Respiration; international review of thoracic diseases
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Randomized Controlled Trial
Efficacy of salbutamol and ipratropium bromide in the management of acute bronchiolitis--a clinical trial.
A wide range of drugs are commonly used to treat bronchiolitis, but evidence of their effectiveness is limited. ⋯ Clinical scores and oxygen saturation levels improved more rapidly in the bronchodilator groups than in the placebo group up to 24 h, but these drugs did not have a sufficient effect to change the natural course of the disease.
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Randomized Controlled Trial
Titration efficacy of two auto-adjustable continuous positive airway pressure devices using different flow limitation-based algorithms.
Auto-adjustable continuous positive airway pressure devices are widely used in titration procedures to determine therapeutic pressure levels in obstructive sleep apnea patients. However, differences in operational characteristics may influence the effect on the apnea-hypopnea index (AHI). ⋯ While the RR provided a lower AHI than the RS at lower pressure levels, it could not be assessed whether this difference was relevant for clinical outcomes. However, this face-to-face comparison of Auto-adjustable continuous positive airway pressure devices seems useful for the assessment of titration efficacy.
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Randomized Controlled Trial Comparative Study
Noninvasive assisted pressure-controlled ventilation: as effective as pressure support ventilation in chronic obstructive pulmonary disease?
Noninvasive ventilation (NIV) is being increasingly used in hypercapnic chronic obstructive pulmonary disease (COPD) patients but the most appropriate ventilation mode is still not known. ⋯ From these data, we deduce that APCV can be a better alternative to PSV for NIV in COPD patients with AHRF owing to its more beneficial physiological effects.
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Combined pulmonary fibrosis and emphysema (CPFE) is a unique disorder described in several case series of upper lobe emphysema associated with lower lobe fibrosis. Patients with this entity have relatively preserved lung volumes and spirometry but marked reductions in diffusing capacity on pulmonary function testing. Smoking appears to be the predominant risk factor for this disorder. Usual interstitial pneumonia has been the most common histological pattern of interstitial lung disease described on biopsy in the literature. ⋯ The imaging findings and pathology in patients with CPFE are heterogeneous.
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Pleural effusions (PEs) are common in critically ill patients mainly as a consequence of severe cardiopulmonary disorders frequently encountered in these patients. Their impact on the pathophysiology of acute respiratory failure remains unknown. ⋯ CT provides a much more accurate evaluation of the size and location of PEs and is extremely helpful in the guidance of catheters into loculated fluid collections. Hemothorax in critically ill patients is usually related to trauma or surgical interventions and requires early drainage and possibly surgical exploration.