Resp Care
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Multicenter Study
Performance of maximum inspiratory pressure tests and maximum inspiratory pressure reference equations for 4 race/ethnic groups.
Maximum inspiratory pressure (MIP) is an important and noninvasive index of diaphragm strength and an independent predictor of all-cause mortality. The ability of adults over a wide age range and multiple race/ethnicities to perform MIP tests has previously not been evaluated. ⋯ Race-specific reference equations for MIP are unnecessary in the United States. More than 80% of adults can be successfully coached for 5 maneuvers, with repeatability within 10 cm H2O.
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Randomized Controlled Trial Multicenter Study
Feasibility study of noninvasive ventilation with helium-oxygen gas flow for chronic obstructive pulmonary disease during exercise.
Individually, noninvasive ventilation (NIV) and helium-oxygen gas mixtures (heliox) diminish ventilatory workload and improve exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). NIV in combination with heliox may have additive effects on exercise tolerance in severe COPD. ⋯ The adjunctive use of NIV with heliox during exercise proved both safe and tolerable in patients with severe COPD. The lack of demonstrable efficacy to any of the treatment arms relative to placebo (P = .09) may be the result of the small sample size (ie, type 2 error)-a conclusion emphasized by the large standard deviations and differences in treatment group variances in exercise duration alone.
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Multicenter Study
Management of tracheostomy: a survey of Dutch intensive care units.
To determine tracheostomy-management practices in Dutch intensive care units (ICUs) and post-ICU step-down facilities. ⋯ There were large differences in tracheostomy management among Dutch ICUs. ICU and post-ICU tracheostomy-management guidelines are lacking and needed.
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Randomized Controlled Trial Multicenter Study Comparative Study
A study of the physiologic responses to a lung recruitment maneuver in acute lung injury and acute respiratory distress syndrome.
To determine the magnitude, duration, and consistency of the effects of lung recruitment maneuvers (RMs) on oxygenation, lung mechanics, and comfort in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). ⋯ These results do not support the addition of scheduled RMs to usual treatment for ALI or ARDS.
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Multicenter Study Comparative Study
Spirometric correlates of dyspnea improvement among emergency department patients with chronic obstructive pulmonary disease exacerbation.
To examine whether change in slow vital capacity (SVC) correlates to dyspnea improvement during emergency department (ED) treatment of chronic obstructive pulmonary disease (COPD) exacerbation. ⋯ Increase in SVC significantly correlated with dyspnea improvement among ED patients with moderate-to-severe COPD exacerbation. Change in SVC merits consideration when evaluating therapeutic response during COPD exacerbation.