Agreement between Alternative Classifications of Acute Respiratory Distress Syndrome

Meade, Maureen O.; Guyatt, Gordon; Cook, Richard; Groll, Ryan; Kachura, John R.; Wigg, Melanie; Cook, Deborah J.; Slutsky, Arthur S.; Stewart, Thomas E.

doi:10.1164/ajrccm.163.2.2006067

Cited by 75 publications

(45 citation statements)

References 15 publications

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“…21 For the primary outcome of IOP-lowering effects between groups at study completion, we calculated the weighted mean difference (WMD) across studies using the DerSimonian-Laird random effects model, that recognizes …”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: a meta-analysis

Eyawo

Nachega

Lefèbvre

et al. 2009

OPTH

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Background: First-line therapy for primary open-angle glaucoma and ocular hypertension generally involves prostaglandin analogue therapy. The relative efficacy of differing prostaglandin therapy is disputed. Methods: A meta-analysis was conducted of head-to-head randomized trials of prostaglandin therapies. We included randomized trials assessing head-to-head evaluations of prostaglandin analogues travoprost, latanoprost and bimatoprost in patients with predominantly primary open-angle glaucoma or ocular hypertension. Findings were interpreted in light of equivalence margins. Results: Our search identified 16 eligible trials, of which 15 were included in the meta-analysis. Trials were, in general, poorly reported. We pooled 9 trials assessing IOP-lowering effects of travoprost vs latanoprost (total n = 1098, weighted mean difference [WMD], -0.24 mmHg, 95% CI, -0.87 to 0.38, P = 0.45, I 2 = 56%, 95% CI, 0 to 0.77, heterogeneity P = 0.01). Eight trials assessed travoprost vs bimatoprost (total n = 714, WMD, 0.88 mmHg, 95% CI, 0.13 to 1.63, P = 0.02, I 2 = 56%, 95% CI, 0% to 78%, heterogeneity P = 0.02). And 8 trials assessed latanoprost vs bimatoprost (total n = 943, WMD, 0.73 mmHg, 95% CI, 0.10 to 1.37, P = 0.02, I 2 = 47%, 95% CI, 0% to 74%, heterogeneity P = 0.06). Travoprost was associated with greater incidence of conjunctival hyperemia than latanoprost (RR 5.71, 95% CI, 1.81 to 18.02, P  0.001, I 2 = 97%, 95% CI, 95 to 98, P  0.001). Five trials assessing latanoprost and bimatoprost revealed an elevated risk of conjunctival hyperemia with bimatoprost (RR 1.59, 95% CI, 1.02 to 2.48, P = 0.04, I 2 = 76%, 95% CI, 16 to 88, P = 0.002). Conclusion: Randomized head-to-head evaluations of prostaglandin therapy demonstrate similar efficacy effects, but differing hyperemia effects.

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Section: Discussionmentioning

confidence: 99%

Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: a meta-analysis

Eyawo

Nachega

Lefèbvre

et al. 2009

OPTH

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“…To analyze the degree of agreement among the scales, we used the Kappa agreement statistic, which designates the following levels of concordance: 0 = absent; 0 to 0.2 = minimal; 0.2 to 0.4 = reasonable; 0.4 to 0.6 = moderate; 0.6 to 0.8 = substantial; 0.8 to 1.0 = near-perfect (28) . Fisher's exact test was applied to analyze correlations between the characteristics of two or more variables.…”

Section: Methodsmentioning

confidence: 99%

Dispnéia crônica e alterações funcionais respiratórias em ex-trabalhadores com asbestose avaliados para concessão de benefício

Nápolis¹,

Sette²,

Bagatin³

et al. 2004

J. bras. pneumol.

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INTRODUÇÃO: A dispnéia é um sintoma de difícil avaliação, principalmente nas doenças ocupacionais. OBJETIVO: Avaliar a relação entre presença e intensidade de dispnéia crônica, e sua repercussão funcional em ex-trabalhadores com asbestose na avaliação de disfunção e incapacidade. MÉTODO: Escores de dispnéia pelas escalas Medical Research Council modificada, American Medical Association de 1984 e 1993 e Baseline Dyspnea Index foram obtidos em 40 ex-trabalhadores com diagnóstico de asbestose, os quais foram também submetidos a espirometria, medidas da capacidade de difusão pulmonar do monóxido de carbono e testes de exercício cardiopulmonar incremental e submáximo. RESULTADO: Dispnéia esteve presente em 72,5% e 67,5% dos indíviduos de acordo com as escalas do Medical Research Council e American Medical Association de 1984, respectivamente e em apenas 37,5% e 31,6% dos pacientes de acordo com as escalas American Medical Association de 1.993 e Baseline Dyspnea Index. Houve melhor concordância entre as escalas Medical Research Council e American Medical Association de 1993, e American Medical Association de 1984 e American Medical Association de 1993 quando as graduações "ausente" e "leve" foram agrupadas. Não foi observada relação significativa entre dispnéia de acordo com cada uma das escalas e presença de anormalidades funcionais no repouso e/ou exercício. CONCLUSÃO: O nível de concordância entre as escalas de dispnéia varia significativamente em indivíduos com asbestose. Há falta de relação dos índices de dispnéia com variáveis que avaliam disfunção respiratória em repouso e exercício.

