7,906 results match your criteria Ventilator Management


Mechanical Ventilation during ECMO: Lessons from Clinical Trials and Future Prospects.

Semin Respir Crit Care Med 2022 Jun 27. Epub 2022 Jun 27.

Critical Care Research Group, The Prince Charles Hospital, Brisbane, QLD, Australia.

Acute Respiratory Distress Syndrome (ARDS) accounts for 10% of ICU admissions and affects 3 million patients each year. Despite decades of research, it is still associated with one of the highest mortality rates in the critically ill. Advances in supportive care, innovations in technologies and insights from recent clinical trials have contributed to improved outcomes and a renewed interest in the scope and use of Extracorporeal life support (ECLS) as a treatment for severe ARDS, including high flow veno-venous Extracorporeal Membrane Oxygenation (VV-ECMO) and low flow Extracorporeal Carbon Dioxide Removal (ECCO2R). Read More

View Article and Full-Text PDF

Liberation from Mechanical Ventilation: Established and New Insights.

Semin Respir Crit Care Med 2022 Jun 27. Epub 2022 Jun 27.

The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

A substantial proportion of critically ill patients require ventilator support with the majority requiring invasive mechanical ventilation. Timely and safe liberation from invasive mechanical ventilation is a critical aspect of patient care in the intensive care unit (ICU) and is a top research priority for patients and clinicians. In this article, we discuss how to (1) identify candidates for liberation from mechanical ventilation, (2) conduct spontaneous breathing trials (SBTs), and (3) optimize patients for liberation from mechanical ventilation. Read More

View Article and Full-Text PDF

ABCDE and ABCDEF care bundles: A systematic review of the implementation process in intensive care units.

Medicine (Baltimore) 2022 Jun 24;101(25):e29499. Epub 2022 Jun 24.

Graduate Program in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, São Paulo, Brazil.

Background: The ABCDE (Awakening and Breathing Coordination of daily sedation and ventilator removal trials, Delirium monitoring and management, and Early mobility and exercise) and ABCDEF (Assessment, prevent and manage pain, Both spontaneous awakening and spontaneous breathing trials, Choice of analgesia and sedation, assess, prevent and manage Delirium, Early mobility and exercise, Family engagement) care bundles consist of small sets of evidence-based interventions and are part of the science behind Intensive Care Unit (ICU) liberation. This review sought to analyse the process of implementation of ABCDE and ABCDEF care bundles in ICUs, identifying barriers, facilitators and changes in perception and attitudes of healthcare professionals; and to estimate care bundle effectiveness and safety.

Methods: We selected qualitative and quantitative studies addressing the implementation of ABCDE and ABCDEF bundles in the ICU, identified on MEDLINE, Embase, CINAHL, The Cochrane Library, Web of Science, Epistemonikos, PsycINFO, Virtual Health Library and Open Grey, without restriction on language or date of publication, up to June 2018. Read More

View Article and Full-Text PDF

Lung Sonography in Critical Care Medicine.

Diagnostics (Basel) 2022 Jun 6;12(6). Epub 2022 Jun 6.

Department of Anaesthesiology and Intensive Care Medicine, Medical University Innsbruck, 6020 Innsbruck, Austria.

During the last five decades, lung sonography has developed into a core competency of intensive care medicine. It is a highly accurate bedside tool, with clear diagnostic criteria for most causes of respiratory failure (pneumothorax, pulmonary edema, pneumonia, pulmonary embolism, chronic obstructive pulmonary disease, asthma, and pleural effusion). It helps in distinguishing a hypovolemic from a cardiogenic, obstructive, or distributive shock. Read More

View Article and Full-Text PDF

High-Frequency Oscillatory Ventilation for Refractory Hypoxemia in Severe COVID-19 Pneumonia: A Small Case Series.

Am J Case Rep 2022 Jun 22;23:e936651. Epub 2022 Jun 22.

Department of Critical Care Medicine, Lexington Medical Center, West Columbia, SC, USA.

