Articles: mechanical-ventilation.
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Back ground and Objective: Mechanical Ventilation (MV) is frequently used as one of the most frequent life-supportive technology in Pediatric Intensive Care Units (PICUs). Very little data is available from Asian countries like Pakistan regarding use of MV in PICUs. Our objective was to assess the frequency, indications and immediate-outcomes in mechanically ventilated pediatric patients in tertiary-care center of developing country. ⋯ About half of PICU admission required mechanical ventilation for more than 24 hours. The neurological illness was the most common reason for ventilation. The low incidence of complication rate and relatively high mortality in cardiac cases and long duration of mechanical ventilation were noted in our cohort.
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Randomized Controlled Trial Comparative Study
In COPD patients on prolonged mechanical ventilation heart rate variability during the T-piece trial is better after pressure support plus PEEP: a pilot physiological study.
To evaluate heart rate variability (HRV), hemodynamics, mechanics, dyspnea and blood gases following different mechanical ventilation (MV) settings. ⋯ The T-piece trial following setting-2 seems less stressful on neural control of HRV. Future studies on T-piece trials should consider the residual effect of the MV setting.
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Randomized Controlled Trial Comparative Study
Home Mechanical Ventilation for COPD: High-Intensity Versus Target Volume Noninvasive Ventilation.
High-intensity noninvasive ventilation (HI-NIV) is the most effective means of improving several physiological and clinical parameters in subjects with chronic hypercapnic COPD. Whether the newer hybrid mode using target tidal volume noninvasive ventilation (target V(T) NIV) provides additional benefits remains unclear. ⋯ Switching subjects from well-established HI-NIV to target V(T) NIV shows no clinical benefits in chronic hypercapnic COPD. In particular, sleep quality, the control of nocturnal hypoventilation, daytime hypercapnia, overnight ventilation patterns, subjects' tolerance, health-related quality of life, lung function, and exercise capability were all similar in subjects who underwent HI-NIV and target V(T) NIV. Nevertheless, target V(T) NIV might offer some physiological advantages in breathing pattern and might be beneficial in some individual patients. (German Clinical Trials Register [www.drks.de] Registration DRKS00000450.).
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Randomized Controlled Trial
Impact of tracheostomy placement on anxiety in mechanically ventilated adult ICU patients.
To determine if self-reported anxiety levels decreased after tracheostomy placement in a sample of mechanically ventilated intensive care unit patients. ⋯ Prospective studies are needed to more accurately assess the impact of tracheostomy placement on patient anxiety and salient outcomes.
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J Intensive Care Med · Sep 2014
Review Case ReportsChiari syndrome and respiratory failure: a literature review.
Patients with failed extubation requiring reintubation have increased morbidity and mortality. This situation may reflect the severity of the underlying disorder or may reflect an undiagnosed condition that was not apparent at the time of the initial intubation. ⋯ Patients with CMs can have repeated extubation failures. Some of these patients have normal neurological examinations and studies and are not identified until they have an MRI study. Clinicians need to consider this possibility in patients who are difficult to wean.