Chest
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CPAP effectiveness is limited by suboptimal adherence. Prior studies of adherence have focused on middle-aged men. ⋯ CPAP adherence rates vary substantially by demographics, with 18- to 30-year-old women having the lowest adherence. The pattern of use over the first 90 days also varies substantially by age and sex. Further research to understand and address the causes of disparities will be crucial to maximizing the benefits of CPAP therapy.
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Comorbidities significantly contribute to morbidity, mortality, and health-care costs in individuals with COPD. Comorbidity prevalence does not always correlate with lung disease severity, and the elevated risk of certain comorbidities is often independent of shared risk factors such as tobacco burden. ⋯ Recent studies suggest that certain radiographic features on thoracic imaging may serve as surrogate markers of comorbidity in patients with COPD. This review evaluates these studies in the context of the growing availability of chest CT scans in the lung cancer screening era and discusses how chest CT imaging can be leveraged to identify those COPD patients at highest risk for comorbid disease.
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Multicenter Study Observational Study
Prevalence of Reverse Triggering in Early ARDS: Results from a Multicenter Observational Study.
The prevalence of reverse triggering (RT) in the early phase of ARDS is unknown. ⋯ Fifty percent of patients receiving assist-control ventilation for mild or moderate ARDS, sedated and nonparalyzed, demonstrate RT without breath stacking on the first day of mechanical ventilation. RT may be associated with low VTS and opiate doses.
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Multicenter Study Observational Study
Critically Ill Adults with COVID-19 in New Orleans and Care with an Evidence-based Protocol.
Characteristics of critically ill adults with coronavirus disease 2019 (COVID-19) in an academic safety net hospital and the effect of evidence-based practices in these patients are unknown. ⋯ Care of critically ill COVID-19 patients with an evidence-based protocol is associated with increased time alive and free of invasive mechanical ventilation. In-hospital survival occurred in most critically ill adults with COVID-19 admitted to an academic safety net hospital's ICUs despite a high rate of comorbidities.