Respiratory care
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Observational Study
Prospective Observational Study of Predictors of Re-Intubation Following Extubation in the Surgical ICU.
Re-intubation is associated with high morbidity and mortality. There is limited information regarding the risk factors that predispose patients admitted to the surgical ICU to re-intubation. We hypothesized that preoperative comorbidities, acquired muscular weakness, and renal dysfunction would be predictors of re-intubation in the surgical ICU population. ⋯ In noncardiac surgery, surgical ICU subjects, elevated blood urea nitrogen level, low hemoglobin level, and muscle weakness were identified as independent risk factors for re-intubation. The presence of these risk factors can potentially aid clinicians in making informed decisions regarding optimal airway management in patients considered for an extubation attempt. (ClinicalTrials.gov registration NCT01967056.).
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This study was conducted to measure the serial changes in pulmonary function over 12 months after lobectomy in subjects with lung cancer and to evaluate the actual recovery of pulmonary function in comparison with the predicted postoperative values. ⋯ Actual pulmonary function compared with predicted postoperative values improved over time over 1 y after lobectomy. However, this improvement was not observed in subjects with COPD or in those who underwent thoracotomy or received postoperative adjuvant chemotherapy.
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Data on the management, clinical course, and outcome of critical patients with Middle East Respiratory Syndrome coronavirus are scarce. We report here our experience and long-term outcome of such patients. ⋯ Middle East Respiratory Syndrome coronavirus pneumonia with ARDS has high mortality in subjects with comorbidities. The mainstay of treatment is meticulous ARDS management. Those who survived the acute infection and its complications remained well after 1 y in our study. The role of ribavirin and interferon warrants urgent further evaluation.