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mechanical ventilation physiology

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https://www.readbyqxmd.com/read/28296993/clinical-characteristics-and-outcomes-of-patients-with-cellulitis-requiring-intensive-care
#1
Duncan R Cranendonk, Lonneke A van Vught, Maryse A Wiewel, Olaf L Cremer, Janneke Horn, Marc J Bonten, Marcus J Schultz, Tom van der Poll, W Joost Wiersinga
Importance: Cellulitis is a commonly occurring skin and soft tissue infection and one of the most frequently seen dermatological diseases in the intensive care unit (ICU). However, clinical characteristics of patients with cellulitis requiring intensive care treatment are poorly defined. Necrotizing fasciitis is often confused for cellulitis at initial presentation and is considered to be more severe and thus has previously been described in more detail. Objective: To describe the clinical presentation and outcomes of patients with ICU-necessitating cellulitis and to compare them with patients with necrotizing fasciitis...
March 15, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28284096/prevalence-of-graduated-compression-stocking-associated-pressure-injuries-in-surgical-intensive-care-units
#2
Deborah B Hobson, Tracy Y Chang, Jonathan K Aboagye, Brandyn D Lau, Hasan M Shihab, Betsy Fisher, Samantha Young, Nancy Sujeta, Dauryne L Shaffer, Victor O Popoola, Peggy S Kraus, Gina Knorr, Norma E Farrow, Michael B Streiff, Elliott R Haut
PURPOSE: This study aimed to determine the prevalence of static graduated compression stocking (sGCS)-associated pressure injury among patients in surgical intensive care units (ICUs). METHODS: We retrospectively reviewed data from wound care rounds between April 2011 and June 2012 at 3 surgical ICUs at an urban, tertiary care hospital. Patients with sGCS-associated pressure injury were identified and descriptive analysis was performed on their demographic, perioperative, and postoperative characteristics...
February 27, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28271450/patient-important-outcomes-in-randomized-controlled-trials-in-critically-ill-patients-a-systematic-review
#3
REVIEW
Stéphane Gaudry, Jonathan Messika, Jean-Damien Ricard, Sylvie Guillo, Blandine Pasquet, Emeline Dubief, Tanissia Boukertouta, Didier Dreyfuss, Florence Tubach
BACKGROUND: Intensivists' clinical decision making pursues two main goals for patients: to decrease mortality and to improve quality of life and functional status in survivors. Patient-important outcomes are gaining wide acceptance in most fields of clinical research. We sought to systematically review how well patient-important outcomes are reported in published randomized controlled trials (RCTs) in critically ill patients. METHODS: Literature search was conducted to identify eligible trials indexed from January to December 2013...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28270863/respiratory-problems-and-management-in-people-with-spinal-cord-injury
#4
David J Berlowitz, Brooke Wadsworth, Jack Ross
Spinal cord injury (SCI) is characterised by profound respiratory compromise secondary to the level of loss of motor, sensory and autonomic control associated with the injury. This review aims to detail these anatomical and physiological changes after SCI, and outline their impact on respiratory function. Injury-related impairments in strength substantially alter pulmonary mechanics, which in turn affect respiratory management and care. Options for treatments must therefore be considered in light of these limitations...
