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ventilation randomized controlled trial

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https://www.readbyqxmd.com/read/28089799/positive-airway-pressure-therapies-and-hospitalization-in-chronic-obstructive-pulmonary-disease
#1
Monica M Vasquez, Leslie A McClure, Duane L Sherrill, Sanjay R Patel, Jerry Krishnan, Stefano Guerra, Sairam Parthasarathy
BACKGROUND: Hospitalization of patients with chronic obstructive pulmonary disease (COPD) places a huge healthcare burden. Positive airway pressure (PAP) therapy is sometimes used in COPD patients, but the possible impact on hospitalization risk remains controversial. We studied the hospitalization risk of COPD patients before and after initiation of various PAP therapies in a "real-world" bioinformatics study. METHODS: We performed a retrospective analysis of administrative claims data of hospitalizations in patients with COPD who received or did not receive PAP therapy - continuous PAP, bilevel PAP, and non-invasive positive pressure ventilation using a home ventilator (NIPPV)...
January 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28087725/neurodevelopmental-outcomes-of-extremely-low-birthweight-infants-randomised-to-different-pco2-targets-the-phelbi-follow-up-study
#2
Ulrich H Thome, Orsolya Genzel-Boroviczeny, Bettina Bohnhorst, Manuel Schmid, Hans Fuchs, Oliver Rohde, Stefan Avenarius, Hans-Georg Topf, Andrea Zimmermann, Dirk Faas, Katharina Timme, Barbara Kleinlein, Horst Buxmann, Wilfried Schenk, Hugo Segerer, Norbert Teig, Annett Bläser, Roland Hentschel, Matthias Heckmann, Rolf Schlösser, Jochen Peters, Rainer Rossi, Wolfgang Rascher, Ralf Böttger, Jürgen Seidenberg, Gesine Hansen, Maria Zernickel, Harald Bode, Jens Dreyhaupt, Rainer Muche, Helmut D Hummler
BACKGROUND: Tolerating higher partial pressures of carbon dioxide (PCO2) in mechanically ventilated extremely low birthweight infants to reduce ventilator-induced lung injury may have long-term neurodevelopmental side effects. This study analyses the results of neurodevelopmental follow-up of infants enrolled in a randomised multicentre trial. METHODS: Infants (n=359) between 400 and 1000 g birth weight and 23 0/7-28 6/7 weeks gestational age who required endotracheal intubation and mechanical ventilation within 24 hours of birth were randomly assigned to high PCO2 or to a control group with mildly elevated PCO2 targets...
January 13, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28079825/the-utility-of-bispectral-index-monitoring-for-prevention-of-rocuronium-induced-withdrawal-movement-in-children-a-randomized-controlled-trial
#3
Byung Gun Lim, Il Ok Lee, Young Sung Kim, Young Ju Won, Heezoo Kim, Myoung Hoon Kong
BACKGROUND: This study was designed to determine whether a deep hypnotic state with a bispectral index (BIS) value less than 40 could alleviate withdrawal movement (WM) upon rocuronium injection during anesthesia induction in children. METHODS: Finally, 135 healthy children (3-12 years) scheduled for minor elective surgery were studied. Without premedication, anesthesia was induced with thiopental sodium 5 mg/kg. Patients were randomized into 2 groups (control vs experimental) and then by virtue of rocuronium injection time, patients in the experimental group were allocated into 2 groups, as follows: in the control group (group C; n = 45), rocuronium 0...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28079629/duration-of-pneumonia-therapy-and-the-role-of-biomarkers
#4
Katerina Kaziani, Adamantia Sotiriou, George Dimopoulos
PURPOSE OF REVIEW: Increasing antimicrobial resistance is a worldwide phenomenon that is threatening public health. Lower respiratory infections are one of the leading causes of morbidity that contribute to antibiotic consumption and thus the emergence of multidrug-resistant microbial strains. The goal of shortening antibiotic regimens' duration in common bacterial infections has been prioritized by antimicrobial stewardship programs as an action against this problem. RECENT FINDINGS: Data coming from randomized controlled trials, meta-analyses, and systematic reviews support the shortening of antimicrobial regimens in community-acquired, hospital-acquired, and ventilator-associated pneumonia...
