Search Tag: mechanical ventilation

ICU Management

How-to-improve-patient-ventilator-synchrony

2019 16 Apr

Waveform analysis and optimization of ventilator settings Anita Orlando, MD, Servizio di Anestesia e Rianimazione I, Fondazione IRCCS Policlinico San Matteo, Pavia, IT Background Asynchronies are a frequent issue in ventilated patients.1They represent a mismatch between the inspiratory and expiratory times of patient and ventilator,...Read more

ICU Management

Innovations-in-icu-ventilation

2019 14 Mar

The future delivered   In this article, we aim to summarise the developments in mechanical ventilation that we believe are shaping the present and will shape the future ahead.   Introduction   Many centuries ago, Socrates stated that “the secret of change is to focus all of your energy, not on fighting the old, but on building the...Read more

ICU Management

Using-ultrasound-to-prevent-diaphragm-dysfunction

2019 24 Jan

Diaphragm ultrasound is a valuable tool to diagnose and prevent ventilator induced diaphragm dysfunction. This review focuses on the use of ultrasound to assess diaphragm structure and function in ventilated patients. The diaphragm is the primary muscle of inspiration. It is a thin dome-shaped muscle that inserts into the lower ribs, xiphoid...Read more

ICU Management

Lives2018-does-energy-dense-nutrition-improve-outcomes

2018 22 Oct

The effect of delivering nutrition at different calorie levels during critical illness is uncertain, and patients typically receive less than the recommended amount. A new randomised trial demonstrates that in patients undergoing mechanical ventilation, increasing energy intake with the administration of energy-dense enteral nutrition did not affect...Read more

ICU Management

Increased-expiratory-muscle-effort-plays-role-in-weaning-failure

2018 23 May

Respiratory muscle weakness in critically ill patients is associated with difficulty in weaning from mechanical ventilation. New research also indicates that weaning failure is associated with increased effort of the expiratory muscles and impaired neuromechanical efficiency of the diaphragm, but no difference in tonic activity of the diaphragm....Read more

ICU Management

Volume-18-issue-1-2018-1

2018 16 Mar

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ICU Management

Optimising-patient-ventilator-synchronisation-1

2018 16 Mar

Dr. Lluís Blanch, Dr. Jean-Michel Arnal and Prof. Francesco Mojoli discuss why patient-ventilator synchrony is important, how to detect asynchronies, and technical solutions for optimising synchronisation.  Definition and clinical effects Patient-ventilator asynchrony occurs when there is a mismatch between the patient’s inspiratory time...Read more

ICU Management

Shortening-ventilator-time-physiology-is-key

2018 28 Feb

Mechanical ventilation is used to decrease work of breathing. However, because complications are axiomatic to mechanical ventilation, it should be discontinued at the earliest possible time, according to a review article published in Annals of the American Thoracic Society. The overriding objective of mechanical ventilation is to decrease work and...Read more

ICU Management

Finding-the-best-strategy-to-improve-weaning-outcomes

2018 14 Feb

Respiratory muscle dysfunction, being a common cause of weaning failure, is strongly associated with prolonged mechanical ventilation (MV) and prolonged stay in intensive care units. Strategies to improve weaning outcomes – i.e., spontaneous breathing trials, noninvasive MV and early mobilisation – can help patients to interrupt MV, according to a...Read more

ICU Management

Ventilation-induced-diaphragm-atrophy-impacts-clinical-outcomes

2018 23 Jan

Diaphragm atrophy developing during mechanical ventilation is associated with prolonged mechanical ventilation and ICU admission and an increased risk of complications of acute respiratory failure, according to new research published in the American Journal of Respiratory and Critical Care Medicine. The findings suggest the need for clinicians to target...Read more

ICU Management

Optimal-approach-to-mechanical-ventilation-after-cardiac-arrest

2017 05 Dec

Return of spontaneous circulation after cardiac arrest results in a systemic inflammatory state called the post-cardiac arrest syndrome (PCAS), characterised by oxidative stress, coagulopathy, neuronal injury, and organ dysfunction. Further, patients who suffer cardiac arrest are at high risk for pulmonary infection. Meticulous attention to mechanical...Read more

ICU Management

Mechanical-ventilation-journey-continues-an-expert-look

2017 14 Sep

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...Read more

ICU Management

Icu-costs-higher-for-patients-dying-before-discharge

2017 22 Aug

The high cost of critical care has engendered research into identifying influential factors. However, previous studies have not considered patient vital status at ICU discharge. This is what a new study has found: The largest drivers of ICU costs at the patient level are day 1 room occupancy and day 1 mechanical ventilation, and mortality before unit...Read more

ICU Management

5-year-trends-of-critical-care-practice-and-outcomes

2017 15 Aug

According to researchers in the U.S., analyses of patients, practices, and outcomes from a large geographically dispersed sample of adult ICUs revealed trends of increasing age and acuity, higher rates of adherence to best practice, use of non-invasive mechanical ventilation and decreased use of antimicrobials, transfusions, and duration of renal...Read more

ICU Management

Finding-ways-to-improve-mechanical-ventilation

2017 18 Jul

A review paper published in the journal Critical Care discusses current problems associated with mechanical ventilation and some important suggestions to improve future care. The review focuses primarily on limiting tissue damage, thereby improving the safety of artificial ventilation.   Also, authors say they limited their analysis...Read more