BACKGROUND COVID-19 continues to place a tremendous burden on the healthcare system, with most deaths resulting from respiratory failure. Management strategies have varied, but the mortality rate for mechanically ventilated patients remains high. Conventional management with ARDSnet ventilation can improve outcomes but alternative and adjunct treatments continue to be explored. Read More

View Article and Full-Text PDF

A Comparison of the Prevalence of, Demographics of, and Effects on Outcomes of Bilateral Versus Unilateral Femoral Shaft Fractures: A Retrospective Cohort Analysis From the National Trauma Data Bank.

J Orthop Trauma 2022 Jul;36(7):349-354

Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO.

Objectives: To document the prevalence of, and the effect on outcomes, operatively treated bilateral femur fractures treated using contemporary treatments.

Design: A retrospective cohort using data from the National Trauma Data Bank.

Participants: In total, 119,213 patients in the National Trauma Data Bank between the years 2007 and 2015 who had operatively treated femoral shaft fractures. Read More

View Article and Full-Text PDF

Understanding the Perseverance of the Muscular Dystrophy Community One-Year into the COVID-19 Pandemic.

J Neuromuscul Dis 2022 Jun 14. Epub 2022 Jun 14.

Department of Neurology, University of Kansas Medical Center, Kansas City, KS, USA.

Introduction: In this study, we examined the long-term social and health impacts of the coronavirus disease 2019 (COVID-19) pandemic on people with muscular dystrophy.

Methods: We modified our prior COVID-19 Impact Survey to assess impacts from the continuing pandemic using feedback from muscular dystrophy experts, patients, and advocacy group/registry representatives. The survey assessed COVID-19 medical history, and the effects of the pandemic on social aspects, muscle disease, and medical care. Read More

View Article and Full-Text PDF

Status of Hospital Infection Prevention Practices in Thailand in the Era of COVID-19: Results from a National Survey.

Am J Infect Control 2022 Jun 16. Epub 2022 Jun 16.

Division of Infectious Diseases, Thammasart University Hospital, Pratumthani, Thailand. Electronic address:

Background: . A 2014 study assessed infection prevention (IP) practices in Thai hospitals for catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). This study compares current IP practices to results obtained in 2014. Read More

View Article and Full-Text PDF

Intensivist -Driven Ventilator Management Shortens Duration of Mechanical Ventilation in Coronary Artery Bypass Graft Surgery Patients.

J Intensive Care Med 2022 Jun 16:8850666221109181. Epub 2022 Jun 16.

Department of Internal Medicine and Neurology, Boonshoft School of Medicine, 2829Wright State University, Dayton, OH, USA.

Background: Prolonged mechanical ventilation in post Coronary Artery Bypass Graft Surgery (CABG) is associated with deleterious effects including, increased ICU and hospital length of stay (LOS), infectious complications, and mortality. Standardized ventilator weaning protocols and the utilization of critical care physicians in post CABG patient care vary substantially among institutions. The purpose of this study was to evaluate if intensivist consultation in conjunction with a multidisciplinary, standardized ventilator weaning protocol improves outcomes in CABG patients. Read More

View Article and Full-Text PDF

A dual-center cohort study on the association between early deep sedation and clinical outcomes in mechanically ventilated patients during the COVID-19 pandemic: The COVID-SED study.

Crit Care 2022 06 15;26(1):179. Epub 2022 Jun 15.

Division of Critical Care, Departments of Anesthesiology and Emergency Medicine, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.

Background: Mechanically ventilated patients have experienced greater periods of prolonged deep sedation during the coronavirus disease (COVID-19) pandemic. Multiple studies from the pre-COVID era demonstrate that early deep sedation is associated with worse outcome. Despite this, there is a lack of data on sedation depth and its impact on outcome for mechanically ventilated patients during the COVID-19 pandemic. Read More

View Article and Full-Text PDF

Pro-, pre- and synbiotics for the prevention of incidental ventilator-associated pneumonia among critically ill patients: a systematic review and meta-analysis of randomized controlled trials.

Expert Rev Anti Infect Ther 2022 Jun 16:1-11. Epub 2022 Jun 16.

Department of Orthopedic, Chi Mei Medical Center, Tainan Taiwan.

Objectives: This study investigated the preventive effects of pro-, pre- and synbiotics on ventilator-associated pneumonia (VAP) among critically ill patients.

Methods: The PubMed, Web of Science, Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched for relevant articles written before 19 February 2022. Read More

View Article and Full-Text PDF

[Accurate evaluation of mechanical ventilation and spontaneous respiratory activity].

