Chronic Respiratory Disease最新文献

{"title":"Long-term mechanical ventilation and transitions in care: A narrative review.","authors":"Lena Xiao,&nbsp;Reshma Amin,&nbsp;Mika Laura Nonoyama","doi":"10.1177/14799731231176301","DOIUrl":"10.1177/14799731231176301","url":null,"abstract":"<p><strong>Objectives: </strong>Individuals dependent on long-term mechanical ventilation (LTMV) for their day-to-day living are a heterogenous population who go through several transitions over their lifetime. This paper describes three transitions: 1) institution/hospital to community/home, 2) pediatric to adult care, and 3) active treatment to end-of-life for ventilator-assisted individuals (VAIs).</p><p><strong>Methods: </strong>A narrative review based on literature and the author's collective practical and research experience. Four online databases were searched for relevant articles. A manual search for additional articles was completed and the results are summarized.</p><p><strong>Results: </strong>Transitions from hospital to home, pediatric to adult care, and to end-of-life for VAIs are complex and challenging processes. Although there are several LTMV clinical practice guidelines highlighting key components for successful transition, there still exists gaps and inconsistencies in care. Most of the literature and experiences reported to date have been in developed countries or geographic areas with funded healthcare systems.</p><p><strong>Conclusions: </strong>For successful transitions, the VAIs and their support network must be front-and-center. There should be a coordinated, systematic, and holistic plan (including a multi-disciplinary team), life-time follow-up, with bespoke consideration of jurisdiction and individual circumstances.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231176301"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4c/dd/10.1177_14799731231176301.PMC10184211.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9476145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of a wearable respiratory rate device: A brief report.","authors":"Arik Eisenkraft,&nbsp;Nir Goldstein,&nbsp;Arik Ben Ishay,&nbsp;Meir Fons,&nbsp;Michael Tabi,&nbsp;Anna Danielle Sherman,&nbsp;Roei Merin,&nbsp;Dean Nachman","doi":"10.1177/14799731231198865","DOIUrl":"10.1177/14799731231198865","url":null,"abstract":"<p><strong>Background: </strong>Respiratory rate (RR) is used for the diagnosis and management of medical conditions and can predict clinical changes. Heavy workload, understaffing, and errors related to poor recording make it underutilized. Wearable devices may facilitate its use.</p><p><strong>Methods: </strong>RR measurements using a wearable photoplethysmography-based monitor were compared with medical grade devices in complementary clinical scenarios: Study one included a comparison to a capnograph in 35 healthy volunteers; Study two included a comparison to a ventilator monitor in 18 ventilated patients; and Study three included a comparison to capnograph in 92 COVID-19 patients with active pulmonary disease. Pearson's correlations and Bland-Altman analysis were used to assess the accuracy and agreement between the measurement techniques, including stratification for Body Mass Index (BMI) and skin tone. Statistical significance was set at <i>p</i> ≤ 0.05.</p><p><strong>Results: </strong>High correlation was found in all studies (r = 0.991, 0.884, and 0.888, respectively, <i>p</i> < 0.001 for all). 95% LOA of ±2.3, 1.7-(-1.6), and ±3.9 with a bias of < 0.1 breaths per minute was found in Bland-Altman analysis in studies 1,2, and 3, respectively. In all, high accordance was found in all sub-groups.</p><p><strong>Conclusions: </strong>RR measurements using the wearable monitor were highly-correlated with medical-grade devices in various clinical settings.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT03603860.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231198865"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7b/d9/10.1177_14799731231198865.PMC10461800.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10103630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability and characteristics of pulmonary rehabilitation programs in family health centers and hospitals from Chile: Descriptive, retrospective and multicentric study.","authors":"Andrea Méndez,&nbsp;Carlos Nieto,&nbsp;Gonzalo Hidalgo,&nbsp;Iván Rodríguez-Núñez","doi":"10.1177/14799731221147059","DOIUrl":"https://doi.org/10.1177/14799731221147059","url":null,"abstract":"<p><strong>Objective: </strong>To determine availability and characteristics of pulmonary rehabilitation programs performed in 2019 in family health centers and hospitals from Chile.