Respiratory care
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Automode is a feature on Servo ventilators that automatically switches between mandatory and spontaneous breaths. Spontaneous breaths suppress mandatory breaths until apnea. The period from the last spontaneous breath to the first mandatory breath is automatically adjusted by a calculated apnea time limit based on a maximum apnea time setting, the mandatory breathing frequency setting, and the spontaneous breath count. The purpose of this study was to validate the apnea time algorithm by using simulated mechanical ventilation. ⋯ The measured apnea time for simulated ventilation settings was within 2% of calculated times. Automode allowed a spontaneous frequency lower than expected based on the mandatory frequency.
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Research is often presented at scientific conferences in abstract form. Unfortunately, a large percentage of abstracts are never published as a full manuscript, but having a strong department process for research can increase the number of abstracts published as manuscripts. Publishing as a full manuscript is critical to the advancement of science due to the rigor of the peer review process. This manuscript covers common reasons abstracts are not published as manuscripts, tips to overcome mistakes, how to respond to reviewer comments, and specific tips to avoid flaws in each manuscript section.
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Randomized controlled trials (RCTs) are considered to produce the highest level of evidence in the original studies that informs the practice of evidence-based medicine (EBM). By manipulating an independent variable to study its impact on the outcome, RCTs establish causal relationships and provide valuable insights into clinical treatment. To improve patient outcomes and optimize the use of clinical resources, the practice of EBM plays a crucial role in designing and conducting RCTs to evaluate the effectiveness of clinical interventions. This review aims to explore the essential steps involved in conducting a rigorous and reliable RCT, ensuring the generation of high-quality evidence.
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It is unclear if high-frequency chest-wall compression (HFCWC) has a role to assist with secretion clearance in patients on mechanical ventilation. The effect of HFCWC on the delivery of mechanical ventilation is unknown. This study describes the effect of HFCWC on mechanical ventilation delivery and flow bias in an orally intubated and mechanically ventilated bench model. ⋯ HFCWC led to 3- to 7-fold increases in ventilator breathing frequency delivered by mechanical ventilation except in the bi-level mode. The bi-level mode may be the optimal mode to use HFCWC to minimize disruption to the delivered ventilator breathing frequency. The peak inspiratory flow to peak expiratory flow ratios < 0.9, the optimal flow bias for secretion clearance, was only achieved in the pressure-regulated volume control and synchronized intermittent mandatory ventilation modes. However, the findings in this bench model with a fixed low compliance may not be generalizable to the patient in the ICU, and we recommend further investigation into the effects of HFCWC in the patient in the ICU.