Статті в журналах: "Patients recruitment"

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Arnal, Jean-Michel, and Aude Garnero. "Lung recruitment in ARDS patients." Acta medica Lituanica 19, no. 3 (October 1, 2012): 201–5. http://dx.doi.org/10.6001/actamedica.v19i3.2449.

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Lung recruitment is used to improve oxygenation and decrease the risk of ventilator induced lung injuries. Assessing the potential of recruitability is a pre-requisite for a rational recruitment strategy and setting of PEEP. Using a low flow pressure-volume loop is helpful to assess the potential of recruitability at the bedside. For patients with a high potential of recruitability, recruitment maneuvers are efficient with an appropriate setting of PEEP to maintain the lung recruited. Recruitment maneuvers use pressures from 40 to 60 cmH2O for a short period of time, either with the sustained inflation or the staircase method. PEEP setting after the maneuver is important; a decreasing PEEP trial is a useful practical method.

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Duffett, Richard, and J. Cookson. "Recruitment of patients with panic disorder." Psychiatric Bulletin 17, no. 12 (December 1993): 770. http://dx.doi.org/10.1192/pb.17.12.770.

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Hoppu, Kalle. "Patient Recruitment—European Perspective." Pediatrics 104, Supplement_3 (September 1, 1999): 623–26. http://dx.doi.org/10.1542/peds.104.s3.623.

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A considerable number of patients have to be recruited in a clinical trial to obtain solid results. In pediatric studies, patient recruitment is frequently problematic. In the simple common childhood illnesses, the number of recruitable patients is certainly large, but they may be hard to reach, and the imbalance between potential benefit and inconvenience of participation may reduce motivation to enroll. In severe diseases, the balance may be right, but the available number of patients may be small. Good communication with the child and family, as well as the motivation of colleagues to admit, is another key element in success. Proper study design, including realistically identified sources of patients, reasonable inclusion, and exclusion criteria, also are required.

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Smith, Alan D., and Dean R. Manna. "E-recruitment of patients for clinical trials." International Journal of Electronic Healthcare 1, no. 4 (2005): 413. http://dx.doi.org/10.1504/ijeh.2005.006688.

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Tannock, IF. "The recruitment of patients into clinical trials." British Journal of Cancer 71, no. 6 (June 1995): 1134–35. http://dx.doi.org/10.1038/bjc.1995.221.

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Zosmer, A., M. Epstein, and T. Al-Shawaf. "Ethical recruitment of patients for PGS trial." Human Reproduction 23, no. 6 (April 11, 2008): 1472. http://dx.doi.org/10.1093/humrep/den116.

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Vluggen, Stan, Ciska Hoving, Lieve Vonken, Nicolaas C. Schaper, and Hein de Vries. "Exploring factors influencing recruitment results of nurses recruiting diabetes patients for a randomized controlled trial." Clinical Trials 17, no. 4 (May 5, 2020): 448–58. http://dx.doi.org/10.1177/1740774520914609.

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Background Effective recruitment of patients by health professionals is challenging but pivotal to the success of clinical trials. Many trials fail to include the required number of participants, which affects the power of the study, generalizability of results, and timely dissemination of positive outcomes. Existing research is inconclusive regarding factors influencing recruitment results, and most research does not focus on perceptions of recruiting health professionals themselves. Therefore, thorough evaluations of recruitment facilitators and barriers in trials are needed in order to optimize future patient recruitment in trials. We observed divergent recruitment results among nurses who recruited diabetes patients to our trial, which examined the effectiveness of an eHealth programme. Therefore, we aimed to describe nurses’ recruitment results and related shifts over time, and to qualitatively explore factors influencing nurses’ recruitment results. Methods Nurses’ recruitment results and related temporal shifts were derived from trial data (NTR6840). Based on their recruitment results, nurses were categorized as non-, low-, medium-, or high-recruiters. Subsequently, a subset of nurses per group participated in an individual semi-structured telephone interview. Interviews were analysed using NVivo software, applying an inductive coding approach. Results Ninety-six nurses participated in our trial and recruited on average seven patients (range: 0–32). Fifteen nurses did not recruit any patients. Most patients were recruited close to recruitment onset. Nurses who did not recruit patients close to recruitment onset generally ended up recruiting no patients. Data show a relatively high number of early recruited patients that progressively declined over time. High-recruiters were generally successful throughout the entire recruitment period. Recruitment facilitators and barriers comprised organizational, study, patient, and especially recruiter characteristics. Contrary to non- and low-recruiters, medium- and high-recruiters reported more in-depth knowledge about the study and trial requirements, expressed more personal participation-related benefits and fewer barriers, and incorporated more recruitment activities, reminders, and barrier-focused coping strategies. Conclusion and implications To optimize patient recruitment to clinical trials, suggested intervention targets include the continued inclusion of recruiters after initial recruitment onset and the encouragement of early recruitment success. A personalized approach may aid recruiters to become and remain successful. Primarily, it is important to provide recruiters with sufficient information on trial requirements and to address salient benefits for participation in the trial, both for themselves and for their patients. Finally, teaching recruiters skills on how to overcome barriers may further enhance motivation and recruitment capacities.

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Rowlands, Ceri, Leila Rooshenas, Katherine Fairhurst, Jonathan Rees, Carrol Gamble, and Jane M. Blazeby. "Detailed systematic analysis of recruitment strategies in randomised controlled trials in patients with an unscheduled admission to hospital." BMJ Open 8, no. 2 (February 2018): e018581. http://dx.doi.org/10.1136/bmjopen-2017-018581.

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ObjectivesTo examine the design and findings of recruitment studies in randomised controlled trials (RCTs) involving patients with an unscheduled hospital admission (UHA), to consider how to optimise recruitment in future RCTs of this nature.DesignStudies within the ORRCA database (Online Resource for Recruitment Research in Clinical TriAls;www.orrca.org.uk) that reported on recruitment to RCTs involving UHAs in patients >18 years were included. Extracted data included trial clinical details, and the rationale and main findings of the recruitment study.ResultsOf 3114 articles populating ORRCA, 39 recruitment studies were eligible, focusing on 68 real and 13 hypothetical host RCTs. Four studies were prospectively planned investigations of recruitment interventions, one of which was a nested RCT. Most recruitment papers were reports of recruitment experiences from one or more ‘real’ RCTs (n=24) or studies using hypothetical RCTs (n=11). Rationales for conducting recruitment studies included limited time for informed consent (IC) and patients being too unwell to provide IC. Methods to optimise recruitment included providing patients with trial information in the prehospital setting, technology to allow recruiters to cover multiple sites, screening logs to uncover recruitment barriers, and verbal rather than written information and consent.ConclusionThere is a paucity of high-quality research into recruitment in RCTs involving UHAs with only one nested randomised study evaluating a recruitment intervention. Among the remaining studies, methods to optimise recruitment focused on how to improve information provision in the prehospital setting and use of screening logs. Future research in this setting should focus on the prospective evaluation of the well-developed interventions to optimise recruitment.

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Joubert, R., U. Raeth, and T. Moehler. "Variation in enrollment of colorectal cancer patients in clinical trials." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): e15094-e15094. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.e15094.

