Tag: mechanical ventilation
Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Weaning on Time to Liberation From Mechanical Ventilation Among Patients With Respiratory Failure
Among patients requiring mechanical ventilation in whom a spontaneous breathing trial had failed, early extubation to noninvasive ventilation did not shorten time to liberation from any ventilation. Among 364 randomized... read more
Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Ventilation
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... read more
Long-term Cognitive Impairment and Delirium in ICU
ICU delirium was positively associated with impaired information processing speed and executive functioning at six-months post-discharge for this cohort. Testing for cognitive impairment with RBANS and TMT should be considered... read more
Impact of a Multifaceted Prevention Program on VAP Including Selective Oropharyngeal Decontamination
Ventilator-associated pneumonia (VAP) remains a serious complication of mechanical ventilation (MV), and has an incidence between 2 and 16 episodes per 1000 ventilator-days, an attributable mortality of 5–13%, excess ICU... read more
Management of Peripheral Venoarterial ECMO in Cardiogenic Shock
Extracorporeal membrane oxygenation (ECMO) is a powerful mechanical circulatory support modality capable of rapidly restoring systemic perfusion yet lacking in defined approaches to management. Adopting a management approach... read more
Sedation, Sleep Promotion, and Delirium Screening Practices in the Care of Mechanically Ventilated Children
The results highlight the heterogeneity in sedation practices among intensivists who care for critically ill children as well as a paucity of sleep promotion and delirium screening in PICUs worldwide. The survey was completed... read more
Interventions for Preventing Critical Illness Polyneuropathy and Critical Illness Myopathy
There is moderate quality evidence from two large trials that intensive insulin therapy reduces CIP/CIM, and high quality evidence that it reduces duration of mechanical ventilation, ICU stay and 180-day mortality, at the... read more
Added Benefit of Noninvasive Ventilation to High-Flow Nasal Oxygen to Prevent Reintubation in Higher-Risk Patients
Liberating patients from ongoing invasive mechanical ventilation is typically a 3-step process. First, clinicians must recognize that patients may no longer require mechanical ventilation, when the reasons for intubation... read more
Early Enteral Nutrition Associated with Improved Clinical Outcomes in Critically Ill Children
In critically ill children with hyperglycemia requiring inotropic support and/or mechanical ventilation, early enteral nutrition was independently associated with better clinical outcomes. Of 608 eligible subjects, 331... read more
Brainstem Responses Can Predict Death and Delirium in ICU Sedated Patients
Assessment of brainstem responses is feasible in sedated critically ill patients and loss of selected responses is predictive of mortality and altered mental status. 72 patients were included in the initial group and 72... read more
Driving Pressure Is Associated with Outcome during Assisted Ventilation in ARDS
In patients with Acute Respiratory Distress Syndrome (ARDS), plateau pressure, driving pressure, and respiratory system compliance can be measured during assisted ventilation, and both higher driving pressure and lower compliance... read more
Long-Term Outcomes and Health Care Utilization after Prolonged Mechanical Ventilation
Critically ill patients who undergo mechanical ventilation in an ICU for longer than 21 days have high in-hospital mortality and greater postdischarge mortality, health care utilization, and health care costs compared with... read more
Impact of Delayed Admission to ICUs on Mortality of Critically Ill Patients
When the number of patients who require intensive care is greater than the number of beds available, intensive care unit (ICU) entry flow is obstructed. This phenomenon has been associated with higher mortality rates... read more
Outcomes of ARDS in Mechanically Ventilated Patients With Cirrhosis
Acute respiratory distress syndrome (ARDS) is common in mechanically ventilated patients with cirrhosis but is not independently associated with increased mortality. The mean age in 181 eligible patients was 53 ± 11 years;... read more
Enteral vs. Parenteral Nutrition in Septic Shock
The strong paradigm of favoring the enteral over the parenteral route in critically ill patients has been challenged. As a consequence, updated guidelines recommend withholding enteral nutrition in patients with uncontrolled... read more
Mobilization Practices for Patients with Burn Injury in Critical Care
Mobilization therapy of patients with burns in the ICU was characterized by a low mobility level during mechanical ventilation with a low functional status at hospital discharge. Of the 74 patients admitted, 66% were placed... read more
Automated vs. Non-automated Weaning for Reducing Mechanical Ventilation Duration for Critically Ill
Automated systems may result in clinically meaningful reduced durations of weaning, ventilation and ICU stay. Overall, these systems appear to be safe and can be considered a reasonable approach in the management of ventilator... read more
