Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
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Monaldi Arch Chest Dis · Apr 2003
ReviewLung protective ventilation in ARDS: role of mediators, PEEP and surfactant.
Lung protective ventilation such as the ARDSnet low tidal volumes strategy can reduce mortality in ARDS patients. The knowledge that an essential therapy such as mechanical ventilation on the intensive care influences patient outcome has given rise to the re-evaluation of current ventilation practices. This review addresses the current state of lung protective strategies and their physiological rationale. ⋯ Furthermore, the role of tidal volume, PEEP, recruitment manoeuvres and surfactant on lung injury is discussed. Finally, we discuss results from clinical studies on mechanical ventilation and elucidate these results with data acquired in experimental studies. Guidelines for future strategies and/or investigations are presented.
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Monaldi Arch Chest Dis · Apr 2003
The role of prophylactic brain irradiation in small cell lung cancer treatment.
To review the effectiveness and safety of prophylactic cranial irradiation (PCI) in patients with small-cell lung cancer (SCLC). ⋯ PCI improves both overall and disease free survival and decreases the risk for brain relapse in SCLC patients in complete remission. PCI should be applied early, and useful and safe doses may be 30-36 GY in 2-3 Gy fractions, though future studies may further illuminate the optimal dose, fractionation and timing.