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Weaning ventilation

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https://www.readbyqxmd.com/read/29465631/near-infrared-cerebral-oximetry-to-predict-outcome-after-pediatric-cardiac-surgery-a-prospective-observational-study
#1
Marine Flechet, Fabian Güiza, Dirk Vlasselaers, Lars Desmet, Stoffel Lamote, Heidi Delrue, Marc Beckers, Michaël P Casaer, Pieter Wouters, Greet van den Berghe, Geert Meyfroidt
OBJECTIVES: To assess whether near-infrared cerebral tissue oxygen saturation, measured with the FORESIGHT cerebral oximeter (CAS Medical Systems, Branford, CT) predicts PICU length of stay, duration of invasive mechanical ventilation, and mortality in critically ill children after pediatric cardiac surgery. DESIGN: Single-center prospective, observational study. SETTING: Twelve-bed PICU of a tertiary academic hospital. PATIENTS: Critically ill children and infants with congenital heart disease, younger than 12 years old, admitted to the PICU between October 2012 and November 2015...
February 19, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29461885/physiologic-basis-of-mechanical-ventilation
#2
Martin J Tobin
The primary purpose of mechanical ventilation is to decrease work of breathing. Achieving this goal requires that cycling of the ventilator be carefully aligned with the intrinsic rhythm of a patient's respiratory center output. Problems arise at the point of ventilator triggering, post-trigger inflation, and inspiration-expiration switchover. Careful, iterative adjustments of ventilator settings are required to minimize work of breathing. Use of protocols for the selection of ventilator settings can lead to complications (including alveolar overdistention) and risk of death...
February 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29458319/proportional-assist-ventilation-versus-pressure-support-ventilation-in-weaning-ventilation-a-pilot-randomised-controlled-trial
#3
John Botha, Cameron Green, Ian Carney, Kavi Haji, Sachin Gupta, Ravindranath Tiruvoipati
OBJECTIVE: Proportional assist ventilation with load-adjustable gain factors (PAV+) is a mode of ventilation that provides assistance in proportion to patient effort. This may have physiological and clinical advantages when compared with pressure support ventilation (PSV). Our objective was to compare these two modes in patients being weaned from mechanical ventilation. DESIGN: Prospective randomised controlled trial comparing PSV with PAV+. SETTING: University-affiliated, tertiary referral intensive care unit (ICU)...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29445530/update-non-invasive-ventilation-in-chronic-obstructive-pulmonary-disease
#4
REVIEW
Neeraj Mukesh Shah, Rebecca Francesca D'Cruz, Patrick B Murphy
Chronic obstructive pulmonary disease (COPD) remains a common cause of morbidity and mortality worldwide. Patients with COPD and respiratory failure, whether acute or chronic have a poorer prognosis than patients without respiratory failure. Non-invasive ventilation (NIV) has been shown to be a useful tool in both the acute hospital and chronic home care setting. NIV has been well established as the gold standard therapy for acute decompensated respiratory failure complicating an acute exacerbation of COPD with reduced mortality and intubation rates compared to standard therapy...
January 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29438246/impact-of-weaning-from-mechanical-ventilation-the-importance-of-pleural-effusions-and-their-effect-on-pulmonary-vascular-resistance
#5
Eric Jacobsohn, Hilary P Grocott
No abstract text is available yet for this article.
March 2018: Anesthesiology
https://www.readbyqxmd.com/read/29435329/use-of-diaphragm-thickening-fraction-combined-with-rapid-shallow-breathing-index-for-predicting-success-of-weaning-from-mechanical-ventilator-in-medical-patients
#6
Pattarin Pirompanich, Sasithon Romsaiyut
Background: Weaning failure is a crucial hindrance in critically ill patients. Rapid shallow breathing index (RSBI), a well-known weaning index, has some limitations in predicting weaning outcomes. A new weaning index using point-of-care ultrasound with diaphragmic thickening fraction (DTF) has potential benefits for improving weaning success. The aim of this study was to evaluate the efficacy of a combination of DTF and RSBI for predicting successful weaning compared to RSBI alone. Methods: This prospective study enrolled patients from the medical intensive care unit or ward who were using mechanical ventilation and readied for weaning...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29432138/characteristics-of-subjects-who-failed-a-120-minute-spontaneous-breathing-trial
#7
Guopeng Liang, Tingting Liu, Yihua Zeng, Yunfeng Shi, Wei Yang, Yunqin Yang, Yan Kang
BACKGROUND: The objective of this work was to identify the unique characteristics of patients who experienced success in a 30-min spontaneous breathing trial (SBT) but failed at 120 min. METHODS: Patients who had received mechanical ventilation for >24 h were eligible for inclusion in this study. The SBT was performed by 7 cm H 2 O of pressure support with zero PEEP. After a successful 120-min SBT, weaning from mechanical ventilation was performed. Data were collected at 30 and 120 min or at the failure of the SBT...
