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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The aim of this comparative study was to assess the impact of two different settings of tidal volume (Vt) on the function and morphology of the mechanically ventilated lungs during a 12-h period. ⋯ Mechanical ventilation with a Vt of 6 ml/kg induces minimal histological lung parenchymal changes in terms of proliferation and apoptosis. Positive pressure mechanical ventilation with Vt of 10 ml/kg does not protect lung tissue and induces substantial proliferative and apoptotic changes within the lung parenchyma. Positive pressure mechanical ventilation with Vt of 10 ml/kg does not guarantee protection of healthy pulmonary tissue in the absence of a priming pulmonary insult.
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Management of critically ill patients in austere environments is a logistic challenge. Availability of oxygen cylinders for the mechanically ventilated patient may be difficult in such a context. A solution is to use a ventilator able to function with an oxygen concentrator. ⋯ The ability of an oxygen concentrator to deliver high FiO2 when used with a turbine ventilator makes this method of oxygen delivery a viable alternative to cylinders in austere environments when used with a turbine ventilator. However, FiO2 has to be monitored continuously because delivered FiO2 decreases when minute ventilation is increased.
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Prior researches have showed that weaning protocols may decrease the duration of mechanical ventilation. The effect of these protocols on chronic obstructive pulmonary disease (COPD) patients is unknown. The purpose of this study was to evaluate the impact of an extensive mechanical ventilation protocol including weaning applied by a respiratory therapist (RT) on the duration of mechanical ventilation and intensive care unit (ICU) stay in COPD patients. ⋯ In our center, a protocolized mechanical ventilation and weaning strategy improved weaning success and shortened the total duration of mechanical ventilation and ICU stay in COPD patients requiring mechanical ventilation.
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Journal of critical care · Aug 2014
Randomized Controlled Trial Comparative StudyComparison of invasive and noninvasive positive pressure ventilation delivered by means of a helmet for weaning of patients from mechanical ventilation.
The effectiveness of noninvasive positive pressure ventilation delivered by helmet (H-NPPV) as a weaning approach in patients with acute respiratory failure is unclear. ⋯ H-NPPV was well tolerated and effective in patients who were difficult to wean.