Chest
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Editorial Comment
High-frequency ventilation in acute pediatric respiratory failure.
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We report a dramatic case of factitious hemoptysis in a 36-year-old black man who presented with hemoptysis and chest pain. ⋯ A factitious cause should be considered in the differential diagnosis of hemoptysis of unclear etiology, especially when the medical history or the patient's behavior is unusual.
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To evaluate the ability of preoperative variables to identify patients at increased risk for complications after lung resection and the usefulness of predicted postoperative FEV1 as a marker of risk for adverse outcomes. ⋯ A low predicted postoperative FEV1 appears to be the best indicator of patients at high risk for complications, and it was the only significant correlate of complications when the effect of other potential risk factors was controlled for in a multivariate analysis. Pulmonary resection should not be denied on the basis of traditionally cited preoperative pulmonary variables, and a prediction of postoperative pulmonary function by a technique of simple calculation may be useful to identify patients at increased risk for medical complications.
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To study sequences of colonization of different species of microorganisms and to determine the importance of gastric colonization for the development of nosocomial pneumonia. ⋯ Based on studying sequences of colonization in ICU patients, we concluded that the stomach is unlikely to be an important source of pathogens leading to nosocomial pneumonia as diagnosed by BAL/PSB. Furthermore, the initial site and route of colonization might not be the same for all microorganisms.
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To describe the importance of measuring work of breathing (WOB) in patients with high airway resistance (Raw) during continuous positive airway pressure (CPAP) support. ⋯ Patients with high Raw may suffer excessive WOB even during CPAP with advanced demand-flow system type ventilators. It is vital to monitor WOB continuously using an adequate pulmonary function monitor such as that used in this study.