Respirology : official journal of the Asian Pacific Society of Respirology
-
Randomized Controlled Trial
Adaptive support ventilation for complete ventilatory support in acute respiratory distress syndrome: a pilot, randomized controlled trial.
Low tidal volume ventilation has been shown to improve survival in acute respiratory distress syndrome (ARDS). Adaptive support ventilation (ASV), a closed-loop ventilatory mode, can minimize the work of breathing, and thus potentially improve the outcomes in ARDS. The aim of this pilot, randomized clinical trial was to compare the outcomes of ASV versus volume-cycled ventilation (VCV) in ARDS. ⋯ There was no significant difference in the outcomes of patients with ARDS ventilated with either VCV or ASV in this study.
-
Comparative Study
Comparing finger and forehead sensors to measure oxygen saturation in people with chronic obstructive pulmonary disease.
Oxyhaemoglobin saturation of arterial blood is commonly measured using a finger sensor attached to a pulse oximeter (SpO(2)). We sought to compare SpO(2) measured using finger and forehead sensors with oxyhaemoglobin saturation in arterialized capillary samples (ACS) in people with chronic obstructive pulmonary disease (COPD) during exercise. ⋯ Oxygen saturation measured using the forehead sensor was higher than that measured in ACS. Assuming that oxygen saturation in ACS is slightly less than arterial blood, forehead sensors may yield measures more concordant with arterial blood. Both sensors detected exercise-induced desaturation.
-
Mutation of bone morphogenetic protein receptor type 2 (BMPR2) is a cause of pulmonary arterial hypertension (PAH). We measured the prevalence of this mutation and its impact on the phenotypes and long-term clinical outcomes in Japanese patients. ⋯ The prevalence of BMPR2 mutations in Japanese with PAH was similar to that reported in other populations. At onset of PAH, BMPR2 mutation non-carriers were, on average, younger than carriers, possibly due to the heterogeneity of this subpopulation. With state-of-the-art therapy, the long-term survival of patients with PAH was high, regardless of the mutation status.
-
The impact of ambient wood smoke and traffic-related air pollution on adult asthma has not been well studied. This paper aims to investigate associations between exposure to ambient wood smoke, traffic-related air pollution and current asthma/asthma severity in middle age, and whether any associations are modified by atopic status. ⋯ In middle-aged adults, ambient wood smoke and traffic pollution were associated with increased asthma severity. These findings suggest that avoiding or limiting exposure to traffic pollution and wood smoke may help to reduce asthma. Future studies to replicate this finding are recommended and should examine specific biological mechanisms for this effect.
-
Comparative Study
Physician-performed ultrasound can accurately screen for a vulnerable intercostal artery prior to chest drainage procedures.
Laceration of the intercostal artery during pleural procedures is a rare but serious complication. This study evaluates the utility of thoracic ultrasound (US) to screen for a vulnerable vessel compared with the gold standard computed tomography (CT). ⋯ US can be used to screen for a vulnerable vessel prior to pleural procedures, in a time amenable to use in clinical practice. Further, it is achievable by a pulmonologist using a portable US machine. If thoracentesis or chest tube insertion is being performed on a patient at increased risk of bleeding, screening for a vulnerable vessel with US prior to beginning the procedure is recommended.