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The Effect of Hospi...
The Effect of Hospital Discharge with Empiric Noninvasive Ventilation on Mortality in Hospitalized Patients with Obesity Hypoventilation Syndrome An Individual Patient Data Meta-Analysis
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- Mokhlesi, Babak (författare)
- Univ Chicago, Dept Med, Chicago, IL 60637 USA.
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- Masa, Juan Fernando (författare)
- San Pedro Alcantara Hosp, Resp Dept, Caceres, Spain.;Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain.
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- Afshar, Majid (författare)
- Loyola Univ, Dept Hlth Informat & Data Sci, Chicago, IL 60611 USA.
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- Pacheco, Virginia Almadana (författare)
- Hosp Univ Virgen Macarena, Clin Unit Pneumol, Seville, Spain.
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- Berlowitz, David J. (författare)
- Austin Hlth, Inst Breathing & Sleep, Heidelberg, Vic, Australia.
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- Borel, Jean-Christian (författare)
- Univ Grenoble Alpes, HP2 Lab, INSERM U1042, Grenoble, France.
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- Budweiser, Stephan (författare)
- RoMed Clin Ctr, Div Pulm & Resp Med, Rosenheim, Germany.
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- Carrillo, Andres (författare)
- Hosp JM Morales Meseguer, Intens Care Unit, Murcia, Spain.
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- Castro-Anon, Olalla (författare)
- Lucus Augusti Univ Hosp, Pneumol Serv, Galicia, Spain.
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- Ferrer, Miquel (författare)
- Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain.;Univ Barcelona, Hosp Clin Barcelona, Dept Pneumol, Barcelona, Spain.
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- Gagnadoux, Frederic (författare)
- Angers Univ Hosp, Dept Resp Dis, Angers, France.;Angers Univ Hosp, INSERM U1063, Angers, France.
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- Golpe, Rafael (författare)
- Lucus Augusti Univ Hosp, Pneumol Serv, Galicia, Spain.
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- Hart, Nicholas (författare)
- Guys & St Thomas NHS Fdn Trust, Lane Fox Resp Serv, London, England.
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- Howard, Mark E. (författare)
- Austin Hlth, Inst Breathing & Sleep, Heidelberg, Vic, Australia.
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- Murphy, Patrick B. (författare)
- Guys & St Thomas NHS Fdn Trust, Lane Fox Resp Serv, London, England.
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- Palm, Andreas, 1971- (författare)
- Uppsala universitet,Lung- allergi- och sömnforskning
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- de Llano, Luis A. Perez (författare)
- Lucus Augusti Univ Hosp, Pneumol Serv, Galicia, Spain.
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- Piper, Amanda J. (författare)
- Royal Prince Alfred Hosp, Camperdown, NSW, Australia.;Univ Sydney, Camperdown, NSW, Australia.
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- Pepin, Jean Louis (författare)
- Univ Grenoble Alpes, HP2 Lab, INSERM U1042, Grenoble, France.
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- Priou, Pascaline (författare)
- Angers Univ Hosp, Dept Resp Dis, Angers, France.;Angers Univ Hosp, INSERM U1063, Angers, France.
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- Sanchez-Gomez, Jesus F. (författare)
- Hosp Univ Virgen Macarena, Clin Unit Pneumol, Seville, Spain.
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- Soghier, Israa (författare)
- Albert Einstein Coll Med, Dept Med, Bronx, NY 10467 USA.
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- Kakazu, Maximiliano Tamae (författare)
- Michigan State Univ, Div Pulm & Crit Care Med Spectrum Hlth, Coll Human Med, Grand Rapids, MI USA.
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- Wilson, Kevin C. (författare)
- Boston Univ, Sch Med, Dept Med, Boston, MA 02118 USA.;Amer Thorac Soc, New York, NY USA.
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Univ Chicago, Dept Med, Chicago, IL 60637 USA San Pedro Alcantara Hosp, Resp Dept, Caceres, Spain.;Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain. (creator_code:org_t)
- American Thoracic Society, 2020
- 2020
- Engelska.
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Ingår i: Proceedings of the American Thoracic Society online. - : American Thoracic Society. - 1546-3222 .- 1943-5665. ; 17:5, s. 627-637
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Rationale: Hospitalized patients with acute-on-chronic hypercapnic respiratory failure due to obesity hypoventilation syndrome (OHS) have increased short-term mortality. It is unknown whether prescribing empiric positive airway pressure (PAP) at the time of hospital discharge reduces mortality compared with waiting for an outpatient evaluation (i.e., outpatient sleep study and outpatient PAP titration).Objectives: An international, multidisciplinary panel of experts developed clinical practice guidelines on OHS for the American Thoracic Society. The guideline panel asked whether hospitalized adult patients with acute-on-chronic hypercapnic respiratory failure suspected of having OHS, in whom the diagnosis has not yet been made, should be discharged from the hospital with or without empiric PAP treatment until the diagnosis of OHS is either confirmed or ruled out.Methods: A systematic review with individual patient data meta-analyses was performed to inform the guideline panel’s recommendation. Grading of Recommendations, Assessment, Development, and Evaluation was used to summarize evidence and appraise quality.Results: The literature search identified 2,994 articles. There were no randomized trials. Ten studies met a priori study selection criteria, including two nonrandomized comparative studies and eight nonrandomized noncomparative studies. Individual patient data on hospitalized patients who survived to hospital discharge were obtained from nine of the studies and included a total of 1,162 patients (1,043 discharged with PAP and 119 discharged without PAP). Empiric noninvasive ventilation was prescribed in 91.5% of patients discharged on PAP, and the remainder received empiric continuous PAP. Discharge with PAP reduced mortality at 3 months (relative risk 0.12, 95% confidence interval 0.05–0.30, risk difference −14.5%). Certainty in the estimated effects was very low.Conclusions: Hospital discharge with PAP reduces mortality following acute-on-chronic hypercapnic respiratory failure in patients with OHS or suspected of having OHS. Well-designed clinical trials are needed to confirm this finding.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
Nyckelord
- positive airway pressure
- continuous positive airway pressure
- hypercapnia
- hypercarbia
- Pickwickian
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Mokhlesi, Babak
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Masa, Juan Ferna ...
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Afshar, Majid
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Pacheco, Virgini ...
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Berlowitz, David ...
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Borel, Jean-Chri ...
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Budweiser, Steph ...
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Carrillo, Andres
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Castro-Anon, Ola ...
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Ferrer, Miquel
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Gagnadoux, Frede ...
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Golpe, Rafael
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Hart, Nicholas
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Howard, Mark E.
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Murphy, Patrick ...
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Palm, Andreas, 1 ...
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de Llano, Luis A ...
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Piper, Amanda J.
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Pepin, Jean Loui ...
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Priou, Pascaline
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Sanchez-Gomez, J ...
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Soghier, Israa
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Kakazu, Maximili ...
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Wilson, Kevin C.
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Lungmedicin och ...
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Proceedings of t ...
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Uppsala universitet