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Mechanical ventilation

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4 papers 0 to 25 followers
By MD Aware Emergency Medicine
https://www.readbyqxmd.com/read/27818334/neuromuscular-blockade-in-the-21-st-century-management-of-the-critically-ill-patient
#1
REVIEW
Julian deBacker, Nicholas Hart, Eddy Fan
Neuromuscular blockings agents (NMBAs) have a controversial role in the ventilatory and medical management of critical illness. The clinical concern surrounding NMBA-induced complications stems from evidence presented in the 2002 clinical practice guidelines, but new evidence from subsequent randomized trials and studies provides a more optimistic outlook about the application of NMBAs in the intensive care unit (ICU). Furthermore, changes in the delivery of critical care such as protocolized care pathways, minimizing or interrupting sedation, increased monitoring techniques, and overall improvements in reducing immobility have created a modern, 21st century ICU environment whereby NMBAs may be administered safely...
November 3, 2016: Chest
https://www.readbyqxmd.com/read/26045965/mechanical-ventilation-of-acute-respiratory-distress-syndrome
#2
REVIEW
Ryoichi Ochiai
Acute respiratory distress syndrome (ARDS) has been intensively and continuously studied in various settings, but its mortality is still as high as 30-40 %. For the last 20 years, lung protective strategy has become a standard care for ARDS, but we still do not know the best way to ventilate patients with ARDS. Tidal volume itself does not seem to have an important role to develop ventilator-induced lung injury (VILI), but the driving pressure, which is inspiratory plateau pressure-PEEP, is the most important to predict and affect the outcome of ARDS, though there is no safe limit for the driving pressure...
2015: Journal of Intensive Care
https://www.readbyqxmd.com/read/24645944/late-outcomes-of-a-randomized-trial-of-high-frequency-oscillation-in-neonates
#3
RANDOMIZED CONTROLLED TRIAL
Sanja Zivanovic, Janet Peacock, Mireia Alcazar-Paris, Jessica W Lo, Alan Lunt, Neil Marlow, Sandy Calvert, Anne Greenough
BACKGROUND: Results from an observational study involving neonates suggested that high-frequency oscillatory ventilation (HFOV), as compared with conventional ventilation, was associated with superior small-airway function at follow-up. Data from randomized trials are needed to confirm this finding. METHODS: We studied 319 adolescents who had been born before 29 weeks of gestation and had been enrolled in a multicenter, randomized trial that compared HFOV with conventional ventilation immediately after birth...
March 20, 2014: New England Journal of Medicine
https://www.readbyqxmd.com/read/23753238/evaluation-of-a-new-index-of-mechanical-ventilation-weaning-the-timed-inspiratory-effort
#4
COMPARATIVE STUDY
Leonardo Cordeiro de Souza, Fernando Silva Guimar√£es, Jocemir Ronaldo Lugon
PURPOSE: The performance of most indices used to predict ventilator weaning outcomes remains below expectation. The purpose of this study was to evaluate a new weaning index, the timed inspiratory effort (TIE) index, which is based on the maximal inspiratory pressure and the occlusion time required to reach it. METHODS: This observational prospective study included patients undergoing mechanical ventilation. Patients ready to be weaned had their TIE index and 6 previously reported indices recorded...
January 2015: Journal of Intensive Care Medicine
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