Resp Care
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Comparative Study
Clinical relevance of classification according to weaning difficulty.
To evaluate the clinical relevance of the weaning from mechanical ventilation classification system derived from the 2005 international consensus conference, in patients who receive mechanical ventilation for more than 48 hours, and evaluate its correlation with prognosis. ⋯ The new weaning classification system is clinically relevant and correlates to ICU and hospital mortality, but not to one-year mortality.
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Comparative Study
Population-based study on the prevalence of spirometric obstructive pattern in Porto, Portugal.
The diagnosis of obstructive lung disease (OLD) based on clinical grounds is challenging. There have been no population-based COPD studies that collected pulmonary function data in Portugal, a country in transition between phases 2 and 3 of the smoking epidemic. ⋯ The prevalence of spirometric obstructive pattern was high. Considering Portugal's position in the smoking epidemic, together with the aging of the population, we can expect an increase in the prevalence of OLD in older people and in women. Our results confirm the limited validity of self-reported OLD in epidemiological studies.
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Case Reports
Use of non-partitioned ventilator tubing results in dead-space ventilation hypercarbia.
We present a case of severe postoperative hypercarbia in a patient with severe COPD. Hypercarbia and respiratory acidosis continued to increase despite maximal ventilation, bronchodilator therapy, sedation, and paralysis. ⋯ The ventilator's self-test function failed to detect the error. We changed to a partitioned-lumen circuit, with much less ventilation dead space, and the hypercarbia resolved immediately.