Abstract:
:The benefit of noninvasive pressure support ventilation (NIPSV) in avoiding the need for endotracheal intubation and reducing morbidity and mortality associated with endotracheal intubation was evaluated in 41 patients who presented with acute respiratory failure not related to chronic obstructive pulmonary disease (COPD). Patients were randomly assigned to receive conventional therapy (n = 20) or conventional therapy plus NIPSV (n = 21). NIPSV was delivered to the patient by a face mask connected to a ventilator (Puritan-Bennett 7200a) set in inspiratory pressure support (IPS) mode. The mean levels of IPS, positive end-expiratory pressure (PEEP), and fraction of inspired oxygen (FIO2) were respectively 15 +/- 3 cm H2O, 4 +/- 2 cm H2O, and 57 +/- 22%. The rate of endotracheal intubation (62 vs 70%, p = 0.88), the length of ICU stay (17 +/- 19 days vs 25 +/- 23 days, p = 0.16), and the mortality rate (33 vs 50%, p = 0.46) were not different between patients treated with NIPSV and those treated conventionally. Post hoc analysis suggested that in patients with PaCO2 > 45 mm Hg (n = 17), NIPSV was associated with a reduction in the rate of endotracheal intubation (36 vs 100%, p = 0.02), in the length of ICU stay (13 +/- 15 days vs 32 +/- 30 days, p = 0.04), and in the mortality rate (9 vs 66%, p = 0.06). We conclude that NIPSV is of no benefit when used systematically in all forms of acute respiratory failure not related to COPD. A subgroup of patients, characterized by acute ventilatory failure and hypercapnia, may potentially benefit from this therapy and further studies are needed to focus on this aspect.
journal_name
Chestjournal_title
Chestauthors
Wysocki M,Tric L,Wolff MA,Millet H,Herman Bdoi
10.1378/chest.107.3.761subject
Has Abstractpub_date
1995-03-01 00:00:00pages
761-8issue
3eissn
0012-3692issn
1931-3543pii
S0012-3692(15)44537-4journal_volume
107pub_type
临床试验,杂志文章,随机对照试验相关文献
CHEST文献大全abstract:BACKGROUND:The use of infrared thermometry to measure temperatures in hospitalized patients is increasing. Although infrared thermometers have been proven to be accurate when they are used by well-trained personnel, no previous studies have examined their accuracy during routine hospital use. OBJECTIVE:To determine th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.115.4.1002
更新日期:1999-04-01 00:00:00
abstract:BACKGROUND:Average volume-assured pressure support (AVAPS) has been introduced as a new additional mode for a bilevel pressure ventilation (BPV) device (BiPAP; Respironics; Murrysville, PA), but studies on the physiologic and clinical effects have not yet been performed. There is a particular need to better define the ...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.130.3.815
更新日期:2006-09-01 00:00:00
abstract::Angiotensin-converting enzyme (ACE) was localized in sarcoid lymph nodes by an in vitro autoradiographic technique using a synthetic ACE inhibitor of high affinity, 125I-labelled 351A. The lymph nodes were from seven patients with active sarcoidosis who underwent mediastinoscopy and from six control subjects who had n...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.90.3.315
更新日期:1986-09-01 00:00:00
abstract::Although amebiasis is prevalent in tropical and subtropical areas, it occurs sporadically in the United States. Pleuropulmonary involvement is seen in about 20 percent of the patients with amebic liver abscesses. We describe a patient with pleuropulmonary amebiasis who complained of hemoptysis but had no gastrointesti...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.98.5.1275
更新日期:1990-11-01 00:00:00
abstract:OBJECTIVE:To assess pulmonologists' use, training in the use, and knowledge base of the drug cyclophosphamide. DESIGN:Survey through questionnaire. Testing of knowledge base before and after instructional conference. PARTICIPANTS AND METHODS:Pulmonologists (94 attendings, 31 fellows), selected randomly at the 1996 an...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.116.5.1159
更新日期:1999-11-01 00:00:00
abstract:BACKGROUND:During noninvasive ventilation, nonintentional leaks have a detrimental effect on the efficacy of ventilation. A wide range of industrial masks are available, with intentional leaks of different importance. The potential impact of this variability in intentional leaks on performances of bilevel ventilators h...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-1340
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Contemporary clinical risk stratification schemata for predicting stroke and thromboembolism (TE) in patients with atrial fibrillation (AF) are largely derived from risk factors identified from trial cohorts. Thus, many potential risk factors have not been included. METHODS:We refined the 2006 Birmingham/Na...