January 12, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28077531/sodium-bicarbonate-does-not-prevent-postoperative-acute-kidney-injury-after-off-pump-coronary-revascularization-a-double-blinded-randomized-controlled-trial
#5
S Soh, J W Song, J K Shim, J H Kim, Y L Kwak
BACKGROUND: Acute kidney injury (AKI) is a common morbidity after off-pump coronary revascularization. We investigated whether perioperative administration of sodium bicarbonate, which might reduce renal injury by alleviating oxidative stress in renal tubules, prevents postoperative AKI in off-pump coronary revascularization patients having renal risk factors. METHODS: Patients (n=162) having at least one of the following AKI risk factors were enrolled: (i) age >70 yr; (ii) diabetes mellitus; (iii) chronic renal disease; (iv) congestive heart failure or left ventricular ejection fraction <35%; and (v) reoperation or emergency...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#6
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28069319/effect-of-ulinastatin-combined-with-thymosin-alpha1-on-sepsis-a-systematic-review-and-meta-analysis-of-chinese-and-indian-patients
#7
REVIEW
Dadong Liu, Zongying Yu, Jiangtao Yin, Yikun Chen, Hao Zhang, Fan Xin, Haiyan Fu, Bing Wan
PURPOSE: To assess the effects of urinary trypsin inhibitor (UTI) ulinastatin combined with thymosin alpha1 (Tα1) on sepsis. MATERIALS AND METHODS: The meta-analysis included 8 randomized controlled trials (N=1112 patients) on UTI-based therapy for sepsis published before July 10, 2016. Two investigators independently extracted data and assessed the quality of each study. The short-term mortality rate, duration of mechanical ventilator and vasopressor use, length of intensive care unit stay, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and differences in inflammatory cytokines (interleukin [IL]-6, IL-10, and tumor necrosis factor α) were assessed using statistical software...
December 27, 2016: Journal of Critical Care
https://www.readbyqxmd.com/read/28067007/vaginal-progesterone-decreases-preterm-birth-and-neonatal-morbidity-and-mortality-in-women-with-a-twin-gestation-and-a-short-cervix-an-updated-meta-analysis-of-individual-patient-data
#8
REVIEW
Roberto Romero, Agustin Conde-Agudelo, Waleed El-Refaie, Line Rode, Maria L Brizot, Elcin Cetingoz, Vicente Serra, Eduardo da Fonseca, Mohamed S Abdelhafez, Ann Tabor, Alfredo Perales, Sonia S Hassan, Kypros H Nicolaides
OBJECTIVE: To assess the efficacy of vaginal progesterone for the prevention of preterm birth and neonatal morbidity and mortality in asymptomatic women with a twin gestation and a sonographic short cervix (cervical length ≤25 mm) in the midtrimester. METHODS: Updated systematic review and meta-analysis of individual patient data from randomized controlled trials comparing vaginal progesterone with placebo/no treatment in women with a twin gestation and a midtrimester sonographic cervical length ≤25 mm...
January 9, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28065217/early-enteral-combined-with-parenteral-nutrition-treatment-for-severe-traumatic-brain-injury-effects-on-immune-function-nutritional-status-and-outcomes-%C3%A2
#9
Fan Ming-Chao, Wang Qiao-Ling, Fang Wei, Jiang Yun-Xia, Li Lian-di, Sun Peng, Wang Zhi-Hong
Objective To compare the conjoint effect of enteral nutrition (EN) and parenteral nutrition (PN) with single EN or PN on immune function, nutritional status, complications and clinical outcomes of patients with severe traumatic brain injury (STBI). Methods A prospective randomized control trial was carried out from January 2009 to May 2012 in Neurological Intensive Care Unit (NICU). Patients of STBI who met the enrolment criteria (Glasgow Coma Scale score 6~8; Nutritional Risk Screening ≥3) were randomly divided into 3 groups and were admi- nistrated EN, PN or EN+PN treatments respectively...
November 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28061910/use-of-noninvasive-ventilation-in-immunocompromised-patients-with-acute-respiratory-failure-a-systematic-review-and-meta-analysis
#10
Hui-Bin Huang, Biao Xu, Guang-Yun Liu, Jian-Dong Lin, Bin Du
BACKGROUND: Acute respiratory failure (ARF) remains a common hazardous complication in immunocompromised patients and is associated with increased mortality rates when endotracheal intubation is needed. We aimed to evaluate the effect of early noninvasive ventilation (NIV) compared with oxygen therapy alone in this patient population. METHODS: We searched for relevant studies in MEDLINE, EMBASE, and the Cochrane database up to 25 July 2016. Randomized controlled trials (RCTs) were included if they reported data on any of the predefined outcomes in immunocompromised patients managed with NIV or oxygen therapy alone...