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e15094 Background: Correct estimation of patient enrollment is an important success factor for planning clinical studies including studies for metastatic colorectal cancer (CRC). Methods: We reviewed all CRC studies published in the Journal of Clinical Oncology and Annals of Oncology between 01/2007 and 10/01/2008. 43 studies were found and the following data were collected from 39 studies: indication, phase, number of sites, number of patients enrolled, mean patient age, recruitment time, sponsor (Industry, NIH, Organization, University), region, line of treatment and type of drug (6 categories). 4 studies were omitted from analysis as recruitment data were largely missing. Our analysis is based on a literature review as information from unpublished trials is unavailable. This implies some limitations regarding the data interpretation. Results: An average enrollment of 0.92 Patient/Site/Month (range 0.10–7.38) was observed for these trials. The highest recruitment efficacy with a median of 4.11 Pt/S/M (range 1.81–7.38) was found in 5 single institution phase II trials. For multi-center phase II and III studies the median enrollment was 1.82 and 0.32 Pt/S/M respectively, with significant higher recruitment in phase II studies. The highest enrollment rate was observed for studies located in Europe or in USA (0.77 and 2.21 Pt/S/M respectively, p=0.03). No correlation was seen with the mechanism of action (targeted drug vs. chemotherapy), sponsor (NIH vs. Industry vs. IIT), line of treatment (first line vs. 2nd and subsequent line). For phase I recruitment analysis we retrieved 2 studies that investigated novel agents in solid tumor patients including advanced or metastatic colorectal cancer patients with a median recruitment of 0.46 Pt/S/M. For phase Ib and I/II recruitment analysis 5 studies were found with a median recruitment of 0.78 Pt/S/M. Conclusions: Single institution phase II clinical trials on novel agents with high potential to change future treatment standard demonstrate almost a tenfold higher than average recruitment rate for multi-center trials (0.45 Pt/S/M). Despite some limitations in the interpretation of results our analysis provides important information to support estimation of patient recruitment in future clinical trials for colorectal cancer. No significant financial relationships to disclose.

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Bentley, Kia J. "Voluntary Recruitment of Psychiatric Patients for Clinical Research." International Journal of Mental Health 20, no. 2 (June 1991): 94–104. http://dx.doi.org/10.1080/00207411.1991.11449199.

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Constantin, J. M., S. Cayot-Constantin, L. Roszyk, V. Sapin, and J. E. Bazin. "Recruitment maneuvers reduce lung oedema in ARDS patients." European Journal of Anaesthesiology 23, Supplement 37 (June 2006): 193. http://dx.doi.org/10.1097/00003643-200606001-00693.

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Ankum, W. M., J. B. Reitsma, and M. Offringa. "Reply: Ethical recruitment of patients for PGS trial." Human Reproduction 23, no. 6 (April 11, 2008): 1472–73. http://dx.doi.org/10.1093/humrep/den117.

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13

Bennett, Wendy L., Carolyn T. Bramante, Scott D. Rothenberger, Jennifer L. Kraschnewski, Sharon J. Herring, Michelle R. Lent, Jeanne M. Clark, et al. "Patient Recruitment Into a Multicenter Clinical Cohort Linking Electronic Health Records From 5 Health Systems: Cross-sectional Analysis." Journal of Medical Internet Research 23, no. 5 (May 27, 2021): e24003. http://dx.doi.org/10.2196/24003.

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Background There is growing interest in identifying and recruiting research participants from health systems using electronic health records (EHRs). However, few studies have described the practical aspects of the recruitment process or compared electronic recruitment methods to in-person recruitment, particularly across health systems. Objective The objective of this study was to describe the steps and efficiency of the recruitment process and participant characteristics by recruitment strategy. Methods EHR-based eligibility criteria included being an adult patient engaged in outpatient primary or bariatric surgery care at one of 5 health systems in the PaTH Clinical Research Network and having ≥2 weight measurements and 1 height measurement recorded in their EHR within the last 5 years. Recruitment strategies varied by site and included one or more of the following methods: (1) in-person recruitment by study staff from clinical sites, (2) US postal mail recruitment letters, (3) secure email, and (4) direct EHR recruitment through secure patient web portals. We used descriptive statistics to evaluate participant characteristics and proportion of patients recruited (ie, efficiency) by modality. Results The total number of eligible patients from the 5 health systems was 5,051,187. Of these, 40,048 (0.8%) were invited to enter an EHR-based cohort study and 1085 were enrolled. Recruitment efficiency was highest for in-person recruitment (33.5%), followed by electronic messaging (2.9%), including email (2.9%) and EHR patient portal messages (2.9%). Overall, 779 (65.7%) patients were enrolled through electronic messaging, which also showed greater rates of recruitment of Black patients compared with the other strategies. Conclusions We recruited a total of 1085 patients from primary care and bariatric surgery settings using 4 recruitment strategies. The recruitment efficiency was 2.9% for email and EHR patient portals, with the majority of participants recruited electronically. This study can inform the design of future research studies using EHR-based recruitment.

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Milovanov, Svyatoslav. "Calculation of Recruitment Which Were Proposed by Clinical Sites on Stage of Feasibility to Clinical Trial of II – III Phases." Corpus Journal of Clinical Trails (CJCT) 2, no. 1 (September 22, 2021): 1–07. http://dx.doi.org/10.54026/cjct/1006.

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Many of clinical trials failed due to absence of needed per protocol recruitment of patients. Recruitment of patients in centralized trials is announcing by PI of clinical sites during the feasibility stage. This is subjective decision of investigator based on integral approach like experience, incidence of disease and many other parameters. The objective approach like calculation is apparently needed for calculation of proposed recruitment on the stage of feasibility. Materials and methods: retrospective analysis data of four clinical trials II-III phases, conducted since 2007 to 2017 years. Aim: to find out the approach for calculation of proposed by sites the recruitment on particular study on the stage of feasibility. Statistical analysis: data had been collected from feasibility questionnaires, open statistical sources. Results: It was proposed the formula for calculation of proposed recruitment of patients on the stage of feasibility. Discussion: Recruitment of patients might be calculated which will decrease the number of failed clinical trials. We called the calculation “Calculated proposed recruitment of patients” - CPRP».

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Pressler, Susan J., Usha Subramanian, Rose Mary Shaw, Leslie E. Meyer, Klarisa Stoudemire, and Irmina Gradus-Pizlo. "Research in Patients With Heart Failure: Challenges in Recruitment." American Journal of Critical Care 17, no. 3 (May 1, 2008): 198–203. http://dx.doi.org/10.4037/ajcc2008.17.3.198.

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Background Published studies of patients with heart failure may not include details about the challenges in the recruitment process. Objectives To describe the recruitment process during the first 18 months of a study being conducted to evaluate cognitive deficits in patients with chronic heart failure. Methods Details of the recruitment process are described for 2 clinic sites. Results A total of 4027 echocardiograms were screened at site 1 to evaluate eligibility. Of the 161 patients eligible, 61 (38%) were invited to participate, and 29 of the 61 (48%) completed the study. At site 2, four hundred thirty-seven medical records of patients were screened, resulting in 163 eligible patients (37%). The staff invited 70 of the 163 patients (43%) to participate, and 52 of the 70 (74%) completed the study. The refusal rate was 23% at site 1 and 21% at site 2. Conclusions Successful recruitment in studies involving patients with heart failure often requires screening of a large group of patients.

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Radwan, Waheed A., Mohamed M. Khaled, Ayman G. Salman, Mohmed A. Fakher, and Shady Khatab. "Use of Lung Ultrasound for Assessment of Lung Recruitment Maneuvers in Patients with ARDS." Open Access Macedonian Journal of Medical Sciences 9, B (September 9, 2021): 952–63. http://dx.doi.org/10.3889/oamjms.2021.6883.