February 6, 2018: Respiratory Care
https://www.readbyqxmd.com/read/29430408/using-bronchoscopy-to-detect-acquired-tracheoesophageal-fistula-in-mechanically-ventilated-patients
#8
Michael S Green, Johann J Mathew, Lia J Michos, Parmis Green, Mansoor M Aman
Introduction: An acquired Tracheoesophageal fistula (TEF) is commonly caused by a malignancy or trauma, with pulmonary infection or aspiration being the presenting symptom. However, in the critical care setting the presentation can be subtle and may present with difficult ventilation. High endotracheal tube cuff pressures can lead to tracheal erosions and thus increasing the chances for developing a TEF. Prolonged intubation in the presence of other risk factors like poor general state of health, episodic hypotension, nasogastric tubes, and repeated intubations can increase the likelihood of developing an acquired TEF...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29428925/adjuvant-therapy-yiqiditantongfu-decoction-with-external-diaphragm-pacer-for-chronic-obstructive-pulmonary-disease-patients-with-difficulty-weaning-from-mechanical-ventilation
#9
Cong He, Shan Ren, Quansheng Du, Yong Wang, Hui Liu, Heling Zhao, Limin Shen, Ling Long, Xianlei Wang
Context • Global morbidity from chronic obstructive pulmonary disease (COPD) is high worldwide. Diaphragm pacing (DP) can maintain the natural, negative pressure breathing of COPD patients with diaphragmatic muscle dysfunction. The YiqiDitanTongfu (YDTF) decoction has been used clinically with COPD patients to help them to wean from mechanical ventilation, with their ventilation functions being improved and the success rate of weaning being largely increased. Objective • The study intended to investigate the combined therapeutic effects of external DP and the YDTF decoction for COPD patients who have had difficulty weaning from mechanical ventilation...
February 10, 2018: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29426584/non-invasive-ventilation-in-children-and-adults-in-low-and-low-middle-income-countries-a-systematic-review-and-meta-analysis
#10
Keren Mandelzweig, Aleksandra Leligdowicz, Srinivas Murthy, Rejani Lalitha, Robert A Fowler, Neill K J Adhikari
PURPOSE: We systematically reviewed the effects of NIV for acute respiratory failure (ARF) in low- and low-middle income countries. MATERIALS AND METHODS: We searched MEDLINE, CENTRAL, and EMBASE (to January 2016) for observational studies and trials of NIV for ARF or in the peri-extubation period in adults and post-neonatal children. We abstracted outcomes data and assessed quality. Meta-analyses used random-effect models. RESULTS: Fifty-four studies (ten pediatric/n=1099; 44 adult/n=2904), mostly South Asian, were included...
January 12, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29424188/revolving-door-respiratory-patients-a-rehabilitative-perspective
#11
Massimiliano Polastri, Lara Pisani, Andrea Dell'Amore, Stefano Nava
Rehabilitation is an integral component of care for patients affected by either acute or chronic pulmonary diseases. The key elements of rehabilitation treatment for critical respiratory patients are as follows: weaning from mechanical ventilation, respiratory therapy, physical reconditioning, and occupational therapy. It should be noted that patients affected by pulmonary diseases are prone to hospital re-admission due to frequent exacerbations, especially in cases with more severe stages of chronic obstructive pulmonary disease...
September 22, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/29413508/weaning-failure-and-respiratory-muscle-function-what-has-been-done-and-what-can-be-improved
#12
REVIEW
Paulo A F Magalhães, Carlos A Camillo, Daniel Langer, Lívia B Andrade, Maria do Carmo M B Duarte, Rik Gosselink
INTRODUCTION: Respiratory muscle dysfunction, being a common cause of weaning failure, is strongly associated with prolonged mechanical ventilation (MV) and prolonged stay in intensive care units. Inspiratory muscle training (IMT) has been described as an important contributor to the treatment of respiratory muscle dysfunction in critically ill patients. Its effectiveness is however yet controversial. OBJECTIVE: To discuss evidence for assessment of readiness and the effectiveness of interventions for liberation from MV, with special attention to the role of IMT...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29409085/-point-of-care-sonography-in-emergency-and-intensive-care-medicine
#13
Caroline Busche, Hans-Jörg Busch, Guido Michels
The use of Point-of-care ultrasonography (POC Ultrasonography) is getting more and more important in the bedside care of patients, especially in emergency- and intensive care units. In addition to the focused sonography of the heart, lungs and abdomen, the POC Ultrasonography recently includes also cases in prehospital care. Increasingly special applications in intensive care, e.g. the assessment of weaning from mechanical ventilation or evaluation of the hemodynamics of a patient by means of sonographic control, gain meaning...
February 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29406380/progressive-diaphragm-atrophy-in-pediatric-acute-respiratory-failure
#14
Christie L Glau, Thomas W Conlon, Adam S Himebauch, Nadir Yehya, Scott L Weiss, Robert A Berg, Akira Nishisaki
OBJECTIVES: Diaphragm atrophy is associated with delayed weaning from mechanical ventilation and increased mortality in critically ill adults. We sought to test for the presence of diaphragm atrophy in children with acute respiratory failure. DESIGN: Prospective, observational study. SETTING: Single-center tertiary noncardiac PICU in a children's hospital. PATIENTS: Invasively ventilated children with acute respiratory failure...
