Critical care medicine
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Critical care medicine · Jun 2007
Editorial CommentHigh-frequency oscillation: how high should we go?
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Critical care medicine · Jun 2007
Randomized Controlled TrialAcute effects of combined high-frequency oscillation and tracheal gas insufflation in severe acute respiratory distress syndrome.
In acute respiratory distress syndrome (ARDS), high-frequency oscillation (HFO) improves oxygenation relative to conventional mechanical ventilation (CMV). Alveolar ventilation is improved by adding tracheal gas insufflation (TGI) to CMV. We hypothesized that combined HFO and TGI (HFO-TGI) might result in improved gas exchange relative to both standard HFO and CMV according to the ARDS Network protocol. ⋯ In early onset, primary, severe ARDS, short-term HFO-TGI improves oxygenation relative to standard HFO and ARDS Network CMV.
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Critical care medicine · Jun 2007
Randomized Controlled TrialAutomatic control of tracheal tube cuff pressure in ventilated patients in semirecumbent position: a randomized trial.
The aspiration of subglottic secretions colonized by bacteria pooled around the tracheal tube cuff due to inadvertent deflation (<20 cm H2O) of the cuff plays a relevant role in the pathogenesis of ventilator-associated pneumonia. We assessed the efficacy of an automatic, validated device for the continuous regulation of tracheal tube cuff pressure in preventing ventilator-associated pneumonia. ⋯ Cuff pressure is better controlled with the automatic device. However, it did not result in additional benefits to the semirecumbent position in preventing ventilator-associated pneumonia.