American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2015
Randomized Controlled Trial Multicenter StudyEarly High-volume Hemofiltration vs. Standard Care for Postcardiac Surgery Shock (The HEROICS Study).
Post-cardiac surgery shock is associated with high morbidity and mortality. By removing toxins and proinflammatory mediators and correcting metabolic acidosis, high-volume hemofiltration (HVHF) might halt the vicious circle leading to death by improving myocardial performance and reducing vasopressor dependence. ⋯ For patients with post-cardiac surgery shock requiring high-dose catecholamines, the early HVHF onset for 48 hours, followed by standard volume until resolution of shock and recovery of renal function, did not lower Day-30 mortality and did not impact other important patient-centered outcomes compared with a conservative strategy with delayed CVVHDF initiation only for patients with persistent, severe acute kidney injury. Clinical trial registered with www.clinicaltrials.gov (NCT 01077349).
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Am. J. Respir. Crit. Care Med. · Nov 2015
Randomized Controlled Trial Multicenter StudyFLIGHT: Efficacy and Safety of QVA149 (Indacaterol/Glycopyrrolate) Versus its Monocomponents and Placebo in Patients with COPD.
Current Global Initiative for Chronic Obstructive Lung Disease (GOLD) strategy recommends the combination of two long-acting bronchodilators of different pharmacologic classes for the management of chronic obstructive pulmonary disease (COPD) if symptoms are not adequately controlled by a single bronchodilator. ⋯ Indacaterol/glycopyrrolate twice daily can be an alternative treatment option for the management of symptomatic patients with moderate-to-severe COPD. Clinical trial registered with www.clinicaltrials.gov (NCT 01727141 and NCT 0171251).
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Am. J. Respir. Crit. Care Med. · Nov 2015
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of Treatment Response in Idiopathic and Connective Tissue Disease-Associated Pulmonary Arterial Hypertension.
Studies suggest that patients with connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) have a poorer treatment response to therapies for PAH compared with patients with idiopathic PAH (IPAH), but individual randomized controlled trials (RCTs) have been underpowered to examine differences within these subgroups. ⋯ Treatment for PAH was less effective in CTD-PAH compared with IPAH in terms of increasing 6MWD and preventing clinical worsening. The heterogeneity of treatment response supports the need for identifying therapies that are more effective for CTD-PAH.