7,274 results match your criteria Ventilator Management


Clinical Analysis and Management of Long-Stay Patients.

Authors:
Chienhsiu Huang

Int J Gen Med 2021 4;14:2351-2357. Epub 2021 Jun 4.

Department of Internal Medicine, Division of Chest Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.

Background: Worldwide, a certain proportion of patients stay for long periods. Reduction of length of stay is a critical intervention to optimize in-hospital resource utilization. Length of stay itself is a reliable quality index for healthcare systems. Read More

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[Research progress of extracellular vesicle microRNA in acute lung injury].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 May;33(5):633-637

Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical University, Zunyi 563000, Guizhou, China. Corresponding author: Chen Miao, Email:

Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are characterized by the destruction of the barrier function of alveolar epithelial cells and capillary endothelial cells and the recruitment of inflammatory cells, which leads to alveolar and interstitial edema, hyaline membrane formation and inflammatory infiltration of the lungs, etc. The mechanism is not completely defined. The current treatment plan focuses on comprehensive treatments such as ventilator support treatment, fluid management, and nutritional support, but the prognosis is still poor. Read More

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The Optimising Cardiac Surgery ouTcOmes in People with diabeteS (OCTOPuS) randomised controlled trial to evaluate an outpatient pre-cardiac surgery diabetes management intervention: a study protocol.

BMJ Open 2021 Jun 9;11(6):e050919. Epub 2021 Jun 9.

Wessex Institute, University of Southampton, Southampton, Hampshire, UK.

Introduction: Cardiothoracic surgical outcomes are poorer in people with diabetes compared with those without diabetes. There are two important uncertainties in the management of people with diabetes undergoing major surgery: (1) how to improve diabetes management in the weeks leading up to an elective procedure and (2) whether that improved management leads to better postoperative outcomes. We previously demonstrated the feasibility of delivering the Optimising Cardiac Surgery ouTcOmes in People with diabeteS (OCTOPuS) intervention, an outpatient intervention delivered by diabetes healthcare professionals for people with suboptimally managed diabetes over 8-12 weeks before elective cardiac surgery. Read More

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US Ventilator Allocation and Patient Triage Policies in Anticipation of the COVID-19 Surge.

Health Secur 2021 Jun 9. Epub 2021 Jun 9.

Julia S. C. Chelen, PhD, is a Research Associate; Amanda N. Perry, CCRP is a Research Project Specialist; Maia L. Crawford, MS, is Research Project Manager; and Amber E. Barnato, MD, MPH, MS, FACPM, is a Professor and Director, Health Policy & Clinical Practice; all at The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH. Amber E. Barnato is also Professor of Medicine, Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH. Douglas B. White, MD, MAS, is Vice Chair and Professor of Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Stephanie Zaza, MD, MPH, is President, Board of Regents, American College of Preventive Medicine, Washington, DC. Deborah S. Feifer is a Presidential Scholar, Dartmouth College, Hanover, NH. The findings and conclusions in this article are those of the authors and do not necessarily reflect the views of the Agency for Healthcare Research and Quality or other sources of support.

Before the predicted March 2020 surge of COVID-19, US healthcare organizations were charged with developing resource allocation policies. We assessed policy preparedness and substantive triage criteria within existing policies using a cross-sectional survey distributed to public health personnel and healthcare providers between March 23 and April 23, 2020. Personnel and providers from 68 organizations from 34 US states responded. Read More

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Lung ultrasound score as a tool to monitor disease progression and detect ventilator-associated pneumonia during COVID-19-associated ARDS.

Heart Lung 2021 May 31;50(5):700-705. Epub 2021 May 31.

Hospices Civils de Lyon, Hôpital Edouard Herriot, Service de Médecine Intensive-Réanimation, F-69437, Lyon, France; Université de Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon-Est, F-69373, Lyon, France.

Background: Lung ultrasound can accurately detect pandemic coronavirus disease (COVID-19) pulmonary lesions. A lung ultrasound score (LUS) was developed to improve reproducibility of the technique.

Objectives: To evaluate the clinical value of LUS monitoring to guide COVID-19-associated acute respiratory distress syndrome (ARDS) management. Read More

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Nonventilator hospital-acquired pneumonia: A call to action.

