Chest
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Multicenter Study
Simplified prediction rule for prognosis of patients with severe community-acquired pneumonia in ICUs.
To develop a simplified prognostic prediction rule for patients admitted to ICUs for severe community-acquired pneumonia (CAP). ⋯ As an aid to clinicians in stratifying the prognosis of patients with severe CAP, the simplified prediction rule used in this study could be useful for therapeutic decisions and appropriate care.
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Comparative Study Clinical Trial
Nocturnal efficiency and tolerance of a demand oxygen delivery system in COPD patients with nocturnal hypoxemia.
We compared the efficacy of the standard nasal cannula and the demand oxygen delivery system (DODS) during sleep in patients with COPD. ⋯ In a majority of moderate to severe COPD patients, the use of a DODS device does not induce any significant alteration of nocturnal neurophysiologic and ventilatory profiles. However, the presence of nocturnal desaturation in a few patients justifies the need to systematically perform a ventilatory polygraphic recording when prescribing a DODS device.
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Comparative Study
An in vitro comparison of the mucoactive properties of guaifenesin, iodinated glycerol, surfactant, and albuterol.
The mechanism of action of potential mucoactive agents could relate to effects on the mucociliary apparatus or to direct effects on the secretions. The purpose of this study was to determine the in vitro effects of several agents on the properties of mucus simulants and sputum collected from 30 adults with stable chronic bronchitis. ⋯ These agents appear to have a minimal direct action on sputum in vitro, suggesting that at the concentrations studied, these agents do not have a significant beneficial effect on either the mucociliary transportability or CTR of chronic bronchitis sputum. However, there could be an effect of some of these agents after oral administration, especially if there is a secondary effect of the agent on an effector cell.
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Bilevel pressure ventilation has had proven success in the treatment of acute respiratory failure (ARF). The purpose of this study was to identify patient characteristics early in the course of acute illness that can predict the successful use of bilevel pressure ventilation. ⋯ Our inability to predict success based on initial data supports the use of bilevel pressure ventilation trials for all stable patients with ARF. If the patient's condition fails to improve within 30 min, intubation and mechanical ventilation is indicated.
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To evaluate patient-related and procedure-related risk factors for thoracentesis-related pneumothorax. ⋯ The results of a bivariate analysis suggest that pneumothorax following thoracentesis is a rare event that is not easily predictable when the procedure is performed by experienced operators in a controlled setting.