American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Oct 2014
The Role of Bacteria in the Pathogenesis and Progression of Idiopathic Pulmonary Fibrosis.
Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease of unknown cause that leads to respiratory failure and death within 5 years of diagnosis. Overt respiratory infection and immunosuppression carry a high morbidity and mortality, and polymorphisms in genes related to epithelial integrity and host defense predispose to IPF. ⋯ IPF is characterized by an increased bacterial burden in BAL that predicts decline in lung function and death. Trials of antimicrobial therapy are needed to determine if microbial burden is pathogenic in the disease.
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Am. J. Respir. Crit. Care Med. · Oct 2014
Seeking Worldwide Professional Consensus on the Principles of End-of-life Care for the Critically Ill: The Welpicus Study.
Great differences in end-of-life practices in treating the critically ill around the world warrant agreement regarding the major ethical principles. This analysis determines the extent of worldwide consensus for end-of-life practices, delineates where there is and is not consensus, and analyzes reasons for lack of consensus. Critical care societies worldwide were invited to participate. ⋯ Consensus was obtained for 77 of 81 (95%) statements. Worldwide consensus could be developed for the majority of definitions and statements about end-of-life practices. Statements achieving consensus provide standards of practice for end-of-life care; statements without consensus identify important areas for future research.
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Am. J. Respir. Crit. Care Med. · Oct 2014
Pulmonary Hypertension in Cystic Fibrosis with Advanced Lung Disease.
The impact of pulmonary hypertension (PH) on survival in cystic fibrosis (CF) remains unclear. ⋯ The manifestation of PH is associated with significantly increased risk for death in CF patients with advanced lung disease.