Respiration; international review of thoracic diseases
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Long-term adherence to positive airway pressure (PAP) treatment is essential in patients with obstructive sleep apnea syndrome (OSAS). ⋯ PAP treatment adherence has to be optimized in OSAS patients. When initiating PAP therapy, clinicians have to focus on those patients at risk for discontinuing treatment. Education sessions and closer follow-up are possible strategies to improve treatment adherence and to avoid treatment discontinuation.
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Comparative Study Clinical Trial
Differences in response to pulmonary rehabilitation in idiopathic pulmonary fibrosis and chronic obstructive pulmonary disease.
The benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) are well recognized. However, whether individuals with idiopathic pulmonary fibrosis (IPF) benefit is less clear. ⋯ Pulmonary rehabilitation in IPF produces only modest short-term gains in dyspnea, exercise capacity and ADL, but does not improve health status.
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Randomized Controlled Trial
Propofol safety in bronchoscopy: prospective randomized trial using transcutaneous carbon dioxide tension monitoring.
Midazolam is commonly used for sedation during flexible bronchoscopy because of its relatively wide therapeutic window. Recently, sedation with propofol for bronchoscopy has gained popularity, although concern has been raised regarding its potential ability to induce severe respiratory depression. ⋯ Midazolam + alfentanil and propofol are equally safe for sedation during bronchoscopy. Sedation with propofol, using small boluses at short intervals, does not cause excessive respiratory drive depression and represents an excellent alternative to traditional sedation agents.
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Randomized Controlled Trial Comparative Study
Comparison of noninvasive ventilation by sequential use of mask and helmet versus mask in acute exacerbation of chronic obstructive pulmonary disease: a preliminary study.
Noninvasive positive pressure ventilation (NPPV) using a face mask is the ventilatory mode of choice in selected patients experiencing acute exacerbation of chronic obstructive pulmonary disease (COPD). A high incidence of intolerance limits the use of this approach. ⋯ In patients with acute exacerbation of COPD and undergoing NPPV, the sequential use of a mask and helmet diminished the incidence of failure. Under the present experimental conditions, the use of a helmet increased LOS and the duration of artificial ventilation.
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Factors associated with medication adherence in patients with chronic obstructive pulmonary disease.
Predictors of medication adherence are not well known in chronic obstructive pulmonary disease (COPD). It is therefore necessary to identify factors associated with adherence to improve the effectiveness of COPD management within real-world situations. ⋯ Adherence to COPD medication regimens is poor. Less frequent dosing regimens could be an effective method to enhance adherence to respiratory therapy. Quality-of-life monitoring within clinical practice settings could facilitate improved medication adherence.