Mechanical ventilation journey continues - an expert look
While mechanical ventilation is widely used and has improved greatly since first used in the 1950s, there is still room for improvement, according to a state-of-the-art review of mechanical ventilation, published in the September 2017 issue of Mayo Clinic Proceedings. Mechanical ventilation experts Tài Pham MD, Laurent Brochard and Arthur Slutsky from the University of Toronto and St. Michael's Hospital, Toronto, Canada, note the lack of precise recommendations on when to start mechanical ventilation (MV) and emphasise that MV is part of a bundle of treatment.
In their article they explain the working principles of MV modes, including the phase variables of a breathing cycle and influence on respiratory muscle activity and importance of synchrony. Dyssynchonies between patient and ventilator are frequent, they write, but it is not clear whether they cause the poor outcomes or are a marker of severity of the underlying condition. They note: "Although improving patient ventilatory synchrony makes intuitive sense, we lack definitive data proving that it improves patients' outcomes."
The complications of MV are explained, including during initiation of MV, through to haemodynamic effects, sedation complications and oxygen toxicity and effects on respiratory muscles and respiratory infections and ventilator-induced lung injury (VILI).
Ventilation for specific groups of patients is then described along with advice on the weaning phase.
Looking to the future, the authors highlight the focus on long-term outcomes as a research subject. They conclude: "The MV journey is making progress but is still far from its ultimate destination."
Source: Mayo Clinic Proceedings
Image Credit: Rcp.basheer
Published on : Thu, 14 Sep 2017
Print as PDF
The HAMILTON-T1 combines for the first time the functionality of a fully featured intensive care unit ventilator with the compactness and ruggedness required for transport. This is why the HAMILTON-T1 enables you to provide optimal ventilation therapy...
The HAMILTON-C3 ventilator is a modular high-end ventilation solution for all patient groups. Offering a number of unique features, the HAMILTON-C3 is one of the first ventilators featuring the “Ventilation Autopilot” INTELLiVENT-ASV®. The HAMILTON-C3’s...
The fully featured ICU ventilator, HAMILTON-MR1, guarantees uncompromised continuous ventilation care from the ICU to the MRI scanner and back. Its reliability and high performance, with advanced lung-protective strategies and patient-adaptive modes,...
The technical and clinical reference standard for all B·R·A·H·M·S PCT assays. All clinical cut-offs and algorithms were developed based on B·R·A·H·M·S PCT sensitive KRYPTOR. Homogeneous immunoassay for the quantitative d
The HAMILTON-C1 neo is a versatile neonatal ventilator that combines invasive and noninvasive modes with the additional options of nCPAP and high flow oxygen therapy. The integrated turbine allows it to be operated independently of a compressed air supply....