</p><p><strong>Methodology: </strong>A descriptive and retrospective study was designed, considering PR programs operated in 2019. A non-probability and convenience sample was obtained. Availability and characteristics of centers and PR were measured using a questionnaire translated, modified, validated, and sent by email.</p><p><strong>Results: </strong>Out of 80 responses (22.8%), 60% of centers offered PR program, where the lack of time was the greatest barrier. The programs were mainly outpatient, non-personalized, with 10(IQR 4-11) participants, 12 (IQR 12-16) weeks of length, with 2.4 ± 0.6 session/week, and 1 (IQR 1-2) hours/session. Chronic Obstructive Pulmonary Disease (COPD) was the most frequent diagnostic. The programs were mainly comprised of strength training exercises of lower extremity, upper extremity, walking and education. Team was constituted of physiotherapist and physician, with completed training, and directed by a physiotherapist. Modified Borg, MRC dyspnea scale, six-minute walking test and oximetry were used in the assessments. Between 40-80% of patients completed PR, and the major barrier was patient relocated.</p><p><strong>Conclusion: </strong>Increasing PR availability, homogenization of exercises and education, prioritization of assessments supported by scientific evidence, and inclusion of follow-up could be useful to improve the access, quality and results of the treatment, considering new models of PR that allow greater access and acceptability.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731221147059"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/b3/10.1177_14799731221147059.PMC9903030.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10671148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of telemonitoring on quality of life for patients with chronic obstructive pulmonary disease-A randomized controlled trial.","authors":"Maria L Køpfli,&nbsp;Sanne Børgesen,&nbsp;Michael Skov Jensen,&nbsp;Charlotte Hyldgaard,&nbsp;Cathrine Bell,&nbsp;Frank D Andersen","doi":"10.1177/14799731231157771","DOIUrl":"https://doi.org/10.1177/14799731231157771","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with chronic obstructive pulmonary disease (COPD) often experience severe physical limitations and psychological distress, which can lead to a deterioration in quality of life (QoL). Telemonitoring (TM) may improve QoL and reduce the number of hospitalizations and readmissions, but results from previous studies have been conflicting. The aim of this study was to assess the effect of TM on QoL in patients with moderate to severe COPD recruited during hospitalization for acute exacerbation (AECOPD).</p><p><strong>Methods: </strong>We conducted a randomized controlled trial at Silkeborg and Viborg Regional Hospitals in Denmark. Participants were recruited during hospitalization for AECOPD and randomized to a six-month telemonitoring service in addition to standard COPD care or standard COPD care alone. Patients were followed for 24 months. QoL was measured by the Hospital Anxiety and Depression Scale (HADS), and St Georges Respiratory Questionnaire (SGRQ) at 3-, 6-, 12-, and 24-months follow-up. The main outcome was QoL at 6 months.</p><p><strong>Results: </strong>In total, 101 patients were randomized to the TM intervention and 97 to standard care. The between-group difference in SGRQ at 6 months was -2.0 (-8.5; 4.5), in HADS-Anxiety -0.3 (-2.0; 1.4) and in HADS-depression 0.2 (-1.0; 1.4) corresponding to no significant difference in health-related QoL for patients receiving TM compared to standard care. No difference was seen at 12-24 months follow-up either.</p><p><strong>Discussion: </strong>TM in addition to standard care did not improve QoL in patients with moderate to severe COPD. Other means of improving management and QoL in severe COPD are urgently needed.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231157771"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/15/49/10.1177_14799731231157771.PMC9926364.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10725986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity and mortality in systemic sclerosis and matched controls: Impact of interstitial lung disease. A population based cohort study based on health registry data.","authors":"Malene Knarborg, Charlotte Hyldgaard, Elisabeth Bendstrup, Jesper Rømhild Davidsen, Anders Løkke, Saher Burhan Shaker, Ole Hilberg","doi":"10.1177/14799731231195041","DOIUrl":"10.1177/14799731231195041","url":null,"abstract":"<p><strong>Objective: </strong>This population-based, matched cohort study evaluates the impact of comorbidities on mortality among systemic sclerosis (SSc) patients with and without interstitial lung disease (ILD).