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BACKGROUND: Positive pressure mechanical ventilation is a non-physiological intervention that saves lives but is not free of important side effects. It invariably results in different degrees of collapse of small airways. Recruitment maneuver (RM) aims to resolve lung collapse by a brief and controlled increment in airway pressure while positive end-expiratory pressure (PEEP) afterward keeps the lungs open. Therefore, ideally RM and PEEP selection must be individualized and this can only be done when guided by specific monitoring tools since lung’s opening and closing pressures vary among patients with different lung conditions. AIM: The aim of this study was to explore the clinical value of ultrasonic monitoring in the assessment of pulmonary recruitment and the best PEEP. PATIENTS AND METHODS: This study was conducted on 120 patients, 30 were excluded as in whom lung collapse cannot be confirmed then the rest were 90 patients from whom another 25 patients excluded as they were hemodynamically unstable the rest 65 patients were divided into two groups: Group A: Included 50 mechanically ventilated patients with ARDS, underwent lung recruitment using lung ultrasound and Group B: Included 15 mechanically ventilated patients with ARDS, underwent lung recruitment using oxygenation index. This prospective study was held at many critical care departments around Egypt. RESULTS: We noticed that lung recruitment in both groups significantly increased Pao2/Fio2 ratio immediately after recruitment compared with basal state and also significantly increase dynamic compliance compared with basal state. The increase in PF ratio immediately was significantly more in ultrasound group than in oxygenation group. Furthermore, we noticed that that P/F ratio 12 h after recruitment decreased compared with P/F ratio immediately after recruitment but significantly increased compared with basal state before recruitment and also we found that the increase in P/F ratio 12 h after recruitment was more significantly in lung ultrasound group than in oxygenation group. Furthermore, we noticed that lung recruitment (both lung ultrasound and oxygenation group) significantly increase RV function using TAPSE compared with basal state. Both opening pressure and optimal PEEP were significantly higher in lung ultrasound group than in oxygenation group. In our study, opening pressure was 37.28 ± 1.25 in lung ultrasound group and was 36.67±0.98 in oxygenation group and optimal PEEP was 14.64 ± 1.08 in lung ultrasound group and was 13.13 ± 0.74 in oxygenation group. CONCLUSION: Lung US is an effective mean of evaluating and guiding alveolar recruitment in ARDS. Compared with the maximal oxygenation–guided method, the protocol for reaeration in US-guided lung recruitment achieved a higher opening pressure, resulted in greater improvements in lung aeration, and substantially reduced lung heterogeneity in ARDS.

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Daddato, Andrea, Heidi L. Wald, Carolyn Horney, Diane L. Fairclough, Erin C. Leister, Marilyn Coors, Warren H. Capell, and Rebecca S. Boxer. "A randomized trial of heart failure disease management in skilled nursing facilities (SNF Connect): Lessons learned." Clinical Trials 14, no. 3 (January 31, 2017): 308–13. http://dx.doi.org/10.1177/1740774517690529.

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Background/Aims: Conducting clinical trials in skilled nursing facilities is particularly challenging. This manuscript describes facility and patient recruitment challenges and solutions for clinical research in skilled nursing facilities. Methods: Lessons learned from the SNF Connect Trial, a randomized trial of a heart failure disease management versus usual care for patients with heart failure receiving post-acute care in skilled nursing facilities, are discussed. Description of the trial design and barriers to facility and patient recruitment along with regulatory issues are presented. Results: The recruitment of Denver-metro skilled nursing facilities was facilitated by key stakeholders of the skilled nursing facilities community. However, there were still a number of barriers to facility recruitment including leadership turnover, varying policies regarding research, fear of litigation and of an increased workload. Engagement of facilities was facilitated by their strong interest in reducing hospital readmissions, marketing potential to hospitals, and heart failure management education for their staff. Recruitment of patients proved difficult and there were few facilitators. Identified patient recruitment challenges included patients being unaware of their heart failure diagnosis, patients overwhelmed with their illness and care, and frequently there was no available proxy for cognitively impaired patients. Flexibility in changing the recruitment approach and targeting skilled nursing facilities with higher rates of admissions helped to overcome some barriers. Conclusion: Recruitment of skilled nursing facilities and patients in skilled nursing facilities for clinical trials is challenging. Strategies to attract both facilities and patients are warranted. These include aligning study goals with facility incentives and flexible recruitment protocols to work with patients in “transition crisis.”

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Guo, Lin, Jinxiu Zeng, Ziyou Liu, Zijie Wei, Caiyun Wen, Yue Zhang, Xu Chen, and Heping Xie. "Observation of Curative Effect of Lung Recruitment in Patients with Acute Respiratory Distress Syndrome after Cardiopulmonary Bypass Surgery." Applied Bionics and Biomechanics 2022 (September 12, 2022): 1–12. http://dx.doi.org/10.1155/2022/2693500.

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Recruitment maneuver (RM) has become a routine supplementary maneuver for clinical rescue of severe ARDS with low tidal volume/pressure-limited mechanical ventilation. Recruitment of patients with ARDS mechanical ventilation can improve the lung compliance, promote the opening of collapsed alveoli, improve the ratio of ventilation to blood flow, reduce dead space, reduce shunt flow, and improve oxygenation function. In this paper, the patients were divided into lung recruitment group and conventional treatment group by the random number permutation table method. When the patient’s percutaneous oxygen saturation is less than or equal to 88%, the partial pressure of oxygen in the arterial blood gas is less than or equal to 55 mmHg, or the ventilator tube is disconnected during sputum suction or other accidents, a CPAP × 60 − second lung recruitment maneuver is required. Then adjust the ventilator parameters in the same way. In the process of lung recruitment, the changes in invasive continuous arterial blood pressure will also be observed. If the blood pressure dropped to ≤90/60 mmHg, one recruitment maneuver was terminated in advance. And both groups of patients used the Dräger- or PB840-imported multifunctional ventilator. The treatment of primary disease and predisposing factors, fluid management strategies, antibiotics and glucocorticoids, nutrition, and metabolic support in the two groups of patients in the study were the same. The PaO2/FiO2 value improved by 51% 10 minutes after recruitment, and the median increased from 111 (IQR, 73-265) before recruitment to 170 (IQR, 102-340) ( P < 0.01 ), the improvement of PaO2/FiO2 at 4 hours after recruitment and 12 hours after recruitment was 78% ( P < 0.05 ) and 39% ( P < 0.01 ), respectively, and the median PaO2/FiO2 at 4 hours after recruitment was 198 (IQR, 116-256). The median PaO2/FiO2 became 155 (IQR, 127-235) 12 hours after recruitment. Recruitment can reduce the accumulation of neutrophils in lung tissue, reduce the release of inflammatory factors, reduce pulmonary edema, and reduce pathological damage.

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Yip, Kay Por, Simon Gompertz, Catherine Snelson, Jeremy Willson, Shyam Madathil, Syed SA Huq, Farrukh Rauf, et al. "Increase in recruitment upon integration of trial into a clinical care pathway: an observational study." BMJ Open Respiratory Research 8, no. 1 (July 2021): e000967. http://dx.doi.org/10.1136/bmjresp-2021-000967.

