Articles: mechanical-ventilation.
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Review Randomized Controlled Trial
Identification and Prevention of Extubation Failure in Adults using an Automated Continuous Monitoring Alert vs Standard Care: A Randomized Controlled Trial.
Postextubation monitoring helps identify patients at risk of developing respiratory failure. This study aimed to evaluate the effect of our standard respiratory therapist (RT) assessment tool versus an automated continuous monitoring alert to initiate postextubation RT-driven care on the re-intubation rate. ⋯ In subjects who received mechanical ventilation for > 24 h, there were no significant outcome or cost differences between our standard RT assessment tool or an automated monitoring alert to initiate postextubation RT-driven care. Using an automated continuous monitoring alert to initiate RT-driven care saved RT time. (ClinicalTrials.gov registration NCT04231890).
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Minerva anestesiologica · Sep 2022
Meta AnalysisIncidence, clinical characteristics and outcome of barotrauma in critically ill patients with COVID-19: a systematic review and meta-analysis.
ICU patients with COVID have a higher incidence of barotrauma than non-COVID patients, despite similar ventilation management.
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Acute respiratory failure requiring invasive mechanical ventilation is a common presentation in the emergency department. Providers can further improve care for these patients by understanding common modes of mechanical ventilation, recognizing changes in respiratory mechanics, and tailoring ventilator settings and therapies accordingly.
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Acute respiratory distress syndrome (ARDS) occurs in up to 10% of patients with respiratory failure admitted through the emergency department. Use of noninvasive respiratory support has proliferated in recent years; clinicians must understand the relative merits and risks of these technologies and know how to recognize signs of failure. The cornerstone of ARDS care of the mechanically ventilated patient is low-tidal volume ventilation based on ideal body weight. Adjunctive therapies, such as prone positioning and neuromuscular blockade, may have a role in the emergency department management of ARDS depending on patient and department characteristics.