Search Tag: mechanical ventilation
2024 28 Nov
Mechanical ventilation is a critical aspect of care in the ICU. It supports patients who are unable to maintain adequate oxygenation and ventilation on their own, such as those with acute respiratory distress syndrome (ARDS), pneumonia, sepsis, or trauma. It also ensures adequate gas exchange when a patient’s natural breathing is impaired and allows...Read more
2024 26 Nov
Failure to wean from mechanical ventilation is common, affecting up to 35% of critically ill patients undergoing the weaning process and significantly worsening outcomes, including prolonged ICU stays, longer hospitalisations, and higher mortality risk. Respiratory muscle weakness, present in over 60% of mechanically ventilated patients, is a major...Read more
2024 21 Oct
In mechanically ventilated patients with acute respiratory distress syndrome (ARDS), the use of positive end-expiratory pressure (PEEP) presents a therapeutic dilemma. PEEP can improve gas exchange and lung mechanics but may impair haemodynamics. Its effects primarily impact right ventricular (RV) preload and afterload, while left ventricular (LV)...Read more
2024 16 Sep
Mechanical ventilation is essential for managing acute respiratory failure but can cause ventilator-induced lung injury (VILI). VILI arises from four main mechanisms: alveolar over-distention (volutrauma), over-pressurisation (barotrauma), cyclic opening and collapse of alveoli (atelectotrauma), and inflammation (biotrauma), leading to alveolar...Read more
2024 02 Sep
Mechanical ventilation with positive pressure aims to deliver well-conditioned gas, ensure lung expansion, and monitor key parameters like airway pressures and tidal volume (VT). Despite technological advancements, current invasive ventilation has limitations, particularly for critically ill patients who require timely, precise interventions. Positive...Read more
2024 05 Aug
Over 1 million patients with acute respiratory failure requiring mechanical ventilation are admitted to ICUs every year, with a one-in-five mortality rate. While interventions like lung-protective ventilation, prone positioning, and protocols such as spontaneous awakening and breathing trials are crucial, there's a growing interest in optimising...Read more
2024 03 Jul
Up to 80% of mechanically ventilated ICU patients experience acute brain dysfunction, commonly manifesting as delirium or coma. Both conditions are linked to increased mortality and long-term cognitive impairment in survivors. The underlying pathophysiology of acute brain dysfunction during respiratory failure is poorly understood. Previous...Read more
2024 22 May
Expiratory flow limitation (EFL) occurs when the expiratory flow cannot increase despite higher driving pressure at a given lung volume. In airway disease patients, this can happen during tidal expiration (tidal EFL - EFLT). The prevalence of EFLT in intubated patients varies with population, PEEP settings, and detection methods, with up to one-third...Read more
2024 17 May
Dyspnoea is among the worst suffering that a human being can experience. Because mechanically ventilated patients are strongly exposed to high dyspnoea intensity, it is important that clinicians monitor dyspnoea in this population. Relieving dyspnoea in patients is a human right. Suffocating, not getting enough air or the feeling...Read more
2024 30 Apr
Understanding respiratory drive is crucial in managing critically ill patients. Recent data suggest high and low respiratory drive can negatively impact patient outcomes. However, “respiratory drive” can be ambiguous without understanding its determinants and underlying pathophysiology. In critically ill patients, ventilatory demands reflected...Read more
2024 02 Apr
Mechanical ventilation can lead to complications like ventilator-induced lung injury and ventilator-induced diaphragm dysfunction. However, there may be other forms of ventilator-associated issues that require understanding to improve outcomes for patients on mechanical ventilation. In particular, ventilator-associated brain injury (VABI) should be...Read more
2023 05 Dec
Ventilation management is a critical aspect of patient care, and staying at the forefront of this discipline is paramount for healthcare professionals. Hamilton Medical recognizes this need for innovative training tools and is excited to introduce the VenTrainer app, which enables new training opportunities in the world of mechanical ventilation....Read more
2023 13 Oct
Chronic obstructive pulmonary disease and asthma are pathologies par excellence with an obstructive pattern. It is important to understand the fundamentals of mechanical ventilation management in these patients. Therefore, it is crucial to perform proper measurement of respiratory mechanics in patients with obstructive pathology Introduction...Read more
2023 13 Oct