December 2016: Breathe
https://www.readbyqxmd.com/read/28269712/heart-rate-variability-as-a-biomarker-for-sedation-depth-estimation-in-icu-patients
#5
Sunil B Nagaraj, Sowmya M Ramaswamy, Siddharth Biswal, Emily J Boyle, David W Zhou, Lauren M Mcclain, Eric S Rosenthal, Patrick L Purdon, M Brandon Westover
An automated patient-specific system to classify the level of sedation in ICU patients using heart rate variability signal is presented in this paper. ECG from 70 mechanically ventilated adult patients with administered sedatives in an ICU setting were used to develop a support vector machine based system for sedation depth monitoring using several heart rate variability measures. A leave-one-subject-out cross validation was used for classifier training and performance evaluations. The proposed patient-specific system provided a sensitivity, specificity and an AUC of 64%, 84...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28268882/noninvasive-estimation-of-alveolar-pressure
#6
Francesco Vicario, Roberto Buizza, William A Truschel, Nicolas W Chbat
This paper presents an algorithm for noninvasive estimation of alveolar pressure in mechanically ventilated patients who are spontaneously breathing. Continual monitoring of alveolar pressure is desirable to prevent ventilator-induced lung injury and to assess the intrinsic positive end-expiratory pressure (PEEPi), which is a parameter of clinical relevance in respiratory care and difficult to measure noninvasively. The algorithm is based on a physiological model of the respiratory system and, as such, it also provides insight into the respiratory mechanics of the patient under mechanical ventilation...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28258734/-validation-of-the-brazilian-version-of-behavioral-pain-scale-in-adult-sedated-and-mechanically-ventilated-patients
#7
Isabela Freire Azevedo-Santos, Iura Gonzalez Nogueira Alves, Manoel Luiz de Cerqueira Neto, Daniel Badauê-Passos, Valter Joviniano Santana-Filho, Josimari Melo de Santana
BACKGROUND AND OBJECTIVES: The Behavioral Pain Scale is a pain assessment tool for uncommunicative and sedated Intensive Care Unit patients. The lack of a Brazilian scale for pain assessment in adults mechanically ventilated justifies the relevance of this study that aimed to validate the Brazilian version of Behavioral Pain Scale as well as to correlate its scores with the records of physiological parameters, sedation level and severity of disease. METHODS: Twenty-five Intensive Care Unit adult patients were included in this study...
March 1, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28244700/the-influence-of-protein-provision-in-the-early-phase-of-intensive-care-on-clinical-outcomes-for-critically-ill-patients-on-mechanical-ventilation
#8
Joo Han Song, Ho Sun Lee, Song Yee Kim, Eun Young Kim, Jie Ye Jung, Young Ae Kang, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Kyung Soo Chung
BACKGROUND AND OBJECTIVES: Mechanically ventilated patients often face progressive and rapid losses of body mass and muscle because of hypermetabolism and increased protein catabolism. To investigate the impact of adequate nutritional provision during the early phase of intensive care unit (ICU) admission on the clinical outcomes in patients with medical illnesses receiving mechanical ventilation support. METHODS AND STUDY DESIGN: Two hundred and eleven mechanically ventilated patients admitted to a 30-bed medical ICU were included...
March 2017: Asia Pacific Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28244001/relating-clinical-and-electrophysiological-parameters-in-death-determination-in-a-laboratory-model-of-progressive-hypoxemia
#9
Eugene Park, Elaine Liu, Sam D Shemie, Andrew J Baker
BACKGROUND: Death after withdrawal of mechanical ventilation frequently follows the sequence of progressive hypoxemia and hypotension leading to cardiac arrest. Accurate timing of the determination of death is fundamental to trust in controlled donation after circulatory death (cDCD) programs and is generally based on cessation of circulation (pulselessness), brain function (apnea), and the passage of time. If death is understood to be the unresuscitatable loss of brain function, the clinical determination that death following apnea and pulselessness has occurred is largely inferential...
February 27, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28242078/awake-extracorporeal-membrane-oxygenation-as-bridge-to-lung-transplantation-a-9-year-experience
#10
Mauer Biscotti, Whitney D Gannon, Cara Agerstrand, Darryl Abrams, Joshua Sonett, Daniel Brodie, Matthew Bacchetta
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is used as a bridge to lung transplantation, but characteristics that influence its success are poorly understood. This large, single-center experience evaluated the implementation and outcomes of ECMO in this setting. METHODS: Data were collected for patients at our institution (New York-Presbyterian Hospital/Columbia University Medical Center in New York) who received ECMO as a bridge to lung transplantation from January 1, 2007 through July 10, 2016...
