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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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.
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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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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.
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Description of the development of a community-based weaning unit and the outcomes from that unit. ⋯ Rehabilitation-based ventilator weaning units play an important role in the spectrum of medical care necessary in population centers. Excellent results can result from community-based units with open admissions policies.