January 7, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28049256/initial-energy-supplementation-in-critically-ill-patients-receiving-enteral-nutrition-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
Feng Tian, Xuejin Gao, Chao Wu, Li Zhang, Xianfeng Xia, Xinying Wang
BACKGROUND AND OBJECTIVES: Here we systematically reviewed and quantitatively analyzed randomized controlled trials (RCTs) to compare the important initial outcomes of critically ill adults receiving low- and highenergy enteral nutrition. METHODS AND STUDY DESIGN: RCTs comparing low- and high-energy supplementation in critically ill adults receiving enteral nutrition admitted to the intensive care unit for an expected stay of >48 h were included. Abstracts submitted to major scientific meetings were included and the primary endpoint was mortality...
January 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28047750/we-fg-206-08-pulmonary-functional-imaging-biomarkers-of-nsclc-to-guide-and-optimize-functional-lung-avoidance-radiotherapy
#12
Khadija Sheikh, Dante Pi Capaldi, Douglas A Hoover, David A Palma, Brian P Yaremko, Grace Parraga
PURPOSE: Functional lung avoidance radiotherapy promises optimized therapy planning by minimizing dose to well-functioning lung and maximizing dose to the rest of the lung. Patients with NSCLC commonly present with co-morbid COPD and heterogeneously distributed ventilation abnormalities stemming from emphysema, airways disease, and tumour burden. We hypothesized that pulmonary functional imaging methods may be used to optimize radiotherapy plans to avoid regions of well-functioning lung and significantly improve outcomes like quality-of-life and survival...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046370/th-cd-202-09-free-breathing-proton-mri-functional-lung-avoidance-maps-to-guide-radiation-therapy
#13
D Capaldi, K Sheikh, D Hoover, B Yaremko, D Palma, G Parraga
PURPOSE: Pulmonary functional MRI using inhaled gas contrast agents was previously investigated as a way to identify well-functioning lung in patients with NSCLC who are clinical candidates for radiotherapy. Hyperpolarized noble-gas ((3) He and (129) Xe) MRI has also been optimized to measure functional lung information, but for a number of reasons, the clinical translation of this approach to guide radiotherapy planning has been limited. As an alternative, free-breathing pulmonary 1H MRI using clinically available MRI systems and pulse sequences provides a non-contrast-enhanced method to generate both ventilation and perfusion maps...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28043204/safety-of-gelatin-solutions-for-the-priming-of-cardiopulmonary-bypass-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#14
Idris Ghijselings, Dirk Himpe, Steffen Rex
This systematic review and meta-analysis was conducted to evaluate the safety of gelatin versus hydroxyethyl starches (HES) and crystalloids when used for cardiopulmonary bypass (CPB)-priming in cardiac surgery. MEDLINE (Pubmed), Embase and CENTRAL were searched. We included only randomized, controlled trials comparing CPB-priming with gelatin with either crystalloids or HES-solutions of the newest generation. The primary endpoint was the blood loss during the first 24 hours. Secondary outcomes included perioperative transfusion requirements, postoperative kidney function, postoperative ventilation times and length of stay on the intensive care unit...
December 1, 2016: Perfusion
https://www.readbyqxmd.com/read/28042054/design-and-rationale-of-heart-and-lung-failure-pediatric-insulin-titration-trial-half-pint-a-randomized-clinical-trial-of-tight-glycemic-control-in-hyperglycemic-critically-ill-children
#15
Michael Sd Agus, Ellie Hirshberg, Vijay Srinivasan, Edward Vincent Faustino, Peter M Luckett, Martha Aq Curley, Jamin Alexander, Lisa A Asaro, Kerry Coughlin-Wells, Donna Duva, Jaclyn French, Natalie Hasbani, Martha T Sisko, Carmen L Soto-Rivera, Garry Steil, David Wypij, Vinay M Nadkarni
OBJECTIVES: Test whether hyperglycemic critically ill children with cardiovascular and/or respiratory failure experience more ICU-free days when assigned to tight glycemic control with a normoglycemic versus hyperglycemic blood glucose target range. DESIGN: Multi-center randomized clinical trial. SETTING: Pediatric ICUs at 35 academic hospitals. PATIENTS: Children aged 2weeks to 17years receiving inotropic support and/or acute mechanical ventilation, excluding cardiac surgical patients...