February 5, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29404723/physiological-predictors-of-respiratory-and-cough-assistance-needs-after-extubation
#15
Nicolas Terzi, Frédéric Lofaso, Romain Masson, Pascal Beuret, Hervé Normand, Edith Dumanowski, Line Falaize, Bertrand Sauneuf, Cédric Daubin, Jennifer Brunet, Djillali Annane, Jean-Jacques Parienti, David Orlikowski
BACKGROUND: Identifying patients at high risk of post-extubation acute respiratory failure requiring respiratory or mechanical cough assistance remains challenging. Here, our primary aim was to evaluate the accuracy of easily collected parameters obtained before or just after extubation in predicting the risk of post-extubation acute respiratory failure requiring, at best, noninvasive mechanical ventilation (NIV) and/or mechanical cough assistance and, at worst, reintubation after extubation...
February 5, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29398169/efficacy-of-respiratory-muscle-training-in-weaning-of-mechanical-ventilation-in-patients-with-mechanical-ventilation-for-48hours-or-more-a-randomized-controlled-clinical-trial
#16
L M Sandoval Moreno, I C Casas Quiroga, E C Wilches Luna, A F García
OBJECTIVE: To evaluate the efficacy of respiratory muscular training in the weaning of mechanical ventilation and respiratory muscle strength in patients on mechanical ventilation of 48hours or more. DESIGN: Randomized controlled trial of parallel groups, double-blind. Ambit: Intensive Care Unit of a IV level clinic in the city of Cali. PATIENTS: 126 patients in mechanical ventilation for 48hours or more. INTERVENTIONS: The experimental group received daily a respiratory muscle training program with treshold, adjusted to 50% of maximal inspiratory pressure, additional to standard care, conventional received standard care of respiratory physiotherapy...
February 2, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29395561/-tracheostomy-performed-in-icu-professional-practice-assessment-and-patient-outcome
#17
L Martinez, J Demanet, V Mignaux, F Dewavrin
INTRODUCTION: Tracheostomy is a commonly performed procedure. The aim of this study was to assess professional practice, describe patient characteristics and examine short and long-term outcomes. METHODS: All patients with CCAM GEPA004 code were retrospectively included. RESULTS: Two hundred and fourteen (7%) patients who were mecanically ventilated had a tracheostomy performed in intensive care unit (ICU). Median time to tracheostomy was 22 (14-28) days...
January 29, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29380491/extracorporeal-photopheresis-as-second-line-treatment-therapy-in-life-threatening-primary-graft-dysfunction-following-lung-transplantation
#18
Cécile A Robinson, Ilhan Inci, Mirjam Naegeli, Christian Murer, Macé M Schuurmans, Mirjana Urosevic-Maiwald, Reto Schüpbach, Walter Weder, Christian Benden
ECP is an established "second-line" treatment for CLAD/BOS. Recently, ECP was used for the first time in an adolescent CF patient as a "second-line" treatment therapy in life-threatening primary graft dysfunction following lung transplantation who deteriorated despite extensive treatment including ECMO and ATG. Within 10 days after initiation of ECP twice weekly, allograft function and clinical status improved significantly and the patient was weaned from mechanical ventilation support. ECP has been continued every 2 weeks since...
January 29, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29380080/reliability-of-respiratory-pressure-measurements-in-ventilated-and-non-ventilated-patients-in-icu-an-observational-study
#19
Clément Medrinal, Guillaume Prieur, Yann Combret, Aurora Robledo Quesada, Tristan Bonnevie, Francis Edouard Gravier, Eric Frenoy, Olivier Contal, Bouchra Lamia
BACKGROUND: Assessment of maximum respiratory pressures is a common practice in intensive care because it can predict the success of weaning from ventilation. However, the reliability of measurements through an intubation catheter has not been compared with standard measurements. The aim of this study was to compare maximum respiratory pressures measured through an intubation catheter with the same measurements using a standard mouthpiece in extubated patients. METHODS: A prospective observational study was carried out in adults who had been under ventilation for at least 24 h and for whom extubation was planned...
January 30, 2018: Annals of Intensive Care
https://www.readbyqxmd.com/read/29373223/factors-associated-with-pulmonary-dysfunction-in-patients-undergoing-coronary-artery-bypass-graft-surgery-with-use-of-intra-aortic-balloon-pump
#20
Helena Amaral Gonçalves Fusatto, Luciana Castilho de Figueiredo, Ana Paula Ragonete Dos Anjos Agostini, Melissa Sibinelli, Desanka Dragosavac
OBJECTIVE: The aim of this study was to identify pulmonary dysfunction and factors associated with prolonged mechanical ventilation, hospital stay, weaning failure and mortality in patients undergoing coronary artery bypass grafting with use of intra-aortic balloon pump (IABP). METHODS: This observational study analyzed respiratory, surgical, clinical and demographic variables and related them to outcomes. RESULTS: We analyzed 39 patients with a mean age of 61...
January 16, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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