American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jul 2017
Effects of Physician-Targeted Pay-for-Performance on Use of Spontaneous Breathing Trials in Mechanically Ventilated Patients.
Pay for performance is an increasingly common quality improvement strategy despite the absence of robust supporting evidence. ⋯ In hospitals with low baseline SBT completion, physician-targeted financial incentives were associated with increased SBT rates driven in part by increased exclusion rates, without consistent improvements in outcome.
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Am. J. Respir. Crit. Care Med. · Jul 2017
ReviewFifty Years of Research in ARDS. Insight into ARDS - From Models to Patients.
Clinicians who treat patients with acute respiratory distress syndrome (ARDS) use information and guidance from a wide array of sources, ranging from laboratory experiments, clinical data, health services research, intuition, to personal experience. Each of these sources of information brings unique methodology and information, but each is inherently limited. ⋯ However, an overwhelming body of knowledge has accumulated in the field from multiple sources. In this review, we describe the nature of some of these sources as they relate to ARDS and review examples of when they have succeeded (and sometimes failed) in shaping practice or advancing knowledge about ARDS.
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Am. J. Respir. Crit. Care Med. · Jul 2017
Multicenter Study Observational StudyPalivizumab Prophylaxis in Preterm Infants and Subsequent Recurrent Wheezing: 6 Year Follow Up Study.
Respiratory syncytial virus (RSV) induces not only infantile recurrent wheezing but also potentially atopic asthma. ⋯ Palivizumab prophylaxis administered to preterm infants did not suppress the onset of atopic asthma but resulted in a significantly lower incidence of recurrent wheezing during the first 6 years. Clinical trial registered with www.clinicaltrials.gov (NCT 01545245).
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Am. J. Respir. Crit. Care Med. · Jul 2017
Multicenter StudyFrailty and Subsequent Disability and Mortality Among Patients With Critical Illness.
The prevalence of frailty (diminished physiologic reserve) and its effect on outcomes for those aged 18 years and older with critical illness is unclear. ⋯ Frailty is common in critically ill adults aged 18 years and older and is independently associated with increased mortality and greater disability. Future studies should explore routine screening for clinical frailty in critically ill patients of all ages. Interventions to reduce mortality and disability among patients with heightened vulnerability should be developed and tested. Clinical trial registered with www.clinicaltrials.gov (NCT 00392795 and NCT 00400062).