American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · May 2017
Randomized Controlled TrialPedometer Step Count Targets During Pulmonary Rehabilitation in COPD: A Randomized Controlled Trial.
Increasing physical activity is a key therapeutic aim in chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) improves exercise capacity, but there is conflicting evidence regarding its ability to improve physical activity levels. ⋯ Pedometer-directed step-count targets during an outpatient PR program did not enhance moderate-intensity physical activity levels in people with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT01719822).
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Am. J. Respir. Crit. Care Med. · May 2017
Randomized Controlled Trial Comparative StudyBalanced Crystalloids versus Saline in the Intensive Care Unit: The SALT Randomized Trial.
Saline is the intravenous fluid most commonly administered to critically ill adults, but it may be associated with acute kidney injury and death. Whether use of balanced crystalloids rather than saline affects patient outcomes remains unknown. ⋯ An electronic health record-embedded, cluster-randomized, multiple-crossover trial comparing saline with balanced crystalloids can produce well-balanced study groups and separation in crystalloid receipt. Clinical trial registered with www.clinicaltrials.gov (NCT 02345486).
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Am. J. Respir. Crit. Care Med. · May 2017
Randomized Controlled TrialPhysiologic Effects of High-flow Nasal Cannula in Acute Hypoxemic Respiratory Failure.
High-flow nasal cannula (HFNC) improves the clinical outcomes of nonintubated patients with acute hypoxemic respiratory failure (AHRF). ⋯ In patients with AHRF, HFNC exerts multiple physiologic effects including less inspiratory effort and improved lung volume and compliance. These benefits might underlie the clinical efficacy of HFNC.
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Am. J. Respir. Crit. Care Med. · May 2017
Randomized Controlled Trial Multicenter StudyBlood Eosinophils and Response to Maintenance COPD Treatment: Data from the FLAME Trial.
Post hoc analyses suggest that blood eosinophils have potential as a predictive biomarker of inhaled corticosteroid efficacy in the management of chronic obstructive pulmonary disease (COPD). ⋯ Our prospective analyses indicate that indacaterol/glycopyrronium provides superior or similar benefits over salmeterol/fluticasone regardless of blood eosinophil levels in patients with COPD. Clinical trial registered with www.clinicaltrials.gov (NCT01782326).
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Am. J. Respir. Crit. Care Med. · May 2017
Randomized Controlled TrialImpact of Mandibular Advancement Therapy on Endothelial Function in Severe Obstructive Sleep Apnea.
Endothelial dysfunction, a major predictor of late cardiovascular events, is linked to the severity of obstructive sleep apnea (OSA). ⋯ In moderately sleepy patients with severe OSA, mandibular advancement therapy reduced OSA severity and related symptoms but had no effect on endothelial function and blood pressure despite high treatment compliance. Clinical trial registered with www.clinicaltrials.gov (NCT 01426607).