American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Dec 2012
Randomized Controlled Trial Multicenter StudyNatriuretic peptide-driven fluid management during ventilator weaning: a randomized controlled trial.
Difficult weaning from mechanical ventilation is often associated with fluid overload. B-type natriuretic peptide (BNP) has been proposed as a tool for predicting and detecting weaning failure of cardiovascular origin. ⋯ Our results suggest that a BNP-driven fluid management strategy decreases the duration of weaning without increasing adverse events, especially in patients with left ventricular systolic dysfunction. Clinical trial registered with www.clinicaltrials.gov (NCT00473148).
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Am. J. Respir. Crit. Care Med. · Dec 2012
Randomized Controlled Trial Multicenter StudyRandomized controlled trial of chlorhexidine dressing and highly adhesive dressing for preventing catheter-related infections in critically ill adults.
Most vascular catheter-related infections (CRIs) occur extraluminally in patients in the intensive care unit (ICU). Chlorhexidine-impregnated and strongly adherent dressings may decrease catheter colonization and CRI rates. ⋯ A large randomized trial demonstrated that chlorhexidine-gel-impregnated dressings decreased the CRI rate in patients in the ICU with intravascular catheters. Highly adhesive dressings decreased dressing detachment but increased skin and catheter colonization. Clinical trial registered with www.clinicaltrials.gov (NCT 01189682).
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Am. J. Respir. Crit. Care Med. · Dec 2012
Letter Randomized Controlled Trial Comparative StudyPlasma gelsolin levels in the diagnosis, prognosis, and treatment of lung complications of prematurity.
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Am. J. Respir. Crit. Care Med. · Dec 2012
Randomized Controlled Trial Comparative StudyWeight gain after lung reduction surgery is related to improved lung function and ventilatory efficiency.
Lung volume reduction surgery (LVRS) is associated with weight gain in some patients, but the group that gains weight after LVRS and the mechanisms underlying this phenomenon have not been well characterized. ⋯ LVRS leads to weight gain in nonobese patients, which is associated with improvement in lung function, exercise capacity, respiratory muscle strength, and ventilatory efficiency. These physiological changes may be partially responsible for weight gain in patients who undergo LVRS.
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Am. J. Respir. Crit. Care Med. · Dec 2012
Randomized Controlled Trial Comparative StudyThe utility of fractional exhaled nitric oxide suppression in the identification of nonadherence in difficult asthma.
Nonadherence to inhaled corticosteroid therapy (ICS) is a major contributor to poor control in difficult asthma, yet it is challenging to ascertain. ⋯ Fe(NO) suppression after DOICS provides an objective test to distinguish adherent from nonadherent patients with difficult asthma. Clinical trial registered with www.clinicaltrials.gov (NCT 01219036).