Articles: mechanical-ventilation.
-
Journal of critical care · Dec 2018
An open-loop, physiological model based decision support system can reduce pressure support while acting to preserve respiratory muscle function.
To assess whether a clinical decision support system (CDSS) suggests PS and FIO2 maintaining appropriate breathing effort, and minimizing FIO2. ⋯ The CDSS advised on low values of PS often not prohibiting extubation, while acting to preserve respiratory muscle function and preventing passive lung inflation. CDSS advice minimized FIO2 maintaining SpO2 at safe and beneficial values.
-
To determine predictors of inability to return to work due to health six-months after intensive care admission; and compare functional recovery between patients who had not returned to work and employed patients. ⋯ Major trauma, lower GCS and increased hospital length of stay predicted inability to return to work due to health at six-months post-ICU admission. Compared to employed patients, those who had not returned to work reported poorer functional recovery.
-
Journal of critical care · Dec 2018
Patient views regarding the impact of hydrotherapy on critically ill ventilated patients: A qualitative exploration study.
Intensive Care Unit Acquired Weakness can be mitigated by early activity and progressive mobilization. Hydrotherapy enables patients to work on their recovery in a very early stage. This may lead to higher levels of self-efficacy, subsequently higher activity-rates and faster functional recovery. Hydrotherapy might positively affect the regaining of control, hope and trust. Our aim is to explore patient perspective regarding the impact of hydrotherapy on critically ill ventilated patients. ⋯ Hydrotherapy seemed to help patients regain control and belief in their recovery. Patients experienced exercising in water as a turning point in their recovery process. This study encourages to continue providing hydrotherapy to critically ill ventilated patients and may stimulate future research.
-
The diaphragm is the primary muscle of inspiration. Its capacity to respond to the load imposed by pulmonary disease is a major determining factor both in the onset of ventilatory failure and in the ability to successfully separate patients from ventilator support. It has recently been established that a very large proportion of critically ill patients exhibit major weakness of the diaphragm, which is associated with poor clinical outcomes. ⋯ Loss of force production by the diaphragm under these conditions is caused by a combination of defective contractility and reduced diaphragm muscle mass. Importantly, many of the same molecular mechanisms are implicated in the diaphragm dysfunction associated with both mechanical ventilation and sepsis. This review outlines the primary cellular mechanisms identified thus far at the nexus of diaphragm dysfunction associated with mechanical ventilation and/or sepsis, and explores the potential for treatment or prevention of diaphragm weakness in critically ill patients through therapeutic manipulation of these final common pathway targets.