Articles: mechanical-ventilation.
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The Journal of infection · Sep 2014
Multicenter StudyAspergillus in the lower respiratory tract of immunocompetent critically ill patients.
To shed light on the meaning of Aspergillus-positive lower-respiratory-tract samples in non immunocompromized critically ill patients. ⋯ In critically ill immunocompetent patients, risk factors for presence of Aspergillus in lower respiratory tract specimens are steroid therapy (either chronic or initiated in the ICU), ARDS, and high severity of the acute illness. Prospective studies are warranted to further examine these risk factors and to investigate immune functions as well as the impact of antifungal therapy on patient outcomes.
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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
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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The objective of this project was to reduce the number of failed extubations in the pediatric intensive care unit. This article describes extubation failures in the pediatric intensive care unit and the development and implementation of an extubation readiness protocol using the Iowa Model for Evidence-based Practice as a guideline. The Iowa Model consists of processes for implementing evidence into practice, such as critiquing and synthesizing the literature, identifying stakeholders, and recognizing triggers. The extubation protocol was developed excluding children with previous lung injury and/or neuromuscular conditions, which contribute to an increased risk and complexity of planned extubations.
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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.