Chest
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Review Meta Analysis
Respiratory physiotherapy to prevent pulmonary complications after abdominal surgery: a systematic review.
To examine the efficacy of respiratory physiotherapy for prevention of pulmonary complications after abdominal surgery. ⋯ There are only a few trials that support the usefulness of prophylactic respiratory physiotherapy. The routine use of respiratory physiotherapy after abdominal surgery does not seem to be justified.
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Multicenter Study
Lung function and ischemic stroke incidence: the Atherosclerosis Risk in Communities study.
Few studies have examined the relation between lung function and ischemic stroke incidence; none have studied African Americans. ⋯ Among white subjects, participants with impaired lung function have a modestly higher risk of ischemic stroke even if they have never smoked nor had respiratory symptoms.
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The impact of ventilatory support on the natural history of neuromuscular disease (NMD) has become clearer over the last 2 decades as techniques have been more widely applied. Noninvasive ventilation (NIV) allows some patients with nonprogressive pathology to live to nearly normal life expectancy, extends survival by many years in patients with other conditions (eg, Duchenne muscular dystrophy), and in those patients with rapidly deteriorating disease (eg, amyotrophic lateral sclerosis) survival may be increased, but symptoms can be palliated even if mortality is not reduced. ⋯ The combination of NIV with cough-assist techniques decreases pulmonary morbidity and hospital admissions. Trials have confirmed that NIV works in part by enhancing chemosensitivity, and in patients with many different neuromuscular conditions the most effective time to introduce NIV is when symptomatic sleep-disordered breathing develops.
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Multicenter Study Comparative Study
A statistical rationale for the use of forced expired volume in 6 s.
The purpose of the study was to determine the best surrogate for FVC when performing spirometry to detect obstruction or restriction. Volume-time curves from 3,539 participants in the Family Heart Study with acceptable quality test sessions were analyzed. An index of the variability of each timed volume (FEVx) from 1 to 12 s was determined for each subject. ⋯ Sensitivity was 76% before the 50-mL error analysis and 95% after. Specificity was 98% before the 50-mL error analysis and 99.5% after. We conclude that use of FEV(6) to replace the FVC for spirometry testing will result in improved reproducibility, with no significant loss of sensitivity or specificity, after allowing a 50-mL measurement error, for detecting obstruction or restriction.
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Multicenter Study
Risk factors for extubation failure in patients following a successful spontaneous breathing trial.
To assess the factors associated with reintubation in patients who had successfully passed a spontaneous breathing trial. ⋯ Among routinely measured clinical variables, RSBI, positive fluid balance 24 h prior to extubation, and pneumonia at the initiation of ventilation were the best predictors of extubation failure. However, the combined predictive ability of these variables was weak.