journal_title:Chest
pub_type: 杂志文章,多中心研究
doi:10.1378/chest.09-1584
更新日期:2010-02-01 00:00:00
abstract::Alterations in peripheral vascular tone are presumed to contribute to circulatory failure during severe sepsis. Decreased venous tone with venous pooling may decrease effective circulatory blood volume, while decreased arterial tone with redistribution of systemic blood may compromise tissue nutrient flow. We compared...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.96.2.363
更新日期:1989-08-01 00:00:00
abstract::A 41-year-old man was found to have a miliary infiltrate on chest roentgenogram two months after recovery from varicella pneumonia. The patient remained in good health and there was no objective sign of pulmonary disease. The infiltrate showed no change in subsequent serial chest films, and after one year, open lung b...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.89.3.457
更新日期:1986-03-01 00:00:00
abstract::Transbronchial lung biopsy (TBB) was performed during fiberoptic bronchoscopy under fluoroscopic guidance in 107 patients. TBB was diagnostic in 17 of 21 (81 percent) cases with localized malignant lesions greater than 4 cm in diameter and bronchial brushing was positive in 12 (57 percent). TBB was diagnostic in 14 of...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.68.4.524
更新日期:1975-10-01 00:00:00
abstract:STUDY OBJECTIVES:Human T-cell lymphotropic virus type 1 (HTLV-1)-associated bronchiolitis and diffuse panbronchiolitis might overlap. We examined whether these conditions can be differentiated by comparing their clinical features and the effect of long-term macrolide treatment. PATIENTS AND METHODS:Fifty-eight Japanes...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.125.4.1239
更新日期:2004-04-01 00:00:00
abstract:OBJECTIVE:To determine the incidence, diagnostic features, and perioperative predictors of acute cholecystitis after cardiovascular surgery. DESIGN:Inception cohort study. SETTING:A tertiary care 54-bed cardiothoracic ICU. PATIENTS:All patients admitted to an ICU after cardiovascular surgery during a 42-month period...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.114.1.76
更新日期:1998-07-01 00:00:00
abstract:OBJECTIVES:We aimed to identify the bronchial response to inhaled methacholine in patients with mitral stenosis (MS) and to clarify whether or not the bronchial hyperreactivity (BHR) is reversible after percutaneous mitral balloon valvulotomy (PBMV). PATIENTS AND SETTING:Thirty patients with MS and 28 age-matched heal...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.116.6.1582
更新日期:1999-12-01 00:00:00
abstract::Cardiac tamponade, a potentially lethal complication following cardiac surgery, may present either early or late postoperatively and may be difficult to diagnose due to atypical clinical, hemodynamic, or echocardiographic findings. To determine the frequency and clinical features of postoperative cardiac tamponade, we...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.104.1.71
更新日期:1993-07-01 00:00:00
abstract::Complications following open chest massage in patients with porcine xenografts in the mitral location have not been previously described. The authors report a case of cardiac resuscitation following mitral valve replacement with a stented porcine valve. The patient died following brief closed chest, and then, prolonge...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.77.2.216
更新日期:1980-02-01 00:00:00
abstract::Caveolae are cell plasma membrane microdomains implicated in organizing and concentrating many signaling molecules. In the lung, caveolae are in endothelium, smooth muscle, fibroblasts, and pneumocytes. Caveolin is the main structural protein of caveolae. Caveolin 1 is down-regulated in transformed cells and may be a ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.129.3.696
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Disease progression in COPD is associated with a decline in exercise performance over time. We assessed whether tiotropium might mitigate this by determining its effect on treadmill endurance time (ET) over 2 years. METHODS:This was a randomized, double-blind, placebo-controlled trial of tiotropium, 18 μg d...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.12-2613
更新日期:2013-08-01 00:00:00
abstract::This study investigated the effect of dynamic exercise on mitral regurgitation (MR) as assessed by color flow Doppler imaging and tested the hypothesis that MR increases in patients with left ventricular (LV) function worsening during exercise. We studied 513 patients (390 men, 123 women:mean age [+/-1 SD] 58+/-11 yea...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.114.4.1075
更新日期:1998-10-01 00:00:00
abstract::A 60-pack-year smoker presented with cough, dyspnea and orthopnea of three months' duration. Spirometry revealed severe reduction in maximal expiratory flow; CT of the chest and bronchoscopy demonstrated expiratory collapse of a mid-tracheal segment, and a presumptive diagnosis of tracheomalacia was made. A right late...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.97.4.939
更新日期:1990-04-01 00:00:00
abstract::Forty-four patients with newly discovered biopsy-proven pulmonary sarcoidosis in roentgenographic stage II (adenopathy and interstitial abnormalities) who also had abnormal pulmonary function (TLC and/or DCO less than 80 percent predicted) were assigned in alternate sequence to either a daily or alternate day predniso...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.88.5.687
更新日期:1985-11-01 00:00:00
abstract:BACKGROUND:Altitude exposure is associated with mild pulmonary hypertension and decreased exercise capacity. We tested the hypothesis that pulmonary vascular resistance (PVR) contributes to decreased exercise capacity in hypoxic healthy subjects. METHODS:An incremental cycle ergometer cardiopulmonary exercise test and...
