Browsing by Author "Maltais, François"

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    A Randomized Controlled Trial to Assess the Efficacy of Tiotropium in Canadian Patients with Chronic Obstructive Pulmonary Disease
    (2007-01-01) Chan, Charles KN; Maltais, François; Sigouin, Chris; Haddon, Jennifer M; Ford, Gordon T; on behalf of the SAFE Study Group,
    BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) who smoke have a greater annual rate of decline in forced expiratory volume in 1 s (FEV1) than those patients who have stopped smoking.OBJECTIVES: To assess the effect of tiotropium on pre-dose (trough) FEV1 in patients with COPD followed in Canada.METHODS: A total of 913 patients were randomly assigned to receive either tiotropium 18 μg once daily (n=608) or placebo (usual care minus inhaled anticholinergics) (n=305) for 48 weeks in the present randomized, double-blind, parallel-group study. The effect of tiotropium on measurements of lung function (FEV1, FEV6 and forced vital capacity), symptoms, health-related quality of life (St George’s Respiratory Questionnaire) and exacerbations were examined.RESULTS: Tiotropium improved trough FEV1 in both current and ex-smokers compared with placebo. Baseline FEV1 in smokers and ex-smokers was 1.03 L and 0.93 L, respectively (Pud_less_than0.001). At week 48, the mean difference between the tiotropium and placebo groups was 0.14±0.04 L (Pud_less_than0.001) in the smoker group and 0.08±0.02 L (Pud_less_than0.0001) in the ex-smoker group. Tiotropium also significantly improved trough forced vital capacity and FEV6 compared with placebo throughout the treatment period (Pud_less_than0.05, for all). Furthermore, tiotropium significantly improved the St George’s Respiratory Questionnaire total score compared with placebo at week 48 (40.9 versus 43.7 units, Pud_less_than0.005).CONCLUSIONS: Compared with the placebo group, tiotropium provides sustained improvements in lung function in patients with COPD, with improvements for smokers and ex-smokers.
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    Home Mechanical Ventilation: A Canadian Thoracic Society Clinical Practice Guideline
    (2011-01-01) McKim, Douglas A; Road, Jeremy; Avendano, Monica; Abdool, Steve; Côté, Fabien; Duguid, Nigel; Fraser, Janet; Maltais, François; Morrison, Debra L; O’Connell, Colleen; Petrof, Basil J; Rimmer, Karen; Skomro, Robert; Canadian Thoracic Society Home Mechanical Ventilation Committee,
    Increasing numbers of patients are surviving episodes of prolonged mechanical ventilation or benefitting from the recent availability of user-friendly noninvasive ventilators. Although many publications pertaining to specific aspects of home mechanical ventilation (HMV) exist, very few comprehensive guidelines that bring together all of the current literature on patients at risk for or using mechanical ventilatory support are available. The Canadian Thoracic Society HMV Guideline Committee has reviewed the available English literature on topics related to HMV in adults, and completed a detailed guideline that will help standardize and improve the assessment and management of individuals requiring noninvasive or invasive HMV. The guideline provides a disease-specific review of illnesses including amyotrophic lateral sclerosis, spinal cord injury, muscular dystrophies, myotonic dystrophy, kyphoscoliosis, post-polio syndrome, central hypoventilation syndrome, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease as well as important common themes such as airway clearance and the process of transition to home. The guidelines have been extensively reviewed by international experts, allied health professionals and target audiences. They will be updated on a regular basis to incorporate any new information.