Chest
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Comparative Study
Stability of improvements in exercise performance and quality of life following bilateral lung volume reduction surgery in severe COPD.
To evaluate the long-term stability of improvements in exercise capacity and quality of life (QOL) after lung volume reduction surgery (LVRS). ⋯ We conclude that bilateral LVRS via median sternotomy in selected patients with severe, diffuse emphysema improves exercise performance and QOL at 3 months following LVRS and these improvements are maintained for at least 12 to 18 months in follow-up.
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To assess the relations among right ventricular (RV) pressures and volumes in sepsis. ⋯ During sepsis, RV EDV and ESV vary independently of changes in Pra and ejection pressure. These data can be explained by assuming that the RV is a highly compliant chamber during filling, such that changes in RV EDV do not alter RV wall stress (preload) or ejection efficiency (RVEF). Thus, changes in RV EDV should proportionally alter RV ESV. Furthermore, the slope of the ESV/EDV relation should be inversely proportional to ejection efficiency.
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To determine the predictors of outcome in cardiac surgical patients with prolonged ICU stay. ⋯ Preoperative health status and early organ failure were not predictive of late hospital mortality. The pattern of late organ failure associated with hospital mortality changed with time.
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To determine the usefulness of serial measurements of the rapid-shallow-breathing index (f/VT) as a predictor for successfully weaning elderly medical patients from mechanical ventilator support using a threshold value (< or =130) derived specifically for this population. ⋯ Serial measurements of the rapid-shallow-breathing index in medical elderly patients during a period of spontaneous breathing can accurately predict the ability to be successfully weaned from mechanical ventilator support.
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Thoracoscopy is an excellent means for staging esophageal cancer. Staging of esophageal carcinoma facilitates prognostication and allocation of patients to appropriate treatment regimens. ⋯ Routine thoracoscopic and laparoscopic lymph node staging has been used in patients with esophageal carcinoma with excellent results. Thoracoscopy can allocate patients for neoadjuvant therapy and help avoid an unnecessary thoracotomy in patients found to have gross spread of locoregional disease.