February 24, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28240700/factors-influencing-weaning-older-adults-from-mechanical-ventilation-an-integrative-review
#11
Karen V Stieff, Fidelindo Lim, Leon Chen
This study aim was to describe the influences that affect weaning from mechanical ventilation among older adults in the intensive care unit (ICU). Adults older than 65 years comprised only 14.5% of the US population in 2014; however, they accounted up to 45% of all ICU admissions. As this population grows, the number of ICU admissions is expected to increase. One of the most common procedures for hospitalized adults 75 years and older is mechanical ventilation. An integrative review methodology was applied to analyze and synthesize primary research reports...
April 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/28236393/special-considerations-in-the-nursing-care-of-mechanically-ventilated-children
#12
REVIEW
Karen Dryden-Palmer, Jason Macartney, Leanne Davidson, Faiza Syed, Cathy Daniels, Shaindy Alexander
Mechanical ventilation is often required to support the recovery of critically ill children. Critical care nurses must understand the unique needs of the children and design supportive care that is sensitive to their changing physiology, developmental stage, and socioemotional needs. This article describes the unique considerations in providing care for mechanically ventilated children. It addresses invasive and noninvasive ventilation and the needs of long-term ventilated children and family in critical care...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236390/optimizing-oxygenation-in-the-mechanically-ventilated-patient-nursing-practice-implications
#13
REVIEW
Glenn Barton, Brandi Vanderspank-Wright, Jacqueline Shea
Critical care nurses constitute front-line care provision for patients in the intensive care unit (ICU). Hypoxemic respiratory compromise/failure is a primary reason that patients require ICU admission and mechanical ventilation. Critical care nurses must possess advanced knowledge, skill, and judgment when caring for these patients to ensure that interventions aimed at optimizing oxygenation are both effective and safe. This article discusses fundamental aspects of respiratory physiology and clinical indices used to describe oxygenation status...
December 2016: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28236262/comparing-effects-between-music-intervention-and-aromatherapy-on-anxiety-of-patients-undergoing-mechanical-ventilation-in-the-intensive-care-unit-a-randomized-controlled-trial
#14
Chiu-Hsiang Lee, Chiung-Ling Lai, Yi-Hui Sung, Mei Yu Lai, Chung-Ying Lin, Long-Yau Lin
PURPOSE: Using patient-reported outcomes and physiological indicators to test the effects of music intervention and aromatherapy on reducing anxiety for intensive care unit (ICU) patients undergoing mechanical ventilation. METHODS: Patients with ICU admission duration >24 h were randomly assigned to a Music intervention group (n = 41), Aromatherapy group (n = 47), or Control group (rest only; n = 44). Each patient in the Music group listened to music; each patient in the Aromatherapy group received lavender essential oil massage on his/her back for 5 min; each patient in the Control group wore noise-canceling headphones...
