Chest
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Randomized Controlled Trial Multicenter Study Clinical Trial
Mask proportional assist vs pressure support ventilation in patients in clinically stable condition with chronic ventilatory failure.
To compare the short-term physiologic effects of mask pressure support ventilation (PSV) and proportional assist ventilation (PAV) in patients in clinically stable condition with chronic ventilatory failure (CVF). ⋯ In resting, awake patients in clinically stable condition with CVF caused by either COPD or RCWD, noninvasive application of PAV, set at the patient's comfort, was not superior to PSV either in increasing VT and E or in unloading the inspiratory muscles. We failed to find any difference in patient/ventilator interaction between ventilatory modes.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Using quality of life to predict hospitalization and mortality in patients with obstructive lung diseases.
Condition-specific measures of quality of life (QOL) for patients with COPD have been demonstrated to be highly reliable and valid, but they have not conclusively been shown to predict hospitalization or death. ⋯ Lower QOL is a powerful predictor of hospitalization and all-cause mortality. Brief, self-administered instruments such as the SOLDQ may provide an opportunity to identify patients who could benefit from preventive interventions.
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Randomized Controlled Trial Clinical Trial
Teaching time for metered-dose inhalers in the emergency setting.
In some acute-care settings, practitioners are reluctant to institute bronchodilator therapy with metered-dose inhalers (MDIs) as standard management. Such therapy requires that personnel ensure optimal use of these devices. We prospectively evaluated the time required to teach patients correct inhaler use for the emergency treatment of asthma and COPD, and patient factors associated with duration of teaching. ⋯ Successful MDI/DED teaching followed by self-medication is feasible in the emergency setting, based on a simple protocol. A single bronchodilator dose administered by wet nebulization may facilitate subsequent MDI teaching.
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Randomized Controlled Trial Comparative Study Clinical Trial
Refillable oxygen cylinders may be an alternative for ambulatory oxygen therapy in COPD.
To compare, in clinical conditions, the efficacy of refilled oxygen cylinders (O2-HFs) in improving oxygenation and exercise capacity of patients with COPD during a 6-min walking test. ⋯ O2-HFs are as efficient as O2-Cs for performing short-term exercises. Because of a lower cost, pressurizing units may be worthwhile for improving ambulatory oxygen therapy and pulmonary rehabilitation programs.
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Randomized Controlled Trial Clinical Trial
Effects of training with heliox and noninvasive positive pressure ventilation on exercise ability in patients with severe COPD.
We sought to determine whether breathing heliox or using nasal noninvasive positive pressure ventilation (NIPPV) would produce immediate improvements in exercise capability in patients with COPD, and whether training for 6 weeks with one of these modalities would result in greater exercise improvement than with training unassisted. ⋯ Heliox treatment does not appear to offer an immediate or training advantage with exercise in patients with COPD. For patients who have undergone regular exercise conditioning with NIPPV, use of the ventilator produces an immediate improvement in both exercise time and maximum workload attained, and it may confer a training advantage.