative VO2max are predictive of operative morbidity and mortality: a VO2max-ppo of < 10 mL/kg/min may indicate inoperability. Further, short-term postoperative performance is accurately predicted by FEV1-ppo and VO2max-ppo, but long-term function is underestimated after lobectomy.
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Comparative Study
Using tracheal pressure to trigger the ventilator and control airway pressure during continuous positive airway pressure decreases work of breathing.
We evaluated the difference in work of breathing (WOB) during spontaneous ventilation with continuous positive airway pressure (CPAP) among three methods of triggering the ventilator: conventional pressure triggering, tracheal pressure triggering, and flow-by triggering. ⋯ Compared with conventional pressure and flow-by methods, triggering with tracheal pressure decreased WOB significantly. This method of triggering may improve patient-ventilator interaction.
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To assess a standard classification of adverse events and evaluate the safety and long-term outcome of thoracoscopy in patients with pleural disease. ⋯ Using the proposed classification of major and minor adverse events, prospective evaluation demonstrated the safety, diagnostic utility, and long-term efficacy of thoracoscopy performed for diagnosis and management of pleural processes. Potential dangers, however, of thoracoscopy are acknowledged, and limitations of the procedure are addressed.
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To evaluate gas exchange, pulmonary function, and lung histology during gas ventilation of the perfluorocarbon-filled lung compared with gas ventilation of the gas-filled lung in severe respiratory failure. ⋯ In a model of severe respiratory failure, PLV improves pulmonary gas exchange and pulmonary function and is associated with a reduction in pulmonary pathology.
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To develop a predictive equation that estimates the probability of life-supporting therapy among ICU monitor admissions and to explore its potential for reducing cost and improving ICU utilization. ⋯ Objective predictions can accurately identify groups of ICU admissions who are at a low risk for receiving life support. This capability can be used to assess ICU resource use and develop strategies for providing graded critical care services at a reduced cost.