American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Apr 2017
Randomized Controlled Trial Multicenter StudyRandomized Trial of Pleural Fluid Drainage Frequency in Patients with Malignant Pleural Effusions-The ASAP Trial.
Patients with malignant pleural effusions have significant dyspnea and shortened life expectancy. Indwelling pleural catheters allow patients to drain pleural fluid at home and can lead to autopleurodesis. The optimal drainage frequency to achieve autopleurodesis and freedom from catheter has not been determined. ⋯ Among patients with malignant pleural effusion, daily drainage of pleural fluid via an indwelling pleural catheter led to a higher rate of autopleurodesis and faster time to liberty from catheter. Clinical trial registered with www.clinicaltrials.gov (NCT 00978939).
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Am. J. Respir. Crit. Care Med. · Apr 2017
Randomized Controlled Trial Multicenter StudyFluctuation Analysis of Peak Expiratory Flow and its Association with Treatment Failure in Asthma.
Temporal fluctuations have been demonstrated in lung function and asthma control, but the effect of controller therapy on these fluctuations is unknown. ⋯ We conclude that increased temporal self-similarity (α) of more variable lung function (CVpef) is associated with treatment failure, but the pattern of change in self-similarity leading up to treatment failure is variable across individuals.
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Am. J. Respir. Crit. Care Med. · Apr 2017
Randomized Controlled TrialEffect of Fluticasone Furoate and Vilanterol on Exacerbations of COPD in Patients with Moderate Airflow Obstruction.
Inhaled corticosteroids have been shown to decrease exacerbations in patients with moderate to severe chronic obstructive pulmonary disease (COPD). Their effects in patients with milder airflow obstruction remain unclear. ⋯ Patients with moderate chronic airflow obstruction experienced a reduction in exacerbations with FF/VI compared with placebo, irrespective of a history of exacerbations or baseline FEV1. Clinical trial registered with www.clinicaltrials.gov (NCT 01313676; GSK Study number 113782).
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Am. J. Respir. Crit. Care Med. · Apr 2017
Randomized Controlled Trial Multicenter StudyA Multicenter Randomized Trial Assessing the Efficacy of Helium/Oxygen in Severe Exacerbations of Chronic Obstructive Pulmonary Disease.
During noninvasive ventilation (NIV) for chronic obstructive pulmonary disease (COPD) exacerbations, helium/oxygen (heliox) reduces the work of breathing and hypercapnia more than air/O2, but its impact on clinical outcomes remains unknown. ⋯ Heliox improves respiratory acidosis, encephalopathy, and the respiratory rate more quickly than air/O2 but does not prevent NIV failure. Overall, the rate of NIV failure was low. Clinical trial registered with www.clinicaltrials.gov (NCT 01155310).
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Am. J. Respir. Crit. Care Med. · Apr 2017
Letter Randomized Controlled TrialProlonged Apnea Supported by High-Frequency Noninvasive Ventilation: A Pilot Study.