Chest
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Randomized Controlled Trial Clinical Trial
Oxygen uptake kinetics and cardiopulmonary performance in lone atrial fibrillation and the effects of sotalol.
Atrial fibrillation (AF) is associated with impaired exercise capacity. Oxygen uptake (VO2) kinetics determines cardiopulmonary performance during submaximal exercise, which may be impaired in patients with AF. ⋯ In addition to maximal exercise capacity and cardiopulmonary performance, patients with chronic AF without significant structural heart disease had impaired submaximal exercise performance as assessed by VO2 kinetics. These parameters were not significantly affected by sotalol used for rate control.
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Comparative Study
Do-not-resuscitate decisions in the medical ICU: comparing physician and nurse opinions.
To determine how soon after admission to a medical ICU physicians and nurses decide that attempts at resuscitation are inappropriate and how frequently physicians and nurses disagree about do-not-resuscitate (DNR) decisions. ⋯ At our institution, recognition of DNR appropriateness by nurses and physicians occurs over a similar time frame. However, physicians are more likely to recommend DNR in cases of disagreement between nurses and physicians.
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Randomized Controlled Trial Clinical Trial
Proportional assist ventilation and exercise tolerance in subjects with COPD.
This study determined whether proportional assist ventilation (PAV) applied during constant power submaximal exercise could enable individuals with severe but stable COPD to increase their exercise tolerance. ⋯ In this study, PAV+CPAP provided ventilatory assistance during cycle exercise sufficient to increase the endurance time. It is now appropriate to evaluate whether PAV+CPAP will facilitate exercise training.
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To identify and discriminate between patient and institutional determinants of investigation costs in the ICU. ⋯ ICU investigation costs vary significantly between institutions and are not always linked to patient-dependent factors. Acquisition of nosocomial and iatrogenic events during ICU admission increases costs dramatically. Costs are not necessarily greater in teaching hospitals.
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To determine the prevalence and causes of pleural effusions in patients admitted to a medical ICU (MICU). ⋯ Pleural effusions in MICU patients are common, and most are detected by careful review of chest radiographs taken with the patient in erect or semierect position. When clinical suspicion for infection is low, observation of these effusions is warranted initially, because most are caused by noninfectious processes that should improve with treatment of the underlying disease.