Respiration; international review of thoracic diseases
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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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The pleural mesothelial cell is an essential cell in maintaining the normal homeostasis of the pleural space and it is also a central component of the pathophysiologic processes affecting the pleural space. In this review, we will review the defense mechanisms of the pleural mesothelium and changes in pleural physiology as a result of inflammatory, infectious, and malignant conditions with a focus on cytokine and chemokine networks. We will also review the processes involved in the pathogenesis of pleural fibrosis.
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Randomized Controlled Trial Comparative Study
Comparison of automatic and continuous positive airway pressure in a night-by-night analysis: a randomized, crossover study.
Long-term compliance is suboptimal in the treatment of the obstructive sleep apnea syndrome (OSAS). ⋯ Treatment efficacy and adherence are similar with CPAP and APAP. There is a trend towards lower leakage with APAP therapy. Patients prefer the automatic mode to fixed pressure.
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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.