Annals of internal medicine
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Randomized Controlled Trial Clinical Trial
Early administration of corticosteroids in emergency room treatment of acute asthma.
To determine the effect of early administration of high-dose intravenous corticosteroids on duration of emergency room treatment and hospital admission rate in patients with acute asthma. ⋯ These results fail to show any benefit for early administration of corticosteroids in patients with acute asthma. Routine administration of corticosteroids on initial presentation in such patients may not be warranted.
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Randomized Controlled Trial Clinical Trial
Bicarbonate does not improve hemodynamics in critically ill patients who have lactic acidosis. A prospective, controlled clinical study.
To determine whether correction of acidemia using bicarbonate improves hemodynamics in patients who have lactic acidosis. ⋯ Correction of acidemia using sodium bicarbonate does not improve hemodynamics in critically ill patients who have metabolic acidosis and increased blood lactate or the cardiovascular response to infused catecholamines in these patients. Sodium bicarbonate decreases plasma ionized calcium and increases PaCO2.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bolus or intravenous infusion of ranitidine: effects on gastric pH and acid secretion. A comparison of relative efficacy and cost.
To compare the effects of intravenous bolus injection of ranitidine, continuous intravenous infusion of ranitidine, and placebo on gastric pH, acid secretion, and plasma ranitidine concentration during a 24-hour period, and to determine by survey the use, delivery methods, and costs of histamine H2-receptor antagonists in intensive care units. ⋯ On the basis of both efficacy and cost, intermittent bolus injections should be discontinued and replaced by continuous intravenous infusion in hospitalized patients requiring treatment with histamine H2-receptor antagonists. If ranitidine is used, either 150 mg or 300 mg administered as a 24-hour continuous infusion is most effective.
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Randomized Controlled Trial Clinical Trial
The effect of oxygen on respiration and sleep in patients with congestive heart failure.
To determine the effect of supplemental oxygen on Cheyne-Stokes respiration, nocturnal oxygen saturation (SaO2), and sleep in male patients with severe, stable congestive heart failure. ⋯ In severe, stable congestive heart failure, nocturnal oxygen therapy reduces Cheyne-Stokes respiration, corrects hypoxemia, and consolidates sleep by reducing arousals caused by the hyperpneic phase of Cheyne-Stokes respiration. Correction of nocturnal hypoxemia and sleep disruption may improve the clinical status of these patients.
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Randomized Controlled Trial Clinical Trial
Targeted inspiratory muscle training improves respiratory muscle function and reduces dyspnea in patients with chronic obstructive pulmonary disease.
To examine the effects of targeted inspiratory muscle training on respiratory muscle function, clinical ratings of dyspnea, and perception of resistive loads in symptomatic patients with chronic obstructive pulmonary disease. ⋯ Targeted inspiratory muscle training may enhance respiratory muscle function and reduce dyspnea in symptomatic patients with moderate to severe chronic obstructive pulmonary disease.