Infect Control Hosp Epidemiol 2021 Jun 9:1-6. Epub 2021 Jun 9.

Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston.

In 2020 a group of U.S. healthcare leaders formed the National Organization to Prevent Hospital-Acquired Pneumonia (NOHAP) to issue a call to action to address non-ventilator-associated hospital-acquired pneumonia (NVHAP). Read More

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Umbilical cord mesenchymal stromal cells as critical COVID-19 adjuvant therapy: A randomized controlled trial.

Stem Cells Transl Med 2021 Jun 8. Epub 2021 Jun 8.

Stem Cell Medical Technology Integrated Service Unit, Cipto Mangunkusumo Central Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.

One of the main causes of acute respiratory distress syndrome in coronavirus disease 2019 (COVID-19) is cytokine storm, although the exact cause is still unknown. Umbilical cord mesenchymal stromal cells (UC-MSCs) influence proinflammatory T-helper 2 (Th ) cells to shift to an anti-inflammatory agent. To investigate efficacy of UC-MSC administration as adjuvant therapy in critically ill patients with COVID-19, we conducted a double-blind, multicentered, randomized controlled trial at four COVID-19 referral hospitals in Jakarta, Indonesia. Read More

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Use of Intravenous Vitamin C in Critically Ill Patients With COVID-19 Infection.

J Pharm Pract 2021 Jun 8:8971900211015052. Epub 2021 Jun 8.

New York City Health + Hospitals/Queens, Jamaica, NY, USA.

Introduction: The pathophysiology for Coronavirus Disease 2019 (COVID-19) infection is characterized by cytokine oxidative stress and endothelial dysfunction. Intravenous (IV) vitamin C has been utilized as adjuvant therapy in critically ill patients with sepsis for its protective effects against reactive oxygen species and immunomodulatory effects. The primary objective of this study was to evaluate the effects of IV vitamin C in critically ill patients with COVID-19 infection. Read More

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Variation in Early Management Practices in Moderate-to-Severe Acute Respiratory Distress Syndrome in the United States.

Chest 2021 Jun 2. Epub 2021 Jun 2.

Temple University Hospital, Philadelphia, PA.

Background: While specific interventions have previously demonstrated benefit in patients with the Acute Respiratory Distress Syndrome (ARDS), use of these interventions is inconsistent, and patient mortality remains high. The impact of variability in center management practices on ARDS mortality rates remains unknown.

Research Question: What is the impact of treatment variability on mortality in patients with moderate-to-severe ARDS in the United States (US)?

Study Design And Methods: We conducted a multicenter, observational cohort study of mechanically ventilated adults with ARDS and PaO/FiO< 150 on positive end expiratory pressure (PEEP) > 5 cm HO, who were admitted to 29 US centers between October 1, 2016 and April 30, 2017. Read More

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Non-invasive Oxygenation Strategies for Respiratory Failure with COVID-19: A concise narrative review of literature in pre and mid-COVID-19 era.

Anaesth Crit Care Pain Med 2021 Jun 1:100897. Epub 2021 Jun 1.

Intensive Care Unit, Jikei University Hospital, Tokyo, Japan. Electronic address:

The coronavirus disease 2019 (COVID-19) has spread globally and can cause a shortage of medical resources, in particular, mechanical ventilators. High-flow nasal cannula oxygen therapy (HFNC) and non-invasive positive pressure ventilation (NPPV) are frequently used for acute respiratory failure patients as alternatives to invasive mechanical ventilation. They are drawing attention because of a potential role to save mechanical ventilators. Read More

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Training needs assessment of intensive care nurses in Zabol University of Medical Sciences' Hospitals.

J Educ Health Promot 2021 31;10:85. Epub 2021 Mar 31.

Health Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Background: The improvement of the knowledge, skill, and attitude of nurses working at the intensive care unit (ICU) through implementing training need assessment and holding continuous in-service training courses are of main requisites for providing better health services to the community. Based on this, in the present work, we are looking for the identification and prioritization of the training need of intensive care nurses in the Zabol University of Medical Sciences' hospitals.

