Articles: mechanical-ventilation.
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J Intensive Care Med · Oct 2019
Multicenter StudyOncologists' and Intensivists' Attitudes Toward the Care of Critically Ill Patients with Cancer.
Patients with cancer represent an important proportion of intensive care unit (ICU) admissions. Oncologists and intensivists have distinct knowledge backgrounds, and conflicts about the appropriate management of these patients may emerge. ⋯ Oncologists and intensivists share different views regarding life support measures in critically ill patients with cancer. Oncologists tend to focus on the cancer characteristics, whereas intensivists focus on multiple organ failure when weighing in on the same decisions. Regular meetings between oncologists and intensivists may reduce possible conflicts regarding the critical care of patients with cancer.
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Observational Study
Energy balance in obese, mechanically ventilated intensive care unit patients.
The aims of this study were, first, to compare the predicted (calculated) energy requirements based on standard equations with target energy requirement based on indirect calorimetry (IC) in critically ill, obese mechanically ventilated patients; and second, to compare actual energy intake to target energy requirements. ⋯ Predictive equations underestimated target energy needs in this population. Further, we found that feeding to goal was often delayed resulting in failure to meet both protein and energy intake goals.
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Multicenter Study Observational Study
Epidemiology, Mechanical Power, and 3-Year Outcomes in Acute Respiratory Distress Syndrome Patients Using Standardized Screening. An Observational Cohort Study.
Rationale: Limited data on the epidemiology of acute respiratory distress syndrome (ARDS) using a standardized screening program exist. Objectives: To describe the population-based incidence of hypoxemic respiratory failure and ARDS using a prospective standardized screening protocol; and to describe the mechanical ventilation practice and the mechanical power and examine their association with 28-day and 3-year survival outcomes. Methods: A prospective standardized screening program for ARDS, as a quality improvement initiative, was initiated at four adult intensive care units over a 27-month period. ⋯ Increasing ARDS severity was associated with increased 28-day hospital and 3-year mortality. Increased mechanical power was associated with increased mortality. Potentially modifiable determinants of mechanical power associated with lower survival included plateau pressure and driving pressure.
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J. Cardiothorac. Vasc. Anesth. · Oct 2019
Observational StudyDevelopment and Validation of a Score to Identify Cardiac Surgery Patients at High Risk of Prolonged Mechanical Ventilation.
To develop and validate a score for the early identification of cardiac surgery patients at high risk of prolonged mechanical ventilation (MV) who may be suitable targets for interventional trials. ⋯ The authors developed a simple score to predict prolonged MV after cardiac surgery. This score, if externally validated, is potentially suitable for identifying a high-risk target population for future randomized controlled trials of postoperative care after cardiac surgery.
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Mechanical ventilation alarms and alerts, both audible and visual, provide the clinician with vital information about the patient's physiologic condition and the status of the machine's function. Not all alarms generated by the mechanical ventilator provide actionable information. ⋯ To date, mechanical ventilator alarm settings do not have standardized nomenclature. The aim of this review was to examine and report on the literature that pertains to mechanical ventilation alarms and alarm fatigue and to propose recommendations for future research that may lead to safer mechanical ventilation alarm practices.