American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2017
Comparative StudyMicroCT Comparison of Preterminal Bronchioles in Centrilobular and Panlobular Emphysema.
Very little is known about airways that are too small to be visible on thoracic multidetector computed tomography but larger than the terminal bronchioles. ⋯ These results provide new information about small airways pathology in centrilobular and panlobular emphysema and show that these changes affect airways that are not visible with thoracic multidetector computed tomography scans but located proximal to the terminal bronchioles in chronic obstructive pulmonary disease.
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Am. J. Respir. Crit. Care Med. · Mar 2017
Randomized Controlled Trial Multicenter StudyBenefits of Long-Term Pulmonary Rehabilitation Maintenance Program in Severe COPD Patients: 3 Year Follow-Up.
In chronic obstructive pulmonary disease (COPD), the benefits of pulmonary rehabilitation (PR) tend to wane over time. Whether maintenance techniques may help sustain the benefits achieved after completion of the initial PR program remains controversial. ⋯ This study shows a 2-year beneficial effect of a program of rehabilitation maintenance on the BODE index and 6MWD when compared with a standard strategy. This effect vanishes after the second year of follow-up. Clinical trial registered with www.clinicaltrials.gov (NCT 01090999).
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Am. J. Respir. Crit. Care Med. · Mar 2017
Multicenter StudyA New Approach for Identifying Patients with Undiagnosed Chronic Obstructive Pulmonary Disease.
Chronic obstructive pulmonary disease (COPD) is often unrecognized and untreated. ⋯ CAPTURE with PEF can identify patients with COPD who would benefit from currently available therapy and require further diagnostic evaluation. Clinical trial registered with clinicaltrials.gov (NCT01880177).
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Am. J. Respir. Crit. Care Med. · Mar 2017
Randomized Controlled TrialRandomized Trial of Liposomal Amikacin for Inhalation in Nontuberculous Mycobacterial Lung Disease.
Lengthy, multidrug, toxic, and low-efficacy regimens limit management of pulmonary nontuberculous mycobacterial disease. ⋯ Although the primary endpoint was not reached, LAI added to a multidrug regimen produced improvements in sputum conversion and 6-minute-walk distance versus placebo with limited systemic toxicity in patients with refractory MAC lung disease. Further research in this area is needed. Clinical trial registered with www.clinicaltrials.gov (NCT01315236).
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Am. J. Respir. Crit. Care Med. · Mar 2017
Multicenter Study Observational StudyEpidemiology of Weaning Outcome According to a New Definition. The WIND Study.
The weaning process concerns all patients receiving mechanical ventilation. A previous classification into simple, prolonged, and difficult weaning ignored weaning failure and presupposed the use of spontaneous breathing trials. ⋯ A new classification allows us to categorize all weaning situations. Every additional day without a weaning success after the first separation attempt increases the risk of dying.