Materials And Methods: As a cross-sectional, descriptive study, including two phases of identification and prioritization of training needs of ICU nurses, it was conducted by a close-ended researcher-made questionnaire for collecting the data on training needs from the viewpoint nursing officials, supervisors, and head nurses of the ICU wards in the first phase and a multiple-choice scientific test plus a checklist for measuring the knowledge and skill of the nurses in the ICU in the second phase. Read More

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A simple method to provide positive end expiratory pressure to treat hypoxaemia in an anaesthetised Asian Elephant (Elephas maximus).

J S Afr Vet Assoc 2021 May 19;92(0):e1-e4. Epub 2021 May 19.

UVet Animal Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee.

Hypoxaemia is a common complication in anaesthetised or immobilised elephants. It is presumably because of hypoventilation and ventilation-perfusion mismatch. To prevent hypoxaemia, orotracheal intubation and positive pressure ventilation are recommended. Read More

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Cardio-Pulmonary-Renal Consequences of Severe COVID-19.

Cardiorenal Med 2021 Jun 3:1-7. Epub 2021 Jun 3.

Department of Cardiology, Unit Heart Failure, Heart Transplantation & Mechanical Circulatory Support, Thorax Center, Rotterdam, The Netherlands.

Severe acute respiratory syndrome coronavirus 2 has rapidly spread worldwide and resulted in the coronavirus disease 2019 (COVID-19) pandemic. The disease raised an unprecedented demand for intensive care support due to severe pulmonary dysfunction and multiorgan failure. Although the pulmonary system is the potential target of the COVID-19, recent reports have demonstrated that COVID-19 profoundly influences the cardiovascular system and the kidneys. Read More

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Ceftolozane/Tazobactam for Resistant Drugs Respiratory Infections: A Systematic Literature Review of the Real-World Evidence.

Life (Basel) 2021 May 24;11(6). Epub 2021 May 24.

Department of Women, Child, General and Specialistic Surgery, University of Campania "L. Vanvitelli", 80138 Naples, Italy.

Background: Ceftolozane/tazobactam (C/T) is a β-lactam/β-lactamase inhibitor combination that mainly targets Gram-negative bacteria. The current international guidelines recommend including C/T treatment in the empirical therapy for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP). (PA) is one of the most challenging Gram-negative bacteria. Read More

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Changes in Plasma Soluble Receptor for Advanced Glycation End-Products Are Associated with Survival in Patients with Acute Respiratory Distress Syndrome.

J Clin Med 2021 May 12;10(10). Epub 2021 May 12.

Department of Anaesthesia and Critical Care, DREAM, Sorbonne Université, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 75013 Paris, France.

The plasma soluble receptor for advanced glycation end-products (sRAGE) is a marker of lung epithelial injury with prognostic value when measured at baseline in acute respiratory distress syndrome (ARDS). However, whether changes in plasma sRAGE could inform prognosis in ARDS remains unknown. In this secondary analysis of the Lung Imaging for Ventilator Setting in ARDS (LIVE) multicenter randomized controlled trial, which evaluated a personalized ventilation strategy tailored to lung morphology, plasma sRAGE was measured upon study entry (baseline) and on days one, two, three, four and six. Read More

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Neonates with Maternal Colonization of Carbapenemase-Producing, Carbapenem-Resistant Enterobacteriaceae: A Mini-Review and a Suggested Guide for Preventing Neonatal Infection.

Children (Basel) 2021 May 15;8(5). Epub 2021 May 15.

Department of Newborn and Developmental Paediatrics, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada.

Carbapenemase-producing, carbapenem-resistant Enterobacteriaceae (CP-CRE) are highly drug-resistant Gram-negative bacteria. They include New Delhi metallo-ß-lactamase (NDM)-producing carbapenemase (50.4% of all species in Ontario). Read More

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The Considerations and Controversies in Using High-Flow Nasal Oxygen with Self-Prone Positioning in SARS-CoV-2 COVID-19 Disease.

Case Rep Crit Care 2021 24;2021:5541298. Epub 2021 May 24.