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IntroductionMany respiratory clinical trials fail to reach their recruitment target and this problem exacerbates existing funding issues. Integration of the clinical trial recruitment process into a clinical care pathway (CCP) may represent an effective way to significantly increase recruitment numbers.MethodsA respiratory support unit and a CCP for escalation of patients with severe COVID-19 were established on 11 January 2021. The recruitment process for the Randomised Evaluation of COVID-19 Therapy-Respiratory Support trial was integrated into the CCP on the same date. Recruitment data for the trial were collected before and after integration into the CCP.ResultsOn integration of the recruitment process into a CCP, there was a significant increase in recruitment numbers. Fifty patients were recruited over 266 days before this process occurred whereas 108 patients were recruited over 49 days after this process. There was a statistically significant increase in both the proportion of recruited patients relative to the number of COVID-19 hospital admissions (change from 2.8% to 9.1%, p<0.0001) and intensive therapy unit admissions (change from 17.8% to 50.2%, p<0.001) over the same period, showing that this increase in recruitment was independent of COVID-19 prevalence.DiscussionIntegrating the trial recruitment process into a CCP can significantly boost recruitment numbers. This represents an innovative model that can be used to maximise recruitment without impacting on the financial and labour costs associated with the running of a respiratory clinical trial.

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Gilbertson-White, Stephanie, Nicole Bohr, and Karen E. Wickersham. "Conducting Biobehavioral Research in Patients With Advanced Cancer: Recruitment Challenges and Solutions." Biological Research For Nursing 19, no. 5 (May 16, 2017): 481–90. http://dx.doi.org/10.1177/1099800417709529.

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Despite significant advances in cancer treatment and symptom management interventions over the last decade, patients continue to struggle with cancer-related symptoms. Adequate baseline and longitudinal data are crucial for designing interventions to improve patient quality of life and reduce symptom burden; however, recruitment of patients with advanced cancer in longitudinal research is difficult. Our purpose is to describe challenges and solutions to recruitment of patients with advanced cancer in two biobehavioral research studies examining cancer-related symptoms. Study 1: Symptom data and peripheral blood for markers of inflammation were collected from newly diagnosed patients receiving chemotherapy on the first day of therapy and every 3–4 weeks for up to 6 months. Study 2: Symptom data, blood, and skin biopsies were collected from cancer patients taking epidermal growth factor receptor inhibitors at specific time points over 4 months. Screening and recruitment results for both studies are summarized. Timing informed consent with baseline data collection prior to treatment initiation was a significant recruitment challenge for both the studies. Possible solutions include tailoring recruitment to fit clinic needs, increasing research staff availability during clinic hours, and adding recruitment sites. Identifying solutions to these challenges will permit the conduct of studies that may lead to identification of factors contributing to variability in symptoms and development of tailored patient interventions for patients with advanced cancer.

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Hussainy, Safeera Y., and Jennifer L. Marriott. "Recruitment strategies for palliative cancer care patients and carers." International Journal of Pharmacy Practice 17, no. 6 (December 2009): 369–71. http://dx.doi.org/10.1211/ijpp.17.06.0009.

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Hussainy, Safeera Y., and Jennifer L. Marriott. "Recruitment strategies for palliative cancer care patients and carers." International Journal of Pharmacy Practice 17, no. 6 (December 1, 2009): 369–71. http://dx.doi.org/10.1211/ijpp/17.06.0009.

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Vallerand, A., S. Schim, S. Hasenau, and S. Robinson. "Recruitment of urban African American patients with cancer pain." Journal of Pain 14, no. 4 (April 2013): S40. http://dx.doi.org/10.1016/j.jpain.2013.01.456.

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De Baets, L., E. Jaspers, and S. Van Deun. "Scapular muscle recruitment in stroke patients and healthy controls." Annals of Physical and Rehabilitation Medicine 56 (October 2013): e51. http://dx.doi.org/10.1016/j.rehab.2013.07.030.

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McGlashan, T. H., J. Addington, T. Cannon, M. Heinimaa, P. McGorry, M. O'Brien, D. Penn, et al. "Recruitment and Treatment Practices for Help-Seeking "Prodromal" Patients." Schizophrenia Bulletin 33, no. 3 (March 19, 2007): 715–26. http://dx.doi.org/10.1093/schbul/sbm025.

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Gaszynski, T. "Hemodynamic effects of lung recruitment in morbid obese patients." European Journal of Anaesthesiology 31 (June 2014): 60. http://dx.doi.org/10.1097/00003643-201406001-00165.

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Biais, Matthieu, Romain Lanchon, Musa Sesay, Lisa Le Gall, Bruno Pereira, Emmanuel Futier, and Karine Nouette-Gaulain. "Changes in Stroke Volume Induced by Lung Recruitment Maneuver Predict Fluid Responsiveness in Mechanically Ventilated Patients in the Operating Room." Anesthesiology 126, no. 2 (February 1, 2017): 260–67. http://dx.doi.org/10.1097/aln.0000000000001459.

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Abstract Background Lung recruitment maneuver induces a decrease in stroke volume, which is more pronounced in hypovolemic patients. The authors hypothesized that the magnitude of stroke volume reduction through lung recruitment maneuver could predict preload responsiveness. Methods Twenty-eight mechanically ventilated patients with low tidal volume during general anesthesia were included. Heart rate, mean arterial pressure, stroke volume, and pulse pressure variations were recorded before lung recruitment maneuver (application of continuous positive airway pressure of 30 cm H2O for 30 s), during lung recruitment maneuver when stroke volume reached its minimal value, and before and after volume expansion (250 ml saline, 0.9%, infused during 10 min). Patients were considered as responders to fluid administration if stroke volume increased greater than or equal to 10%. Results Sixteen patients were responders. Lung recruitment maneuver induced a significant decrease in mean arterial pressure and stroke volume in both responders and nonresponders. Changes in stroke volume induced by lung recruitment maneuver were correlated with those induced by volume expansion (r2 = 0.56; P < 0.0001). A 30% decrease in stroke volume during lung recruitment maneuver predicted fluid responsiveness with a sensitivity of 88% (95% CI, 62 to 98) and a specificity of 92% (95% CI, 62 to 99). Pulse pressure variations more than 6% before lung recruitment maneuver discriminated responders with a sensitivity of 69% (95% CI, 41 to 89) and a specificity of 75% (95% CI, 42 to 95). The area under receiver operating curves generated for changes in stroke volume induced by lung recruitment maneuver (0.96; 95% CI, 0.81 to 0.99) was significantly higher than that for pulse pressure variations (0.72; 95% CI, 0.52 to 0.88; P < 0.05). Conclusions The authors’ study suggests that the magnitude of stroke volume decrease during lung recruitment maneuver could predict preload responsiveness in mechanically ventilated patients in the operating room.

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U. Ekpene, Ubong, Mawuli Ametefe, Patrick Bankah, George Wepeba, Harry Akoto, Jerome Boatey, Muta Iddrissu, and Thomas Dakurah. "Physicians’ knowledge, attitude, practice and perceived barriers to subject recruitment for randomized controlled trials in ghana." Clinical Research and Clinical Trials 4, no. 1 (July 19, 2021): 01–11. http://dx.doi.org/10.31579/2693-4779/045.

