Tag: ventilation

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

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

Predicting and measuring fluid responsiveness with echocardiography

Echocardiography is an essential tool to predict and measure fluid responsiveness, according to a recent article, which provides a practical guide. Ashley Miller and Justin Mandeville outline the physiological basis of fluid... 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

The ICM research agenda on ICU-acquired weakness

Intensive care unit (ICU)-acquired weakness (ICUAW) develops as a complication of critical illness and may represent the extreme end of a spectrum of weakness that begins with any serious illness regardless of care location.... 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

Opening pressures and atelectrauma in ARDS

Data show that the prerequisites of the open lung strategy are not satisfied using PEEP up to 15 cmH2O and plateau pressure up to 30 cmH2O. For an effective open lung strategy, higher pressures are required. Therefore,... read more

National ICU Quality Indicators Revisited

The use of QI at a national level is a suitable method to focus on quality in healthcare. Independently of public access to the results, a local or national ICU network will have a lot to gain from engaging in the process... read more

Effects of Neuromuscular Blockers on Transpulmonary Pressures in Moderate to Severe ARDS

Thirty patients were included, 24 with moderate ARDS and 6 with severe ARDS. NMBA infusion was associated with an improvement in oxygenation in both moderate and severe ARDS, accompanied by a decrease in both plateau pressure... 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

A randomized placebo-controlled phase II study of a Pseudomonas vaccine in ventilated ICU patients

This phase II study has shown that IC43 vaccination of ventilated ICU patients produced a significant immunogenic effect. P. aeruginosa infection rates did not differ significantly between groups. In the absence of any difference... read more

New Infection Data and Sepsis-Guideline Critique at SCCM

The potential of probiotics to reduce nosocomial infections and ventilator-associated pneumonia in the critically ill and the latest data on readmissions will be among the major research advances presented here at the Society... 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

Spinraza Cuts Risk of Permanent Ventilation with SMA

Biogen announced new data from the Phase 3 ENDEAR study that showed a statistically significant reduction in the risk of death or permanent ventilation in Spinraza (nusinersen)-treated infants with spinal muscular atrophy... read more

In-Bed Cycling Feasible for ICU Patients on Ventilation

TryCYCLE was the first study in the CYCLE research program. In TryCYCLE, we determined it was safe and feasible to bike with mechanically ventilated medical surgical patients very early in their ICU stay.... read more

End-Inspiratory Pause Prolongation in ARDS Patients

Prolonging EIP allowed a significant decrease in Vt without changes in PaCO2 in passively ventilated ARDS patients. This produced a significant decrease in plateau pressure and driving pressure and significantly increased... read more

Non-invasive Respiratory Support and Methylxanthines Reduce Re-Intubations

In a meta-analysis of randomized studies evaluating efforts to reduce re-intubations and respiratory failure in preterm infants, non-invasive respiratory support and use of methylxanthines (theophylline, caffeine) were found... read more

Dexmedetomidine Use in Critically-Ill Children with Acute Respiratory Failure

Margaret Parker, MD, MCCM, speaks with Mary Jo C. Grant, APRN, PhD, about the article, "Dexmedetomidine Use in Critically-Ill Children with Acute Respiratory Failure," published in the December 2016 issue of Pediatric... read more

Skeletal muscle quality as assessed by CT-derived skeletal muscle density is associated with 6-month mortality in mechanically ventilated critically ill patients

Low skeletal muscle quality at ICU admission, as assessed by CT-derived skeletal muscle density, is independently associated with higher 6-month mortality in mechanically ventilated patients. Thus, muscle quality as well... read more

Apnoeic oxygenation via high-flow nasal cannula oxygen combined with non-invasive ventilation preoxygenation for intubation in hypoxaemic patients in the intensive care unit

A novel strategy for preoxygenation in hypoxaemic patients, adding HFNC for apnoeic oxygenation to NIV prior to orotracheal intubation, may be more effective in reducing the severity of oxygen desaturation than the reference... read more

Limited predictability of maximal muscular pressure using the difference between peak airway pressure and positive end-expiratory pressure during proportional assist ventilation (PAV)

Deducing maximal muscular pressure from ΔP during PAV has limited accuracy. The extrapolated pressure time product from ΔP is usually less than the pressure time product calculated from oesophageal pressure tracing.... 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