Intensive Care Unit, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU, UK.

Evidence exists for the use of high-flow nasal oxygen (HFNO) in the general critical care population for acute hypoxemic respiratory failure. There is discord between guidelines for hypoxemia management in COVID-19. Both noninvasive management and intubation present risk to patients and staff and potentially overwhelm hospital mechanical ventilator capacity. Read More

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[Design and application of Checklist for quality control in intensive care unit].

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2021 Apr;33(4):466-471

Department of Intensive Care Unit, the First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui, China.

Objective: To design a Checklist for quality control in intensive care unit and observe the effect of clinical application.

Methods: By consulting guidelines and literature, such as Critical care medicine professional medical quality control index (2015 edition), the quality control Checklist of intensive care unit was designed. It included four parts: quality control data collection, medical record quality verification, special diagnosis and treatment, and hospital infection prevention and control supervision. Read More

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Normal saline and lung recruitment with paediatric endotracheal suction (NARES): A pilot, factorial, randomised controlled trial.

Aust Crit Care 2021 May 26. Epub 2021 May 26.

Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Queensland, Australia; Intensive Care Unit, Princess Alexandra Hospital, Queensland, Australia.

Background/objective: Endotracheal suction is one of the most common and harmful procuedres performed on mechanically ventilated children. The aim of the study was to establish the feasibility of a randomised controlled trial (RCT) examining the effectiveness of normal saline instillation (NSI) and a positive end-expiratory pressure recruitment manoeuvre (RM) with endotracheal suction in the paediatric intensive care unit.

Methods: Pilot 2 × 2 factorial RCT. Read More

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Patient Monitoring Alarms in an Intensive Care Unit: Observational Study With Do-It-Yourself Instructions.

J Med Internet Res 2021 05 28;23(5):e26494. Epub 2021 May 28.

Department of Anesthesiology and Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

Background: As one of the most essential technical components of the intensive care unit (ICU), continuous monitoring of patients' vital parameters has significantly improved patient safety by alerting staff through an alarm when a parameter deviates from the normal range. However, the vast number of alarms regularly overwhelms staff and may induce alarm fatigue, a condition recently exacerbated by COVID-19 and potentially endangering patients.

Objective: This study focused on providing a complete and repeatable analysis of the alarm data of an ICU's patient monitoring system. Read More

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Patient-ventilator asynchrony in Saudi Arabia: Where we stand?

World J Crit Care Med 2021 May 9;10(3):58-60. Epub 2021 May 9.

UCL Respiratory, University College London, London WC1E 6BT, United Kingdom.

Patient-ventilator asynchrony in Saudi Arabia practices is common, and more emphasis on how to mitigate such a clinical problem is needed. This letter is intended to shed the light on the current national evidence of patient-ventilator asynchrony and how to step ahead for better patients' ventilation management. Read More

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Determinants of in-hospital mortality in COVID-19; a prospective cohort study from Pakistan.

PLoS One 2021 27;16(5):e0251754. Epub 2021 May 27.

Infectious Disease Department, The Indus Hospital, Karachi, Pakistan.

A prospective cohort study was conducted at the Indus Hospital Karachi, Pakistan between March and June 2020 to estimate the in-hospital mortality among hospitalized COVID-19 patients and its determinants. A total of 170 adult patients were enrolled and all-cause mortality was found to be 39% (67/170). Most non-survivors were above 60 years of age (64%) while gender distribution was quite similar in both groups (males: 77% vs 78%). Read More

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[Intraoperative Ventilation in Adults].

Anasthesiol Intensivmed Notfallmed Schmerzther 2021 May 26;56(5):318-328. Epub 2021 May 26.

Avoiding postoperative pulmonary complications (PPC) is an important goal for anesthesiologists during general anesthesia, and ventilation strategies may play a role. It seems reasonable to apply knowledge from lessons we learned from ventilation of intensive care unit patients aiming at avoiding ventilator associated lung injury. Ventilation associated lung injuries occur frequently and are associated with substantial morbidity and mortality. Read More

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Effect of open versus closed endotracheal suctioning on intracranial pressure in severe brain-injured children: Study protocol for a randomized controlled trial.

