Articles: mechanical-ventilation.
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Journal of critical care · Jun 2021
Bayesian analysis of the epidemiology of bleeding in critically ill children.
We updated our findings on the epidemiology of clinically relevant bleeding (CRB) in critically ill children. We also determined the concordance of CRB as defined by the International Society of Thrombosis and Haemostasis, i.e., ISTH definition, and characteristics identified by pediatric intensivists in a recent survey, i.e., survey definition. ⋯ Our updated findings highlight the high frequency of CRB regardless of definition used for CRB.
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Eur Arch Otorhinolaryngol · Jun 2021
Multicenter Study Observational StudyOpen versus percutaneous tracheostomy in COVID-19: a multicentre comparison and recommendation for future resource utilisation.
The COVID-19 pandemic placed an unprecedented demand on critical care services for the provision of mechanical ventilation. Tracheostomy formation facilitates liberation from mechanical ventilation with advantages for both the patient and wider critical care resource, and can be performed using both percutaneous dilatational and surgical techniques. We compared outcomes in those patients undergoing percutaneous dilatational tracheostomy to those undergoing surgical tracheostomy and make recommendations for provision of tracheostomy services in any future surge. ⋯ In patients with COVID-19 pneumonitis that require tracheostomy to facilitate weaning from mechanical ventilation, there was no difference in outcomes between those patients that had percutaneous dilatational tracheostomy compared with those that had surgical tracheostomy. Planning for future surges in COVID-19-related critical care demands should utilise all available resource and expertise.
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Journal of critical care · Jun 2021
Effect of early hyperoxemia on the outcome in servere blunt chest trauma: A propensity score-based analysis of a single-center retrospective cohort.
Our study aimed to explore the association between early hyperoxemia of the first 24 h on outcomes in patients with severe blunt chest trauma. ⋯ In our cohort early hyperoxemia during the first 24 h of admission after severe blunt chest trauma was not associated with worse outcome.
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Patients with obesity are at higher risk for community-acquired and nosocomial infections. However, no study has specifically evaluated the relationship between obesity and ventilator-associated pneumonia (VAP). ⋯ Our results suggest that obesity has no significant impact on the incidence of VAP.
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Extracorporeal membrane oxygenation is used as rescue therapy for patients with acute respiratory distress syndrome in whom conventional therapy has failed prior to an Extra Corporeal Membrane Oxygenator to rescue Lung Injury in Severe Acute Respiratory Distress Syndrome trial. Since then, extracorporeal membrane oxygenation has been incorporated as part of the standard treatment algorithm in many centers for patients with severe acute respiratory distress syndrome. Since the emergence of coronavirus disease 2019 in early 2020, extracorporeal membrane oxygenation has been used effectively as rescue therapy and as a bridge to recovery in some patients with refractory respiratory failure. ⋯ To our knowledge, this is one of the first cases to be reported in the literature on the use of awake extracorporeal membrane oxygenation as a "treatment" for barotrauma due to severe acute respiratory distress syndrome in a coronavirus disease 2019 patient, without the need for invasive mechanical ventilation. In selected patients with severe respiratory failure, awake extracorporeal membrane oxygenation can be used as a salvage treatment and obviate the need for invasive mechanical ventilation.