Chest
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Randomized Controlled Trial Comparative Study Clinical Trial
A prospective randomized comparison of train-of-four monitoring and clinical assessment during continuous ICU cisatracurium paralysis.
Train-of-four (TOF) monitoring is often recommended during the continuous use of neuromuscular blockade (NMB) [paralysis] in the ICU. Prior study results are conflicting regarding the benefits of TOF monitoring. ⋯ TOF monitoring does not lead to improved recovery time or lower cisatracurium dosing compared with monitoring by clinical assessment. We conclude that TOF monitoring is unnecessary, and careful titration of the neuromuscular blocking agent by clinical assessment alone is sufficient in patients undergoing continuous cisatracurium NMB.
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Randomized Controlled Trial Clinical Trial
Mechanisms of improvement in exercise capacity using a rollator in patients with COPD.
We analyzed the effects of the use of a rollator on walking distance and physiologic variables: pulmonary gas exchange, heart rate, minute ventilation (Ve), oxygen saturation, and symptoms during the 6-min walk test (6MWT) in patients with COPD. ⋯ The use of a rollator improves walking distance of patients with COPD through an increased ventilatory capacity and/or better walking efficiency.
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Multicenter Study
The hospital mortality of patients admitted to the ICU on weekends.
Previous studies have suggested that patients are more likely to die in the hospital if they are admitted on a weekend than on a weekday. This study was conducted to determine whether weekend admission to the ICU increases the risk of dying in the hospital. ⋯ The overall adjusted hospital mortality rate of patients admitted to the ICU on a weekend was not higher than that of patients admitted on a weekday. However, weekend ICU admission to the surgical ICU was associated with an increased hospital mortality rate.
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Randomized Controlled Trial Clinical Trial
Impact of evacuated collection tube fill volume and mixing on routine coagulation testing using 2.5-ml (pediatric) tubes.
Anecdotal observations by pharmacists monitoring anticoagulated patients indicate that blood samples collected in 2.7-mL (pediatric) evacuated tubes frequently produced falsely elevated international normalized ratio (INR) results. ⋯ Pediatric blood collection tubes should be filled at least 90% full to ensure accurate INR test results. Anticoagulation therapy providers should routinely inquire about the type of collection tube used (adult vs pediatric) and the adequacy of sample collection volume before deriving therapeutic plans in asymptomatic excessively anticoagulated patients.
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The aim of this study was to investigate the prognostic value of plasma d-dimer levels in patients with community-acquired pneumonia (CAP). ⋯ d-Dimer plasma levels could be useful for predicting clinical outcome in patients with CAP.