American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Sep 2011
Multicenter StudyDetection of pulmonary emboli with 99mTc-labeled anti-D-dimer (DI-80B3)Fab' fragments (ThromboView).
We report a new method to diagnose acute pulmonary embolism (PE) by single photon emission computerized tomography (SPECT) after administration of (99m)Tc-labeled anti-D-dimer (DI-80B3) monoclonal antibody Fab' fragments. This novel technique provides an additional approach to diagnosing PE in patients for whom other methods are nondiagnostic or contraindicated. Objectives: We performed a prospective, multicenter study to investigate the sensitivity and specificity of (99m)Tc-DI-80B3/SPECT in patients with suspected acute PE. ⋯ (99m)Tc-DI-80B3/SPECT was sensitive and specific for acute PE in subjects with moderate to high clinical probability of PE or a positive D-dimer test. (99m)Tc-DI-80B3/SPECT demonstrated an acceptable safety profile and avoids exposure to contrast.
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Am. J. Respir. Crit. Care Med. · Sep 2011
Randomized Controlled Trial Multicenter StudyNoninvasive ventilation and weaning in patients with chronic hypercapnic respiratory failure: a randomized multicenter trial.
The use of noninvasive ventilation (NIV) as an early weaning/extubation technique from mechanical ventilation remains controversial. ⋯ No difference was found in the reintubation rate between the three weaning strategies. NIV decreases the intubation duration and may improve the weaning results in difficult-to-wean patients with CHRF by reducing the risk of postextubation ARF. The benefit of rescue NIV in these patients deserves confirmation.
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Am. J. Respir. Crit. Care Med. · Sep 2011
Randomized Controlled Trial Multicenter Study Comparative StudyRandomized, placebo-controlled clinical trial of an aerosolized β₂-agonist for treatment of acute lung injury.
β₂-Adrenergic receptor agonists accelerate resolution of pulmonary edema in experimental and clinical studies. ⋯ These results suggest that aerosolized albuterol does not improve clinical outcomes in patients with ALI. Routine use of β₂-agonist therapy in mechanically ventilated patients with ALI cannot be recommended. Clinical trial registered with www.clinicaltrials.gov (NCT 00434993).