British journal of anaesthesia
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Editorial Comment
Need for a new paradigm in the design of alarms for patient monitors and medical devices.
Modern computerised medical devices emit large numbers of tone-based alerts and alarms. Notifications that comprise auditory icons or natural human speech substantially increase the psychological salience of alerts and alarms and may allow a larger set of notifications to be used, as they do not require memorisation of arbitrary sounds.
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Lung rest has been recommended during extracorporeal membrane oxygenation (ECMO) for severe acute respiratory distress syndrome (ARDS). Whether positive end-expiratory pressure (PEEP) confers lung protection during ECMO for severe ARDS is unclear. We compared the effects of three different PEEP levels whilst applying near-apnoeic ventilation in a model of severe ARDS treated with ECMO. ⋯ During near-apnoeic ventilation and ECMO in experimental severe ARDS, 10 cm H2O PEEP minimised lung injury and improved gas exchange without compromising haemodynamic stability.