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“…TRALI in TACO je težko ločiti med seboj, saj je klinična slika zelo podobna, pri TRALI gre namreč za nekardiogeni, pri TACO pa kardiogeni pljučni edem (32). V pomoč so nam lahko vrednosti krvnega tlaka (pri TRALI so značilno nizke, pri TACO pa visoke) in povišana telesna temperatura (TRALI), pri TRALI lahko beležimo v hemogramu tudi prehodno levkopenijo (33)(34)(35)(36). Poleg tega nam je v pomoč tudi NT proBNP, ki je kazalec srčnega popuščanja in je tipično povišan pri TACO ter načeloma nizek pri TRA-LI (37,38).…”

Section: Obravnava In Zdravljenje Respiratornih Transfuzijskih Reakcijunclassified

Respiracijske transfuzijske reakcije

Marić¹,

Mlakar

Bricl³

2017

SlovMedJour

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IzvlečekTransfuzijske reakcije niso pogoste, vendar kljub temu verjetno pogostejše, kot jih ocenjujemo na splošno, saj je prepoznavanje in poročanje o transfuzijskih reakcijah še vedno pomanjkljivo. Čla-nek opisuje najpogostejše respiracijske transfuzijske reakcije, patofiziologijo le-teh, klinično sliko in zdravljenje. Med primarnimi transfuzijskimi reakcijami so najpomembnejše: s transfuzijo povezana akutna okvara pljuč oz. TRALI, s transfuzijo povezana volumska preobremenitev oz. TACO ter s transfuzijo povezana dispneja oz. TAD. Pri TRALI pride do aktiviranja imunskega sistema, katerega posledica je povečana prepustnost bazalne membrane v pljučnih mešičkih, kar vodi v nekardiogeni pljučni edem. Zdravljenje je podporno z dodajanjem kisika, tekočin ob hipotenziji, v hujših primerih dihalne odpovedi tudi mehansko predihavanje. Klinična slika TACO je kardiogeni pljučni edem, do katerega pride zaradi volumske obremenitve pri predisponiranih osebah, ki so: dojenčki, starostniki, bolniki s srčnim popuščanjem, anemijo in bolniki s pozitivno tekočinsko bilanco. TACO zdravimo po načelih zdravljenja kardiogenega pljučnega edema z dodajanjem kisika, diuretiki, po potrebi pa tudi z neinvazivnim ali invazivnim mehanskim predihavanjem. Pri TAD pa gre za etiološko nepojasnjeno dispnejo, ki se pojavi po transfuziji in je ne moremo opredeliti kot TACO ali TRALI, prav tako pa je ne pojasnijo bolnikove kronične bolezni. Ponavadi je TAD blaga reakcija. Čeprav transfuzijske reakcije niso zelo pogoste, je znanje o prepoznavanju, zdravljenju in preprečevanju respiracijskih transfuzijskih reakcij nujno potrebno, da se preprečijo resne posledice pri bolnikih. AbstractRespiratory transfusion-related reactions are not very frequent, partly also because recognition and reporting transfusion reactions is still underemphasized. This article describes the most important respiratory transfusion reactions, their pathophysiology, clinical picture and treatment strategies. Respiratory transfusion related reactions can be primary or secondary. The most important primary transfusion-related reactions are TRALI -transfusion-related acute lung injury, TACO -transfusion-associated circulatory overload, and TAD -transfusion-associated dyspnea. TRALI is immuneassociated injury of alveolar basal membrane, which becomes highly permeable and causes noncardiogenic pulmonary edema. Treatment of TRALI is mainly supportive with oxygen, fluids (in case of hypotension) and in cases of severe acute respiratory failure also mechanic ventilation. TACO is caused by volume overload in predisposed individuals, such as patients with heart failure, the elderly, infants, patients with anemia and patients with positive fluid balance. Clinical picture is that of a typical pulmonary cardiogenic edema, and the therapy is classical: oxygen and diuretics, and in severe cases also non-invasive or invasive mechanical ventilation. TAD is usually a mild reaction of unknown cause and cannot be classified as TACO or TRALI, nor can it be ascribed to patient's preexisting diseases. ...

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Agreement between Alternative Classifications of Acute Respiratory Distress Syndrome

Cited by 75 publications

References 15 publications

Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: a meta-analysis

Efficacy and safety of prostaglandin analogues in patients with predominantly primary open-angle glaucoma or ocular hypertension: a meta-analysis

Dispnéia crônica e alterações funcionais respiratórias em ex-trabalhadores com asbestose avaliados para concessão de benefício

Respiracijske transfuzijske reakcije

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