3 research outputs found
Small bowel enteroscopy - A joint clinical guideline from the spanish and portuguese small bowel study groups
The present evidence-based guidelines are focused on the
use of device-assisted enteroscopy in the management of
small-bowel diseases. A panel of experts selected by the
Spanish and Portuguese small bowel study groups reviewed
the available evidence focusing on the main indications of
this technique, its role in the management algorithm of each
indication and on its diagnostic and therapeutic yields. A set
of recommendations were issued accordingly.Estas recomendaçÔes baseadas na evidĂȘncia detalham o
uso da enteroscopia assistida por dispositivo no manejo
clĂnico das doenças do intestino delgado. Um conjunto de
Gastrenterologistas diferenciados em patologia do intestino delgado foi selecionado pelos grupos de estudos Espanhol e PortuguĂȘs de intestino delgado para rever a evidĂȘncia disponĂvel sobre as principais indicaçÔes desta
técnica, o seu papel nos algoritmos de manejo de cada
indicação e sobre o seu rendimento diagnĂłstico e terapĂȘutico. Foi gerado um conjunto de recomendaçÔes pelos autores
Small bowel enteroscopy - A joint clinical guideline from the spanish and portuguese small bowel study groups
The present evidence-based guidelines are focused on the
use of device-assisted enteroscopy in the management of
small-bowel diseases. A panel of experts selected by the
Spanish and Portuguese small bowel study groups reviewed
the available evidence focusing on the main indications of
this technique, its role in the management algorithm of each
indication and on its diagnostic and therapeutic yields. A set
of recommendations were issued accordingly.Estas recomendaçÔes baseadas na evidĂȘncia detalham o
uso da enteroscopia assistida por dispositivo no manejo
clĂnico das doenças do intestino delgado. Um conjunto de
Gastrenterologistas diferenciados em patologia do intestino delgado foi selecionado pelos grupos de estudos Espanhol e PortuguĂȘs de intestino delgado para rever a evidĂȘncia disponĂvel sobre as principais indicaçÔes desta
técnica, o seu papel nos algoritmos de manejo de cada
indicação e sobre o seu rendimento diagnĂłstico e terapĂȘutico. Foi gerado um conjunto de recomendaçÔes pelos autores
Mechanical ventilation in patients with cardiogenic pulmonary edema : a sub-analysis of the LUNG SAFE study
Patients with acute respiratory failure caused by cardiogenic pulmonary edema (CPE) may require mechanical ventilation that can cause further lung damage. Our aim was to determine the impact of ventilatory settings on CPE mortality. Patients from the LUNG SAFE cohort, a multicenter prospective cohort study of patients undergoing mechanical ventilation, were studied. Relationships between ventilatory parameters and outcomes (ICU discharge/hospital mortality) were assessed using latent mixture analysis and a marginal structural model. From 4499 patients, 391 meeting CPE criteria (median age 70 [interquartile range 59-78], 40% female) were included. ICU and hospital mortality were 34% and 40%, respectively. ICU survivors were younger (67 [57-77] vs 74 [64-80] years, p < 0.001) and had lower driving (12 [8-16] vs 15 [11-17] cmHO, p < 0.001), plateau (20 [15-23] vs 22 [19-26] cmHO, p < 0.001) and peak (21 [17-27] vs 26 [20-32] cmHO, p < 0.001) pressures. Latent mixture analysis of patients receiving invasive mechanical ventilation on ICU day 1 revealed a subgroup ventilated with high pressures with lower probability of being discharged alive from the ICU (hazard ratio [HR] 0.79 [95% confidence interval 0.60-1.05], p = 0.103) and increased hospital mortality (HR 1.65 [1.16-2.36], p = 0.005). In a marginal structural model, driving pressures in the first week (HR 1.12 [1.06-1.18], p < 0.001) and tidal volume after day 7 (HR 0.69 [0.52-0.93], p = 0.015) were related to survival. Higher airway pressures in invasively ventilated patients with CPE are related to mortality. These patients may be exposed to an increased risk of ventilator-induced lung injury. Trial registration Clinicaltrials.gov NCT02010073