Articles: mechanical-ventilation.
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Currently, no clinical or animal studies have been performed to establish the relationship between airway humidification and mechanical ventilation-induced lung inflammatory responses. Therefore, an animal model was established to better define this relationship. ⋯ Pathology and reduced inflammation observed in animals treated at 40°C was similar to that observed in the control animals, suggesting that appropriate humidification reduced inflammatory responses elicited as a consequence of mechanical ventilation, in addition to reducing damage to the cilia and reducing water loss in the airway.
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On June 14, 2015, Ladha and colleagues published an article in the BMJ entitled "Intraoperative protective mechanical ventilation and risk of postoperative respiratory complications: hospital based registry study", which investigated the effects of intraoperative protective ventilation on major postoperative respiratory complications. This study used data of over 69,265 patients in order to investigate patients over the age of 18 who underwent a non-cardiac surgical procedure between January 2007 and August 2014 and required general anesthesia with endotracheal intubation. The investigators found that intraoperative protective ventilation was associated with a decreased risk of postoperative respiratory complications. This study raises important questions about the ventilatory management of surgical patients.
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Comparative Study
Pressurized Metered-Dose Inhalers Versus Nebulizers in the Treatment of Mechanically Ventilated Subjects With Artificial Airways: An In Vitro Study.
The primary focus of previous aerosol research during mechanical ventilation was the endotracheal tube (ETT). Consequently, there are limited data in the literature on the delivery of inhaled medications administered with different aerosol devices in mechanically ventilated patients with a tracheostomy tube (TT). The purpose of this study was to quantify and compare the efficiency of aerosol devices in a lung model of an intubated and mechanically ventilated adult with a TT. ⋯ Aerosol drug delivery via a TT was greater than with an ETT, whereas the delivery efficiency of a pMDI via either airway was greater than that of a jet nebulizer.
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Indian J Crit Care Med · Nov 2015
Critical illness associated with 2013-2014 influenza A (H1N1): Postpandemic characteristics, presentation and outcomes.
The United States experienced a postpandemic outbreak of H1N1 influenza in 2013-2014. Unlike the pandemic in 2009 clinical course and outcomes associated with critical illness in this postpandemic outbreak has been only sparsely described. ⋯ Compared to the 2009-2010 pandemic, the 2013-2014 H1N1 strain affected older patients with more underlying co-morbid cardio-pulmonary diseases. The patients had worse oxygenation indices and rescue modalities such as prone ventilation, inhaled epoprostenol and ECMO, were used more consistently as compared to the 2009 pandemic.