Respiratory care
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Randomized Controlled Trial
Expiratory Rib Cage Compression, Secretion Clearance and Respiratory Mechanics in Mechanically Ventilated Patients: A Randomized Crossover Trial.
Expiratory rib cage compression (ERCC) has been empirically used by physiotherapists with the rationale of improving expiratory flows and therefore the airway clearance in mechanically ventilated patients. This study evaluates the acute mechanical effects and sputum clearance of an ERCC protocol in ventilated patients with pulmonary infection. ⋯ Although ERCC increases expiratory flow, it has no clinically relevant effects from improving the sputum production and respiratory mechanics in hypersecretive mechanically ventilated patients. The maneuver can cause EFL in some patients. (ClinicalTrials.gov registration NCT01525121).
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Editorial Comment
Clinical practice trends in mechanical ventilation for acute asthma.
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Editorial Comment
Is extended-release guaifenesin no better than a placebo?
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Review Meta Analysis Comparative Study
Tiotropium versus placebo for inadequately controlled asthma: a meta-analysis.
This meta-analysis was performed to evaluate the efficacy and safety of the addition of tiotropium to standard treatment regimens for inadequately controlled asthma. ⋯ The addition of tiotropium to standard treatment regimens has significantly improved lung function without increasing adverse events in patients with inadequately controlled asthma. Long-term trials are required to assess the effects of the addition of tiotropium on asthma exacerbations and mortality.