Chest
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In late ARDS, a persistent and exaggerated inflammatory response causes recurrent injury to the alveolocapillary barrier and amplification of intra-alveolar fibroproliferation. When ARDS patients fail to improve, corticosteroid (CS) rescue treatment frequently leads to rapid improvements in lung function. We tested the hypothesis that response to CS treatment is related to suppressing the inflammatory response by comparing changes in lung function to inflammatory cytokine (IC) levels in the plasma and BAL. ⋯ In patients with late ARDS and a low likelihood of survival, prolonged corticosteroid rescue treatment was associated with a reduction in plasma and BAL IC levels and parallel improvements in indices of endothelial permeability and LIS.
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To determine the utility of routine triage pulse oximetry screening in emergency department (ED) patients. ⋯ Providing physicians with routine triage pulse oximetry measurements resulted in significant changes in medical treatment of these patients.
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To describe and evaluate an ultrasound pattern useful in the diagnosis of pneumothorax. ⋯ Ultrasound was a sensitive test for detection of pneumothorax, although false-positive cases were noted. The principal value of this test was that it could immediately exclude anterior pneumothorax.