| Helmet continuous positive airway pressure vs oxygen therapy to improve oxygenation in community-acquired pneumonia: a randomized, controlled trial. | |
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MedLine Citation:
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PMID: 20154071 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Our objective was to evaluate the efficacy of noninvasive continuous positive airway pressure (CPAP) delivered by helmet in improving oxygenation in comparison with oxygen therapy in community-acquired pneumonia (CAP). METHODS: This was a multicenter, randomized, controlled trial enrolling patients with CAP admitted to an ED with moderate hypoxemic acute respiratory failure (ARF) (Pa(O(2))/Fi(O(2)) ratio > or = 210 and < or = 285). Patients were randomized to helmet CPAP or standard oxygen therapy (control group). The primary end point was the time to reach a Pa(O(2))/Fi(O(2)) ratio > 315. After reaching this value, patients randomized to CPAP were switched to oxygen, and the proportion of subjects who could maintain a Pa(O(2))/Fi(O(2)) ratio > 315 at 1 h was recorded. RESULTS: Forty-seven patients were recruited: 20 randomized to CPAP and 27 to controls. Patients randomized to CPAP reached the end point in a median of 1.5 h, whereas controls reached the end point in 48 h (P < .001). The proportion of patients who reached the primary end point was 95% (19/20) among the CPAP group and 30% (8/27) among controls (P < .001). One hour after reaching the primary end point, 2/14 patients in the CPAP group maintained a Pa(O(2))/Fi(O(2)) value > 315. CONCLUSIONS: CPAP delivered by helmet rapidly improves oxygenation in patients with CAP suffering from a moderate hypoxemic ARF. This trial represents a proof-of-concept evaluation of the potential usefulness of CPAP in patients with CAP. |
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Authors:
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Roberto Cosentini; Anna Maria Brambilla; Stefano Aliberti; Angelo Bignamini; Stefano Nava; Antonino Maffei; Renato Martinotti; Paolo Tarsia; Valter Monzani; Paolo Pelosi |
Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial Date: 2010-02-12 |
Journal Detail:
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Title: Chest Volume: 138 ISSN: 1931-3543 ISO Abbreviation: Chest Publication Date: 2010 Jul |
Date Detail:
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Created Date: 2010-07-07 Completed Date: 2010-08-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0231335 Medline TA: Chest Country: United States |
Other Details:
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Languages: eng Pagination: 114-20 Citation Subset: AIM; IM |
Affiliation:
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Emergency Medicine Department, Gruppo NIV, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy. roberto.cosentini@policlinico.mi.it |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00603564 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Community-Acquired Infections / metabolism, therapy* Equipment Design Female Follow-Up Studies Head Protective Devices* Humans Male Oxygen Consumption / physiology* Oxygen Inhalation Therapy / methods* Pneumonia, Bacterial / metabolism, therapy* Positive-Pressure Respiration / instrumentation* Retrospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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