American journal of respiratory and critical care medicine
-
Am. J. Respir. Crit. Care Med. · Nov 2013
ReviewAn Official American Thoracic Society Systematic Review: Influence of Psychosocial Characteristics on Workplace Disability among Workers with Respiratory Impairment.
Psychosocial characteristics likely play an important role in the severity of workplace disability for workers with a respiratory impairment. ⋯ Psychosocial characteristics likely influence workplace disability in workers with respiratory impairments. The impact of targeted therapies is unclear and warrants further study.
-
Am. J. Respir. Crit. Care Med. · Nov 2013
ReviewPatient Ventilator Interactions: Implications for Clinical Management.
Assisted/supported modes of mechanical ventilation offer significant advantages over controlled modes in terms of ventilator muscle function/recovery and patient comfort (and sedation needs). However, assisted/supported breaths must interact with patient demands during all three phases of breath delivery: trigger, target, and cycle. Synchronous interactions match ventilator support with patient demands; dyssynchronous interactions do not. ⋯ These include adjustments of the trigger variable, the use of pressure versus fixed flow targeted breaths, and a number of manipulations of the cycle variable. Clinicians need to know how to use these modalities and monitor them properly, especially understanding airway pressure and flow graphics. Future strategies are emerging that have theoretical appeal but they await good clinical outcome studies before they become commonplace.