Tag: PEEP
ARDS Diagnosis May Be Underrecognized
The February 27, 2020 Department of Internal Medicine Medical Grand Rounds "Acute Respiratory Distress Syndrome (ARDS),” was presented by Marc Moss, MD, Roger S. Mitchell Professor of Medicine; head, Division of Pulmonary... read more
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
Which Component of Mechanical Power is Most Important in Causing VILI?
Repeated applications of tidal energy inflict lung damage (VILI) when stress and strain exceed the limits of tissue tolerance. Inflation work and energy are the products of pressure and volume, which are loosely associated... 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
Prone Positioning Monitored by Electrical Impedance Tomography in Patients with Severe ARDS on VV-ECMO
Prone positioning (PP) during veno-venous ECMO is feasible, but its physiological effects have never been thoroughly evaluated. Our objectives were to describe, through electrical impedance tomography (EIT), the impact of... 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
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
Adaptive Mechanical Ventilation with Automated Minimization of Mechanical Power
Adaptive mechanical ventilation with automated minimization of inspiratory power may lead to more lung-protective ventilator settings when compared with adaptive mechanical ventilation according to Otis' equation. Comparing... read more
Long-term Cognitive Impairment After ARDS
Reducing the practical burden of cognitive recovery following critical illness depends crucially on understanding the links between brain injury and lung injury. New deficits in learning and memory, and new development... read more
Population Enrichment for Critical Care Trials
Enrichment reduces heterogeneity and will enhance the sensitivity of future trials. However, enrichment, even when it identifies more homogenous populations, may not be efficient to deploy in trials or clinical practice. Many... 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
Vasoactive Medication and Randomized Clinical Trials
Vasoactive medication is one of the cornerstones in the treatment of critically ill patients in shock. Shock can be defined as a failure of the circulatory system to provide adequate tissue perfusion resulting in cellular... read more
Does high PEEP prevent alveolar cycling?
Acute respiratory distress syndrome (ARDS) patients need mechanical ventilation to sustain gas exchange. Animal experiments showed that mechanical ventilation with high volume/plateau pressure and no positive end-expiratory... read more
Ultrasound for Lung Monitoring of Ventilated Patients
In the intensive care unit, patient lung ultrasound provides accurate information on lung morphology with diagnostic and therapeutic relevance. It enables clinicians easy, rapid, and reliable evaluation of lung aeration and... read more
Systemic Early Neuromuscular Blockade in ARDS – The ROSE Trial
The early use of neuromuscular blocking agents in the setting of moderate-to-severe acute respiratory distress syndrome (ARDS) was previously understood to confer a survival advantage at 90 days, based on the outcomes of... read more
Early Neuromuscular Blockade in the ARDS
Among patients with moderate-to-severe ARDS who were treated with a strategy involving a high PEEP, there was no significant difference in mortality at 90 days between patients who received an early and continuous cisatracurium... read more
