Chest
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Randomized Controlled Trial Comparative Study Clinical Trial
Decreasing catheter colonization through the use of an antiseptic-impregnated catheter: a continuous quality improvement project.
To evaluate the use of an antiseptic-impregnated (chlorhexidine and silver sulfadiazine) catheter for the prevention of catheter colonization and catheter-related bloodstream infection (CR-BSI). Then, based on these findings, to implement changes in hospital policy and to assess their effect on a hospital service. ⋯ AICs significantly reduce the rate of central venous catheter colonization. In addition, the apparent protective effects of the catheter over time permit less frequent exchanges or removals of the catheters, decreasing both patient risk and hospital cost.
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Randomized Controlled Trial Comparative Study Clinical Trial
Salmeterol vs theophylline: sleep and efficacy outcomes in patients with nocturnal asthma.
To compare the efficacy, safety, and effects on sleep quality of salmeterol and extended-release theophylline in patients with nocturnal asthma. ⋯ Salmeterol (but not theophylline) was associated with sustained improvements in morning PEF, protection from nighttime lung function deterioration, reductions in albuterol use, and improvements in patient perceptions of sleep. No differences were seen in polysomnographic measures of sleep quality.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of combined kinetic therapy and percussion therapy on the resolution of atelectasis in critically ill patients.
Some critically ill patients have difficulty in mobilizing their respiratory secretions. These patients can develop pulmonary atelectasis that may result in hypoxemia. There are some data to show that atelectasis may be prevented by turning a patient from side to side utilizing special beds. ⋯ KT and mechanical P therapy resulted in significantly greater partial or complete resolution of atelectasis as compared with conventional therapy. There was a generalized trend toward statistical significance in the improvement of oxygenation and a reduced need for bronchoscopy in the group receiving KT and P therapy.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of bronchodilator therapy delivered by nebulization and metered-dose inhaler in mechanically ventilated patients.
The optimal method of delivering bronchodilators in mechanically ventilated patients is unclear. The purpose of this study was to compare the pulmonary bioavailability of albuterol delivered by the nebulizer, the metered-dose inhaler (MDI) and spacer, and the right-angle MDI adaptor in ventilated patients using urinary analysis of drug levels. ⋯ The three delivery systems varied markedly in their efficiency of drug delivery to the lung. As previous studies have confirmed, this study has demonstrated that using an MDI and spacer is an efficient method for delivering inhaled bronchodilators to the lung. The pulmonary bioavailability was poor with the right-angle MDI port. This port should not be used to deliver bronchodilators in mechanically ventilated patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bedside evaluation of efficient airway humidification during mechanical ventilation of the critically ill.
To determine the correlation between simple rating of condensation seen in the flex-tube connecting the heating and humidifying device used with the endotracheal tube and hygrometric parameters (absolute and relative humidity and tracheal temperature) measured by psychrometry. ⋯ In mechanically ventilated ICU patients, visual evaluation of the condensation in the flex-tube provides an estimation of the heating and humidifying efficacy of the heating and humidifying device used, thus allowing the clinician bedside monitoring of airway humidification.