Respiration; international review of thoracic diseases
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Randomized Controlled Trial Comparative Study
Propofol versus midazolam in medical thoracoscopy: a randomized, noninferiority trial.
Hypoxemia is a surrogate marker for periprocedural endoscopic complications. There are no data comparing the safety of propofol sedation with another sedative regimen in medical thoracoscopy. ⋯ As assessed by the surrogate marker hypoxemia, propofol should not be considered the first choice for sedation in medical thoracoscopy.
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Randomized Controlled Trial
Effects of bronchodilators on regional lung sound distribution in patients with chronic obstructive pulmonary disease.
Bronchodilators have been reported to influence regional lung ventilation in patients with chronic obstructive pulmonary disease (COPD), which may change regional lung sound distribution. Vibration response imaging (VRI) is a lung imaging system for the assessment of breath sounds. ⋯ The additional use of an SABA by COPD patients improved their pulmonary function, which was accompanied by changes in regional lung air flow. The distribution of emphysematous lesions and the bronchial reactivity to SABA appeared to affect the redistribution of the lung sounds following bronchodilator administration.
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Randomized Controlled Trial
Prospective randomized trial of bispectral index monitoring of sedation depth during flexible bronchoscopy.
The clinical benefits associated with the use of the bispectral index (BIS) to monitor the depth of sedation during flexible fiberoptic bronchoscopy (FFB) are questionable. ⋯ Using BIS to guide the depth of sedation during propofol sedation in patients undergoing FFB of relatively short duration offers no clinically significant advantages over conventional monitoring.
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Chronic pulmonary aspergillosis (CPA) affects individuals with non-systemic or mildly systemic immunodepression or altered pulmonary integrity due to underlying disease. It has been reported with a variety of clinical and radiological patterns. The condition should be distinguished from simple aspergilloma and allergic bronchopulmonary aspergillosis as well as invasive aspergillosis in severely immunocompromised patients. ⋯ Life-threatening haemoptysis may be prevented by bronchial arteriography with embolisation. However, currently there are no documented treatment recommendations for CPA. This review provides an up-to-date practical overview of this condition, including a comprehensive update on diagnosis and management.
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Thoracic ultrasound is a noninvasive and portable diagnostic tool which is highly indicated for an initial workup of thoracic emergencies. The suspicion of a pneumothorax, pneumonia, pulmonary embolism or a lung contusion after trauma can be quickly assessed using ultrasound. ⋯ Another advantage of thoracic sonography is that this rapid, symptom-based examination has a high sensitivity and specificity. However, a disadvantage is that only pleura-affecting lesions or lesions visible through a sound window, e.g. an effusion or a subpleural consolidation, can be reached.