journal_title:Chest
pub_type: 杂志文章,随机对照试验
doi:10.1378/chest.08-2222
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:To address the major methodological issues of reverse causation and selection bias in epidemiologic studies of antibiotic use in early life and the development of asthma, we undertook a cohort study of this association in a complete population of children. METHODS:Using the health-care and prescription data...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.06-3008
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:A comprehensive evaluation of temporal trends in the treatment of patients who have DVT may assist with identification of modifiable factors that contribute to short-term outcomes. METHODS:We assessed temporal trends in length of hospital stay and use of pharmacological and interventional therapies among 26...
journal_title:Chest
pub_type: 杂志文章
doi:10.1016/j.chest.2016.03.046
更新日期:2016-08-01 00:00:00
abstract:BACKGROUND:In daily clinical work, we often face delayed or recurrent pneumothorax after radiofrequency (RF) ablation for lung tumors, but a large study on this theme has not been done. Thus, we examined the rate of delayed or recurrent pneumothorax after RF ablation for lung tumors and the risk factors associated with...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.08-1499
更新日期:2009-04-01 00:00:00
abstract:STUDY OBJECTIVES:To determine the selective vasodilatory effects of two inhaled "NONOate" aerosols in a closed chest pig model of acute pulmonary hypertension (APH). METHODS:APH was induced by IV infusion of the prostaglandin H(2)/thromboxane A(2) receptor agonist (U46619). Aerosolized diethylenetriamine nitric oxide ...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.123.3.869
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:Choices of pharmacologic therapies for pulmonary arterial hypertension (PAH) are ideally guided by high-level evidence. The objective of this guideline is to provide clinicians advice regarding pharmacologic therapy for adult patients with PAH as informed by available evidence. METHODS:This guideline was bas...
journal_title:Chest
pub_type: 杂志文章,评审
doi:10.1378/chest.14-0793
更新日期:2014-08-01 00:00:00
abstract::Mexiletine is a type 1B antiarrhythmic drug similar to lidocaine. Prolongation of ventricular depolarization has not been previously reported with the usual oral dosage of mexiletine. We describe a patient with renal failure and heart failure on low-dose oral therapy who developed mexiletine toxicity, which was manife...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.95.4.925
更新日期:1989-04-01 00:00:00
abstract::We studied the correspondence between fluctuations of esophageal pressure measured before and after placement of a nasogastric (NG) tube in six normal volunteers. Flow, airway pressure, and esophageal pressure data from at least 20 breaths were recorded in seven ventilatory conditions in two body postures: 0 degree (s...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.106.1.137
更新日期:1994-07-01 00:00:00
abstract::In a prospective study murmurs increased in intensity with carotid sinus pressure in 18 of 26 patients with hypertrophic obstructive cardiomyopathy (HOCM) (sensitivity, 69.2 percent for the 26 patients, 85.7 percent for the 21 patients in whom heart rate and blood pressure decreased with carotid sinus pressure). On th...
journal_title:Chest
pub_type: 杂志文章
doi:10.1378/chest.93.4.814
更新日期:1988-04-01 00:00:00
abstract::The effect of clenbuterol, a beta adrenergic drug, and ambroxol, a secretolytic agent, on regional mucociliary clearance and pulmonary radioaerosol distribution was investigated in two groups of 15 patients with COLD in a double-blind cross-over trial with placebo. Clearance rates of inhaled 99mTc-labelled human serum...
journal_title:Chest
pub_type: 临床试验,杂志文章
doi:10.1378/chest.80.6.881
更新日期:1981-12-01 00:00:00