Tag: mechanical ventilation
Extra Corporeal Carbon Dioxide Removal
In patients with chronic obstructive airway disease and hypercapneic acidosis, who are failing non-invasive ventilation, does extra corporeal carbon dioxide removal compared to non-invasive ventilation alone, reduce the... read more
Spontaneous Breathing during Mechanical Ventilation. Risks, Mechanisms, and Management
Spontaneous respiratory effort during mechanical ventilation has long been recognized to improve oxygenation, and because oxygenation is a key management target, such effort may seem beneficial. Also, disuse and loss of peripheral... read more
Pricey Technology Is Keeping People Alive Who Don’t Want to Live
As an ICU physician, I’ve used technologies like breathing machines and feeding tubes to save lives that would have been lost just a few decades earlier. But I’ve also seen the substantial costs, both human and financial,... read more
Family Responses to Prognostic Information in Chronic Critical Illness
Prognostic disclosure by skilled clinician communicators evokes a repertoire of responses from surrogates for the chronically critically ill. Recognition of these response patterns may help all clinicians better communicate... read more
Use of ‘tidal volume challenge’ to improve the reliability of pulse pressure variation
Fluid loading is usually the first step in the resuscitation of patients with acute circulatory failure. Fluid responsiveness is defined as the ability of the left ventricle to increase its stroke volume in response to fluid... read more
Anesthesiologists Found Underreporting Medication Errors
Medication errors are apparently significantly underreported by anesthesia providers, at least at certain institutions. These recent findings may reflect a culture of underreporting or fear of punitive action, despite the... read more
Mechanical Ventilation: Which Patients Benefit from High PEEP?
Among patients with hypoxaemia after cardiac surgery, the use of an intensive alveolar recruitment strategy compared with a moderate recruitment strategy resulted in less severe pulmonary complications during the hospital... read more
Clinical review: The ABC of weaning failure
About 20% to 30% of patients are difficult to wean from invasive mechanical ventilation. The pathophysiology of difficult weaning is complex. Accordingly, determining the reason for difficult weaning and subsequently developing... read more
Vitamin D and outcomes in adult critically ill patients
In critically ill patients, vitamin D administration might be associated with a reduction in mortality without significant adverse events. A large multicenter randomized trial should conclusively confirm these findings. Seven... read more
An Educational Intervention Optimizes the Use of Arterial Blood Gas Determinations Across ICUs
The large scale implementation of guidelines for ABG use reduced the number of inappropriately ordered ABG determinations over seven different multidisciplinary ICUs, without negatively impacting patient care. We saw a reduction... read more
Delirium: Thinking Clearly About a Foggy Issue
Benzodiazepines are one of the leading causes of delirium. These drugs are already falling out of favor in critical care settings for other reasons; they are not easily titratable, and research suggests they can prolong a... read more
Assessing Postoperative Pulmonary Complications After Noncardiothoracic Surgery
In this multicenter study in 1202 American Society of Anesthesiologists physical status 3 patients undergoing noncardiothoracic surgery requiring 2 hours or more of general anesthesia with mechanical ventilation, at least... read more
Liberation from Mechanical Ventilation in Critically Ill Adults
Official Executive Summary of an American Thoracic Society/American College of Chest Physicians Clinical Practice Guideline: Liberation from Mechanical Ventilation in Critically Ill Adults. The panel provides recommendations... read more
Recruitment manoeuvres for adults with acute respiratory distress syndrome receiving mechanical ventilation
Ten trials met the inclusion criteria for this review (n = 1658 participants). We found five trials to be at low risk of bias and five to be at moderate risk of bias.... read more
New Guidelines for Discontinuing Mechanical Ventilation in the ICU
The goal of the guidelines is to help physicians and other healthcare professionals determine when patients with acute respiratory failure can breathe on their own and to provide clinical advice that may increase the chances... read more
Communication App Helps Patients Voice Their Needs
An innovative tablet-based application offers intubated and ventilated intensive care unit (ICU) patients a way to converse with their medical staff.... read more
