Respiratory care
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Randomized Controlled Trial Multicenter Study Comparative Study
GAS6 IN ARDS PATIENTS: DETERMINATION OF PLASMA LEVELS AND INFLUENCE OF PEEP SETTING.
Growth-arrest-specific protein 6 (GAS6) is a vitamin K-dependent protein expressed by endothelial cells and leukocytes participating in cell survival, migration and proliferation and involved in many pathological situations. The aim of our study was to assess its implication in ARDS and its variation according to PEEP setting, considering that different cyclic stresses could alter GAS6 plasma levels. ⋯ GAS6 plasma level is elevated in ARDS patients. The high-PEEP strategy is associated with a decrease in GAS6 and IL-8 plasma levels at day 3, without significant differences in day 28 mortality between the 2 groups. (Clinicaltrials.gov NCT00188058).
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Multicenter Study
High Resource Utilization Does Not Affect Mortality in Acute Respiratory Failure Patients Managed with Tracheostomy.
Tracheostomy practice in patients with acute respiratory failure (ARF) varies greatly among institutions. This variability has the potential to be reflected in the resources expended providing care. In various healthcare environments, increased resource expenditure has been associated with a favorable effect on outcome. ⋯ We were unable to demonstrate a positive relationship between resource expenditure and outcome in ARF patients managed with tracheostomy.
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Multicenter Study
Development and Validation of a Chronic Obstructive Pulmonary Disease Self-Management Scale.
Although self-management reportedly can improve the health and quality of life of patients with COPD, there is no validated instrument for evaluating the status of the self-management of patients with COPD. ⋯ The CSMS is reliable, valid, and sensitive for evaluating the self-management status of COPD patients. To our knowledge, it is the first dedicated scale for evaluating the self-management status of COPD patients, and will serve as an important instrument for assessing and improving the self-management of COPD patients, particularly, those in the Hunan region of China.
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Randomized Controlled Trial Multicenter Study
Are oxygen-conserving devices effective for correcting exercise hypoxemia?
Correction of exercise hypoxemia in advanced lung diseases is crucial and often challenging. However, oxygen-conserving devices have been introduced in the market with limited evidence of effectiveness. In the present study the efficacy of 2 oxygen-conserving devices, a pulse demand oxygen delivery (DOD) system and pendant reservoir cannula (PRC), were evaluated in subjects with COPD and interstitial lung disease (ILD). ⋯ Although these oxygen-conserving devices corrected exercise hypoxemia in most COPD and ILD subjects, correction was not achieved in about 20% of the severe COPD subjects, regardless of the device, and in nearly 40% of the ILD subjects with the DOD device. These findings underscore that individualized adjustment of oxygen flow is needed for optimal correction of exercise hypoxemia, especially with a DOD in an ILD patient. (ClinicalTrials.gov NCT01086891).
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Multicenter Study
Effects of inhaled corticosteroids on pneumonia severity and antimicrobial resistance.
Limited information is available regarding the impact of prior use of inhaled corticosteroids (ICS) in patients subsequently developing community-acquired pneumonia (CAP). We assessed the effects of prior ICS use on severity of illness and microbiology in CAP hospitalized patients. ⋯ Prior ICS use was associated with higher severity of illness at admission and higher incidence of antimicrobial-resistant pathogens in CAP hospitalized patients.