American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2012
Randomized Controlled Trial Multicenter Study Comparative StudyLong-term inhaled dry powder mannitol in cystic fibrosis: an international randomized study.
New treatment strategies are needed to improve airway clearance and reduce the morbidity and the time burden associated with cystic fibrosis (CF). ⋯ Inhaled mannitol, 400 mg twice a day, resulted in improved lung function over 26 weeks, which was sustained after an additional 26 weeks of treatment. The safety profile was also acceptable, demonstrating the potential role for this chronic therapy for CF. Clinical trial registered with www.clinicaltrials.gov (NCT 00630812).
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Am. J. Respir. Crit. Care Med. · Mar 2012
Multicenter Study Comparative Study Clinical TrialA large subgroup of mild-to-moderate asthma is persistently noneosinophilic.
Airway eosinophilia is typical of asthma, and many controller treatments target eosinophilic disease. Asthma is clinically heterogeneous, however, and a subgroup of people with asthma do not have airway eosinophilia. The size of this subgroup is uncertain because prior studies have not examined repeated measures of sputum cytology to determine when people with asthma have intermittent versus persistent sputum eosinophila and when they are persistently noneosinophilic. ⋯ Approximately half of patients with mild-to-moderate asthma have persistently noneosinophilic disease, a disease phenotype that responds poorly to currently available antiinflammatory therapy.
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Am. J. Respir. Crit. Care Med. · Mar 2012
Randomized Controlled Trial Multicenter Study Comparative StudyAutomatic control of pressure support for ventilator weaning in surgical intensive care patients.
Despite its ability to reduce overall ventilation time, protocol-guided weaning from mechanical ventilation is not routinely used in daily clinical practice. Clinical implementation of weaning protocols could be facilitated by integration of knowledge-based, closed-loop controlled protocols into respirators. ⋯ Overall ventilation times did not significantly differ between weaning using automatic control of pressure support ventilation and weaning based on a standardized written protocol. Patients after cardiac surgery may benefit from automated weaning. Implementation of additional control variables besides the level of pressure support may further improve automated-weaning systems. Clinical trial registered with www.clinicaltrials.gov (NCT 00445289).
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Am. J. Respir. Crit. Care Med. · Mar 2012
Multicenter StudyDepressive symptoms and impaired physical function after acute lung injury: a 2-year longitudinal study.
Survivors of acute lung injury (ALI) frequently have substantial depressive symptoms and physical impairment, but the longitudinal epidemiology of these conditions remains unclear. ⋯ Incident depressive symptoms and impaired physical function are common and long-lasting during the first 2 years after ALI. Interventions targeting potentially modifiable risk factors (e.g., substantial depressive symptoms in early recovery) should be evaluated to improve ALI survivors' long-term outcomes.