Respiratory care
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Editorial Multicenter Study
Managing Asthma on the College Campus: Findings of a Texas Pilot Study.
Students attending institutions of higher education have the option of utilizing their student health center (SHC) for asthma management. However, a review of the available literature revealed no previous research as to how SHCs on college campuses in Texas manage students with asthma. This led to the following research questions; how are SHCs in Texas managing asthma for college students, and what are the SHC directors' attitudes and perceptions of the impact of asthma on their college campuses? ⋯ The majority of directors were satisfied with asthma services provided to students; however, they felt more face-to-face asthma education was needed.
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Randomized Controlled Trial Multicenter Study
Oxygenation With a Single Portable Pulse-Dose Oxygen-Conserving Device and Combined Stationary and Portable Oxygen Delivery Devices in Subjects With COPD.
Portable oxygen devices simplify and facilitate patient therapy. This study was designed to compare S(pO2) and patient satisfaction with a portable oxygen concentrator or a combined system consisting of a fixed device with continuous-flow oxygen dispensation and a portable device with pulse dispensation for ambulation. ⋯ Subjects preferred using a single portable oxygenation system both at home and during ambulation. Portable systems alone, however, did not supply the same levels of oxygenation as the combination of fixed and portable systems. Before the widespread adoption of portable systems as a single device, additional studies are needed to determine best-practice protocols for adjustment of daytime and nighttime oxygenation settings. (ClinicalTrials.gov registration NCT02079753).
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Multicenter Study
Single-Breath Diffusing Capacity for Carbon Monoxide Instrument Accuracy Across 3 Health Systems.
Measuring diffusing capacity of the lung for carbon monoxide (DLCO) is complex and associated with wide intra- and inter-laboratory variability. Increased D(LCO) variability may have important clinical consequences. The objective of the study was to assess instrument performance across hospital pulmonary function testing laboratories using a D(LCO) simulator that produces precise and repeatable D(LCO) values. ⋯ D(LCO) instrument accuracy was unacceptable in 43% of devices. Instrument inaccuracy can be primarily attributed to errors in inspired volume measurement and not gas analyzer performance. D(LCO) instrument performance may be improved by regular testing with a simulator. Caution should be used when comparing D(LCO) results reported from different laboratories.
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Editorial Randomized Controlled Trial Multicenter Study
THE ASSOCIATION BETWEEN PHYSIOLOGIC DEAD-SPACE FRACTION AND MORTALITY IN PATIENTS WITH THE ACUTE RESPIRATORY DISTRESS SYNDROME ENROLLED INTO A PROSPECTIVE MULTI-CENTERED CLINICAL TRIAL.
We tested the association between pulmonary dead-space fraction (ratio of dead space to tidal volume [V(D)/V(T)]) and mortality in subjects with ARDS (Berlin definition, P(aO2)/F(IO2) ≤ 300 mm Hg; PEEP ≥ 5 cm H2O) enrolled into a clinical trial incorporating lung-protective ventilation. ⋯ Markedly elevated V(D)/V(T) (≥ 0.60) in early ARDS is associated with higher mortality. Measuring V(D)/V(T) may be useful in identifying ARDS patients at increased risk of death who are enrolled into a therapeutic trial.
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Hospital admissions for COPD exacerbations account for 70% of total costs of COPD treatment, and the duration of hospital stay is directly related to this cost. The aim of this study was to investigate possible associations of demographic, clinical, laboratory, and functional parameters with stay of subjects admitted for COPD exacerbations and to provide a score for the prediction of the need for prolonged hospitalization. ⋯ The AECOPD-F score could accurately predict stay in hospitalized COPD subjects. The implementation of this score in clinical practice could be useful in the discharge planning of such subjects.