The clinical respiratory journal
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Review Meta Analysis
Efficacy of intrapleural instillation of fibrinolytics for treating pleural empyema and parapneumonic effusion: a meta-analysis of randomized control trials.
The effects of intrapleural fibrinolysis for treating pleural empyema and parapneumonic effusion remain uncertain. ⋯ The present results show that intrapleural fibrinolysis with urokinase may be potentially effective for reducing the need for surgery. Intrapleural fibrinolytic therapy is effective for shortening the lengths of hospital stays without increasing the incidence of severe side effects.
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Chronic cough is a common problem of various etiologies. While diagnosis may relatively be easy in the presence of some specific findings, it tends to be rather difficult when there are no clear symptoms. Therefore, practical guidelines are needed for management of patients with chronic cough. We aimed to evaluate assessment and management of chronic cough in children according to the British Thoracic Society guidelines published in 2008. ⋯ Postnasal drip syndrome and asthma was the most common cause of chronic cough. Asthma-associated findings were found in some of the patients diagnosed with postnasal drip syndrome. It has been observed that there could be more than one particular cause for cough concerning some patients. The gastroesophageal reflux disease was not a common primary cause of chronic cough in children.
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Comparative Study
Differences in incidence and outcome of ventilator-associated pneumonia in surgical and medical ICUs in a tertiary hospital in China.
Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in intensive care units (ICUs). The incidences and outcomes of VAP in a medical ICU (MICU) and a surgical ICU (SICU) were compared. ⋯ These data indicate that VAP prolonged time on ventilator and ICU stay in our institute and increased the mortality in the MICU. There were no differences in incidence of or mortality from VAP in the MICU and SICU.
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The Berlin Questionnaire (BQ) and Epworth Sleepiness Scale (ESS) are two of the widely used screening instruments for subjects suffering from sleep disorders. ⋯ The BQ is a poor predictor of obstructive sleep apnea (OSA) in subjects admitted to our sleep clinic. BQ and ESS together may be used to detect patients with low risk for OSA.
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Observational Study
Noninvasive positive pressure ventilation is required following extubation at the pulmonary infection control window: a prospective observational study.
Timely extubation and sequential invasive to noninvasive positive pressure ventilation (NPPV) at the pulmonary infection control (PIC) window is beneficial for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, it remains unclear whether patients can breathe independently at the PIC window and if NPPV is indeed necessary after extubation. ⋯ Our results provide experimental evidence that most AECOPD patients can breathe independently at the PIC window, but nonetheless develop respiratory distress and thus require NPPV following extubation.