Authors:
Yingzhi Qin

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue 2022 Apr;34(4):343-345

Department of Critical Care Medicine, Tianjin Third Central Hospital, Tianjin 300170, China. Corresponding author: Qin Yingzhi, Email:

Maintenance of spontaneous effort during mechanical ventilation has long been recognized to improve oxygenation. Such effort has been considered beneficial because oxygenation is a key management aim. However, accumulating evidence indicates that spontaneous effort during mechanical ventilation may cause or worsen acute lung injury. Read More

View Article and Full-Text PDF

The Utility of the 5-Factor Modified Frailty Index to Predict Postoperative Risk in Microsurgical Reconstruction.

Ann Plast Surg 2022 06 18;88(5 Suppl 5):S485-S489. Epub 2022 Feb 18.

From the Division of Plastic & Reconstructive Surgery, Department of Surgery, Prisma Health/University of South Carolina School of Medicine, Columbia.

Background: Microsurgical reconstruction is an integral part of plastic surgery. The 5-factor modified frailty index (5-mFI) is an effective tool to predict postoperative complications across multiple subspecialties. We aimed to determine if frailty scores using the 5-mFI can predict postoperative complications specifically in microvascular reconstruction. Read More

View Article and Full-Text PDF

Efficacy of COVID-19 treatments among geriatric patients: a systematic review.

Ther Adv Infect Dis 2022 Jan-Dec;9:20499361221095666. Epub 2022 Jun 1.

School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland.

Introduction: A majority of the fatalities due to COVID-19 have been observed in those over the age of 60. There is no approved and universally accepted treatment for geriatric patients. The aim of this review is to assess the current literature on efficacy of COVID-19 treatments in geriatric populations. Read More

View Article and Full-Text PDF

Management of Ventilator-Associated Pneumonia: Quality Assessment of Clinical Practice Guidelines and Variations in Recommendations on Drug Therapy for Prevention and Treatment.

Front Pharmacol 2022 20;13:903378. Epub 2022 May 20.

Department of Pharmacy, Qindao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China.

To assess the quality of clinical practice guidelines (CPGs) related to drug therapy for prevention and control of ventilator-associated pneumonia (VAP) and compare the differences and similarities between recommendations. Electronic databases (including PubMed, Cochrane library, Embase, Web of Science), guideline development organizations, and professional societies were searched to identify CPGs for VAP from 20 January 2012 to 20 January 2022. The Appraisal of Guidelines Research & Evaluation (AGREE) II instrument was used to evaluate the quality of the guidelines. Read More

View Article and Full-Text PDF

Monitoring Long Term Noninvasive Ventilation: Benefits, Caveats and Perspectives.

Front Med (Lausanne) 2022 19;9:874523. Epub 2022 May 19.

Pulmonary Department and Respiratory Critical Care Unit, University Hospital Dijon, Dijon, France.

Long term noninvasive ventilation (LTNIV) is a recognized treatment for chronic hypercapnic respiratory failure (CHRF). COPD, obesity-hypoventilation syndrome, neuromuscular disorders, various restrictive disorders, and patients with sleep-disordered breathing are the major groups concerned. The purpose of this narrative review is to summarize current knowledge in the field of monitoring during home ventilation. Read More

View Article and Full-Text PDF

Positioning for acute respiratory distress in hospitalised infants and children.

Cochrane Database Syst Rev 2022 06 6;6:CD003645. Epub 2022 Jun 6.

Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.

Background: Acute respiratory distress syndrome (ARDS) is a significant cause of hospitalisation and death in young children. Positioning and mechanical ventilation have been regularly used to reduce respiratory distress and improve oxygenation in hospitalised patients. Due to the association of prone positioning (lying on the abdomen) with sudden infant death syndrome (SIDS) within the first six months, it is recommended that young infants be placed on their back (supine). Read More

View Article and Full-Text PDF

Endobronchial blood-patch: A novel technique for a persistent pleural air leak.

Respir Med Case Rep 2022 28;38:101670. Epub 2022 May 28.

Interventional Pulmonology and Pulmonary Critical Care Attending, Icahn School of Medicine at Mount Sinai: Elmhurst Hospital, United States.

