Articles: mechanical-ventilation.
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The extubation period is one of the most challenging aspects for intensive care teams. Timely recognition of the return to spontaneous ventilation is essential for reducing costs, morbidity, and mortality. Several weaning predictors were studied in an attempt to evaluate the outcome of removing ventilatory support. The purpose of this study was to analyze the predictive performance of the modified integrative weaning index (IWI) in the extubation process. ⋯ We concluded that modified IWI, similar to other extubation predictors, does not accurately predict extubation failure.
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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.
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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).
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Mechanical ventilation is a fundamental treatment of acute respiratory distress syndrome (ARDS). Despite compliance with the recommendations of protective mechanical ventilation, it can results in serious complications including the pulmonary barotrauma. ⋯ This observation describes an unusual aspect of barotrauma which is pneumomediastinum. The authors also point out the role of chest imaging in the management of mechanical ventilation during ARDS.
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Preservation or restoration of normal alveolar epithelial barrier function is crucial for pulmonary oedema resolution. Keratinocyte growth factor-2 (KGF-2), a potent epithelial cell mitogen, may have a role in preventing ventilator-induced lung injury (VILI), which occurs frequently in mechanically ventilated patients. The aim of the study was to test the role of KGF-2 in VILI in rats. ⋯ Inflammatory cytokines (tumour necrosis factor-α, macrophage inflammatory protein 2), neutrophil and total protein levels in bronchoalveolar lavage fluid and surfactant protein mRNA expression in lung tissue were detected; the number of alveolar type II cells, lung water content and lung morphology were also evaluated. The results indicate that pre-treatment with KGF-2 showed dramatic improvement in lung oedema and inflammation compared with HVZP alone, together with increased surfactant protein mRNA and alveolar type II cells. Our results suggest that KGF-2 might be considered a promising prevention for human VILI or other acute lung injury diseases.