Tag: mechanical ventilation
Respiratory Drive in the ARDS: Pathophysiology, Monitoring, and Therapeutic Interventions
Neural respiratory drive, i.e., the activity of respiratory centres controlling breathing, is an overlooked physiologic variable which affects the pathophysiology and the clinical outcome of acute respiratory distress syndrome... read more
It’s Insane to Keep Using Mortality As a Primary Endpoint in Critical Care Trials
Mortality is an important endpoint, so we shouldn't ignore mortality trends entirely. However, the vast majority of these will be spurious. Thus, we should generally not change practice due to them. In the history of critical... read more
Coronavirus (2019-nCoV): Evidence Relevant to Critical Care
The 2019 Coronavirus outbreak was declared a global Public Health Emergency by the World Health Organization (WHO) on 30th January 2020. In order to ensure immediate access to relevant systematic reviews, this Cochrane... read more
Ventilatory Support and Mechanical Properties of the Fibrotic Lung Acting as a “Squishy Ball”
The management of the patient with lung fibrosis in the ICU is a challenge for the intensivist. The lack of studies defining the mechanical ventilation strategy, and the different underlying etiologies, make it difficult... read more
Expiratory Muscle Dysfunction in Critically Ill Patients
The expiratory muscles are the "neglected component" of the respiratory muscle pump. Rather as the heart does not comprise only a left ventricle, but also a right one, the respiratory muscle pump is much more than just the... read more
The ABCDE Bundle Associated with Significant Reductions in Duration of Mechanical Ventilation
The focus on long-term consequences of critical illness has intensified with increasing ICU utilization and survivorship. Post Intensive Care Syndrome (PICS) is increasingly recognized and has profound and long-lasting negative... read more
Clinical Decision Support Systems: Future or Present in ICU?
Clinical decision support systems (CDSS) are today, a reality. More complex, useful systems will be developed in the near future, forging CDSS an essential part of ICU monitoring. However, we need to understand the algorithms... read more
Risk Factors for the Development of ARDS in Mechanically Ventilated Adults in Peru
In this study of mechanically ventilated patients, 31% of study participants had acute respiratory distress syndrome (ARDS) at some point during their ICU stay. Optimal lung-protective ventilation was not used in a majority... read more
Effect of Stress Ulcer Prophylaxis on In-Hospital Mortality Among ICU Patients Receiving Invasive Mechanical Ventilation
Among ICU patients requiring mechanical ventilation, a strategy of stress ulcer prophylaxis with use of proton pump inhibitors vs histamine-2 receptor blockers resulted in hospital mortality rates of 18.3% vs 17.5%, respectively,... read more
Compliance With Evidence-Based Processes of Care After Transitions Between Staff Intensivists
No significant impact of transitions of care observed between individual staff physicians on evidence-based processes of care for mechanically ventilated adult patients. However, transitions were associated with a lower likelihood... read more
Ventilator Management: Advanced Concepts In Critical Care
Mechanical ventilation is a broad subject that encompasses many factors that must be considered while providing overall resuscitation. It is not as easy as just entering in a rate and tidal volume and pushing start. Critical... read more
Critical Care Opioids Impact in the 21st Century
Critical Care is impacted by opioids in multiple ways. Not only do they form the backbone of managing pain and sedation in the intensive care unit (ICU), the burgeoning opioid epidemic also feeds into opioid-related ICU admissions.... read more
Pulse oximeter as a sensor of fluid responsiveness: do we have our finger on the best solution?
Additional studies – including volume challenge – are mandatory if we are to determine whether respiratory variation in pulse oximetry really can predict volume responsiveness in mechanically ventilated patients without... read more
Optimal Duration of Mechanical Ventilation and Influencing Factors Following Mandibular Distraction Osteogenesis in Infants
Mandibular distraction osteogenesis (MDO) is an effective treatment for tongue-based airway obstruction in infants with severe Pierre Robin sequence (PRS). Most infants receiving MDO require postoperative mechanical ventilation... read more
Impact of Natural Light Exposure on Delirium Burden in Adult Patients Receiving Invasive Mechanical Ventilation in the ICU
Admission to a single room with potential exposure to natural light via windows was not associated with reduced delirium burden, as compared to admission to a single room without windows. However, natural light exposure was... read more
Sedation and Analgesia in the ICU
Sedation and analgesia have high importance in patient-centered care. Patients in the ICU are seriously ill and often suffer from anxiety, agitation, and pain. There is sometimes a need to use deep and prolonged sedation,... read more
High Flow Nasal Cannula Benefits and Pitfalls
Emergency physicians should be familiar with the benefits and pitfalls of high-flow nasal cannula (HFNC). HFNC is well tolerated by patients, and its use contributes to superior outcomes for patients with pure hypoxemic... read more
Differential Gene Expression in Peripheral White Blood Cells with Permissive Underfeeding and Standard Feeding in Critically Ill Patients
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... read more
Mechanical Ventilation in Patients with Acute Ischemic Stroke
Although there are no specific data regarding the effect of respiratory management on stroke patients' outcomes, specific ventilator strategies in this population could potentially improve neurologic outcome and prevent respiratory... read more
Economic Evaluation of a Patient-Directed Music Intervention for ICU Patients Receiving Mechanical Ventilatory Support
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... read more
Timing of Tracheostomy in Pediatric Patients
In children on mechanical ventilation, early tracheostomy may improve important medical outcomes. However, our data demonstrate the urgent need for high-quality, randomized controlled trials in the pediatric population. Data... read more
PICU Up! A Multicomponent Early Mobility Intervention for Critically Ill Children
Pediatric intensive units traditionally have had a culture where critically ill children are intubated and mechanically ventilated, immobilized, and highly sedated. This practice is primarily driven by a focus on safety... read more
