Tag: ventilation

In-Hospital Cardiac Arrest

In-hospital cardiac arrest is common and associated with a high mortality rate. Despite this, in-hospital cardiac arrest has received little attention compared with other high-risk cardiovascular conditions, such as stroke,... read more

Neurally adjusted ventilatory assist decreases work of breathing during non-invasive ventilation in infants with severe bronchiolitis

In this physiological study, we report an improvement of respiratory unloading by adding a second level of pressure with NAVA in infants with severe bronchiolitis. WOB decreased immediately after switching to NAVA, as reported... read more

What is the lowest change in cardiac output that transthoracic echocardiography can detect?

In critically ill patients, changes in the velocity-time integral (VTI) of the left ventricular outflow tract, measured by transthoracic echocardiography (TTE), are often used to non-invasively assess the response to fluid... read more

Effect of position and positive pressure ventilation on functional residual capacity in morbidly obese patients

In awake morbidly obese volunteers, an increase in the FRC is observed when spontaneous ventilation at zero inspiratory pressure is switched to positive pressure. Compared with S positioning, the BC position had no measurable... read more

Sleep Deprived-Patients in ICU May Fail to Get Off Ventilation

Attempts to wean intubated, critically ill patients off mechanical ventilators were less successful when the patients exhibited atypical sleep or pathological wakefulness, researchers reported. The findings suggest that sleep... read more

Effect of Titrating PEEP with Esophageal Pressure-Guided Strategy vs Empirical High PEEP-Fio2 Strategy on Death and Days Free From Mechanical Ventilation Among Patients With ARDS

Among patients with moderate to severe Acute Respiratory Distress Syndrome (ARDS), PES-guided positive end-expiratory pressure (PEEP), compared with empirical high PEEP-Fio2, resulted in no significant difference in death... read more

Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock

Among patients with septic shock, a resuscitation strategy targeting normalization of capillary refill time, compared with a strategy targeting serum lactate levels, did not reduce all-cause 28-day mortality. Among 424 patients... read more

Bag-Mask Ventilation during Tracheal Intubation of Critically Ill Adults

Among critically ill adults undergoing tracheal intubation, patients receiving bag-mask ventilation had higher oxygen saturations and a lower incidence of severe hypoxemia than those receiving no ventilation. Among the 401... read more

Implementing Early Mobilization in the ICU

The use of a quality improvement appraisal tool can help identify high quality projects when planning a similar mobility program. Even though projects were conducted in a variety of intensive care unit settings, and implementation... read more

The PreVent Trial, Assessing the Role of Bag-mask Ventilation During Tracheal Intubation in Critically Ill Adults

In this "Breathe Easy Critical Perspective" podcast, Dr. Dominique Pepper interviews Dr. Matthew Semler. They discuss the PreVent trial, a recent publication in the 2019 issue of the NEJM that assessed the role of bag-mask... read more

Muscle Atrophy in Mechanically-ventilated Critically Ill Children

In children receiving invasive mechanical ventilation, diaphragm and other skeletal muscle atrophy is common and rapid. Increasing age and TBI may increase severity of limb muscle atrophy. Prospective studies are required... read more

ICU Utilization for Patients With Acute Exacerbation of COPD Receiving Noninvasive Ventilation

There is wide variability in the rate of ICU utilization for noninvasive ventilation across hospitals. Chronic obstructive pulmonary disease (COPD) patients receiving noninvasive ventilation had similar in-hospital mortality... read more

DeepSOFA: A Continuous Acuity Score for Critically Ill Patients using Clinically Interpretable Deep Learning

Traditional methods for assessing illness severity and predicting in-hospital mortality among critically ill patients require time-consuming, error-prone calculations using static variable thresholds. These methods do not... read more

Effect of high-flow nasal cannula oxygen therapy in adults with acute hypoxemic respiratory failure

Conflicting recommendations exist on whether high-flow nasal cannula (HFNC) oxygen therapy should be administered to adult patients in critical care with acute hypoxemic respiratory failure. We performed a meta-analysis of... read more

One of the Deadliest Hospital-Acquired Infections Is Preventable

Johns Hopkins Study Shows One of the Deadliest Hospital-Acquired Infections Is Preventable. For some hospital patients, going on a ventilator is often the difference between life and death. About 800,000 hospital patients... read more

High-frequency Oscillatory Ventilation: Still a Role?

In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. Although not first-line, HFOV remains... read more

Relationship Between Level of CPR Training, Self-reported Skills, and Actual Manikin Test Performance

As expected, higher levels of BLS training correlated with better cardiopulmonary resuscitation (CPR) quality. However, this study showed that ventilations and hands-on time were the components of CPR that were most affected... read more

Cricoid Pressure in Airway Management: The IRIS Trial

This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the non-inferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in... read more

The Benefit of Lung-Protective Ventilation in the ED

Intubation and mechanical ventilation are commonly performed ED interventions and although patients optimally go to an ICU level of care afterwards, many of them remain in the ED for prolonged periods of time. It is widely... read more

A Familiar Story: Delirium in the Acute Care Setting

A few years ago, I received report that a patient was ready to be weaned from the ventilator. He had no respiratory need for mechanical ventilation, and every time the medical team attempted to wean sedation to extubate,... read more

Prospective Assessment of the Feasibility of a Trial of Low Tidal Volume Ventilation for Patients with Acute Respiratory Failure

Use of initial tidal volumes less than 8 ml/kg PBW is common at hospitals participating in the NHLBI PETAL Network. After considering the size and budgetary requirement for a cluster-randomized trial of LTVV vs. usual care... read more

Decontaminants Don’t Cut Bloodstream Infection Risk in Ventilated ICU Patients

The use of digestive and oral decontaminants in patients in the intensive care unit (ICU) who are mechanically ventilated and who have moderate to high antibiotic resistance is not associated with a reduction in ICU-acquired... read more