American journal of respiratory and critical care medicine
-
Am. J. Respir. Crit. Care Med. · May 2015
Historical ArticleHistory of Mechanical Ventilation: From Vesalius to Ventilator-Induced Lung Injury.
Mechanical ventilation is a life-saving therapy that catalyzed the development of modern intensive care units. The origins of modern mechanical ventilation can be traced back about five centuries to the seminal work of Andreas Vesalius. ⋯ One of the great advances in ventilatory support over the past few decades has been the development of lung-protective ventilatory strategies, based on our understanding of the iatrogenic consequences of mechanical ventilation such as ventilator-induced lung injury. These strategies have markedly improved clinical outcomes in patients with respiratory failure.
-
Am. J. Respir. Crit. Care Med. · May 2015
Observational StudyFailure of Empirical Systemic Antifungal Therapy in Mechanically-ventilated Critically Ill Patients.
Systemic antifungal treatments are empirically administered to the sickest critically ill patients, often without documented invasive fungal infection. ⋯ This study failed to show outcome benefits for empirical systemic antifungal therapy in the sickest critically ill, nonneutropenic, nontransplanted patients. The post hoc power did not allow us to conclude to an absence of treatment effect especially for specific subgroups. Studies to refine indications for empirical treatment based on surrogate markers of invasive candidiasis are warranted.
-
Am. J. Respir. Crit. Care Med. · May 2015
Randomized Controlled TrialLong-term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography.
Screening for lung cancer with low-dose spiral computed tomography (LDCT) has been shown to reduce lung cancer mortality by 20% compared with screening with chest X-ray (CXR) in the National Lung Screening Trial, but uncertainty remains concerning the efficacy of LDCT screening in a community setting. ⋯ Because of its limited statistical power, the results of the DANTE (Detection And screening of early lung cancer with Novel imaging TEchnology) trial do not allow us to make a definitive statement about the efficacy of LDCT screening. However, they underline the importance of obtaining additional data from randomized trials with intervention-free reference arms before the implementation of population screening.
-
Am. J. Respir. Crit. Care Med. · May 2015
Global Epidemiology of Pediatric Severe Sepsis: the Sepsis PRevalence, OUtcomes, and Therapies Study.
Limited data exist about the international burden of severe sepsis in critically ill children. ⋯ Pediatric severe sepsis remains a burdensome public health problem, with prevalence, morbidity, and mortality rates similar to those reported in critically ill adult populations. International clinical trials targeting children with severe sepsis are warranted.