American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Mar 2014
Randomized Controlled Trial Multicenter StudyThe Beta Agonist Lung Injury Trial (BALTI) Prevention: A Randomized Controlled Trial.
Experimental studies suggest that pretreatment with β-agonists might prevent acute lung injury (ALI). ⋯ Perioperative treatment with inhaled salmeterol was well tolerated but did not prevent ALI. Clinical trial registered with International Standard Randomized Controlled Trial Register (ISRCTN47481946) and European Union database of randomized Controlled Trials (EudraCT 2007-004096-19).
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Am. J. Respir. Crit. Care Med. · Mar 2014
Observational StudyStatin Use and Risk of Delirium in the Critically Ill.
Delirium is common in intensive care unit (ICU) patients and is a predictor of worse outcomes and neuroinflammation is a possible mechanism. The antiinflammatory actions of statins may reduce delirium. ⋯ Ongoing statin therapy is associated with a lower daily risk of delirium in critically ill patients. An ongoing clinical trial, informed by this study, is investigating if statins are a potential therapy for delirium in the critically ill.
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Am. J. Respir. Crit. Care Med. · Mar 2014
Penalizing hospitals for chronic obstructive pulmonary disease readmissions.
In October 2014, the U. S. Centers for Medicare and Medicaid Services (CMS) will expand its Hospital Readmission Reduction Program (HRRP) to include chronic obstructive pulmonary disease (COPD). ⋯ In this perspective, we review the history of the HRRP, including the recent addition of COPD to the policy. We critically assess the use of 30-day all-cause COPD readmissions as an accountability measure, discussing potential benefits and then highlighting the substantial drawbacks and potential unintended consequences of the measure that could adversely affect providers, hospitals, and patients with COPD. We conclude by emphasizing the need to place the 30-day COPD readmission measure in the context of a reconceived model for postdischarge quality and review several frameworks that could help guide this process.
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Am. J. Respir. Crit. Care Med. · Mar 2014
Clinical TrialQuantification of Pulmonary Inflammation after Segmental Allergen Challenge Using TIRM Magnetic Resonance Imaging.
There is a need to develop novel noninvasive imaging biomarkers that help to evaluate antiinflammatory asthma treatments. ⋯ The MRI-based noninvasive TIRM score is a promising biomarker for the noninvasive detection of the inflammatory response after segmental allergen challenge in patients with asthma and may serve to monitor the therapeutic effectiveness of novel antiinflammatory drugs in future human trials.