5 results on '"Jan O. Friedrich"'
Search Results
2. The RECOVER Program: Disability Risk Groups and 1-Year Outcome after 7 or More Days of Mechanical Ventilation
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Linda Chan, Matteo Parotto, Leslie M. Chu, C. Chaparro, Claire Thomas, Claudia C. dos Santos, Najib T. Ayas, Stacey Burns, Hilary Meggison, Jane Batt, Chung-Wai Chow, Paul C. Hébert, Jan O. Friedrich, Priscila Robles, Yoanna Skrobik, Brian H Cuthbertson, Jill C. Rudkowski, Linda Flockhart, Denise Morris, Jill I. Cameron, Shaf Keshavjee, Sangeeta Mehta, Susan E. Abbey, Marcelo Cypel, Laurent Brochard, Tasnim Sinuff, John G. Flannery, Adrienne Tan, Deborah J. Cook, Eddy Fan, M. Elizabeth Wilcox, John C. Marshall, Mark Bayley, Vincent Lo, Neill K. J. Adhikari, Christie M. Lee, Francois Lamontagne, Robert A. Fowler, Margaret S. Herridge, George Tomlinson, Sunita Mathur, Lianne G. Singer, Louise Rose, Karen Choong, Mélanie Levasseur, Niall D. Ferguson, Damon C. Scales, Arthur S. Slutsky, Andrea Matte, and Recover Program Investigators
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Pulmonary and Respiratory Medicine ,Mechanical ventilation ,medicine.medical_specialty ,Rehabilitation ,business.industry ,health care facilities, manpower, and services ,medicine.medical_treatment ,030208 emergency & critical care medicine ,Surgical intensive care unit ,Recursive partitioning ,Critical Care and Intensive Care Medicine ,Functional Independence Measure ,03 medical and health sciences ,0302 clinical medicine ,Risk groups ,030228 respiratory system ,Cohort ,medicine ,Physical therapy ,Risk factor ,business - Abstract
Disability risk groups and 1-year outcome after greater than or equal to 7 days of mechanical ventilation (MV) in medical/surgical intensive care unit (ICU) patients are unknown and may inform education, prognostication, rehabilitation, and study design.To stratify patients for post-ICU disability and recovery to 1 year after critical illness.We evaluated a multicenter cohort of 391 medical/surgical ICU patients who received greater than or equal to 1 week of MV at 7 days and 3, 6, and 12 months after ICU discharge. Disability risk groups were identified using recursive partitioning modeling.The 7-day post-ICU Functional Independence Measure (FIM) determined the recovery trajectory to 1-year after ICU discharge and was an independent risk factor for 1-year mortality. The 7-day post-ICU FIM was predicted by age and ICU length of stay. By 2 weeks of MV, ICU patients could be stratified into four disability groups characterized by increasing risk for post ICU disability, ICU and post-ICU healthcare use, and disposition. Patients less than 42 years with ICU length of stay less than 2 weeks had the best function and fewest deaths at 1 year compared with patients greater than 66 years with ICU length of stay greater than 2 weeks who sustained the worst disability and 40% 1-year mortality. Depressive symptoms (17%) and post-traumatic stress disorder (18%) persisted at 1 year.ICU survivors of greater than or equal to 1 week of MV may be stratified into four disability groups based on age and ICU length of stay. These groups determine 1-year recovery and healthcare use and are independent of admitting diagnosis and illness severity. Clinical trial registered with www.clinicaltrials.gov (NCT 00896220).