Introduction: Patients with severe COVID-19 Pneumonia requiring prolonged mechanical ventilation have an increased incidence of pneumothorax. Mechanically ventilated patients who are critically ill and develop a persistent air leak from pneumothorax are poor candidates for surgical repair. As the persistent air leak can be a significant barrier to vent-weaning and clinical stability, these patients present a unique clinical challenge. Read More

View Article and Full-Text PDF

Diagnostic Values of the Critical Care Pain Observation Tool and the Behavioral Pain Scale for Pain Assessment among Unconscious Patients: A Comparative Study.

Indian J Crit Care Med 2022 ;26(4):472-476

Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.

Background: Pain assessment in unconscious patients is a major challenge for healthcare providers. This study aims to compare the diagnostic value of the critical-care pain observation tool (CPOT) and the behavioral pain scale (BPS) for pain assessment among unconscious patients.

Materials And Methods: This cross-sectional study was conducted in 2019. Read More

View Article and Full-Text PDF
January 2022

Ventilation Liberation Practices Among 380 International PICUs.

Crit Care Explor 2022 Jun 27;4(6):e0710. Epub 2022 May 27.

Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Los Angeles, Los Angeles, CA.

1) Characterize the prevalence of ventilator liberation protocol use in international PICUs, 2) identify the most commonly used protocol elements, and 3) estimate an international extubation failure rate and use of postextubation noninvasive respiratory support modes.

Design: International cross-sectional study.

Subjects: Nontrainee pediatric medical and cardiac critical care physicians. Read More

View Article and Full-Text PDF

Capnography and Pulse Oximetry Improve Fast Track Extubation in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Clinical Trial.

Front Surg 2022 11;9:826761. Epub 2022 May 11.

Trauma Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Background: Use of capnography as a non-invasive method during the weaning process for fast track extubation (FTE) is controversial. We conducted the present study to determine whether pulse oximetry and capnography could be utilized as alternatives to arterial blood gas (ABG) measurements in patients under mechanical ventilation (MV) following coronary artery bypass graft (CABG) surgery.

Methods: In this randomized clinical trial, 70 patients, who were candidates for CABG surgery, were randomly assigned into two equal groups ( = 35), intervention and control group. Read More

View Article and Full-Text PDF

Efficacy and safety of fibrinogen administration in acute post-traumatic hypofibrinogenemia in isolated severe traumatic brain injury: A randomized clinical trial.

J Clin Neurosci 2022 Jul 26;101:204-211. Epub 2022 May 26.

Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Iran.

Aim: This study was conducted to evaluate clinical outcomes after fibrinogen administration in hypofibrinogenemia following severe traumatic brain injury.

Background: Post traumatic coagulopathy (PTC) is a common but devastating medical condition in patients with severe head injury. Hypofibrinogenemia is considered as an indicator for poor clinical outcomes in traumatic brain injury (TBI). Read More

View Article and Full-Text PDF

Real-Time Analysis of Dry-Side Nebulization With Heated Wire Humidification During Mechanical Ventilation.

Respir Care 2022 May 31. Epub 2022 May 31.

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Stony Brook University Medical Center, Stony Brook, New York.

Background: Recent observational studies of nebulizers placed on the wet side of the humidifier suggest that, after some time, considerable condensation can form, which triggers an occlusion alarm. In the current study, an inline breath-enhanced jet nebulizer was tested and compared in vitro with a vibrating mesh nebulizer on the humidifier dry-inlet side of the ventilator circuit.

Methods: Two duty cycle breathing patterns were tested during continuous infusion (5 or 10 mL/h) with and without dynamic changes in infusion flow and duty cycle, or bolus delivery (3 or 6 mL) of radiolabeled saline solution. Read More

View Article and Full-Text PDF

Postoperative Nursing Care of a Deceased Donor Tracheal Transplant Recipient.

Crit Care Nurse 2022 Jun;42(3):12-18

Roopa Kohli-Seth is the Director of the Institute for Critical Care Medicine at Mount Sinai Hospital.