</p><p><strong>Method: </strong>Patients with a first-time SSc diagnosis between 2002 and 2015 were identified in the Danish National Patient Registry, separated into two cohorts - with ILD (SSc-ILD) and without ILD (non-ILD SSc), and matched 1:4 with controls from the general population on age, sex, residency and marital status. Comorbidity and mortality data were obtained from national registries. The Deyo-Charlson comorbidity score (DCcs) was used for assessment of the burden of comorbidities.</p><p><strong>Results: </strong>1732 patients with SSc and 6919 controls were included; 258 (14.9%) patients had SSc-ILD. The hazard ratio (HR) for death was 2.8 (95% CI 2.4-3.3) in SSc, and especially increased in SSc-ILD (HR 4.2 (95% CI 3.2-5.4)), males (HR 3.1 95% CI 2.4-4.1) and younger adults (aged 18-40 (HR 6.9, 95% CI 3.4-14.2) and 41-50 (HR 7.7, 95% CI 3.8-15.6)). In non-ILD SSc, mortality increased with increasing DCcs. Cancer was the most frequent cause of death in SSc (24.9% of deaths) and in controls (33.5%), in SSc followed by musculoskeletal and connective tissue diseases (22.7%); the cause of only 0.8% of deaths among controls.</p><p><strong>Conclusion: </strong>The high prevalence of comorbidities in SSc had extensive impact on mortality. Mortality was increased in males, in young adults and in SSc-ILD, underlining the excess mortality associated with ILD. These findings emphasise the importance of timely diagnosis and optimal management of organ involvement and comorbidities in SSc.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231195041"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b3/2c/10.1177_14799731231195041.PMC10440053.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10423189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of CPAP treatment on electroencephalographic activity in patients with obstructive sleep apnea syndrome during deep sleep: Preliminary findings of a cross-sectional study.","authors":"Yiran Li, Qi Li, Xueliang Zou, Zhijun Zhong, Qian Ouyang, Qinghong Zeng, Yinyin Hu, Mengmeng Wang, Yaxing Luo, Dongyuan Yao","doi":"10.1177/14799731231215094","DOIUrl":"10.1177/14799731231215094","url":null,"abstract":"<p><p><b>Study objectives:</b> To investigate whether electroencephalographic (EEG) activities during non-rapid eye movement sleep stage 3 (N3) in obstructive sleep apnea syndrome (OSAS) patients were changed with continuous positive airway pressure (CPAP) treatment.<b>Methods:</b> A cross-sectional study of EEG activity during N3 sleep was conducted in 15 patients with moderate to severe OSAS without and with CPAP treatment compared to 15 normal controls. The amplitude, and absolute and relative power of delta, theta, alpha and beta waves as well as the absolute power ratio of slow to fast EEG waves (i.e., absolute power of delta and theta waves/absolute power of alpha and beta waves) and the spectral power density of 0-30 Hz EEG activities were analyzed.<b>Results:</b> CPAP significantly increased N3 sleep, the absolute and relative powers, amplitudes of delta and theta waves, and absolute power ratio of slow to fast EEG waves, but decreased relative alpha and beta powers during N3 sleep. However, there were no significant differences in those parameters between the OSAS patients with CPAP treatment and normal controls.<b>Conclusions:</b> CPAP prolongs N3 sleep and increases the power and amplitude of slow EEG waves during N3 sleep, which indicates an improvement in sleep quality and further provides evidence for recommendation of CPAP treatment for OSAS patients.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231215094"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10655652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134648613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect on muscle strength after blood flow restriction resistance exercise in early in-patient rehabilitation of post-chronic obstructive pulmonary disease acute exacerbation, a single blinded, randomized controlled study.","authors":"Chung Wai Lau, Siu Yin Leung, Shu Hong Wah, Choi Wan Yip, Wei Yin Wong, Kin Sang Chan","doi":"10.1177/14799731231211845","DOIUrl":"10.1177/14799731231211845","url":null,"abstract":"<p><strong>Background: </strong>Early commencement of rehabilitation might counteract the loss of muscle strength due to a chronic obstructive pulmonary disease acute exacerbation (COPDAE). Blood flow restriction resistance exercise (BFR-RE) using a low intensity of training load has demonstrated muscle strength gain in varieties of clinical populations. This trial aimed at studying the efficacy and acceptability of BFR-RE in patients with post-COPDAE which was not reported before.</p><p><strong>Method: </strong>A prospective, assessor blinded, randomized controlled study with 2-week in-patient rehabilitation program with BFR-RE was compared to a matched program with resistance exercise without BFR in patients with post-COPDAE. The primary outcome was the change of muscle strength of knee extensor of dominant leg. The secondary outcomes included changes of hand grip strength (HGS), 6-minute walk test (6MWT) distance, short physical performance battery (SPPB) scores, COPD assessment test (CAT) scores; acceptability and feasibility of BFR-RE; and 1-month unplanned re-admission rate.