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- 2016
3. Effort to Breathe with Various Spontaneous Breathing Trial Techniques. A Physiologic Meta-analysis
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Ewan C. Goligher, Lu Chen, Guang-Qiang Chen, Michela Rauseo, Neill K. J. Adhikari, Laurent Brochard, Michael C. Sklar, Nuttapol Rittayamai, Jan O. Friedrich, Ashley Lanys, Karen E. A. Burns, and Martin Dres
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Pulmonary and Respiratory Medicine ,Research design ,Mechanical ventilation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Respiration ,Editorials ,030208 emergency & critical care medicine ,Critical Care and Intensive Care Medicine ,Spontaneous breathing trial ,Clinical trial ,03 medical and health sciences ,Work of breathing ,0302 clinical medicine ,030228 respiratory system ,Meta-analysis ,Rapid shallow breathing index ,Breathing ,Physical therapy ,Medicine ,Humans ,business ,Work of Breathing - Abstract
Spontaneous breathing trials (SBTs) are designed to simulate conditions after extubation, and it is essential to understand the physiologic impact of different methods.We conducted a systematic review and pooled measures reflecting patient respiratory effort among studies comparing SBT methods in a meta-analysis.We searched Medline, Excerpta Medica Database, and Web of Science from inception to January 2016 to identify randomized and nonrandomized clinical trials reporting physiologic measurements of respiratory effort (pressure-time product) or work of breathing during at least two SBT techniques. Secondary outcomes included the rapid shallow breathing index (RSBI), and effort measured before and after extubation. The quality of physiologic measurement and research design was appraised for each study. Outcomes were analyzed using ratio of means.Among 4,138 citations, 16 studies (n = 239) were included. Compared with T-piece, pressure support ventilation significantly reduced work by 30% (ratio of means [RoM], 0.70; 95% confidence interval [CI], 0.57-0.86), effort by 30% (RoM, 0.70; 95% CI, 0.60-0.82), and RSBI by 20% (RoM, 0.80; 95% CI, 0.75-0.86). Continuous positive airway pressure had significantly lower pressure-time product by 18% (RoM, 0.82; 95% CI, 0.68-0.999) compared with T-piece, and reduced RSBI by 16% (RoM, 0.84; 95% CI, 0.74-0.95). Studies comparing SBTs with the postextubation period demonstrated that pressure support induced significantly lower effort and RSBI; T-piece reduced effort, but not the work, compared with postextubation. Work, effort, and RSBI measured while intubated on the ventilator with continuous positive airway pressure of 0 cm HPressure support reduces respiratory effort compared with T-piece. Continuous positive airway pressure of 0 cm H
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- 2016
4. Has mortality from acute respiratory distress syndrome decreased over time?: A systematic review
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Jeff Singh, Andrew Jones, David Gattas, David Hallett, Neill K. J. Adhikari, Niall D. Ferguson, Jason Phua, David R. Stather, Amanda Li, Damon C. Scales, Thomas E. Stewart, Jan O. Friedrich, Robert A. Fowler, Joan Ramon Badia, and George Tomlinson
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,ARDS ,Respiratory Distress Syndrome ,Time Factors ,Respiratory distress ,business.industry ,Lung injury ,Critical Care and Intensive Care Medicine ,medicine.disease ,Global Health ,law.invention ,Survival Rate ,Randomized controlled trial ,law ,Meta-analysis ,Intensive care ,Internal medicine ,Medicine ,Humans ,Observational study ,business ,Intensive care medicine ,Survival rate - Abstract
It is commonly stated that mortality from acute respiratory distress syndrome (ARDS) and acute lung injury (ALI) is decreasing.To systematically review the literature assessing ARDS mortality over time and to determine patient- and study-level factors independently associated with mortality.We searched multiple databases (MEDLINE, EMBASE, CINAHL, Cochrane CENTRAL) for prospective observational studies or randomized controlled trials (RCTs) published during the period 1984 to 2006 that enrolled 50 or more patients with ALI/ARDS and reported mortality. We pooled mortality estimates using random-effects meta-analysis and examined mortality trends before and after 1994 (when a consensus definition of ALI/ARDS was published) and factors associated with mortality using meta-regression models.Of 4,966 studies, 89 met inclusion criteria (53 observational, 36 RCTs). There was a total of 18,900 patients (mean age 51.6 years; 39% female). Overall pooled weighted mortality was 44.3% (95% confidence interval [CI], 41.8-46.9). Mortality decreased with time in observational studies conducted before 1994; no temporal associations with mortality were demonstrated in RCTs (any time) or observational studies (after 1994). Pooled mortality from 1994 to 2006 was 44.0% (95% CI, 40.1-47.5) for observational studies, and 36.2% (95% CI, 32.1-40.5) for RCTs. Meta-regression identified study type (observational versus RCT, odds ratio, 1.36; 95% CI, 1.08-1.73) and patient age (odds ratio per additional 10 yr, 1.27; 95% CI, 1.07-1.50) as the only factors associated with mortality.A decrease in ARDS mortality was only seen in observational studies from 1984 to 1993. Mortality did not decrease between 1994 (when a consensus definition was published) and 2006, and is lower in RCTs than observational studies.
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- 2008
5. 'Stop Right There…I Gotta Know Right Now!' Do Steroids Really Help for CAP?
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Jan O. Friedrich, Niall D. Ferguson, and Damon C. Scales
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Pulmonary and Respiratory Medicine ,business.industry ,Law ,Medicine ,Critical Care and Intensive Care Medicine ,business - Published
- 2005
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