Chest
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To determine if minute ventilation (E) measured as a trend following the final weaning trial prior to extubation may identify patients ready for extubation and be useful as a predictive measure of extubation outcome. ⋯ E recovery time is an easy-to-measure parameter that may assist in determining respiratory reserve. Preliminary data demonstrates that it may be a useful adjunct in the decision to discontinue mechanical ventilation.
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Acute effects of hyperoxia on dyspnea in hypoxemia patients with chronic airway obstruction at rest.
Supplemental oxygen is used in hypoxemic patients with chronic airways obstruction (CAO) because it reduces pulmonary artery pressure and prolongs life. The purpose of this study was to assess at rest the effects of 30% oxygen inhalation on dyspnea, breathing pattern, neuromuscular inspiratory drive based on measurement of mouth occlusion pressure (P(0.1)), and dynamic hyperinflation (DH), as reflected by changes in inspiratory capacity (IC). ⋯ Patients with CAO receiving long-term oxygen may benefit from hyperoxic breathing at rest, since it decreases the ventilation and the degree of DH, with concurrent improvement of dyspnea sensation.
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Obstructive sleep apnea (OSA) is common in severely obese subjects (body mass index [BMI] > 35). Overnight polysomnography (OPS) is the "gold standard" method of evaluating this condition; however, it is time-consuming, inconvenient, and expensive. Selection of patients for OPS would be enhanced if we could better predict those likely to have clinically significant OSA. ⋯ We explore sleep disturbance and report a simple method of predicting OSA in severely obese symptomatic subjects. This should assist in limiting the use of OPS to those with greater risk and provide a method of assessing risk in those not presenting primarily with a sleep problem.
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Editorial Comment
Blood cultures in community-acquired pneumonia: are we ready to quit?