Heart & lung : the journal of critical care
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Patients with chronic obstructive pulmonary disease (COPD) appear to have impaired cardiac autonomic modulation with depressed heart rate variability (HRV). Pulmonary rehabilitation (PR) is recommended as an integral part of the management. However, the effect of PR on HRV at peak exercise remains unclear. ⋯ PR results in significant improvements in autonomic function, with concurrent improvements in HRQL and exercise capacity.
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Case Reports
Delayed multifocal recurrent stress-induced cardiomyopathy after antidepressants withdrawal.
Stress-induced cardiomyopathy is an acute disease characterized by a large left ventricular apical dyskinesia ("apical ballooning"), triggered by intense emotional or physical stress, acute illnesses or, rarely, by alcohol or opiates withdrawal. Connection to stress and apical asynergy suggest a catecholamine-mediated pathogenesis. ⋯ The lack of relevant triggering stress and the evidence of multifocal asynergies could support the hypothesis of a non-catecholaminergic pathogenesis. Moreover, the long latency after antidepressant withdrawal may suggest that prolonged antidepressant treatments may have delayed pathological consequences, possibly related to their known neuroplastic effects.
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Randomized Controlled Trial Comparative Study
Seated and semi-recumbent positioning of the ventilated intensive care patient - effect on gas exchange, respiratory mechanics and hemodynamics.
To compare the effect of semi-recumbent and sitting positions on gas exchange, respiratory mechanics and hemodynamics in patients weaning from mechanical ventilation. ⋯ Neither position resulted in significant changes in respiratory and hemodynamic parameters. Both positions can be applied safely in patients being weaned from ventilation.
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To test the impact of two levels of intervention on communication frequency, quality, success, and ease between nurses and intubated intensive care unit (ICU) patients. ⋯ This study provides support for the feasibility, utility and efficacy of a multi-level communication skills training, materials and SLP consultation intervention in the ICU.
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Meta Analysis
The efficacy of noninvasive ventilation in managing postextubation respiratory failure: a meta-analysis.
To determine the effectiveness of noninvasive ventilation (NIV) in the management of postextubation respiratory failure. ⋯ Current evidence suggests that the use of NIV in patients with established postextubation respiratory failure should be monitored cautiously. Early use of NIV can benefit patients with planned extubation by decreasing the reintubation rate and the ICU and hospital mortality rates.