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Objectives: This study assesses the knowledge, attitude, practice and perceived barriers to subject recruitment into randomized controlled trials, and determine strategies to maximize subject recruitment and retention. Methods: A cross sectional, quantitative survey of 73 physicians working in Ghana was conducted assessing their knowledge and attitude towards randomized controlled trials, subject recruitment practices, self-reported barriers to subject recruitment and strategies to enhance subject recruitment. Results: Responses from 73 Ghanaian physicians were analyzed. 23 (31.5%) respondents knew of ongoing clinical trials in their specialty in Ghana while 32 (43.8%) physicians knew about trials in their specialties in various places in the world. 23 (31.5%) physicians responded that they had referred patients for recruitment into clinical trials before. 49 (67.1%) respondents had never referred any patient for recruitment into clinical trials. Conclusion: Most Ghanaian doctors are unaware of ongoing trials in their specialty and thus do not refer patients for recruitment.

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Protić, Alen, Matej Bura, Alan Šustić, Josip Brusić, and Vlatka Sotošek. "Segmental Lung Recruitment in Patients with Bilateral COVID-19 Pneumonia Complicated by Acute Respiratory Distress Syndrome: A Case Report." Medicina 59, no. 1 (January 11, 2023): 142. http://dx.doi.org/10.3390/medicina59010142.

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Bilateral COVID-19 pneumonia is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and usually leads to life-threatening acute respiratory distress syndrome (ARDS). Treatment of patients with ARDS is difficult and usually involves protective mechanical ventilation and various types of recruitment maneuvers. A segmental lung recruitment maneuver by independent lung ventilation has been described as a successful recruitment maneuver in patients with lobar pneumonia, and may, therefore, be useful for the treatment of patients with bilateral COVID-19 pneumonia complicated by ARDS in the critical phase of the disease when all other therapeutic options have been exhausted. The aim of this case series was to present a case report of four mechanically ventilated patients with severe bilateral COVID-19 pneumonia complicated by ARDS using the segmental lung recruitment maneuver. The effect of the segmental lung recruitment maneuver was assessed by the increase in PaO2/FiO2 ratio and the lung ultrasound (LUS) scoring system (0 points—presence of sliding lungs with A-lines or one or two isolated B-lines; 1 point-moderate loss of lung ventilation with three to five B lines; 2 points-severe loss of lung ventilation with more than five B lines (B pattern); and 3 points-lung consolidation) determined 12, 24, and 48 h after segmental lung recruitment. In three of four patients with bilateral COVID-19 pneumonia complicated by ARDS, an increase in the PaO2/FiO2 ratio and an improvement in the LUS scoring system were observed 48 h after segmental lung recruitment. In conclusion, the segmental lung recruitment maneuver in patients with bilateral COVID-19 complicated by ARDS is an effective method of lung recruitment and may be a useful treatment method.

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Lakhin, R. Y., E. A. Zhirnova, V. V. Shustrov, S. G. Shulman, A. A. Yemelyanov, and B. N. Bogomolov. "Ultrasonography in the Assessment of Lung Recruitment in Patients with Severe Pneumonia." Russian Sklifosovsky Journal "Emergency Medical Care" 8, no. 4 (January 17, 2020): 418–22. http://dx.doi.org/10.23934/2223-9022-2019-8-4-418-422.

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BACKGROUND. Ultrasound study significantly expanded the possibilities of bedside diagnosis in patients with respiratory failure. Using ultrasound, it is possible to determine the volume of lung damage in the form of collapsed alveoli and infiltration areas with preserved airness of the lung tissue. AIM OF STuDY To study the possibility of assessing the recruitment maneuver of the alveoli based on changes in the ultrasound signs of lung tissue damage.MATERIAL AND METHODS. A prospective study was performed in the Clinic of Anesthesiology and Resuscitation of S.M. Kirov Military Medical Academy. The study included 36 patients who were treated in the period from 2010 to 2017 with a duration of respiratory support of at least 48 hours and oxygenation index less than 300 mmHg. For 36 patients, 48 alveoli recruitment maneuvers were performed according to a step-by-step method under the control of dynamic compliance and average tidal volume. Ultrasound determined the type and extent of destruction of lung tissue by signs of infiltration and consolidation.RESULTS. In the studied patients, after carrying out a maneuver of recruitment of the alveoli, arterial blood oxygenation indices increased statistically significantly, PaCO2 level decreased, pulmonary tissue compliance improved, respiratory volume grew. All this confirmed the mobilization of the alveoli and improved lung ventilation. Ultrasonographic evaluation of lung tissue showed a significant decrease in the severity of the ultrasound sign of infiltration after recruitment maneuver from 46.5 (38; 57.5) to 37.5 (30.5; 49.5). However, recruitment had practically no effect on the volume of the consolidated area of lung tissue: the general consolidation index before (4 (3; 5)) and after (4 (3; 5)) the maneuver had no statistically significant differences.CONCLUSIONS. The pneumonia-affected consolidated lung tissue has a low recruitment potential and the volume of consolidation does not change with the growth of PEEP. After the recruitment maneuver, the number of B-lines decreases, indicating a decrease in infiltration and an increase in lung airness.Authors declare lack of the conflicts of interests.

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Bell-Syer, Sally E. M., Lucy N. Thorpe, Kate Thomas, and Hugh MacPherson. "GP Participation and Recruitment of Patients to RCTs: Lessons from Trials of Acupuncture and Exercise for Low Back Pain in Primary Care." Evidence-Based Complementary and Alternative Medicine 2011 (2011): 1–7. http://dx.doi.org/10.1093/ecam/nen044.

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The objective of this study was to identify factors associated with general practitioner (GP) participation and the recruitment of people to trials in primary care, based on data from two trials of interventions for treating chronic low back pain. The study was based on data from two randomized controlled trials (RCTs), one involving exercise, the other acupuncture, and subsequent reporting by GPs in a postal questionnaire. The exercise trial achieved 62% recruitment whereas the acupuncture trial achieved 100% recruitment. In both trials GPs most efficient at referring patients were those with a special interest in the subject area, and those known personally to the research team. A follow-up GP questionnaire found that both trials had maintained a high profile with over 80% of GPs, and successful recruitment strategies included project reminder letters, updates and personal contacts. Achieving target recruitment of patients in the acupuncture trial was aided by the deliberate application of lessons learned in the exercise trial, in particular the need to keep initial study entry criteria broad, with subsequent filtering undertaken by the study researcher. In addition the use of effective methods of maintaining the trial profile, the involvement of a GP advisor, the decision to maximize the recruitment of GPs early in the trial and the direct recruitment of interested individual GPs. The successful recruitment of patients to trials in primary care requires careful planning and continuous monitoring from the outset. Prior to starting recruitment, it is useful to identify previous trials in a similar environment in order to learn from their experience and optimize patient recruitment.

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Knowlson, Catherine, and David J. Torgerson. "Effects of rapid recruitment and dissemination on Covid-19 mortality: the RECOVERY trial." F1000Research 9 (August 21, 2020): 1017. http://dx.doi.org/10.12688/f1000research.25842.1.

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The RECOVERY trial is a large multi-armed, adaptive randomised controlled trial of treatments for Covid-19. It has rapidly recruited and demonstrated that hydroxychloroquine is ineffective in reducing mortality for hospitalised patients, whilst dexamethasone significantly reduces mortality among those patients using supplemental oxygen or on a ventilator. We estimate that the speed of recruitment and dissemination has probably decreased mortality in the UK by at least 200 hospitalised patients in the first month since the British Prime Minister announced the results. Despite its impressive speed, the trial only recruited about 15% of eligible patients, with recruitment rates ranging between 3% to 80% at participating hospitals. Had the trial recruited 50% of the eligible patients then our analysis suggests that more than 2,000 additional lives could have been saved. In a pandemic, rapid recruitment with high centre recruitment is absolutely essential to reduce deaths. Methods of improving site specific recruitment rates need investigating urgently.