February 24, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28227974/heart-rate-variability-as-a-biomarker-for-sedation-depth-estimation-in-icu-patients
#15
Sunil B Nagaraj, Sowmya M Ramaswamy, Siddharth Biswal, Emily J Boyle, David W Zhou, Lauren M Mcclain, Eric S Rosenthal, Patrick L Purdon, M Brandon Westover, Sunil B Nagaraj, Sowmya M Ramaswamy, Siddharth Biswal, Emily J Boyle, David W Zhou, Lauren M Mcclain, Eric S Rosenthal, Patrick L Purdon, M Brandon Westover, M Brandon Westover, Sunil B Nagaraj, Siddharth Biswal, Sowmya M Ramaswamy, Lauren M Mcclain, David W Zhou, Emily J Boyle, Patrick L Purdon, Eric S Rosenthal
An automated patient-specific system to classify the level of sedation in ICU patients using heart rate variability signal is presented in this paper. ECG from 70 mechanically ventilated adult patients with administered sedatives in an ICU setting were used to develop a support vector machine based system for sedation depth monitoring using several heart rate variability measures. A leave-one-subject-out cross validation was used for classifier training and performance evaluations. The proposed patient-specific system provided a sensitivity, specificity and an AUC of 64%, 84...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28227081/noninvasive-estimation-of-alveolar-pressure
#16
Francesco Vicario, Roberto Buizza, William A Truschel, Nicolas W Chbat, Francesco Vicario, Roberto Buizza, William A Truschel, Nicolas W Chbat, Francesco Vicario, Roberto Buizza, Nicolas W Chbat, William A Truschel
This paper presents an algorithm for noninvasive estimation of alveolar pressure in mechanically ventilated patients who are spontaneously breathing. Continual monitoring of alveolar pressure is desirable to prevent ventilator-induced lung injury and to assess the intrinsic positive end-expiratory pressure (PEEPi), which is a parameter of clinical relevance in respiratory care and difficult to measure noninvasively. The algorithm is based on a physiological model of the respiratory system and, as such, it also provides insight into the respiratory mechanics of the patient under mechanical ventilation...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28223465/assessment-of-bohr-and-enghoff-dead-space-equations-in-mechanically-ventilated-children
#17
Pierre Bourgoin, Florent Baudin, David Brossier, Guillaume Emeriaud, Marc Wysocki, Philippe Jouvet
BACKGROUND: Recent findings suggest that using alveolar PCO2 (PACO2 ) estimated by volumetric capnography in the Bohr equation instead of PaCO2 (Enghoff modification) could be appropriate for the calculation of physiological dead space to tidal volume ratio (VD/VT Bohr and VD/VT Enghoff, respectively). We aimed to describe the relationship between these 2 measurements in mechanically ventilated children and their significance in cases of ARDS. METHODS: From June 2013 to December 2013, mechanically ventilated children with various respiratory conditions were included in this study...
February 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28223396/personalising-airway-clearance-in-chronic-lung-disease
#18
REVIEW
Maggie McIlwaine, Judy Bradley, J Stuart Elborn, Fidelma Moran
This review describes a framework for providing a personalised approach to selecting the most appropriate airway clearance technique (ACT) for each patient. It is based on a synthesis of the physiological evidence that supports the modulation of ventilation and expiratory airflow as a means of assisting airway clearance. Possession of a strong understanding of the physiological basis for ACTs will enable clinicians to decide which ACT best aligns with the individual patient's pathology in diseases with anatomical bronchiectasis and mucus hypersecretion...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28197046/outcome-of-noncardiac-surgical-patients-admitted-to-a-multidisciplinary-intensive-care-unit
#19
Pradeep Kumar, M K Renuka, M S Kalaiselvan, A S Arunkumar
CONTEXT: Surgical procedures carry significant morbidity and mortality depending on the type of surgery and patients. There is a dearth of evidence from India on the outcome of surgical patients admitted to an Intensive Care Unit (ICU). AIMS: We aimed to describe the incidence and risk factors of postoperative complications and mortality in noncardiac surgical patients admitted to the ICU. SETTINGS AND DESIGN: This was a prospective observational study on all perioperative patients admitted to a multidisciplinary ICU for 18 months...
January 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28192243/the-influence-of-mechanical-ventilation-on-physiological-parameters-in-ball-pythons-python-regius
#20
Sashia L Jakobsen, Catherine J A Williams, Tobias Wang, Mads F Bertelsen
Mechanical ventilation is widely recommended for reptiles during anesthesia, and while it is well-known that their low ectothermic metabolism requires much lower ventilation than in mammals, very little is known about the influence of ventilation protocol on the recovery from anesthesia. Here, 15 ball pythons (Python regius) were induced and maintained with isoflurane for 60min at one of three ventilation protocols (30, 125, or 250mlmin(-1)kg(-1) body mass) while an arterial catheter was inserted, and ventilation was then continued on 100% oxygen at the specified rate until voluntary extubation...
February 10, 2017: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
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