Articles: mechanical-ventilation.
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Anaesthesiol Intensive Ther · Jan 2015
ReviewTranspulmonary pressure monitoring during mechanical ventilation: a bench-to-bedside review.
Different ventilation strategies have been suggested in the past in patients with acute respiratory distress syndrome (ARDS). Airway pressure monitoring alone is inadequate to assure optimal ventilatory support in ARDS patients. The assessment of transpulmonary pressure (PTP) can help clinicians to tailor mechanical ventilation to the individual patient needs. ⋯ Knowledge of the real lung distending pressure, i.e. the transpulmonary pressure, has shown to be useful in both controlled and assisted mechanical ventilation. In the latter ventilator modes, Peso measurement allows one to assess a patient's respiratory effort, patient-ventilator asynchrony, intrinsic PEEP and the calculation of work of breathing. Conditions that have an impact on Peso, such as abdominal hypertension, will also be discussed briefly.
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Yonsei medical journal · Jan 2015
Efficacy of veno-venous extracorporeal membrane oxygenation in severe acute respiratory failure.
The objective of this study was to evaluate our institutional experience with veno-venous (VV) extracorporeal membrane oxygenation (ECMO) in patients with severe acute respiratory failure (ARF). ⋯ VV ECMO is an excellent, life-saving treatment option in patients suffering from acute and life-threatening respiratory failure due to various causes, especially trauma, and early use of VV ECMO therapy improved outcomes in these patients.
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No previous study has been done to evaluate the admission serum potassium level as a predictor of morbidity or need for mechanical ventilation. The aim of this study is to determine the predictive ability of serum potassium on admission, in critically ill trauma patients, and to evaluate the relation of the potassium level to organ failure, length of stay, ventilator need, and duration of mechanical ventilation. ⋯ Development of hypokalemia during an ICU stay is associated with the need for mechanical ventilation. Monitoring of the serum potassium levels may be a good prognostic factor for the requirement of mechanical ventilation.
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Review Meta Analysis
Pneumonia prevention to decrease mortality in intensive care unit: a systematic review and meta-analysis.
To determine the strategies of prevention of hospital-acquired pneumonia that reduce mortality in intensive care unit (ICU). ⋯ Selective digestive decontamination with systemic antimicrobial therapy reduced mortality and should be considered in critically ill patients at high risk for death.
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JBI Database System Rev Implement Rep · Jan 2015
ReviewDiagnostic accuracy of methods used to verify nasogastric tube position in mechanically ventilated adult patients: a systematic review.
Nasogastric tubes are widely used in hospitals, e.g. for the administration of nutrients. However, nasogastric tubes can be inserted accidently into the airways leading to complications like pneumonia, pneumothorax and even death. Mechanically ventilated patients are at high risk of having a nasogastric tube misplaced, since they often have reduced consciousness and weak cough reflex. A variety of methods have been used for determination of nasogastric tube placement, but with varying success. ⋯ We found evidence (Level 2b) for colorimetric capnography to be a valid method for verifying nasogastric tube placement.Capnography also detected nasogastric tube position with very high accuracy. However, since these methods were tested in only a single study with a limited sample size, further research is required before clinical recommendations can be made.Despite the impressive results obtained by using colorimetric capnography, implication for practice is not straightforward. A concern is that the colorimetric capnograph is not produced by the manufacture to fit a NG tube and therefore has to be connected to the NG tube by an adaptor-system. Practical issues therefore have to be resolved if the method is supposed to become a standard procedure in a clinical setting.The execution of the procedure using colorimetric capnography differs between the studies. This systematic review therefore recommends that further research should be done to optimize the execution of the procedure.We also recommend that further research be done to reproduce the results obtained using capnography, since this method was tested only in a single study with a limited sample size.