American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2015
Multicenter Study Observational StudyUnderestimation of Patient Breathlessness by Nurses and Physicians during a Spontaneous Breathing Trial.
Breathlessness is a prevalent and distressing symptom in intensive care unit patients. There is little evidence of the ability of healthcare workers to assess the patient's experiences of breathing. Patient perception of breathing is essential in symptom management, and patient perception during a spontaneous breathing trial (SBT) might be related to extubation success. ⋯ Patients reported higher breathlessness after SBT compared with nurses and physicians. Clinical trial registered with www.clinicaltrials.gov (NCT 01928277).
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Am. J. Respir. Crit. Care Med. · Dec 2015
Randomized Controlled Trial Multicenter Study Comparative StudyA Multicenter Randomized Trial of Continuous versus Intermittent β-Lactam Infusion in Severe Sepsis.
Continuous infusion of β-lactam antibiotics may improve outcomes because of time-dependent antibacterial activity compared with intermittent dosing. ⋯ In critically ill patients with severe sepsis, there was no difference in outcomes between β-lactam antibiotic administration by continuous and intermittent infusion. Australian New Zealand Clinical Trials Registry number (ACT RN12612000138886).
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Am. J. Respir. Crit. Care Med. · Dec 2015
Randomized Controlled Trial Multicenter StudyCharacteristics and Outcomes of Eligible Non-Enrolled Patients in a Mechanical Ventilation Trial of Acute Respiratory Distress Syndrome.
Patients eligible for randomized controlled trials may not be enrolled for various reasons. Nonenrollment may affect study generalizability and lengthen the time required for trial completion. ⋯ Nonenrollment was common, with approximately one ENE patient for every randomized patient. Our study suggests that enrollment in trials of mechanical ventilation may be associated with improved outcomes compared with standard care and highlights the need for prospective tracking and transparent reporting of ENE patients as part of trial management.
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Am. J. Respir. Crit. Care Med. · Dec 2015
Multicenter Study Comparative StudyMulti-center Comparison of Lung and Oral Microbiomes of HIV-infected and HIV-uninfected Individuals.
Improved understanding of the lung microbiome in HIV-infected individuals could lead to better strategies for diagnosis, therapy, and prophylaxis of HIV-associated pneumonias. Differences in the oral and lung microbiomes in HIV-infected and HIV-uninfected individuals are not well defined. Whether highly active antiretroviral therapy influences these microbiomes is unclear. ⋯ The overall similarity of the microbiomes in participants with and without HIV infection was unexpected, because HIV-infected individuals with relatively preserved CD4 cell counts are at higher risk for lower respiratory tract infections, indicating impaired local immune function.
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Am. J. Respir. Crit. Care Med. · Dec 2015
Multicenter StudyFrailty Phenotypes, Disability, and Outcomes in Adult Candidates for Lung Transplantation.
Frailty is associated with morbidity and mortality in abdominal organ transplantation but has not been examined in lung transplantation. ⋯ Frailty is prevalent among lung transplant candidates and is independently associated with greater disability and an increased risk of delisting or death.