American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Jul 2020
Association of Pre-Morbid Blood Pressure with Vasopressor Infusion Duration in Patients with Shock.
Rationale: Guidelines for vasopressor titration suggest a universal target-mean arterial pressure (MAP) >65 mm Hg. The implications for patients with premorbid low/high blood pressure are unknown. Objectives: To investigate the relationship between premorbid blood pressure and vasopressor duration for patients with shock. ⋯ After adjustment, premorbid low admissions had longer vasopressor use (median, 1.35 d vs. 1.04 d for normal; hazard ratio for discontinuation vs. normal, 0.78 [0.73-0.85]; P < 0.001) and premorbid high admissions had shorter use (median, 0.84 d; hazard ratio, 1.22 [1.12-1.33]; P < 0.001). Premorbid low admissions had longer adjusted length of stay and higher adjusted mortality than premorbid normal admissions. Conclusions: Premorbid blood pressure was inversely associated with vasopressor duration.
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Am. J. Respir. Crit. Care Med. · Jul 2020
Prenatal, Early-life and Childhood Exposure to Air Pollution and Lung Function: The ALSPAC Cohort.
Rationale: Exposure to air pollution during intrauterine development and through childhood may have lasting effects on respiratory health. Objectives: To investigate lung function at ages 8 and 15 years in relation to air pollution exposures during pregnancy, infancy, and childhood in a UK population-based birth cohort. Methods: Individual exposures to source-specific particulate matter ≤10 μm in aerodynamic diameter (PM10) during each trimester, 0-6 months, 7-12 months (1990-1993), and up to age 15 years (1991-2008) were examined in relation to FEV1% predicted and FVC% predicted at ages 8 (n = 5,276) and 15 (n = 3,446) years using linear regression models adjusted for potential confounders. ⋯ For PM10 from all sources, the third trimester was associated with lower FVC% predicted (-1.312; 95% CI, -2.100 to -0.525). At age 15 years, no adverse associations with lung function were seen. Conclusions: Exposure to road-traffic PM10 during pregnancy may result in small but significant reductions in lung function at age 8 years.