Introduction: Certain airway disorders, such as tracheal stenosis, can severely affect the ability to breathe, reduce quality of life, and increase morbidity and mortality. Treatment options for long-segment tracheal stenosis include multistage tracheal replacement with biosynthetic material, autotransplantation, and allotransplantation. These interventions have not demonstrated long-term dependable results because of lack of adequate blood supply to the organ and ciliated epithelium. Read More

View Article and Full-Text PDF

COVID-19 Associated Acute Pancreatitis: A Case Series from India.

Infect Disord Drug Targets 2022 May 30. Epub 2022 May 30.

Department of Microbiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Introduction: Initially, COVID-19 was typically concerned with respiratory symptoms and had a mild and asymptomatic to critical clinical course. Over time, many atypical presentations related to cardiac, hepatic, gastrointestinal, renal, musculoskeletal, and neurological features have been reported in COVID-19.

Case Presentation: We present three confirmed cases of COVID-19 who developed acute pancreatitis without any other obvious discernible cause. Read More

View Article and Full-Text PDF

Geriatric Burn Injuries Presenting to the Emergency Department of a Major Burn Center: Clinical Characteristics and Outcomes.

J Emerg Med 2022 May 27. Epub 2022 May 27.

Department of Emergency Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York. Electronic address:

Background: Burn injuries in geriatric patients are common and may have significant associated morbidity and mortality. Most research has focused on the care of hospitalized patients after admission to burn units. Little is known about the clinical characteristics of geriatric burn victims who present to the emergency department (ED) and their ED assessment and management. Read More

View Article and Full-Text PDF

Developing and Implementing Noninvasive Ventilator Training in Haiti during the COVID-19 Pandemic.

ATS Sch 2022 Mar 17;3(1):112-124. Epub 2022 Feb 17.

Department of Anesthesiology, Perioperative Medicine and Pain Management, and.

Background: Noninvasive ventilation (NIV) is an important component of respiratory therapy for a range of cardiopulmonary conditions. The World Health Organization recommends NIV use to decrease the use of intensive care unit resources and improve outcomes among patients with respiratory failure during periods of high patient capacity from coronavirus disease (COVID-19). However, healthcare providers in many low- and middle-income countries, including Haiti, do not have experience with NIV. Read More

View Article and Full-Text PDF

Performance and Usability Evaluation of an Extended Reality Platform to Monitor Patient's Health during Surgical Procedures.

Sensors (Basel) 2022 May 21;22(10). Epub 2022 May 21.

Department of Electronics and Telecommunications, Polytechnic University of Turin, 10129 Turin, Italy.

An extended-reality (XR) platform for real-time monitoring of patients' health during surgical procedures is proposed. The proposed system provides real-time access to a comprehensive set of patients' information, which are made promptly available to the surgical team in the operating room (OR). In particular, the XR platform supports the medical staff by automatically acquiring the patient's vitals from the operating room instrumentation and displaying them in real-time directly on an XR headset. Read More

View Article and Full-Text PDF

Design and Rationale of the Sevoflurane for Sedation in Acute Respiratory Distress Syndrome (SESAR) Randomized Controlled Trial.

J Clin Med 2022 May 16;11(10). Epub 2022 May 16.

Department of Perioperative Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France.

Preclinical studies have shown that volatile anesthetics may have beneficial effects on injured lungs, and pilot clinical data support improved arterial oxygenation, attenuated inflammation, and decreased lung epithelial injury in patients with acute respiratory distress syndrome (ARDS) receiving inhaled sevoflurane compared to intravenous midazolam. Whether sevoflurane is effective in improving clinical outcomes among patients with ARDS is unknown, and the benefits and risks of inhaled sedation in ARDS require further evaluation. Here, we describe the SESAR (Sevoflurane for Sedation in ARDS) trial designed to address this question. Read More

View Article and Full-Text PDF

Enteroviral Rhombencephalitis with Abducens Nerve Palsy and Cardio-Pulmonary Failure in a 2-Year-Old Boy.

Children (Basel) 2022 Apr 29;9(5). Epub 2022 Apr 29.

Department of Medicine, MacKay Medical College, New Taipei 25160, Taiwan.

Enterovirus infection is endemic in many areas, especially in Southeast Asia. Enterovirus infection with severe complications (EVSC) is life-threatening, and timely diagnosis and management are crucial for successful management. Here, we report on a 2-year-old boy with hand, foot, and mouth disease. Read More

View Article and Full-Text PDF