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7 papers 0 to 25 followers Research Papers used in aid of the in-house ICU registrar teaching programme at Royal Perth Hospital in the first half of 2016.
Duncan Young, David A Harrison, Brian H Cuthbertson, Kathy Rowan
IMPORTANCE: Tracheostomy is a widely used intervention in adult critical care units. There is little evidence to guide clinicians regarding the optimal timing for this procedure. OBJECTIVE: To test whether early vs late tracheostomy would be associated with lower mortality in adult patients requiring mechanical ventilation in critical care units. DESIGN AND SETTING: An open multicentered randomized clinical trial conducted between 2004 and 2011 involving 70 adult general and 2 cardiothoracic critical care units in 13 university and 59 nonuniversity hospitals in the United Kingdom...
May 22, 2013: JAMA: the Journal of the American Medical Association
Alexander S Niven, Kevin C Doerschug
PURPOSE OF REVIEW: Management of the difficult airway is associated with significant morbidity and mortality in critically ill patients. An increasing array of advanced airway tools are available, but appropriate selection and application in the ICU remains poorly defined. RECENT FINDINGS: Difficult airway incidence during emergent intubation is 10%, but complications of ICU airway management remain common. Training and equipment in many ICUs remain variable despite data that demonstrate that an 'intubation management bundle' and a systematic approach to teamwork and training can reduce life-threatening airway complications...
February 2013: Current Opinion in Critical Care
Arnaud W Thille, Irene Cortés-Puch, Andrés Esteban
PURPOSE OF REVIEW: The decision to extubate is a crucial moment for intubated patients. In most cases, the transition to spontaneous breathing is uneventful, but in some patients, it implies a more challenging decision. Both extubation delay and especially the need for reintubation are associated with poor outcomes. We aim to review the recent literature on weaning and to clarify the role of certain interventions intending to help in this process. RECENT FINDINGS: Cardiac dysfunction is probably one of the most common causes of weaning failure...
February 2013: Current Opinion in Critical Care
John F McConville, John P Kress
No abstract text is available yet for this article.
December 6, 2012: New England Journal of Medicine
Brenda Nazaré Gomes Silva, Régis B Andriolo, Humberto Saconato, Alvaro N Atallah, Orsine Valente
BACKGROUND: Long-term mechanical ventilation is the most common situation where tracheostomy is indicated for patients in intensive care units (ICU). 'Early' and 'late' tracheostomies are two categories of the timing of tracheostomy. The evidence on the advantages attributed to early over late tracheostomy is somewhat conflicting but includes shorter hospital stays and lower mortality rates. OBJECTIVES: To evaluate the effectiveness and safety of early (≤ 10 days after intubation) versus late tracheostomy (> 10 days after intubation) in critically ill adult patients predicted to be on prolonged mechanical ventilation and with different clinical conditions...
2012: Cochrane Database of Systematic Reviews
Donald E G Griesdale, William R Henderson, Robert S Green
In critically ill patients, endotracheal intubation is associated with a high risk of complications, including severe hypoxemia and hypotension. The purpose of this review is to discuss the definitions, complications, airway assessment, and patient optimization with respect to these patients. In addition, we present different approaches and techniques to help secure the airway in critically ill patients. We also discuss strategies to help minimize the risk of a difficult or failed airway and to mitigate the severe life-threatening complications associated with this high-risk procedure...
June 2011: Lung
J-M Boles, J Bion, A Connors, M Herridge, B Marsh, C Melot, R Pearl, H Silverman, M Stanchina, A Vieillard-Baron, T Welte
Weaning covers the entire process of liberating the patient from mechanical support and from the endotracheal tube. Many controversial questions remain concerning the best methods for conducting this process. An International Consensus Conference was held in April 2005 to provide recommendations regarding the management of this process. An 11-member international jury answered five pre-defined questions. 1) What is known about the epidemiology of weaning problems? 2) What is the pathophysiology of weaning failure? 3) What is the usual process of initial weaning from the ventilator? 4) Is there a role for different ventilator modes in more difficult weaning? 5) How should patients with prolonged weaning failure be managed? The main recommendations were as follows...
May 2007: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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