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Knowlson, Catherine, and David J. Torgerson. "Effects of rapid recruitment and dissemination on Covid-19 mortality: the RECOVERY trial." F1000Research 9 (December 23, 2020): 1017. http://dx.doi.org/10.12688/f1000research.25842.2.

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The RECOVERY trial is a large multi-armed, adaptive randomised controlled trial of treatments for Covid-19. It has rapidly recruited and demonstrated that hydroxychloroquine is ineffective in reducing mortality for hospitalised patients, whilst dexamethasone significantly reduces mortality among those patients using supplemental oxygen or on a ventilator. We estimate that the speed of recruitment and dissemination has probably decreased mortality in the UK by at least 200 hospitalised patients in the first month since the British Prime Minister announced the results. Despite its impressive speed, the trial only recruited about 10-15% of eligible patients, with recruitment rates ranging between 3% to 80% at participating hospitals. Had the trial recruited 50% of the eligible patients then our analysis suggests that more than 2,000 additional lives could have been saved. In a pandemic, rapid recruitment with high centre recruitment is absolutely essential to reduce deaths. Methods of improving site specific recruitment rates need investigating urgently.

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Reinius, Henrik, Lennart Jonsson, Sven Gustafsson, Magnus Sundbom, Olov Duvernoy, Paolo Pelosi, Göran Hedenstierna, and Filip Fredén. "Prevention of Atelectasis in Morbidly Obese Patients during General Anesthesia and Paralysis." Anesthesiology 111, no. 5 (November 1, 2009): 979–87. http://dx.doi.org/10.1097/aln.0b013e3181b87edb.

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Background Morbidly obese patients show impaired pulmonary function during anesthesia and paralysis, partly due to formation of atelectasis. This study analyzed the effect of general anesthesia and three different ventilatory strategies to reduce the amount of atelectasis and improve respiratory function. Methods Thirty patients (body mass index 45 +/- 4 kg/m) scheduled for gastric bypass surgery were prospectively randomized into three groups: (1) positive end-expiratory pressure of 10 cm H2O (PEEP), (2) a recruitment maneuver with 55 cm H2O for 10 s followed by zero end-expiratory pressure, (3) a recruitment maneuver followed by PEEP. Transverse lung computerized tomography scans and blood gas analysis were recorded: awake, 5 min after induction of anesthesia and paralysis at zero end-expiratory pressure, and 5 min and 20 min after intervention. In addition, spiral computerized tomography scans were performed at two occasions in 23 of the patients. Results After induction of anesthesia, atelectasis increased from 1 +/- 0.5% to 11 +/- 6% of total lung volume (P < 0.0001). End-expiratory lung volume decreased from 1,387 +/- 581 ml to 697 +/- 157 ml (P = 0.0014). A recruitment maneuver + PEEP reduced atelectasis to 3 +/- 4% (P = 0.0002), increased end-expiratory lung volume and increased Pao2/Fio2 from 266 +/- 70 mmHg to 412 +/- 99 mmHg (P < 0.0001). PEEP alone did not reduce the amount of atelectasis or improve oxygenation. A recruitment maneuver + zero end-expiratory pressure had a transient positive effect on respiratory function. All values are presented as mean +/- SD. Conclusions A recruitment maneuver followed by PEEP reduced atelectasis and improved oxygenation in morbidly obese patients, whereas PEEP or a recruitment maneuver alone did not.

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Lemieux, Julie, Pamela J. Goodwin, Kathleen I. Pritchard, Karen A. Gelmon, Louise J. Bordeleau, Thierry Duchesne, Stéphanie Camden, and Caroline H. Speers. "Identification of Cancer Care and Protocol Characteristics Associated With Recruitment in Breast Cancer Clinical Trials." Journal of Clinical Oncology 26, no. 27 (September 20, 2008): 4458–65. http://dx.doi.org/10.1200/jco.2007.15.3726.

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Purpose It is estimated that only 5% of patients with cancer participate in a clinical trial. Barriers to participation may relate to available protocols, physicians, and patients, but few data exist on barriers related to cancer care environments and protocol characteristics. Methods The primary objective was to identify characteristics of cancer care environments and clinical trial protocols associated with a low recruitment into breast cancer clinical trials. Secondary objectives were to determine yearly recruitment fraction onto clinical trials from 1997 to 2002 in Ontario, Canada, and to compare recruitment fraction among years. Questionnaires were sent to hospitals requesting characteristics of cancer care environments and to cooperative groups/pharmaceutical companies for information on protocols and the number of patients recruited per hospital/year. Poisson regression was used to estimate the recruitment fraction. Results Questionnaire completion rate varied between 69% and 100%. Recruitment fraction varied between 5.4% and 8.5% according to year. More than 30% of patients were diagnosed in hospitals with no available trials. In multivariate analysis, the following characteristics were associated with recruitment: use of placebo versus not (relative risk [RR] = 0.80; P = .05), nonmetastatic versus metastatic trial (RR = 2.80; P < .01), and for nonmetastatic trials, protocol allowing an interval of 12 weeks or longer versus less than 12 weeks (from diagnosis, surgery, or end of therapy) before enrollment (RR = 1.36; P < .01). Conclusion Allowable interval of 12 weeks or longer to randomly assign patients in clinical trials could help recruitment. In our study, absence of an available clinical trial represented the largest barrier to recruitment.

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Jenkins, Anastasia B., Elizabeth Holley, Cory Rogers, Natalie Montgomery, and Adam N. Pate. "Evaluating the Efficacy of 3 Recruitment Methods for Enrolling Patients in Chronic Care Management Services: A Pilot Study." INNOVATIONS in pharmacy 13, no. 4 (November 28, 2022): 13. http://dx.doi.org/10.24926/iip.v13i4.5086.

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Chronic Care Management (CCM) is a billable service that pharmacists can provide either in person or via telephone in ambulatory clinics or community pharmacies. Pharmacists may use this service to expand current roles in patient care and add billable services to an ambulatory care practice. The number of clinics employing CCM is steadily increasing, and to date, there has been limited information published to aid pharmacists who are considering implementing these services. The purpose of this study is to compare enrollment success in a clinic-based, pharmacist-led CCM service using three recruitment strategies to enroll patients: in person, telephone, and provider referred recruitment. This pilot study examined the success of three recruitment strategies using 94 patients eligible for CCM services in a rural health clinic. The primary outcome was successful enrollment in the CCM program with differences in recruitment strategy enrollment success examined using a Chi-square test. Overall, 42 of 94 patients (45%) were successfully enrolled in the CCM program with no statistical difference appreciated between telephone, in person, and provider referred recruitment. Nearly 33% (14/42) of patients enrolled in person, 40% (17/42) enrolled via telephone, and 26% (11/42) enrolled when referred from a provider. Ten patients (11%) declined enrollment outright. The remaining 42 patients were hesitant to enroll and requested follow up. In conclusion, there was no statistical difference in CCM enrollment success with in person, telephone, or provider referred recruitment, although more patients were enrolled via telephone than with the other two strategies. Pharmacists implementing new CCM programs may tailor their recruitment and enrollment strategy to suit their specific needs.

