American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · May 2014
Clinical TrialSmall Acute Increases in Serum Creatinine are Associated with Decreased Long Term Survival in the Critically Ill.
Long-term outcomes after acute kidney injury (AKI) are poorly described. ⋯ Patients with one episode of mild AKI have significantly lower long-term survival rates than critically ill patients with no AKI. Close medical follow-up of these patients may be warranted and mechanistic research is required to understand how AKI influences long-term events.
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Am. J. Respir. Crit. Care Med. · May 2014
Outcomes Associated with Corticosteroid Dosage in Critically Ill Patients with Acute Exacerbations of Chronic Obstructive Pulmonary Disease.
Studies evaluating corticosteroid (CS) dosing for patients hospitalized with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) have largely excluded patients admitted directly to the intensive care unit (ICU), and none have evaluated the effect of CS dosing regimens on mortality. ⋯ Two-thirds of patients admitted to the ICU with an AECOPD are treated with high doses of CS that are associated with worse outcomes and more frequent adverse effects. Lower dosage strategies should be encouraged for patients admitted to the ICU and the optimum dose should be determined through clinical trials.
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Am. J. Respir. Crit. Care Med. · May 2014
Clinical TrialShould we view COPD Differently after ECLIPSE? A Clinical Perspective from the Study Team.
Chronic obstructive pulmonary disease (COPD) seems to be a heterogeneous disease with a variable course. ⋯ By following a large, well characterized cohort of patients with COPD over 3 years, we have a clearer picture of a heterogeneous disease with clinically important subtypes ("phenotypes") and a variable and not inherently progressive course. Clinical trial registered with www.clinicaltrials.gov (NCT00292552).
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Am. J. Respir. Crit. Care Med. · May 2014
Multicenter StudyTraffic Related Air Pollution and the Right Ventricle: The Multi-Ethnic Study of Atherosclerosis.
Right heart failure is a cause of morbidity and mortality in common and rare heart and lung diseases. Exposure to traffic-related air pollution is linked to left ventricular hypertrophy, heart failure, and death. Relationships between traffic-related air pollution and right ventricular (RV) structure and function have not been studied. ⋯ Higher levels of NO2 exposure were associated with greater RV mass and larger RV end-diastolic volume.
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The risk of cardiovascular events after severe sepsis is not known, and these events may explain increased long-term mortality in survivors of severe sepsis. ⋯ Survivors of severe sepsis have high risk of cardiovascular events. The higher risk is mainly due to poor prehospitalization health status, and is also seen in a broader population of acutely ill patients.