Articles: mechanical-ventilation.
-
Am. J. Physiol. Lung Cell Mol. Physiol. · Jul 2014
Mechanical ventilation causes airway distension with proinflammatory sequelae in mice.
The pathogenesis of ventilator-induced lung injury has predominantly been attributed to overdistension or mechanical opening and collapse of alveoli, whereas mechanical strain on the airways is rarely taken into consideration. Here, we hypothesized that mechanical ventilation may cause significant airway distension, which may contribute to the pathological features of ventilator-induced lung injury. C57BL/6J mice were anesthetized and mechanically ventilated at tidal volumes of 6, 10, or 15 ml/kg body wt. ⋯ Mechanical ventilation causes a rapid, pronounced, and reversible distension of upper airways in mice that is associated with an increase in functional dead space. Upper airway distension is most pronounced at moderate tidal volumes, whereas higher tidal volumes redistribute preferentially to the alveolar compartment. Airway distension triggers proinflammatory responses and may thus contribute relevantly to ventilator-induced pathologies.
-
Eur J Cardiothorac Surg · Jul 2014
Outcomes in patients requiring mechanical ventilation following pneumonectomy.
The aim of this study was to clarify the outcomes of patients who require post-pneumonectomy mechanical ventilation (PPMV). ⋯ Our findings suggest that continued PPMV patients may have a rate of weaning at hospital dismissal and OS comparable to reintubated PPMV patients. A lower fraction of inhaled oxygen and less positive fluid balance may be favoured managements in reintubated PPMV patients.
-
To test the hypothesis that there would be better clinical outcomes following the treatment of patients with acute lung injury (ALI) using noninvasive positive-pressure mechanical ventilation (NIPPV) delivered via a complex critical care ventilator compared with a conventional mini-ventilator. ⋯ The findings of this present study suggest that there were more satisfactory clinical outcomes following the treatment of patients with ALI when NIPPV was delivered using a complex critical care ventilator compared with a conventional mini-ventilator.
-
Management of the artificial airway includes securing the tube to prevent dislodgement or migration as well as removal of secretions. Preventive measures include adequate humidification and appropriate airway suctioning. ⋯ A number of new monitoring techniques have been introduced, and automated cuff pressure control is becoming more common. The respiratory therapist should be adept with all these devices and understand the appropriate application and management.
-
Although nutrition support is essential in intensive care units, optimal energy intake remains unclear. Here, we assessed the influence of energy intake on outcomes of critically ill, underweight patients. ⋯ Reduced energy intake during the first week in EICU was associated with a reduced MVD in clinically ill patients with BMI <20.0 kg/m(2).