Tag: mechanical ventilation
Prone Positioning of Nonintubated Patients with COVID-19
Despite the significant variability in frequency and duration of prone positioning and respiratory supports applied, prone positioning was associated with improvement in oxygenation variables without any reported serious... read more
Agreement Between IVC Diameter Measurements by Subxiphoid vs. Transhepatic Views
When it is not possible to obtain the subcostal view, it is possible to use the lateral transhepatic view. However, using the percentage variation in IVC size is likely to be more reliable than the absolute diameter alone.... read more
Discharged IMV COVID-19 Survivors Not Functionally Independent
The majority of invasive mechanical ventilation (IMV) COVID-19 survivors were not functionally independent at discharge and required significant follow-up medical care. The COVID-19 circumstance has placed constraints on... read more
Expiratory Flow Limitation During Mechanical Ventilation
Expiratory flow limitation (EFL) is present when the flow cannot rise despite an increase in the expiratory driving pressure. The mechanisms of EFL are debated but are believed to be related to the collapsibility of small... read more
Assess the Intensity of Inspiratory Efforts Using CVP Waveforms
Real case: You are passing by the room of an awake mechanically ventilated patient with advanced IPF. Peeking in from outside the room, the following CVP waveform catches your attention. In a recent post, we discussed... read more
Association of Low Baseline Diaphragm Muscle Mass With Prolonged Mechanical Ventilation and Mortality Among Critically Ill Adults
In this study, low baseline diaphragm muscle mass in critically ill patients was associated with prolonged mechanical ventilation, complications of acute respiratory failure, and an increased risk of death in the hospital. A... read more
90 Day Outcomes of COVID-19 Patients in European ICUs
This communication delineates outcomes in COVID-19 patients in the context of ARDS severity, ventilatory management, and variables associated with mortality on a 90-day follow-up for subgroups of patients after ICU admission.... read more
Individualized vs. Fixed Positive End-expiratory Pressure for Intraoperative Mechanical Ventilation in Obese Patients
This secondary analysis of obese patients undergoing laparoscopic surgery found better oxygenation, lower driving pressures, and redistribution of ventilation toward dependent lung areas measured by electrical impedance tomography... read more
A Controlled Trial of Methylprednisolone in COVID-19 Pneumonia
The use of corticosteroids in patients with pneumonia secondary to COVID-19 has been a controversially hot topic, particularly early on in the pandemic. Prior evidence seen in Severe Acute Respiratory Syndrome (SARS) and... read more
Clinical Features and Predictors in Critically Ill COVID-19 Patients
We aim to describe a case series of critically and non-critically ill COVID-19 patients in Singapore. This was a multicentered prospective study with clinical and laboratory details. Details for fifty uncomplicated COVID-19... read more
Prone Position in Intubated, Mechanically Ventilated COVID-19 Patients
During the COVID-19 pandemic, prone position has been widely adopted to treat mechanically ventilated patients with respiratory failure. The majority of patients improved their oxygenation during prone position, most likely... read more
IVCDV is not a reliable indicator of preload responsiveness
During mechanical ventilation with Vt = 6 mL/kg, the effects of passive leg raising (PLR) can be assessed by changes in pulse pressure variation (PPV). If inferior vena cava diameter (IVCDV) is used, it should be expressed... read more
Effect of intubation timing on clinical outcomes of critically ill patients with COVID-19
The synthesized evidence suggests that timing of intubation may have no effect on mortality and morbidity of critically ill patients with COVID-19. These results might justify a wait-and-see approach, which may lead to fewer... read more
Replacement of Fentanyl Infusion by Enteral Methadone Decreases the Weaning Time From Mechanical Ventilation
The introduction of enteral methadone during weaning from sedation and analgesia in mechanically ventilated patients resulted in a decrease in the weaning time from mechanical ventilation (MV). A double-blind randomized... read more
24-Hour Esophageal pH Measurement in Mechanically Ventilated Children
The current study shows high incidence of gastroesophageal reflux on 24-hour esophageal pH-metry in mechanically ventilated children with medical diagnoses. The significance of this finding and its impact on ventilator-associated... read more
Early Tracheotomy Shortens ICU Stay and Lowers Risk of VAP
Compared with late tracheotomy, early intervention was associated with lower ventilator-associated pneumonia (VAP) rates and shorter durations of mechanical ventilation and ICU stay, but not with reduced short-term, all-cause... read more
Ventilator Weaning and Discontinuation Practices for Critically Ill Patients
In this observational study of invasive mechanical ventilation discontinuation in 142 ICUs in Canada, India, the UK, Europe, Australia/New Zealand, and the US from 2013 to 2016, weaning practices varied internationally. Among... read more
International Variation in Intubation and Extubation Practices Among Critically Ill Patients Receiving Mechanical Ventilation
Requiring invasive mechanical ventilation acutely outside an operating room is, for many, the definition of critical illness. Although there may be debate regarding whether patients treated with noninvasive ventilation or... read more
Early sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial
In critically ill mechanically ventilated patients, early sedation with dexmedetomidine exhibited a high probability of reduced 90-day mortality in older patients regardless of operative or non-operative cluster status. Conversely,... read more
Body Mass Index and Risk for COVID-19
Obesity* is a recognized risk factor for severe COVID-19, possibly related to chronic inflammation that disrupts immune and thrombogenic responses to pathogens as well as to impaired lung function from excess weight. Obesity... read more
Effect of High-Dose Baclofen on Agitation-Related Events Among Patients With Unhealthy Alcohol Use Receiving Mechanical Ventilation
Among patients with unhealthy alcohol use receiving mechanical ventilation, treatment with high-dose baclofen, compared with placebo, resulted in a statistically significant reduction in agitation-related events. The primary... read more
High-flow nasal oxygen in patients with COVID-19-associated acute respiratory failure
The use of high-flow nasal oxygen upon ICU admission in adult patients with COVID-19 related acute hypoxemic respiratory failure may lead to an increase in ventilator-free days and a reduction in ICU length of stay, when... read more
