Tag: PEEP
Mechanical Power: Meaning, Uses and Limitations
Ventilator-induced lung injury (VILI) carries significant attributable mortality in acute respiratory distress syndrome (ARDS). Even though all the ventilatory variables contribute to VILI, current guidelines focus almost... read more
Postoperative Pulmonary Complications in the ENIGMA II Trial
Respiratory complications remain among the most common and serious adverse outcomes of major surgery. In the Australian and New Zealand Audit of Surgical Mortality, postoperative pneumonia accounted for 44% of infective... read more
Pros and Cons of Disconnecting the Ventilator During Acute Respiratory Decompensation
Disconnecting the ventilator and manual BMV should be performed in cases where device malfunction is the primary cause of decompensation. These instances are quite rare. Disadvantages of switching to BMV include loss of... read more
Improving Outcomes in Patients with Difficult Airways
Evidence indicates that the airway community has successfully conquered the anatomically difficult airway, as these patients are managed safely with a low incidence of morbidity and mortality. In contrast, the literature... read more
Protective Ventilation
As ventilator induced lung injury (VILI) importantly impacts outcome of mechanically ventilated patients, even in those without lung injury, it follows that those caring for the critically ill should apply protective ventilatory... read more
Prone Position in Mechanically Ventilated Patients
The use of prone position (PP) during invasive mechanical ventilation was first reported more than 45 years ago as a mean to improve oxygenation in patients with acute hypoxemic respiratory failure. Improved oxygenation... read more
External Chest-wall Compression in Prolonged COVID-19 ARDS with Low-compliance
SARS-CoV-2 can lead to severe respiratory failure (C-ARDS) with some clinical and radiological characteristics that match the presentation of acute respiratory distress syndrome (ARDS). The management of mechanical ventilation... read more
ARDS Subphenotypes Validation and Utility Identified by Machine-learning Models
Classifier models using clinical variables alone can accurately assign ARDS subphenotypes in observational cohorts. Application of these models can provide valuable prognostic information and could inform management strategies... read more
Energy Transmission in Mechanically Ventilated Children
Mechanical energy (ME) better related to underlying lung pathology and patient outcome than MP. The delivery of generated energy to the lung was not dependent on endotracheal tube diameter (ETT) size during PC ventilation.... read more
Ventilation in Patients with Intra-abdominal Hypertension
The incidence of intra-abdominal hypertension (IAH) is high and still underappreciated by critical care physicians throughout the world. One in four to one in three patients will have IAH on admission, while one out of... read more
ARDS vs. PseudoARDS – Failure of the Berlin Definition
True ARDS might be defined as a histological diagnosis involving diffuse alveolar damage throughout the lungs (characterized by hyaline membrane formation and thickening of the alveolar walls). PseudoARDS refers to patients... read more
Higher vs. Lower PEEP in ARDS Patients
In our meta-analysis of RCTs, higher positive end-expiratory pressure (PEEP), compared with lower PEEP, was not associated with mortality in patients without acute respiratory distress syndrome (ARDS) receiving invasive mechanical... read more
Personalized Mechanical Ventilation in ARDS
A personalized mechanical ventilation approach for patients with adult respiratory distress syndrome (ARDS) based on lung physiology and morphology, ARDS etiology, lung imaging, and biological phenotypes may improve ventilation... read more
When Could Airway Plateau Pressure is Acceptable in ARDS Patients?
Limitation of plateau pressure (Pplateau) is critical for pro-tection from ventilator-induced lung injury in patients with acute respiratory distress syndrome (ARDS). Limiting to a 30 cmH2O threshold is a widely accepted... read more
Percutaneous Dilational Tracheostomy for COVID-19 Patients Requiring Mechanical Ventilation
Patients with COVID-19 who survive the early days of MV experience severe and prolonged respiratory failure. An early modified percutaneous dilational tracheostomy (PDT) was safe for patients and healthcare providers and... 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
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
