Tag: mechanical ventilation
The End-expiratory Occlusion Test
There is growing evidence that the end-expiratory occlusion (EEO) test reliably detects preload responsiveness. It is easier to perform than passive leg raising and has less limitations than pulse pressure variations, provided... read more
A Guide To Designing Low-Cost Ventilators for COVID-19
The best medical treatment currently for COVID-19 is to simply assist the lung function with mechanical ventilation. Unfortunately hospitals are experiencing such huge influx of patients and do not have enough ventilators. This... read more
Respiratory Physiology of Mechanically Ventilated Patients with COVID-19
In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Drs. Jehan Alladina and Corey Hardin. They discuss the respiratory physiology of mechanically ventilated patients with COVID-19. Dr.... read more
In the Fight to Treat Coronavirus, Your Lungs Are a Battlefield
Ventilators have become the single most important piece of medical equipment for critically ill coronavirus patients whose damaged lungs prevent them from getting enough oxygen to vital organs. The machines work by forcing... read more
Supine Body Position As a Risk Factor for Nosocomial Pneumonia in Mechanically Ventilated Patients
The frequency of clinically suspected nosocomial pneumonia was lower in the semirecumbent group than in the supine group. This was also true for microbiologically confirmed pneumonia. Supine body position were independent... read more
COVID-19 NIV: Helmet vs Mask
Over the past few weeks there has been a shift in the management of critically ill COVID-19 patients. Many seem to have moved away from an intubate early strategy to the use of high flow nasal cannula (HFNC) and noninvasive... read more
COVID-19: Two More Trials Just Published on Remdesivir
Currently, there are no approved medications for the treatment of COVID-19, but, there are many investigational agents that have shown antiviral activity against SARS-CoV-2 in vitro. Unfortunately in vitro studies do... read more
Predicting NIV Failure in Hypoxemic Patients
Non-invasive ventilation (NIV) is applied worldwide to patients with hypoxemic respiratory failure. It is often applied as an attempt to avoid invasive mechanical ventilation. However, the application of NIV is often... read more
Management of COVID-19 Respiratory Distress
Acute respiratory distress syndrome (ARDS) can originate from either the gas or vascular side of the alveolus. Although the portal for coronavirus disease 2019 (COVID-19) is inhalational, and alveolar infiltrates are commonly... read more
Comparison of Echocardiographic and Invasive Measures of Volaemia and Cardiac Performance in Critically Ill Patients
Static echocardiographic variables did not reliably reflect the volume state as defined by estimates of mean systemic filling pressure. There was no statistical or clinically robust relationship between static echocardiographic... read more
Oxygen Escalation Therapy and Noninvasive Ventilation During COVID-19
We are in the midst of the COVID-19 pandemic. Many parts of the world have been ravaged by this virus, but disease severity varies significantly. There are several types of patients with COVID-19: those who have mild disease... read more
Allocating Ventilators in a Pandemic
The COVID-19 pandemic has led to shortages of essential goods and services - from hand sanitizers to masks to beds to ventilators. Today, the healthcare system is facing the prospect of rationing medical goods and services. Mechanical... read more
Is COVID-19 ARDS?
Acute respiratory distress syndrome (ARDS) is a heterogeneous disease. It presents with a wide range of severity, varying degrees of hypoxemia and varying degrees of pulmonary mechanical impairment. Failure of hypoxemic vasoconstriction... read more
Optimizing Ventilator Use during the COVID-19 Pandemic
The COVID-19 outbreak is presenting unprecedented challenges to our health care system. According to our best projections, combined with information on the ground, the availability of precious medical resources will be limited... read more
Heart and Lung Damage for COVID-19 Patients
While the focus of the COVID-19 pandemic has been on respiratory problems and securing enough ventilators, doctors on the front lines are grappling with a new medical mystery. In addition to lung damage, many COVID-19... read more
COVID-19 Patients Need Oxygen Not Pressure!
Critically ill coronavirus patients are being inadvertently harmed by the very same breathing machines being used to keep them alive, warning Dr. Cameron Kyle-Sidell from Maimonides Medical Center, NY. In a video posted... read more
Rationing of Critical Care and Ventilators in COVID19
In many hospitals ventilators have become a scarce or non-existent resource in the face of the COVID19 pandemic. We need a ethical structure to allocate ventilators and other scarce resources. ... read more
A Better Way of Connecting Multiple Patients to a Single Ventilator
This differential multi-ventilation setup yields increased safety, monitoring and control for each connected patient. In an ideal world, no one treating patients with Acute Respiratory Distress Syndrome (ARDS) would have... read more
A Comparison of Albumin and Saline for Fluid Resuscitation in the ICU
In this randomized trial, we found that the use of 4 percent albumin or normal saline for intravascular volume resuscitation in a heterogeneous population of patients in the ICU resulted in equivalent rates of death from... read more
1 Million Ventilators Project
We need to develop a strategic reserve of 1,000,000+ emergency ventilators ASAP. These don't need to be fancy medical ventilators, they just need to work. In a pandemic, the limited existing ventilator supply and stockpile... read more
Splitting Ventilators to Provide Titrated Support to a Large Group of Patients
COVID-19 can out-strip the number of mechanical ventilators available to us. This has led to interest in using a single ventilator to support multiple patients. This post will review the theory and evidence regarding this... read more
