Chest
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Observational Study
Inhaled nitric oxide versus epoprostenol during acute respiratory failure: an observational target trial emulation.
The inhaled vasodilators nitric oxide and epoprostenol may be initiated to improve oxygenation in mechanically ventilated patients with severe acute respiratory failure (ARF); however, practice patterns and head-to-head comparisons of effectiveness are unclear. ⋯ Large variation exists in the use of initial inhaled vasodilator for respiratory failure across US hospitals. Comparative effectiveness analyses identified no differences in outcomes based on inhaled vasodilator type.
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A 40-year-old Asian man with COPD presented to the ER with an acute exacerbation and type 2 respiratory failure. He was intubated and placed on the mechanical ventilator. ⋯ The family history was non contributory. His physical development was normal.
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Randomized Controlled Trial Multicenter Study
Effectiveness of a long-term home-based exercise training program in patients with COPD following pulmonary rehabilitation: A multi-center randomized controlled trial.
Most patients with COPD do not maintain exercise training after pulmonary rehabilitation (PR). ⋯ The home exercise program had no effect on dyspnea, but improved 1MSTST performance and patient-perceived fitness. The supported program was well accepted by patients with COPD and may facilitate continued exercise training at home.
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Randomized Controlled Trial Multicenter Study
"Ventilatory Strategy to Prevent Atelectasis During Bronchoscopy Under General Anesthesia: A Multicenter Randomized Controlled Trial" (VESPA Trial).
Atelectasis negatively influences peripheral bronchoscopy, increasing CT scan-body divergence, obscuring targets, and creating false-positive radial-probe endobronchial ultrasound (RP-EBUS) images. ⋯ VESPA significantly reduced the incidence of atelectasis, was well tolerated, and showed a sustained effect over time despite bronchoscopic nodal staging maneuvers. VESPA should be considered for bronchoscopy when atelectasis is to be avoided.