Nurs Open 2021 May 26. Epub 2021 May 26.

SICU, Children's Hospital of Nanjing Medical University, Nanjing City, China.

Aim: To compare the effects and safety of open and closed endotracheal suction in children with severe brain injury.

Design: A single-blinding, single-centre randomized controlled trial (RCT).

Methods: The children with severe brain injury admitted to the intensive care unit (ICU) from 1 September 2020-31 August 2022 will be included. Read More

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Treatment of Bronchopleural and Alveolopleural Fistulas in Acute Respiratory Distress Syndrome With Extracorporeal Membrane Oxygenation, a Case Series and Literature Review.

Crit Care Explor 2021 May 14;3(5):e0393. Epub 2021 May 14.

Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego, La Jolla, CA.

Objectives: To describe a ventilator and extracorporeal membrane oxygenation management strategy for patients with acute respiratory distress syndrome complicated by bronchopleural and alveolopleural fistula with air leaks.

Design Setting And Participants: Case series from 2019 to 2020. Single tertiary referral center-University of California, San Diego. Read More

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Mechanical ventilation in neurocritical care setting: A clinical approach.

Best Pract Res Clin Anaesthesiol 2021 Jul 18;35(2):207-220. Epub 2020 Sep 18.

Anesthesia and Intensive Care, San Martino Policlinico Hospital, IRCCS for Oncology and Neuroscience, Genoa, Italy. Electronic address:

Neuropatients often require invasive mechanical ventilation (MV). Ideal ventilator settings and respiratory targets in neuro patients are unclear. Current knowledge suggests maintaining protective tidal volumes of 6-8 ml/kg of predicted body weight in neuropatients. Read More

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Venous Thromboembolism in a Single Korean Trauma Center: Incidence, Risk Factors, and Assessing the Validity of VTE Diagnostic Tools.

Yonsei Med J 2021 Jun;62(6):520-527

Department of Trauma Surgery, Ajou University School of Medicine, Suwon, Korea.

Purpose: Trauma increases the risk of venous thromboembolism (VTE) in hospitalized patients. However, the risk and incidence of VTE in Korean trauma patients are limited. Therefore, we aimed to evaluate the incidence and identify potential predictors of VTE occurrence in Korean trauma patients. Read More

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Synopsis of Clinical Acute Respiratory Distress Syndrome (ARDS).

Adv Exp Med Biol 2021 ;1304:323-331

Department of Anesthesiology, Albany Medical Center, Albany, NY, USA.

The entity of acute respiratory distress syndrome (ARDS) is an acute inflammatory lung condition associated with lung damage and increased vascular permeability. In the ICU, ARDS was reported to be the cause of 10.4% of admissions. Read More

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Extracorporeal membrane oxygenation in critically ill neonatal and pediatric patients with acute respiratory failure: a guide for the clinician.

Expert Rev Respir Med 2021 Jun 8:1-11. Epub 2021 Jun 8.

Division of Pediatric Critical Care Medicine, Duke University Health System, Durham, NC, USA.

: Extracorporeal membrane oxygenation for neonatal and pediatric respiratory failure continues to demonstrate improving outcomes, largely due to advances in technology along with refined management strategies despite mounting patient acuity and complexity. Successful use of ECMO requires thoughtful initiation and candidacy strategies, along with reducing the risk of ventilator induced lung injury and the progression to multiorgan failure.: This review describes current ECMO management strategies for neonatal and pediatric patients with acute refractory respiratory failure and summarizes relevant published literature. Read More

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Cardiac output estimation based on arterial and venous blood gas analysis: proposal of a monitoring method.

Anaesthesiol Intensive Ther 2021 May 19. Epub 2021 May 19.

Universidad Nacional de Colombia, Anesthesiologist - Clínica los Rosales S.A., Colombia.

Hemodynamic optimization is vital in high risk surgical patients or in high risk surgical procedures. The main objective of hemodynamic management is to maintain tissue perfusion and preserve aerobic metabolism through a cardiac output coupled with the metabolic demand. The technologies used for cardiac output monitoring use special techniques (e. Read More

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