December 30, 2016: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28030502/operative-fixation-of-rib-fractures-after-blunt-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma
#16
George Kasotakis, Erik A Hasenboehler, Erik W Streib, Nimitt Patel, Mayur B Patel, Louis Alarcon, Patrick L Bosarge, Joseph Love, Elliott R Haut, John J Como
BACKGROUND: Rib fractures are identified in 10% of all injury victims and are associated with significant morbidity (33%) and mortality (12%). Significant progress has been made in the management of rib fractures over the last few decades, including operative reduction and internal fixation (rib ORIF); however, the subset of patients that would benefit most from this procedure remains ill-defined. The aim of this project was to develop evidence-based recommendations. METHODS: Population, intervention, comparison and outcome (PICO) questions were formulated for patients with and without flail chest...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28028515/comparison-of-respiratory-and-hemodynamic-stability-in-patients-with-traumatic-brain-injury-ventilated-by-two-ventilator-modes-pressure-regulated-volume-control-versus-synchronized-intermittent-mechanical-ventilation
#17
Omid Aghadavoudi, Babak Alikiaii, Fariba Sadeghi
BACKGROUND: This study aimed to compare pressure regulated volume control (PRVC) and synchronized intermittent mechanical ventilation (SIMV) modes of ventilation according to respiratory and hemodynamic stability in patients with traumatic brain injury (TBI) admitted to Intensive Care Unit (ICU). MATERIALS AND METHODS: In a randomized, single-blinded, clinical trial study, 100 patients who hospitalized in ICU due to TBI were selected and randomly divided into two groups...
2016: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28012036/no-influence-of-ischemic-preconditioning-on-running-economy
#18
Gungeet Kaur, Megan Binger, Claire Evans, Tiffany Trachte, Gary P Van Guilder
PURPOSE: Many of the potential performance-enhancing properties of ischemic preconditioning suggest that the oxygen cost for a given endurance exercise workload will be reduced, thereby improving the economy of locomotion. The aim of this study was to identify whether ischemic preconditioning improves exercise economy in recreational runners. METHODS: A randomized sham-controlled crossover study was employed in which 18 adults (age 27 ± 7 years; BMI 24.6 ± 3 kg/m(2)) completed two, incremental submaximal (65-85% VO2max) treadmill running protocols (3 × 5 min stages from 7...
December 23, 2016: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28002714/hypothermia-for-neuroprotection-in-convulsive-status-epilepticus
#19
RANDOMIZED CONTROLLED TRIAL
Stephane Legriel, Virginie Lemiale, Maleka Schenck, Jonathan Chelly, Virginie Laurent, Fabrice Daviaud, Mohamed Srairi, Aicha Hamdi, Guillaume Geri, Thomas Rossignol, Julia Hilly-Ginoux, Julie Boisramé-Helms, Benjamin Louart, Isabelle Malissin, Nicolas Mongardon, Benjamin Planquette, Marina Thirion, Sybille Merceron, Emmanuel Canet, Fernando Pico, Yves-Roger Tran-Dinh, Jean-Pierre Bedos, Elie Azoulay, Matthieu Resche-Rigon, Alain Cariou
Background Convulsive status epilepticus often results in permanent neurologic impairment. We evaluated the effect of induced hypothermia on neurologic outcomes in patients with convulsive status epilepticus. Methods In a multicenter trial, we randomly assigned 270 critically ill patients with convulsive status epilepticus who were receiving mechanical ventilation to hypothermia (32 to 34°C for 24 hours) in addition to standard care or to standard care alone; 268 patients were included in the analysis. The primary outcome was a good functional outcome at 90 days, defined as a Glasgow Outcome Scale (GOS) score of 5 (range, 1 to 5, with 1 representing death and 5 representing no or minimal neurologic deficit)...
22, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27999152/optimizing-peep-by-electrical-impedance-tomography-in-a-porcine-animal-model-of-ards
#20
Nadine Hochhausen, Ingeborg Biener, Rolf Rossaint, Andreas Follmann, Christian Bleilevens, Till Braunschweig, Steffen Leonhardt, Michael Czaplik
BACKGROUND: Mechanical ventilation is necessary in diverse clinical circumstances. Especially in the context of ARDS, so-called protective ventilation strategies must be followed. It is already known that PEEP might enhance oxygenation in ARDS. However, determining the optimal PEEP settings in clinical routines is challenging. Electrical impedance tomography (EIT) is a promising technique with which to adjust ventilator settings. We investigated whether the combination of different EIT parameters, namely the global inhomogeneity and hyperdistension indices, may lead to a feasible and safe PEEP setting...
December 20, 2016: Respiratory Care
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