In this article, we will examine clinical concepts that have persisted over time, despite advancements in our understanding of physiology and technological innovations that have demonstrated their inapplicability in the routine clinical care of paediatric patients requiring respiratory support. These enduring beliefs have effectively transformed...Read more
2023 03 Oct
Mechanical ventilation is crucial for supporting critically ill patients, and a timely extubation strategy is essential for improved patient outcomes. Despite standard weaning procedures, a significant percentage of patients (3-20%) require reintubation. Post-extubation respiratory failure can cause respiratory fatigue, requiring additional mechanical...Read more
2023 13 Jun
Acute brain injury (BI) affects millions of patients each year, with high mortality rates and significant disability. Invasive mechanical ventilation is often required for the most severe cases of BI. These patients frequently experience respiratory complications, such as ventilator-associated pneumonia and acute respiratory distress syndrome, which...Read more
2022 08 Dec
Current applications and limitations of critical care echocardiography in the critical care context and its use in guiding the care of the critically ill patient. Echocardiography in the ICU Echocardiography is currently considered an essential diagnostic tool at the disposal of the intensivist – a significant change from less than two decades...Read more
2022 09 Aug
During the COVID-19 pandemic, many hospitals in the U.S. exceeded their mechanical ventilation capability. As COVID-19 spread to communities with limited immunity, challenges associated with providing surge mechanical ventilation were reported. Hospitals, healthcare systems, and jurisdictional authorities purchased more ventilators. But the fear that the...Read more
2022 24 May
Sex imbalance in the ICU has been consistently reported. Worldwide, fewer women are admitted to the ICU than men. Several studies have reported systematic differences in the treatment men and women receive in ICUs. Studies from Europe, North America, and Asia all show women are less likely to receive invasive mechanical ventilation than men. Studies...Read more
2022 19 Apr
COVID-19 continues to create a strain on healthcare systems around the world. Approximately 10-30% of COVID-19 patients admitted to the hospital need ICUs, and 15-20% of these patients require ventilatory support. The available data shows an increased risk of ventilator-associated pneumonia (VAP) and ventilator-associated lower respiratory tract infections...Read more
2022 08 Mar
Many patients with COVID-19-associated acute respiratory failure fulfil the criteria of acute respiratory distress syndrome (ARDS) and require invasive mechanical ventilation. Therefore, it is important to understand the features of gas exchange abnormalities, respiratory mechanics and lung recruitability in these patients to provide an appropriate...Read more
2022 25 Jan
In recent years, there has been an increase in awareness of minimising sedation in the ICU. Several benefits of avoiding heavy sedation have been reported in clinical studies, and clinical guidelines also encourage less sedation. Findings from the NONSEDA trial were published in 2020. In this trial, 700 critically ill patients were randomised to...Read more
2021 23 Nov
An overview of the physiological aspects of indirect calorimetry, its limitations in use, the available literature and future prospects for tailored nutrition. Introduction Medical nutrition therapy (MNT) is an essential part of patient care in the intensive care unit (ICU) setting. Similar to mechanical ventilation and haemodynamic...Read more
2021 19 Oct
A study was conducted to evaluate the effects of therapeutic heparin compared with prophylactic heparin among moderately ill patients with COVID-19 admitted to the hospital. Heparin has anticoagulant properties, anti-inflammatory effects and potential antiviral effects and may also improve endothelial function. Early initiation of therapeutic heparin...Read more
2021 12 Oct
Approximately 14 to 17% of COVID-19 patients admitted to the hospital require transfer to the ICU. However, there is insufficient evidence regarding the long-term survival and predictive factors for mortality in patients with acute hypoxaemic respiratory failure due to COVID-19 and undergoing invasive mechanical ventilation. A study was conducted...Read more
2021 30 Sep
Monitoring the strength of the patient´s breathing effort, titrating the sedation, and selecting the correct mode of ventilation is vital when transitioning from controlled to assisted ventilation. Assessing The Transition From Fully Controlled to Assisted Ventilation One of the key issues with mechanical ventilation is the transition...Read more
2021 17 Aug
Millions of people worldwide have been infected with COVID-19, with many requiring hospitalisation. Approximately 30% of hospitalisaed patients with COVID-19 are started on invasive ventilation for several pneumonia. Invasive ventilation portend a poor prognosis as approximately 40% of these patients do not survive hospitalisation. Even those who survive...Read more