Heart & lung : the journal of critical care
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Randomized Controlled Trial Comparative Study
Beta-1 selective adrenergic antagonist landiolol and esmolol can be safely used in patients with airway hyperreactivity.
This study was undertaken to clarify the effects of esmolol and landiolol, beta-1 selective adrenergic antagonists, on hyperreactive airways in both ovalbumin-sensitized guinea pigs and asthmatic patients. In the animal study, asthma was induced by ovalbumin. After control acetylcholine responses for total pulmonary resistance (Raw) and dynamic lung compliance (Cdyn) were obtained, the animals received propranolol, esmolol, or landiolol, and the same protocol was again performed. ⋯ Tracheal intubation increased the incidence of wheezing in asthmatic patients. However, there was no significant difference in the incidence of wheezing among these groups. The ultra-short-acting beta-1 selective adrenergic antagonists esmolol and landiolol can be safely used perioperatively in patients with airway hyperreactivity.
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Chronic obstructive pulmonary disease (COPD) affects millions worldwide. Despite advances in the treatments of other chronic diseases, little progress in decreasing COPD morbidity and mortality has been made. The death rate associated with COPD has doubled in 30 years. The presence of psychiatric comorbidities, such as anxiety and depression, has been linked to increased mortality, decreased functional status, and decreased quality of life. ⋯ Although the prevalence of anxiety and depression among patients with COPD is significantly higher than the general population, there are serious barriers to the recognition and treatment of these comorbid conditions. Routine assessment and screening for anxiety and depression in all patients diagnosed with COPD should be considered.
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Comparative Study
Does race affect readmission to hospital after critical illness?
To examine the influence of race on 7-day hospital readmission rates after discharge of critically ill patients. ⋯ Contrary to our hypothesis, race was not associated with rapid readmission or mortality of critically ill patients. Factors independently associated with rapid readmission were mechanical ventilation beyond 29 days and disposition to an acute rehabilitation or skilled nursing facility. Further studies are required to ascertain whether these factors are generalizable or idiosyncratic to our institution.