Tag: ventilation

Upvote Story 5
Among patients with out-of-hospital cardiorespiratory arrest (OHCA), the use of BMV compared with ETI failed to demonstrate noninferiority or inferiority for survival with favorable 28-day neurological function, an inconclusive result. A determination of equivalence or superiority between these techniques requires further research. This study has several limitations. First, the presence of a physician in the ambulance team may make the results of this study less... Read More | Comment
Upvote Story 4
Pre-preparation of Preparation on Pre-hospital Emergency (PHEA) equipment and drugs resulted in safer performance of PHEA and has the potential to reduce on-scene time by up to a third. In total 23 experiments were completed, 12 using experimental method and 11 using standard practice. Time required to perform PHEA using the experimental method was significantly shorter than with standard practice (11,45 versus 20:59) minutes: seconds;... Read More | Comment
Upvote Story 4
The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance was independently associated with improved survival and more days free of delirium and coma after adjusting for age, severity of illness, and presence of mechanical ventilation. Total and partial bundle compliance were measured daily. Random effects regression... Read More | Comment
Upvote Story 7
Mechanical ventilation is an essential life-sustaining therapy for many critically-ill patients. As technology has evolved, clinicians have been presented with an increasing number of ventilator options as well as an ever-expanding and confusing list of terms, abbreviations, and acronyms. Unfortunately, this has made it extremely difficult for clinicians at all levels of training to truly understand mechanical ventilation and to optimally manage patients with respiratory... Read More | Comment
Upvote Story 14
The Advanced Ventilator Book is a companion to the best-selling The Ventilator Book and is written for clinicians who already have a solid foundation in the basics of mechanical ventilation. It goes beyond the ventilator itself to discuss strategies for severe hypoxemia and rescue maneuvers for refractory respiratory failure. Subjects covered in The Advanced Ventilator Book include: Optimal PEEP, Treatment of severe bronchospasm, Prone positioning,... Read More | Comment
Upvote Story 7
The safety of cuffed endotracheal tubes in the neonatal and critically ill pediatric population continues to be questioned due to the theoretical risk of acquired subglottic stenosis. The incidence of acquired subglottic stenosis in the high-risk mixed surgical and medical critically ill pediatric cohort using high-volume, low-pressure cuffed endotracheal tube policy has not yet been described. We report no single case of acquired subglottic stenosis... Read More | Comment
Upvote Story 6
Acute respiratory distress syndrome (ARDS) is a clinical entity that acutely affects the lung parenchyma, and is characterized by diffuse alveolar damage and increased pulmonary vascular permeability. Currently, computed tomography (CT) is commonly used for classifying and prognosticating ARDS. However, performing this examination in critically ill patients is complex, due to the need to transfer these patients to the CT room. Fortunately, new technologies have... Read More | Comment
Upvote Story 5
Ahsan Akram and colleagues have created a fluorescent imaging probe that can quickly and accurately detect hard-to-trace Gram-negative bacteria (one of the major bacterial groups) in human lungs within minutes. Their first-in-human study, where they successfully used the imaging tool to safely detect infections in hospital patients undergoing ventilation, could streamline the diagnosis of bacterial lung infections and more accurately assess if antibiotics are needed.... Read More | Comment
Upvote Story 9
In this cluster randomized multicenter study in 13 European ICUs, decontamination strategies with either antibiotics (SDD or SOD) or CHX mouthwash were not associated with reductions in ICU-acquired BSI with MDRGNB, nor mortality, in ventilated ICU patients when compared with standard care, which included universal daily BWs with CHX during ICU stay and a hand hygiene program. Furthermore, the unitwide prevalence of carriage with antibiotic-resistant... Read More | Comment
Upvote Story 6
Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. This randomized clinical trial compares the effects of sedation with vs without dexmedetomidine on mortality and ventilator-free days in patients with sepsis. Among patients requiring mechanical ventilation, the use of dexmedetomidine compared with no dexmedetomidine did not result in statistically significant... Read More | Comment
Upvote Story 8
Less than 7 cm H2O positive end-expiratory pressure reduced atelectrauma encountered at zero end-expiratory pressure. Above a defined power threshold, sustained positive end-expiratory pressure contributed to potentially lethal lung damage and hemodynamic impairment. Lung mechanical power was similar at 0 (8.8 ± 3.8 J/min), 4 (8.9 ± 4.4 J/min), and 7 (9.6 ± 4.3 J/min) cm H2O positive end-expiratory pressure, and it linearly increased thereafter... Read More | Comment
Upvote Story 5
Mechanical ventilation and extracorporeal support are marginally integrated. The best environment for lung healing – complete lung collapse or protective ventilation strategy or fully open and immobile lung (all three conditions feasible with extracorporeal support) – remains to be defined. Recent studies provide a description on how mechanical ventilation is normally applied in combination with extracorporeal support in acute respiratory distress syndrome (ARDS). The data... Read More | Comment
Upvote Story 3
Improvements in acute respiratory distress syndrome (ARDS) outcomes in adults have been achieved along-side demonstration of the superiority of low-tidal volume ventilation, the relative advantage of a restrictive fluid strategy and the characterization of the main effectors of ventilator-induced lung injury. The heterogeneity of the group of patients defined as “ARDS” on pragmatic criteria is widely recognized. “Lumping” together patients with different ages, etiologies, time... Read More | Comment
Upvote Story 9
In patients requiring intubation from acute salicylate toxicity, hemodialysis should be considered as part of management, as this is associated with decreased mortality. Salicylates are common substances that can be purchased over the counter. They are readily available, and in the setting of an overdose, can be fatal. Initially, as salicylates are metabolized, they can induce a respiratory alklalosis. This is then followed by an... Read More | Comment
Upvote Story 9
The American Society of Anesthesiologists (ASA) difficult airway algorithm recommends that if initial attempts at tracheal intubation after the induction of general anesthesia are unsuccessful, the practitioner should “consider the advisability of awakening the patient”. With respect to the use of muscle relaxants, “awakening” is assumed to mean return to an unparalyzed state that permits life-sustaining spontaneous ventilation (hereafter referred to as functional recovery). The... Read More | Comment