Tag: ventilator
Tidal Volume Strategies for those without ARDS
This paper justifies utilizing a higher tidal volume strategy for our patients without primary ARDS/pulmonary disease. This can be very useful. Patient comfort and patient-ventilator synchrony are extremely important. This... read more
How to Improve Patient-ventilator Synchrony
Asynchronies are a frequent issue in ventilated patients. They represent a mismatch between the inspiratory and expiratory times of patient and ventilator, and thus a failure to provide ventilated patients with optimal assistance.... read more
Risk Stratification Using Oxygenation in the First 24 Hours of Pediatric ARDS
Oxygenation measured 24 hours after acute respiratory distress syndrome onset more accurately stratifies risk, relative to oxygenation at onset, in both children and adults. However, waiting 24 hours is problematic, especially... read more
Letting the Patient Decide: A Case Report of Self-Administered Sedation During Mechanical Ventilation
It is common for critical care nurses to administer sedative medications to patients receiving mechanical ventilation. Although patient-controlled analgesia is frequently used in practice to promote effective self-management... read more
Score for Predicting Ventilator Weaning Duration in Patients With Tracheostomies
A score derived from ventilator settings may help clinicians predict the timing of ventilator liberation in patients requiring prolonged mechanical ventilation. Of 372 patients, 72% were liberated from mechanical ventilation.... read more
Implementing a bedside assessment of respiratory mechanics in patients with ARDS
Implementing a systematic respiratory mechanics test leads to frequent individual adaptations of ventilator settings and allows improvement in oxygenation indexes and reduction of the risk of overdistention at the same time.... read more
Doubling Down on Re-Expansion Pulmonary Edema: Treatment Approach and Ventilator Management
The treatment of choice for a pneumothorax is a chest tube, and when the small pig-tail catheter doesn’t do the job, the answer is to replace it with a larger bore – right? Not so fast. The exact mechanism of REPE is... read more
Communicating with Conscious and Mechanically Ventilated Critically Ill Patients
Ventilator-dependent patients in the ICU often experience difficulties with one of the most basic human functions, namely communication, due to intubation. Although various assistive communication tools exist, these are infrequently... read more
Prone Positioning for a Morbidly Obese Patient with ARDS
Since the description in the 1970s of external positive end-expiratory pressure for acute respiratory distress syndrome (ARDS), the optimum level of external positive end-expiratory pressure remains unresolved. In the 1990s,... read more
Lumping or Splitting in Pediatric ARDS
Improvements in acute respiratory distress syndrome (ARDS) outcomes in adults have been achieved along-side demonstration of the superiority of low-tidal volume ventilation, the relative advantage of a restrictive fluid strategy... read more
SOS Asynchronies: Do We Need Help?
Synchrony between the patient and the ventilator is defined as the appropriate interaction between the two, where the ventilator recognizes patient’s effort and provides support for breathing at the right time—that is,... read more
Oxygenate, Ventilate, Do No Harm
Emergency physicians (EPs) are experts in emergent airway management and thus must be confident managing mechanical ventilation. Hospital-wide bed shortages mean that EPs will be managing admitted patients for longer periods... read more
Positive End-Expiratory Pressure Lower Than the ARDS Network Protocol Is Associated with Higher Pediatric ARDS Mortality
Patients with PARDS managed with lower PEEP relative to FiO2 than recommended by the ARDSNet model had higher mortality. Clinical trials targeting PEEP management in PARDS are needed. This was a multicenter, retrospective... read more
Neurally adjusted ventilatory assist
Several studies nowadays prove the physiological benefits of neurally adjusted ventilatory assist, as opposed to the conventional modes of partial support. Whether these advantages translate into improvement of clinical outcomes... read more
Automated System Detects Risk of VAP
Approximately 50 percent of all patients receiving mechanical ventilator support develop ventilator-associated pneumonia (VAP). Researchers at Massachusetts General Hospital (MGH) have developed an automated system for identifying... read more
Weaning from the Ventilator and Extubation in ICU
Current research is focusing on preventing extubation failure, especially in the most challenging cases. The use of weaning protocols – written or computerized – attempts to early identify patients who are able to breathe... read more
Simplifying Mechanical Ventilation
Mechanical Ventilation is a modality commonly used in the critically ill, but many providers, may not have a strong understanding of the basics. Emergency Medicine and Critical Care Physicians need to have a firm grasp of... read more
Management of the Traumatized Airway
There is a lack of evidence-based approach regarding the best practice for airway management in patients with a traumatized airway. Airway trauma may not be readily apparent, and its evaluation requires a high level of suspicion... read more
