Chest
-
Randomized Controlled Trial Clinical Trial
Effect of distractive auditory stimuli on exercise tolerance in patients with COPD.
We tested the hypothesis that a distractive stimulus, such as music, introduced during exercise can reduce perception of respiratory effort at any given level of exercise, whereas sensory deprivation increases effort perception. Thirty-six patients with moderate COPD participated in four sessions of symptom-limited exercise. The first session familiarized the subject with the protocol. ⋯ Although the respective RPE was higher for SIL than for GN (p < 0.01) at every level of exercise, WT and EXT were no different. These data indicate that perceived effort can be significantly influenced by external factors. This in turn suggests that the use of distractive stimuli during exercise training programs with patients with COPD may significantly decrease perceived symptoms of respiratory discomfort, thus allowing the patient to exercise to a higher intensity, and potentially achieving more effective exercise reconditioning training.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Reappraisal of continuous positive airway pressure therapy in acute cardiogenic pulmonary edema. Short-term results and long-term follow-up.
To investigate whether serial incremental continuous positive airway pressure (CPAP) has any short-term or long-term advantages over face-mask oxygen therapy by way of intrapulmonary shunt reduction, 100 patients admitted to the coronary care unit for the treatment of acute cardiogenic pulmonary edema were studied. All patients received Swan-Ganz catheterization. Hemodynamic and pulmonary function parameters were recorded over the next 6 h, and the patients were followed until hospital discharge. ⋯ The therapeutic failure rate over 6 h was 24% in the CPAP group and 50% in the control group (p < 0.01). The CPAP group had a significantly lower incidence of tracheal intubation and ventilator therapy than the control group; however, there was no significant difference in short-term mortality and hospital stay between the two groups. In conclusion, although study size was not large enough to demonstrate a difference in mortality, CPAP therapy resulted in physiologic cardiovascular and pulmonary function improvement and significantly reduced the need for intubation; however, it did not decrease mortality in patients with acute cardiogenic pulmonary edema, and a much larger study is needed to investigate this possibility.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Comparing two heat and moisture exchangers with one vaporizing humidifier in patients with minute ventilation greater than 10 L/min.
To evaluate in patients submitted to minute ventilation > 10 L/min the ability to preserve patients' heat and humidity of two heat and moisture exchangers (HMEs) and one vaporizing humidifier (VH). ⋯ In patients with minute ventilation > 10 L/min, the DAR Hygroster HME showed a thermic and humidification capability similar to the reference system, the Bennett Cascade 2 VH. In these patients, the Pall Ultipor HME had a significantly lower capability.
-
To determine the outcome of renal transplant recipients in an intensive care unit (ICU). ⋯ The ICU mortality of renal transplant recipients was twice that of general surgical ICU patients. The hospital mortality rate for recipients admitted immediately postoperatively to the ICU (group 1) was less than predicted by APACHE II.