Articles: mechanical-ventilation.
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Biography Historical Article
Thomas L Petty's Lessons for the Respiratory Care Clinician of Today.
Because of the importance of his original contributions and their practical relevance today, Thomas L Petty (1932-2009) was arguably the most important physician in the history of respiratory care. As much as any single individual, he was responsible for the concept of intensive and multidisciplinary respiratory care. In the 1960s and 1970s, he made key observations and introduced pioneering therapies in the ICU and in the home. ⋯ Dr Petty emphasized the importance of practical, hands-on respiratory care education for both physicians and non-physicians using a collaborative team approach. He targeted educational activities and practical resources specifically to patients, and he showed how researchers and clinicians could interact responsibly with innovators in industry to the benefit of both. His life and career provide 6 important lessons for respiratory clinicians today and in the future: (1) whatever their roles, RTs and other clinicians in this field need to be experts in its core areas, such as mechanical ventilation, ARDS, and COPD; (2) respiratory care is a team activity: every member is important, and all the members need to communicate well and work together; (3) education needs to be targeted to those in the best position to benefit the patient, including primary care providers and family members; (4) everyone in the field needs to understand the important role of the respiratory care industry and to deal with it responsibly; (5) it must never be forgotten that it is all about the patient; and (6) respiratory care should be exciting and fun.
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Significant psychological impacts, including post-traumatic stress disorder (PTSD), have been associated with patients under sedation in intensive care units (ICUs). However, it remains unknown if and how sedation is related to post-ICU psychological outcomes. This literature review explores the relationships between sedation, the depth of sedation and psychological disorders. ⋯ To ensure subject relevance pre-2006, non-English and paediatric-based research was excluded. Findings highlighted that reduced sedation levels did not significantly reduce the outcome of PTSD, yet reduced ICU length of stay and length of mechanical ventilation (MV) were both associated with lighter sedation. Further research is recommended into more specific factual and delusional memories post ICU in relation to the level of sedation and to psychological distress.
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Am. J. Physiol. Lung Cell Mol. Physiol. · Jul 2014
Autophagy in pulmonary macrophages mediates lung inflammatory injury via NLRP3 inflammasome activation during mechanical ventilation.
The inflammatory response is a primary mechanism in the pathogenesis of ventilator-induced lung injury. Autophagy is an essential, homeostatic process by which cells break down their own components. We explored the role of autophagy in the mechanisms of mechanical ventilation-induced lung inflammatory injury. ⋯ Pharmacological inhibition of autophagy also significantly attenuated the inflammatory responses caused by lung hyperinflation. The activation of autophagy in macrophages mediates early lung inflammation during mechanical ventilation via NLRP3 inflammasome signaling. Inhibition of autophagy activation in lung macrophages may therefore provide a novel and promising strategy for the prevention and treatment of ventilator-induced lung injury.