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Pfaff, Emily, Adam Lee, Robert Bradford, Jinhee Pae, Clarence Potter, Paul Blue, Patricia Knoepp, et al. "Recruiting for a pragmatic trial using the electronic health record and patient portal: successes and lessons learned." Journal of the American Medical Informatics Association 26, no. 1 (November 16, 2018): 44–49. http://dx.doi.org/10.1093/jamia/ocy138.

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Abstract Objective Querying electronic health records (EHRs) to find patients meeting study criteria is an efficient method of identifying potential study participants. We aimed to measure the effectiveness of EHR-driven recruitment in the context of ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-Term Effectiveness)—a pragmatic trial aiming to recruit 15 000 patients. Materials and Methods We compared the participant yield of 4 recruitment methods: in-clinic recruitment by a research coordinator, letters, direct email, and patient portal messages. Taken together, the latter 2 methods comprised our EHR-driven electronic recruitment workflow. Results The electronic recruitment workflow sent electronic messages to 12 254 recipients; 13.5% of these recipients visited the study website, and 4.2% enrolled in the study. Letters were sent to 427 recipients; 5.6% visited the study website, and 3.3% enrolled in the study. Coordinators recruited 339 participants in clinic; 23.6% visited the study website, and 16.8% enrolled in the study. Five-hundred-nine of the 580 UNC enrollees (87.8%) were recruited using an electronic method. Discussion Electronic recruitment reached a wide net of patients, recruited many participants to the study, and resulted in a workflow that can be reused for future studies. In-clinic recruitment saw the highest yield, suggesting that a combination of recruitment methods may be the best approach. Future work should account for demographic skew that may result by recruiting from a pool of patient portal users. Conclusion The success of electronic recruitment for ADAPTABLE makes this workflow well worth incorporating into an overall recruitment strategy, particularly for a pragmatic trial.

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Naseer, Mehwish, Rafia Tabassum, and Aamir Furqan. "Effect of Intensive vs Moderate Alveolar Recruitment Strategies Added to Lung Protective Ventilation on PP Complications." Pakistan Journal of Medical and Health Sciences 16, no. 1 (January 18, 2022): 290–92. http://dx.doi.org/10.53350/pjmhs22161290.

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Aim: to establish the effects of intensive alveolar recruitment therapy in decreasing the post-operative pulmonary complications. Methodology: A randomized multi centered study was performed with patients in ICU having hypoxemia after a cardiac surgery. Patients were allocated to two groups (intensive vs moderate recruitment strategy) with ventilation having small tidal volume. Severity of post-operative pulmonary complications was primary outcome. Secondary outcome was duration of stay in hospital and ICU, hospital mortality and the rate of barotrauma. Results: The pulmonary complication severity score of the intensive and moderate group patients was 1.58±0.91 and 2.10±1.01 respectively. The mean ICU stay, hospital stay and mechanical ventilation in ICU mean of the intensive group patients was 4.06±2.12 days, 10.10±3.21 days and 11.26±2.80 respectively. While, the mean ICU stay, hospital stay and mechanical ventilation in ICU mean of the moderate group patients was 4.70±2.04 days, 14.09±2.99 days and 12.15±2.08 respectively. Conclusion: Patients having hypoxemia after a cardiac surgery, intensive alveolar recruitment therapy proves to be more helpful in decreasing the severity and occurrence of post-operative pulmonary complications as compared to moderate alveolar recruitment therapy. Keywords: Alveolar recruitment, tidal volume, pulmonary complications.

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Bisla, Jatinder, Gareth Ambler, Bernhard Frank, Sumit Gulati, Poppy Hocken, Mairi James, Joanna Kelly, et al. "Successful and unsuccessful recruitment and retainment strategies in a UK multicentre drug trial for a rare chronic pain condition which performed above target." British Journal of Pain 14, no. 3 (December 24, 2019): 171–79. http://dx.doi.org/10.1177/2049463719893399.

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Introduction: Recruitment into trials in rare chronic pain conditions can be challenging, so such trials consequently are underpowered or fail. Methods: Drawing from our experience in conducting, to date, the largest academic trial in a rare chronic pain condition, complex regional pain syndrome, we have identified recruitment and retention strategies for successful trial conduct. Results: We present 13 strategies grouped across the categories of ‘setting the recruitment rate’, ‘networking’, ‘patient information’, ‘trial management’ and ‘patient retention’. Moreover, six recruitment risks are also discussed. A conservative recruitment estimate, based on audits of newly referred patients to the trial centres without taking into account availability of ‘old’ patients or recruitment from outside centres, and assuming a 55% patient refusal rate yielded accurate numbers. Conclusion: Appreciation of these identified recruitment challenges and opportunities may contribute to supporting prospective investigators when they design clinical trials for chronic pain patient population groups where it has been historically difficult to conduct high-quality and robust clinical trials.

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Reutershan, Jörg, Andre Schmitt, Klaus Dietz, Klaus Unertl, and Reinhold Fretschner. "Alveolar recruitment during prone position: time matters." Clinical Science 110, no. 6 (May 15, 2006): 655–63. http://dx.doi.org/10.1042/cs20050337.

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Alveolar recruitment is one of the beneficial effects of prone positioning in patients with ARDS (acute respiratory distress syndrome). However, responses vary among patients and, therefore, we hypothesized that alveolar recruitment is an individual time-dependent process and its measurement might be helpful to ‘dose’ prone positioning individually. In 13 patients diagnosed with ARDS, EELV (end-expiratory lung volume) was measured in the supine position, immediately after turning to the prone position, at 1, 2, 4 and 8 h in the prone position and after returning to the supine position. Responders were defined based on a 30% increase in oxygenation. EELV increased in responders, whereas it remained constant in non-responders. The time course was different in individual patients. In some responders, a plateau was reached as early as 2–4 h, whereas, in others, 8 h of prone positioning was not sufficient to allow complete recruitment. The increase in lung volume was associated with both an increase in arterial oxygenation and a decrease in venous admixture. Furthermore, responders had significantly lower baseline EELVs than non-responders. In conclusion, alveolar recruitment during prone positioning has been characterized as an individual time-dependent process. Its measurement might be useful to apply prone positioning more individually and might also help to identify responders.

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Oczenski, Wolfgang, Christoph Hörmann, Christian Keller, Norbert Lorenzl, Anton Kepka, Sylvia Schwarz, and Robert D. Fitzgerald. "Recruitment Maneuvers after a Positive End-expiratory Pressure Trial Do Not Induce Sustained Effects in Early Adult Respiratory Distress Syndrome." Anesthesiology 101, no. 3 (September 1, 2004): 620–25. http://dx.doi.org/10.1097/00000542-200409000-00010.