ICU Management

Humidification-during-mechanical-ventilation-a-systematic-review

2017 07 Jun

Mechanical ventilation (MV) suppresses the mechanisms that heat and moisturise inhaled air; hence, humidification is mandatory during MV. However, a systematic review published in the journal Critical Care finds no clear advantages in terms of clinical outcomes for different humidification devices. Gas delivered during mechanical ventilation must...Read more

ICU Management

Clinical-trials-in-ards-challenges-and-opportunities

2017 07 Jun

A number of supportive therapies have reduced mortality in acute respiratory distress syndrome (ARDS), including lung-protective mechanical ventilation, neuromuscular blockade, and prone positioning. Fluid-conservative therapy has also increased ventilator-free days in patients with ARDS. However, the lack of success of pharmacological therapies...Read more

ICU Management

Mechanical-ventilation-post-extubation-respiratory-support

2017 31 May

A new study, published in Annals of Intensive Care, suggests that high-flow nasal cannula (HFNC) may be a powerful respiratory support in the post-extubation period with multiple physiologic and clinical benefits. The randomised controlled trial compared HFNC versus low-flow oxygen supplied through nasal prongs or facial mask for 24 hours after extubation...Read more

ICU Management

Volume-17-issue-2-2017-1

2017 28 May

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ICU Management

Airway-pressure-release-ventilation-what-s-good-about-it

2017 28 May

The use of APRV has many proposed benefits for patients with lung injury. However, quality evidence supporting the use of this technique is limited. This article summarises the purported benefits and limitations of routine use of the technique in the management of ARDS, and critically reviews the evidence supporting its use.   Airway pressure...Read more

ICU Management

Study-preventing-ventilator-associated-events

2017 28 May

Nearly 800,000 hospital patients undergo mechanical ventilation in the U.S. each year due to different illnesses such as stroke, brain injury or pneumonia. Going on a ventilator can often be the difference between life and death for some patients. While a ventilator does provide assistance in breathing, it is also associated with certain risks that...Read more

ICU Management

To-withhold-or-withdraw-life-support-in-the-icu

2017 15 May

New research finds considerable worldwide variability in decisions to withhold or withdraw life-sustaining therapy in the ICU. Notably, researchers found that almost one-third of patients with a decision to withhold/withdraw life-sustaining treatment left the hospital alive. The multicentre study, already available online as an accepted manuscript,...Read more

ICU Management

Mechanical-ventilation-which-patients-benefit-from-high-peep

2017 21 Mar

Among patients with hypoxaemia after cardiac surgery, the use of an intensive alveolar recruitment strategy compared with a moderate recruitment strategy resulted in less severe pulmonary complications during the hospital stay, according to a randomised clinical trial of postoperative ventilation published in JAMA. See Also : Towards Safer Ventilation...Read more

ICU Management

Failure-to-wean-a-quality-chasm

2016 30 Sep

Writing in the Journal of Critical Care , Constantine Manthous argues that failure to awaken and wean patients on mechanical ventilation is poor practice. He suggests practical solutions to close the gap.   Manthous notes that the evidence is that mechanical ventilation can be reduced substantially in duration, thereby reducing morbidity and mortality....Read more

ICU Management

Masimo-announces-ce-marking-for-pediatric-o3-regional-oximetry

2016 04 Aug

Masimo  has announced the CE marking for the pediatric indication for O3™ regional oximetry with the O3 pediatric sensor. Regional oximetry, also referred to as tissue or cerebral oximetry, helps clinicians monitor cerebral oxygenation. O3 regional oximetry uses near-infrared spectroscopy (NIRS) to continuously monitor absolute and trended regional...Read more

ICU Management

Study-effects-of-inspiratory-muscle-training

2016 25 Jul

A small randomised trial into the effects of inspiratory muscle training for patients who had been weaned from mechanical ventilation found increased inspiratory muscle strength and quality of life in the intervention group. The intervention was inspiratory muscle training once a day for 5 days a week for a fortnight in addition to usual care. The...Read more

ICU Management

Aarc-congress-2016

2016 15 Oct

As the world of health care delivery changes all around us, we too must look for new ways to add meaningful benefit to our patients. From disease educators and case managers to clinical consultants and physician extenders, your attendance could not be more important to the future of our profession. And it starts right here, right now, at AARC Congress...Read more

ICU Management

Lung-protective-strategies-in-the-or-reviewed

2016 14 Jul

Do the principles of lung protective ventilation for ICU patients with acute respiratory failure apply to otherwise healthy patients in the operating room? Satoshi Kimura, from the Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus provide a review of the perioperative perspective on preventing ventilator-associated...Read more

ICU Management

Study-shows-minute-ventilation-preferred-over-end-tidal-co-2

2016 29 Apr

Respiratory Motion, Inc. – Research presented at The Deutsche Anesthesia Congress (DAC) Shows Minute Ventilation Monitoring may be preferable to indirect measurement using EtCO 2 , for non-intubated patients. The study "Evaluation of the Relationship between Non-Invasive Minute Ventilation and End-Tidal CO 2  in Patients Undergoing General vs. Spinal...Read more