Respirology : official journal of the Asian Pacific Society of Respirology
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Randomized Controlled Trial
Efficacy and comfort of volume-guaranteed pressure support in patients with chronic ventilatory failure of neuromuscular origin.
Although non-invasive ventilation is widely used for the management of patients with neuromuscular disease, it remains unclear which ventilatory mode is associated with optimal patient-ventilator interaction and provides more effective gas exchange. The effects of volume-guaranteed pressure support (PSV-VTG) as compared with pressure support ventilation (PSV) and assisted pressure controlled ventilation (APCV) on breathing pattern and patient-ventilator synchrony during sleep, blood gases and subjective comfort were evaluated in a group of stable patients with neuromuscular disease. ⋯ PSV-VTG did not outperform older modes of ventilation in terms of efficacy on breathing pattern and blood gases. In addition, application of PSV-VTG was associated with a higher rate of patient-ventilator dyssynchrony.
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Randomized Controlled Trial
Haemodynamic effects of proportional assist ventilation during high-intensity exercise in patients with chronic obstructive pulmonary disease.
Proportional assist ventilation (PAV) has been proposed as a more physiological modality of non-invasive ventilation, thereby reducing the potential for deleterious cardio-circulatory effects during exercise, in patients with COPD. We therefore evaluated whether PAV modulates the kinetic and 'steady-state' haemodynamic responses to exercise in patients with moderate-to-severe COPD. ⋯ PAV slowed the SV and CO kinetics at the onset of high-intensity exercise in selected patients with moderate-to-severe COPD. However, these adverse effects of PAV disappeared during the stable phase of exercise, and were not related to the ergogenic potential of PAV in this patient population.
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Randomized Controlled Trial Multicenter Study
Sleep hypoventilation due to increased nocturnal oxygen flow in hypercapnic COPD patients.
This study shows the risks and benefits of increasing the nocturnal oxygen flow in hypercapnic COPD patients undergoing LTOT, as recommended by some COPD treatment guidelines to avoid nocturnal desaturation. ⋯ The increase of oxygen flow in severe COPD patients with established daytime hypercapnia improved nocturnal oxygenation but it also led to greater hypercapnia and respiratory acidosis at awakening in a considerable proportion of these patients.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of omalizumab in an Asian population with moderate-to-severe persistent asthma.
The efficacy and safety of the anti-IgE antibody, omalizumab, has been widely studied in patients with asthma. However to date, no large studies have been performed in Asian populations. The aim of this study was to compare the efficacy and safety of omalizumab with placebo, as add-on therapy in Asian patients with moderate-to-severe persistent asthma. ⋯ Add-on treatment with omalizumab improved asthma control without significant adverse events in Japanese patients with moderate-to-severe persistent asthma.
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Randomized Controlled Trial
Topical lidocaine through the bronchoscope reduces cough rate during bronchoscopy.
Topical lidocaine is often administered through the flexible bronchoscope in an attempt to reduce excessive coughing and patient discomfort. With the increasing use of sedation, including opiates that possess central cough suppressant effects, and the potential for serious clinical toxicity, the need for evidence regarding the efficacy of topical lidocaine is important. This study assessed whether topical lidocaine through the bronchoscope could reduce cough and stridor rate. ⋯ Topical lidocaine through the bronchoscope significantly decreased cough frequency and the total dose of sedation required during flexible bronchoscopy.