</p><p><strong>Results: </strong>Forty-Five post-COPDAE patients (mean age = 76 ± 10, mean FEV1%=49% ± 24%) were analyzed. After training, BFR-RE group and control group demonstrated a statistically significant median muscle strength gain of 20 (Interquartile range (IQR) 3 to 38) Newton(N) and 12 (IQR -9 to 30) N respectively. BFR-RE group showed a significant change in SPPB scores, but not in 6MWT distance and HGS after training. Between groups did not have statistically significant different in all primary and secondary outcomes, though with similar acceptability. Drop-out rate due to training-related discomfort in BFR-RE group was 3.7%.</p><p><strong>Conclusion: </strong>BFR-RE is feasible and acceptable in patients with post-COPDAE. A 2-week inpatient pulmonary rehabilitation with BFR-RE improved muscle strength of knee extensors, but not a greater extent than the same rehabilitation program with resistance exercise without BFR. Further studies could be considered with a longer training duration and progression of resistance load. [ClinicalTrials.gov Identifier: NCT04448236].</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"20 ","pages":"14799731231211845"},"PeriodicalIF":4.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10657539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136396536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CRD Editor’s corner archive: October-December","authors":"Michael C Steiner","doi":"10.1177/14799731221091217","DOIUrl":"https://doi.org/10.1177/14799731221091217","url":null,"abstract":"Ventilator dependence in neuromuscular disease – managing life’s basics ... December 21st, 2021 When people with neuromuscular disease become more dependent on round the clock noninvasive ventilation (NIV), the simple basics of life such as eating, drinking and talking become a significant challenge. In the journal this month, Kinnear and colleagues, observe how people manage these functions whilst using NIV. Importantly, they manage to do this safely for example by timing swallowing between ventilator breaths. Providing the right support in this situation may allow tube feeding to be avoided an important consideration for many. -Mick Steiner, Editor-in-Chief, Chronic Respiratory Disease. Management of pleural disease during the COVID-19 pandemic. Keeping the show on the road. December 16th, 2021 A positive consequence of the pandemic has been the pace of innovation in the delivery of clinical services previously highly reliant on face to face patient contact. Ajmal and colleagues demonstrate nicely how this was achieved for the delivery of pleural services in a tertiary hospital by incorporating a triage process to direct cases to the most appropriate form of clinical-patient contact. It seems likely such innovations are here to stay – we look forward to seeing more data on impacts on clinical outcomes and the patient’s experience of their care. -Mick Steiner, Editor-in-Chief, Chronic Respiratory Disease. Ventilatory support in Motor Neurone Disease. Evidence beyond RCTs. December 2nd, 2021 The provision of ventilatory support in people with motor neurone disease is an intervention that therapists know can be effective but is supported by only limited clinical trial evidence. It would be difficult to undertake more trials now because withholding a standard care in a control group would be unethical. Judging effectiveness therefore requires different sources of evidence and in the journal this monthWalsh et al. provide insightful data from a clinical cohort of patients treated in their centre. They demonstrate that successful initiation and adherence to NIV is associated with longer survival in patients with bulbar predominant disease. Of course there may be a variety of confounding factors affecting the causal link between the intervention and the outcome. However, from the clinical perspective, these data should drive the offer of treatment to those who might need it and in particular underpin the support of the wider multi-professional team in helping patients use the equipment consistently. -Mick Steiner, Editor-in-Chief, Chronic Respiratory Disease. Achromobacter species in primary ciliary dyskinesia. How much should we worry? December 2nd, 2021 The clinical importance of persistent bacterial colonisation of the lung in bronchiectasis and cystic fibrosis is increasingly recognised but there are fewer data in rare conditions such as PCD and the role of less common organisms also uncertain. In the journal this month, Holgerson et al. present