American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Feb 2016
Randomized Controlled Trial Comparative StudyThe Effects of Alternative Resuscitation Strategies on Acute Kidney Injury in Patients with Septic Shock.
Septic shock is a common cause of acute kidney injury (AKI), and fluid resuscitation is a major part of therapy. ⋯ In patients with septic shock, AKI is common and associated with adverse outcomes, but it is not influenced by protocolized resuscitation compared with usual care.
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Am. J. Respir. Crit. Care Med. · Feb 2016
Randomized Controlled TrialRandomized Trial of Apneic Oxygenation during Endotracheal Intubation of the Critically Ill.
Hypoxemia is common during endotracheal intubation of critically ill patients and may predispose to cardiac arrest and death. Administration of supplemental oxygen during laryngoscopy (apneic oxygenation) may prevent hypoxemia. ⋯ Apneic oxygenation does not seem to increase lowest arterial oxygen saturation during endotracheal intubation of critically ill patients compared with usual care. These findings do not support routine use of apneic oxygenation during endotracheal intubation of critically ill adults. Clinical trial registered with www.clinicaltrials.gov (NCT 02051816).
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Am. J. Respir. Crit. Care Med. · Feb 2016
Thinking Forward: Future-oriented Thinking Among Patients with Tobacco-associated Thoracic Diseases and Their Surrogates.
The goal of shared decision making is to match patient preferences, including evaluation of potential future outcomes, with available management options. Yet, it is unknown how patients with smoking-related thoracic diseases or their surrogates display future-oriented thinking. ⋯ Patients and surrogates may struggle to generate expectations, and these future-oriented thoughts may be based on loosely related past experiences or unrealistic optimism. These tendencies may lead to errors, preventing selection of treatments that promote true preferences. Clinicians should explore how decision makers engage in future-oriented thinking and what their expectations are as a component of the shared decision-making process. Future research should evaluate whether targeted guidance in future-oriented thinking may improve outcomes important to patients.
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Am. J. Respir. Crit. Care Med. · Feb 2016
Common Mechanisms of Dyspnea in Chronic Interstitial and Obstructive Lung Disorders.
The mechanisms underlying dyspnea in interstitial lung disease (ILD) and chronic obstructive pulmonary disease (COPD) are unknown. ⋯ Disease-specific differences in mechanics and respiratory muscle activity did not influence the key association between dyspnea intensity and inspiratory neural drive to the diaphragm.