Articles: mechanical-ventilation.
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J. Cardiothorac. Vasc. Anesth. · Apr 2018
Review Meta AnalysisEffects of Positive Airway Pressure and Mechanical Ventilation of the Lungs During Cardiopulmonary Bypass on Pulmonary Adverse Events After Cardiac Surgery: A Systematic Review and Meta-Analysis.
To investigate whether different ventilation strategies during cardiopulmonary bypass (CPB) can improve outcomes in adult cardiac surgery patients. ⋯ CPAP during CPB improved the alveolar-arterial oxygen gradient difference compared with apnea, but ventilation during CPB did not. Neither CPAP nor ventilation during CPB demonstrated evidence of improving clinical outcomes in low- or intermediate-risk patients for elective cardiac surgery. The findings are inconclusive because of heterogeneity and small sample sizes.
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Journal of critical care · Feb 2018
Review Meta AnalysisEffect of antibiotics administered via the respiratory tract in the prevention of ventilator-associated pneumonia: A systematic review and meta-analysis.
We evaluated the effect of antibiotics administered via the respiratory tract to prevent the ventilator-associated pneumonia (VAP) in mechanically ventilated (MV) patients. ⋯ Prophylactic antibiotics administered through the respiratory tract by nebulization reduce the occurrence of VAP, without a significant effect on either the ICU mortality or occurrence of VAP due to MDR pathogens.
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Review Meta Analysis
Higher PEEP versus Lower PEEP Strategies for Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.
Higher positive end-expiratory pressure (PEEP) levels may reduce atelectrauma, but increase over-distention lung injury. Whether higher PEEP improves clinical outcomes among patients with acute respiratory distress syndrome (ARDS) is unclear. ⋯ Use of higher PEEP is unlikely to improve clinical outcomes among unselected patients with ARDS.
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Review Meta Analysis
Low Tidal Volume versus Non-Volume-Limited Strategies for Patients with Acute Respiratory Distress Syndrome. A Systematic Review and Meta-Analysis.
Trials investigating use of lower tidal volumes and inspiratory pressures for patients with acute respiratory distress syndrome (ARDS) have shown mixed results. ⋯ The trend toward lower mortality with LTV ventilation in the primary analysis and the significant relationship between the degree of tidal volume reduction and the mortality effect together suggest, but do not prove, that LTV ventilation improves mortality among critically ill adults with ARDS.
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Am. J. Respir. Crit. Care Med. · Sep 2017
Meta Analysis Comparative StudySeverity of Hypoxemia and Effect of High Frequency Oscillatory Ventilation in ARDS.
High-frequency oscillatory ventilation (HFOV) is theoretically beneficial for lung protection, but the results of clinical trials are inconsistent, with study-level meta-analyses suggesting no significant effect on mortality. ⋯ HFOV increases mortality for most patients with ARDS but may improve survival among patients with severe hypoxemia on conventional mechanical ventilation.