Chest
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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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Clinical Trial
Prone postioning and low-volume pressure-limited ventilation improve survival in patients with severe ARDS.
Investigating the effect of low-volume pressure-limited ventilation and repeated prone positioning on the short-term course and outcome in patients with severe ARDS. ⋯ We assume that our low mortality in patients with severe ARDS might be due mainly to low-volume pressure-limited ventilation and prone positioning. This simple strategy seems to allow successful treatment for patients with severe ARDS.
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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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Comparative Study
Indwelling small pleural catheter needle thoracentesis in the management of large pleural effusions.
To evaluate the clinical safety, efficacy, and cost of a small indwelling pleural catheter (7F, Turkel Safety Thoracentesis System [Sherwood, Davis, and Geck; St. Louis]) vs repeated needle thoracentesis or closed tube thoracostomy as a means to drain a large-volume pleural effusion. ⋯ An indwelling pleural catheter with the Turkel safety needle-catheter (as described in the study) can be used to successfully drain the pleural space with reduced morbidity and a significant cost saving in comparison to repeated needle thoracenteses or closed tube thoracostomy.