d","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"18 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2022-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42543082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients experience regarding home mechanical ventilation in an outpatient setting.","authors":"Carla Ribeiro,&nbsp;Cristina Jácome,&nbsp;Pedro Oliveira,&nbsp;Sara Conde,&nbsp;Wolfram Windisch,&nbsp;Rui Nunes","doi":"10.1177/14799731221137082","DOIUrl":"https://doi.org/10.1177/14799731221137082","url":null,"abstract":"<p><strong>Background: </strong>The patient's experience of treatment is a cornerstone of high-quality healthcare, along with clinical safety and effectiveness. We aimed to evaluate the patients' perspectives regarding home mechanical ventilation (HMV) follow up in an outpatient setting and ascertain differences between patients that started HMV in the outpatient setting compared to other settings.</p><p><strong>Methods: </strong>This cross-sectional study was conducted with patients with chronic respiratory failure under HMV in the Outpatient Ventilation Clinic. Patients filled in a patient experience questionnaire and the S3-NIV questionnaire.</p><p><strong>Results: </strong>The study included 235 patients (127, 54% male), median 70 [25-75 percentiles 64-76] years) and about half were adapted to HMV in the outpatient setting (117, 49.8%). Patients had a daily ventilator usage of 8.0 [6.0-10.0] hours and have been on ventilator for a median of 35.0 [12.0-66.0] months. Patients reported an overall good experience regarding education at initiation (209 [88.9%] considered the information given was enough), short time to adaptation [104 (44.3%) felt adapted after some hours], with perceived benefits (171 [72.8%] reported less shortness of breath, 158 (67.2%) improved quality of life and 150 (63.8%) less tiredness). Benefits overcame the treatment side-effects (158 [67.2%] reported mucosal dryness, 109 (46.4%) mask sores and 96 (40.9%) leaks). There was no difference in terms of reported health gains, side effects or time to adaptation between adaptation settings, but patients starting HMV in the outpatient setting reported better communication and education at adaptation.</p><p><strong>Conclusions: </strong>Outpatient setting was perceived as a positive experience, both in HMV initiation and follow up, with good patient-physician communication leading to significant health reported gains, improvement of health status and well-being and good treatment adherence.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"19 ","pages":"14799731221137082"},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/17/10.1177_14799731221137082.PMC9706049.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10479269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Azithromycin use prior to ICU admission is associated with a lower short-term mortality for critically ill acute exacerbations of chronic obstructive pulmonary disease patients: A retrospective cohort study.","authors":"Xuequn Guo,&nbsp;Hongsheng Lin,&nbsp;Donghao Guo,&nbsp;Qiu Luo","doi":"10.1177/14799731221140797","DOIUrl":"https://doi.org/10.1177/14799731221140797","url":null,"abstract":"<p><p>Azithromycin was thought to prevent acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) by anti-microbial and anti-inflammatory effects. However, it's value in the treatment of critically ill patients with AECOPD before ICU admission remains unclear. Our study aimed to find whether azithromycin use prior to ICU admission leads to better clinical outcomes for those individuals. 533 critically ill patients with AECOPD from the MIMIC-IV database were included. Univariate followed multivariate logistic regression was used to select risk factors for short-term mortality. The multivariable logistic regression models were implemented to investigate the association between azithromycin use before ICU admission and short-term mortality. Lower short-term mortality was observed in the azithromycin group (<i>p</i> = .021), independent of differences in demographic data and other clinical outcomes (<i>p</i>>.05). Azithromycin use before ICU admission was proved to have a decreased short-term mortality by multivariable logistic regression (<i>p</i><.05). The results remained consistent after being stratified by age, SOFA scores, pH, and cancer diagnosis. Azithromycin use prior to ICU admission was associated with lower short-term mortality for critically ill AECOPD patients.</p>","PeriodicalId":10217,"journal":{"name":"Chronic Respiratory Disease","volume":"19 ","pages":"14799731221140797"},"PeriodicalIF":4.1,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/62/50/10.1177_14799731221140797.PMC9685141.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10824686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}