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Background Recruitment maneuvers performed in early adult respiratory distress syndrome remain a matter of dispute in patients ventilated with low tidal volumes and high levels of positive end-expiratory pressure (PEEP). In this prospective, randomized controlled study the authors evaluated the impact of recruitment maneuvers after a PEEP trial on oxygenation and venous admixture (Qs/Qt) in patients with early extrapulmonary adult respiratory distress syndrome. Methods After a PEEP trial 30 consecutive patients ventilated with low tidal volumes and high levels of PEEP were randomly assigned to either undergo a recruitment maneuver or not. Data were recorded at baseline, 3 min after the recruitment maneuver, and 30 min after baseline. Recruitment maneuvers were performed with a sustained inflation of 50 cm H2O maintained for 30 s. Results Compared with baseline the ratio of the arterial oxygen partial pressure to the fraction of inspired oxygen (Pao2/Fio2) and Qs/Qt improved significantly at 3 min after the recruitment maneuver (Pao2/Fio2, 139 +/- 46 mm Hg versus 246 +/- 111 mm Hg, P < 0.001; Qs/Qt, 30.8 +/- 5.8% versus 21.5 +/- 9.7%, P < 0.005), but baseline values were reached again within 30 min. No significant differences in Pao2/Fio2 and Qs/Qt were detected between the recruitment maneuver group and the control group at baseline and after 30 min (recruitment maneuver group [n = 15]: Pao2/Fio2, 139 +/- 46 mm Hg versus 138 +/- 39 mm Hg; Qs/Qt, 30.8 +/- 5.8% versus 29.2 +/- 7.4%; control group: [n = 15]: Pao2/Fio2, 145 +/- 33 mm Hg versus 155 +/- 52 mm Hg; Qs/Qt, 30.2 +/- 8.5% versus 28.1 +/- 5.4%). Conclusion In patients with early extrapulmonary adult respiratory distress syndrome who underwent a PEEP trial, recruitment maneuvers failed to induce a sustained improvement of oxygenation and venous admixture.

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Chiu, Peter, and Sitaram Emani. "Left Ventricular Recruitment in Patients With Hypoplastic Left Heart Syndrome." Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual 24 (2021): 30–36. http://dx.doi.org/10.1053/j.pcsu.2021.03.001.

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Hasanin, Ahmed, Mohamed Abdulatif, and Maha Mostafa. "Alveolar recruitment in patients with obesity: Is it really effective?" Anaesthesia Critical Care & Pain Medicine 40, no. 4 (August 2021): 100900. http://dx.doi.org/10.1016/j.accpm.2021.100900.

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Cofield, Stacey S., Robin Conwit, William Barsan, and James Quinn. "Recruitment and Retention of Patients into Emergency Medicine Clinical Trials." Academic Emergency Medicine 17, no. 10 (October 2010): 1104–12. http://dx.doi.org/10.1111/j.1553-2712.2010.00866.x.

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Brill, Simon E., Ethaar El-Emir, James P. Allinson, Gavin C. Donaldson, Irwin Nazareth, and Jadwiga A. Wedzicha. "Community-based recruitment of patients with COPD into clinical research." Thorax 69, no. 10 (March 4, 2014): 951–52. http://dx.doi.org/10.1136/thoraxjnl-2014-205253.

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Petersen, Mihaela, Hoang Nguyen, Kelly Harless, Dina Polichar, Helen Vanderswag, Jody DelaPena, and Dilip V. Jeste. "ISSUES IN RECRUITMENT OF ELDERLY PATIENTS FOR ANTIPSYCHOTIC DRUG STUDIES." American Journal of Geriatric Psychiatry 7 (September 1999): 53. http://dx.doi.org/10.1097/00019442-199911001-00153.

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Hsia, C. C. W., M. Ramanathan, and A. S. Estrera. "Recruitment of Diffusing Capacity with Exercise in Patients after Pneumonectomy." American Review of Respiratory Disease 145, no. 4_pt_1 (April 1992): 811–16. http://dx.doi.org/10.1164/ajrccm/145.4_pt_1.811.

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Mitchell, C. "Recruitment of childhood leukaemia patients to clinical trials, 1980-2007." Archives of Disease in Childhood 99, no. 5 (April 9, 2014): 399–400. http://dx.doi.org/10.1136/archdischild-2013-304189.

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Joseph, Maude, and Margaret Comerford Freda. "The Impact of Staff Nurses on the Recruitment of Patients." American Journal of Nursing 101, no. 2 (February 2001): 26–32. http://dx.doi.org/10.1097/00000446-200102000-00044.

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Fumagalli, Jacopo, Roberta R. S. Santiago, Maddalena Teggia Droghi, Changsheng Zhang, Florian J. Fintelmann, Fabian M. Troschel, Caio C. A. Morais, Marcelo B. P. Amato, Robert M. Kacmarek, and Lorenzo Berra. "Lung Recruitment in Obese Patients with Acute Respiratory Distress Syndrome." Anesthesiology 130, no. 5 (May 1, 2019): 791–803. http://dx.doi.org/10.1097/aln.0000000000002638.

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Abstract Editor’s Perspective What We Already Know about This Topic Obesity increases the propensity to atelectasis in acute respiratory distress syndrome, but the optimal approach to reversing this atelectasis is uncertain What This Article Tells Us That Is New A clinical crossover study comparing three approaches to titrate positive end-expiratory pressure (PEEP; according to a fixed table, according to end-expiratory esophageal pressure, and targeting the best compliance during a decremental PEEP trial) found that a recruitment maneuver followed by decremental PEEP minimized atelectasis and overdistension, and best restored compliance and oxygenation without causing hemodynamic impairment Background Obese patients are characterized by normal chest-wall elastance and high pleural pressure and have been excluded from trials assessing best strategies to set positive end-expiratory pressure (PEEP) in acute respiratory distress syndrome (ARDS). The authors hypothesized that severely obese patients with ARDS present with a high degree of lung collapse, reversible by titrated PEEP preceded by a lung recruitment maneuver. Methods Severely obese ARDS patients were enrolled in a physiologic crossover study evaluating the effects of three PEEP titration strategies applied in the following order: (1) PEEPARDSNET: the low PEEP/Fio2 ARDSnet table; (2) PEEPINCREMENTAL: PEEP levels set to determine a positive end-expiratory transpulmonary pressure; and (3) PEEPDECREMENTAL: PEEP levels set to determine the lowest respiratory system elastance during a decremental PEEP trial following a recruitment maneuver on respiratory mechanics, regional lung collapse, and overdistension according to electrical impedance tomography and gas exchange. Results Fourteen patients underwent the study procedures. At PEEPARDSNET (13 ± 1 cm H2O) end-expiratory transpulmonary pressure was negative (−5 ± 5 cm H2O), lung elastance was 27 ± 12 cm H2O/L, and PaO2/Fio2 was 194 ± 111 mmHg. Compared to PEEPARDSNET, at PEEPINCREMENTAL level (22 ± 3 cm H2O) lung volume increased (977 ± 708 ml), lung elastance decreased (23 ± 7 cm H2O/l), lung collapse decreased (18 ± 10%), and ventilation homogeneity increased thus rising oxygenation (251 ± 105 mmHg), despite higher overdistension levels (16 ± 12%), all values P < 0.05 versus PEEPARDSnet. Setting PEEP according to a PEEPDECREMENTAL trial after a recruitment maneuver (21 ± 4 cm H2O, P = 0.99 vs. PEEPINCREMENTAL) further lowered lung elastance (19 ± 6 cm H2O/l) and increased oxygenation (329 ± 82 mmHg) while reducing lung collapse (9 ± 2%) and overdistension (11 ± 2%), all values P < 0.05 versus PEEPARDSnet and PEEPINCREMENTAL. All patients were maintained on titrated PEEP levels up to 24 h without hemodynamic or ventilation related complications. Conclusions Among the PEEP titration strategies tested, setting PEEP according to a PEEPDECREMENTAL trial preceded by a recruitment maneuver obtained the best lung function by decreasing lung overdistension and collapse, restoring lung elastance, and oxygenation suggesting lung tissue recruitment.

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