American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Oct 2017
ReviewFifty Years of Research in ARDS. Respiratory Mechanics in Acute Respiratory Distress Syndrome.
Acute respiratory distress syndrome is a multifactorial lung injury that continues to be associated with high levels of morbidity and mortality. Mechanical ventilation, although lifesaving, is associated with new iatrogenic injury. ⋯ This review outlines the measurement and application of clinically applicable pulmonary mechanical concepts, such as plateau pressures, driving pressure, transpulmonary pressures, stress index, and measurement of strain. In addition, the concept of the "baby lung" and the utility of dynamic in addition to static measures of pulmonary mechanical variables are discussed.
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Am. J. Respir. Crit. Care Med. · Oct 2017
Multicenter StudyAssociations of Nasopharyngeal Metabolome and Microbiome with Severity Among Infants with Bronchiolitis: A Multi-omic Analysis.
Bronchiolitis is the most common lower respiratory infection in infants; however, it remains unclear which infants with bronchiolitis will develop severe illness. In addition, although emerging evidence indicates associations of the upper-airway microbiome with bronchiolitis severity, little is known about the mechanisms linking airway microbes and host response to disease severity. ⋯ Although further validation is needed, our multiomic analyses demonstrate the potential of metabolomics to predict bronchiolitis severity and better understand microbe-host interaction.
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Am. J. Respir. Crit. Care Med. · Oct 2017
Randomized Controlled TrialImpact of Point-of-care Xpert MTB/RIF on Tuberculosis Treatment Initiation: A Cluster Randomised Trial.
Point-of-care (POC) diagnostics have the potential to reduce pretreatment loss to follow-up and delays to initiation of appropriate tuberculosis (TB) treatment. ⋯ POC positioning of the Xpert test led to more rapid initiation of appropriate TB treatment. Achieving one-stop diagnosis and treatment for all people with TB will require simpler, more sensitive diagnostics and broader strengthening of health systems. Clinical trial registered with www.isrctn.com (ISRCTN 18642314) and www.sanctr.gov.za (DOH-27-0711-3568).