American journal of respiratory and critical care medicine
-
Am. J. Respir. Crit. Care Med. · May 2011
Multicenter Study Clinical TrialSerum PARC/CCL-18 concentrations and health outcomes in chronic obstructive pulmonary disease.
There are no accepted blood-based biomarkers in chronic obstructive pulmonary disease (COPD). Pulmonary and activation-regulated chemokine (PARC/CCL-18) is a lung-predominant inflammatory protein that is found in serum. ⋯ Serum PARC/CCL-18 levels are elevated in COPD and track clinical outcomes. PARC/CCL-18, a lung-predominant chemokine, could be a useful blood biomarker in COPD.
-
Am. J. Respir. Crit. Care Med. · May 2011
Randomized Controlled Trial Clinical TrialNoninferiority of functional outcome in ambulatory management of obstructive sleep apnea.
Home portable monitor testing is increasingly being used to diagnose patients with obstructive sleep apnea (OSA) and to initiate them on continuous positive airway pressure (CPAP) treatment. ⋯ Functional outcome and treatment adherence in patients evaluated according to a home testing algorithm is not clinically inferior to that in patients receiving standard in-laboratory polysomnography.
-
Am. J. Respir. Crit. Care Med. · May 2011
Randomized Controlled TrialSix-minute-walk test in idiopathic pulmonary fibrosis: test validation and minimal clinically important difference.
The 6-minute-walk test (6MWT) is a practical and clinically meaningful measure of exercise tolerance with favorable performance characteristics in various cardiac and pulmonary diseases. Performance characteristics in patients with idiopathic pulmonary fibrosis (IPF) have not been systematically evaluated. ⋯ The 6MWT is a reliable, valid, and responsive measure of disease status and a valid endpoint for clinical trials in IPF.
-
Am. J. Respir. Crit. Care Med. · May 2011
Lung regional metabolic activity and gas volume changes induced by tidal ventilation in patients with acute lung injury.
During acute lung injury (ALI), mechanical ventilation can aggravate inflammation by promoting alveolar distension and cyclic recruitment-derecruitment. As an estimate of the intensity of inflammation, metabolic activity can be measured by positron emission tomography imaging of [(18)F]fluoro-2-deoxy-D-glucose. ⋯ In patients with ALI managed with relatively high end-expiratory pressure, metabolic activity of aerated regions was associated with both plateau pressure and regional Vt normalized by end-expiratory lung gas volume, whereas no association was found between cyclic recruitment-derecruitment and increased metabolic activity.
-
Am. J. Respir. Crit. Care Med. · May 2011
Early corticosteroids in severe influenza A/H1N1 pneumonia and acute respiratory distress syndrome.
Despite their controversial role, corticosteroids are often administered to patients with adult respiratory distress syndrome (ARDS) secondary to viral pneumonia. ⋯ Our study provides no evidence of a beneficial effect of corticosteroids in patients with ARDS secondary to influenza pneumonia, but suggests that very early corticosteroid therapy may be harmful.