Articles: mechanical-ventilation.
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Multicenter Study
Mechanical ventilation during extracorporeal membrane oxygenation. An international survey.
In patients with severe, acute respiratory failure undergoing venovenous extracorporeal membrane oxygenation (VV-ECMO), the optimal strategy for mechanical ventilation is unclear. ⋯ Although ventilation practices in patients supported by VV-ECMO vary across ELSO centers internationally, the majority of centers used a strategy that targeted lung-protective thresholds and prioritized weaning VV-ECMO over mechanical ventilation.
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Journal of critical care · Apr 2014
Multicenter StudyTargeting occult heart failure in intensive care unit patients with acute chronic obstructive pulmonary disease exacerbation: Effect on outcome and quality of life.
To estimate the prevalence of previously undiagnosed heart failure in mechanically ventilated patients with severe exacerbation of chronic obstructive pulmonary disease (COPD) and to evaluate the impact of specific heart failure treatment on patients' outcome. ⋯ In mechanically ventilated patients with severe exacerbation of COPD, unrecognized left or right ventricular failure is common. Among patients with isolated left ventricular failure, the early detection and appropriate treatment improves long-term quality of life and may decrease the short- and 6-month morbidity and mortality.
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J. Thorac. Cardiovasc. Surg. · Jan 2014
Multicenter StudyInvasive mechanical ventilation in patients with fibrosing interstitial pneumonia.
The prognosis of patients with idiopathic pulmonary fibrosis or fibrosing idiopathic nonspecific interstitial pneumonia undergoing invasive mechanical ventilation (MV) for acute respiratory failure is known to be poor. The issue of life support in these patients needs to be reconsidered in light of changes during the past decade in ventilator settings and in the management of acute exacerbation. We therefore aimed to reassess the prognosis of such patients. ⋯ We confirm that use of invasive MV for acute respiratory failure in patients with idiopathic pulmonary fibrosis or fibrosing idiopathic nonspecific interstitial pneumonia is associated with a high mortality; however, a subset of patients may be discharged alive from the intensive care unit and hospital, providing an opportunity to consider lung transplant in case of eligibility. Our results suggest that invasive MV should not be systematically denied to these patients but discussed on a case-by-case basis.
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Multicenter Study Comparative Study
Infants with severe respiratory syncytial virus needed less ventilator time with nasal continuous airways pressure then invasive mechanical ventilation.
Nasal continuous positive airway pressure (NCPAP) has been proposed as an early first-line support for infants with severe respiratory syncytial virus (RSV) infection. We hypothesised that infants <6 months with severe RSV would require shorter ventilator support on NCPAP than invasive mechanical ventilation (IMV). ⋯ Nasal continuous positive airway pressure was independently associated with a shorter duration of ventilatory support. Differences in baseline disease severity mandate a randomised trial before the routine use of NCPAP can be recommended.
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For children with cyanotic congenital heart disease or acute hypoxemic respiratory failure, providers frequently make decisions based on pulse oximetry, in the absence of an arterial blood gas. The study objective was to measure the accuracy of pulse oximetry in the saturations from pulse oximetry (SpO2) range of 65% to 97%. ⋯ Previous studies on pulse oximeter accuracy in children present a single number for bias. This study identified that the accuracy of pulse oximetry varies significantly as a function of the SpO2 range. Saturations measured by pulse oximetry on average overestimate SaO2 from CO-oximetry in the SpO2 range of 76% to 90%. Better pulse oximetry algorithms are needed for accurate assessment of children with saturations in the hypoxemic range.