American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jul 2017
Multicenter StudyFrailty and Subsequent Disability and Mortality Among Patients With Critical Illness.
The prevalence of frailty (diminished physiologic reserve) and its effect on outcomes for those aged 18 years and older with critical illness is unclear. ⋯ Frailty is common in critically ill adults aged 18 years and older and is independently associated with increased mortality and greater disability. Future studies should explore routine screening for clinical frailty in critically ill patients of all ages. Interventions to reduce mortality and disability among patients with heightened vulnerability should be developed and tested. Clinical trial registered with www.clinicaltrials.gov (NCT 00392795 and NCT 00400062).
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Am. J. Respir. Crit. Care Med. · Jul 2017
Effects of Physician-Targeted Pay-for-Performance on Use of Spontaneous Breathing Trials in Mechanically Ventilated Patients.
Pay for performance is an increasingly common quality improvement strategy despite the absence of robust supporting evidence. ⋯ In hospitals with low baseline SBT completion, physician-targeted financial incentives were associated with increased SBT rates driven in part by increased exclusion rates, without consistent improvements in outcome.
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Am. J. Respir. Crit. Care Med. · Jul 2017
An Exome Sequencing Study to Assess the Role of Rare Genetic Variation in Pulmonary Fibrosis.
Idiopathic pulmonary fibrosis (IPF) is an increasingly recognized, often fatal lung disease of unknown etiology. ⋯ We identified TERT, RTEL1, and PARN-three telomere-related genes previously implicated in familial pulmonary fibrosis-as significant contributors to sporadic IPF. These results support the idea that telomere dysfunction is involved in IPF pathogenesis.
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Am. J. Respir. Crit. Care Med. · Jul 2017
Multicenter Study Observational StudyPalivizumab Prophylaxis in Preterm Infants and Subsequent Recurrent Wheezing: 6 Year Follow Up Study.
Respiratory syncytial virus (RSV) induces not only infantile recurrent wheezing but also potentially atopic asthma. ⋯ Palivizumab prophylaxis administered to preterm infants did not suppress the onset of atopic asthma but resulted in a significantly lower incidence of recurrent wheezing during the first 6 years. Clinical trial registered with www.clinicaltrials.gov (NCT 01545245).