Tag: mechanical ventilation

Upvote Story 6
ICU doctors are often required to analyse large volumes of complex, heterogeneous data to make life-critical decisions. Artificial Intelligence (AI), if used effectively, could reduce this burden by transforming data into more actionable information. We can use AI to predict adverse outcomes before they happen, better manage highly complex situations, and ultimately allow clinicians to spend less time analyzing data and more time harnessing their... Read More | Comment
Upvote Story 11
Fundamental concepts of respiratory physiology and the day-to-day duties of a respiratory care professional. Utilizing the wide degree of topics covered, including airway management, understanding ventilator waveforms, and addressing critical care issues, readers have the best resource available for understanding mechanical ventilation and its clinical application. Enhancing the learning experience are valuable illustrations of concepts and equipment, highlighted key points, and self-assessment questions in NRBC... Read More | Comment
Upvote Story 8
Music intervention has been shown to reduce anxiety and sedative exposure among mechanically ventilated patients. The aim of this study was to examine ICU costs for patients receiving a patient-directed music intervention compared with patients who received usual ICU care. The base case cost-effectiveness analysis estimated patient-directed music intervention reduced anxiety by 19 points on the Visual Analogue Scale-Anxiety with a reduction in cost of... Read More | Comment
Upvote Story 6
Lower respiratory tract infections (LRTIs) are the leading cause of infectious disease-related deaths worldwide yet remain challenging to diagnose because of limitations in existing microbiologic tests. In critically ill patients, noninfectious respiratory syndromes that resemble LRTIs further complicate diagnosis and confound targeted treatment. This prospective observational study evaluated adults with acute respiratory failure requiring mechanical ventilation who were admitted to the University of California, San... Read More | Comment
Upvote Story 10
This book discusses mechanical ventilation in emergency settings, covering the management of patients from the time of intubation until transfer to the ICU. It provides an introduction to key concepts of physiology pertinent to mechanical ventilation as well as a review of the core evidence-based principles of ventilation. The text highlights the management of mechanical ventilation for critically ill patients with several conditions commonly encountered... Read More | Comment
Upvote Story 5
Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely accepted that the utilization of lung-protective ventilation reduces ventilator-associated complications including acute respiratory distress syndrome (ARDS). Additionally, it is believed that ventilatory-associated lung injury can occur early after the... Read More | Comment
Upvote Story 6
The high cost of critical care has engendered research into identifying influential factors. However, previous studies have not considered patient vital status at ICU discharge. This is what a new study has found: The largest drivers of ICU costs at the patient level are day 1 room occupancy and day 1 mechanical ventilation, and mortality before unit discharge is associated with substantially higher costs. Read More | Comment
Upvote Story 6
This trial provides evidence that a strategy of avoiding continuous sedation as early as possible, in the absence of residual neuromuscular blockade and hypothermia, compared with usual sedation care, resulted in improvements in several important clinical outcomes in critically ill postoperative patients. Given the clinical and economic burden of critical illness, postoperative morbidity, and the substantial number of patients who could benefit from this strategy,... Read More | Comment
Upvote Story 7
ICU admissions are ever increasing across the United States. Following critical illness, physical functioning (PF) may be impaired for up to 5 years. We performed a systematic review of randomized controlled trials evaluating the efficacy of interventions targeting PF among ICU survivors. The objective of this study was to identify effective interventions that improve long-term PF in ICU survivors. The only effective intervention to improve... Read More | Comment
Upvote Story 5
Emergency Department exposure to hyperoxia is common and associated with increased mortality in mechanically ventilated patients achieving normoxia after admission. This suggests that hyperoxia in the immediate post-intubation period could be particularly injurious, and targeting normoxia from initiation of mechanical ventilation may improve outcome. A total of 688 patients were included. ED normoxia occurred in 350 (50.9%) patients, and 300 (43.6%) had exposure to ED... Read More | Comment
Upvote Story 5
The effect of short-term caloric restriction on gene expression in critically ill patients has not been studied. In this sub-study of the PermiT trial, we examined gene expression patterns in peripheral white blood cells (buffy coat) associated with moderate caloric restriction (permissive underfeeding) in critically ill patients compared to standard feeding. The present study shows that different caloric intake via enteral nutrition lead to differential... Read More | Comment
Upvote Story 6
ABCDEF bundle performance showed significant and clinically meaningful improvements in outcomes including survival, mechanical ventilation use, coma, delirium, restraint-free care, ICU readmissions, and post-ICU discharge disposition. Complete ABCDEF bundle performance was associated with lower likelihood of seven outcomes: hospital death within 7 days, next-day mechanical ventilation, coma, delirium, physical restraint use, ICU readmission, and discharge to a facility other than home. We defined ABCDEF bundle... Read More | Comment
Upvote Story 5
Patient mobilization and physical rehabilitation in the ICU appears safe, with a low incidence of potential safety events, and only rare events having any consequences for patient management. Heterogeneity in the definition of safety events across studies emphasizes the importance of implementing existing consensus-based definitions. Heterogeneity was assessed by I2 statistics, and bias assessed by the Newcastle-Ottawa Scale and Cochrane risk of bias assessment. The... Read More | Comment
Upvote Story 5
Cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction although mortality could be reduced from formerly ∼80% to 40–50%. In addition to percutaneous coronary intervention or coronary artery bypass grafting, catecholamines, fluids, intraaortic balloon pumping (IABP), and also active assist devices are widely used for CS management. However, there is only limited evidence for any of the above... Read More | Comment
Upvote Story 8
This complex randomized, controlled trial failed to demonstrate that early extubation to non-invasive ventilation reduced the total time of mechanical ventilation. I will continue to extubate early and will use non-invasive mechanical ventilation or high-flow nasal oxygen therapy to support patients, with regular audit of re-intubation rates. The beneficial secondary outcomes demonstrated in this trial, such as reduced antibiotic use, reduced sedation requirement and reduced... Read More | Comment