Articles: mechanical-ventilation.
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The current frequency of noninvasive (NIV) and invasive mechanical ventilation use in asthma exacerbations (AEs) and the relationship to outcomes are unknown. ⋯ There was a substantial increase in the use of mechanical ventilation, accompanied by a shift from invasive mechanical ventilation to NIV. Although we could not determine the clinical reasons for this increase, hospital stay and mortality were unchanged. A randomized trial is needed to determine whether NIV can improve outcomes in AEs before widespread adoption makes it impossible to conduct such a trial.
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Iran J Nurs Midwifery Res · May 2014
Developing a readiness assessment tool for weaning patients under mechanical ventilation.
Mechanical ventilation is one of the major supportive interventions in intensive care units. Weaning the patients from mechanical ventilation and its related criteria are of great importance due to the related complications. As there is no comprehensive standard to allocate the time of weaning and due to lack of local research in this field, development of a comprehensive tool to measure patients' readiness for weaning from mechanical ventilation is essential. Therefore, the present study was conducted with an aim to develop a readiness assessment tool for weaning patients from mechanical ventilation. ⋯ A three-domain questionnaire is the product of experts' consensus in the present study, which can be used to reduce the length of connection to mechanical ventilation and its complications.
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Journal of critical care · Apr 2014
Neurally adjusted ventilatory assist vs pressure support ventilation in infants recovering from severe acute respiratory distress syndrome: Nested study.
Neurally adjusted ventilatory assist (NAVA) is a new ventilator modality with an innovative synchronization technique. Our aim is to verify if NAVA is feasible and safe in terms of physiological and clinical variables in infants recovering from severe acute respiratory distress syndrome (ARDS). ⋯ Neurally adjusted ventilatory assist is safe and suitable in infants recovering from severe ARDS. It could provide better results than PSV and is worth to be investigated in a multicenter randomized trial.
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Sleep medicine reviews · Apr 2014
ReviewSleep of critically ill children in the pediatric intensive care unit: a systematic review.
Critically ill children in the pediatric intensive care unit (PICU) are exposed to multiple physical, environmental and pharmacologic factors which increase the propensity for sleep disruption and loss and may, in turn, play a role in short-term recovery from critical illness and long-term neurocognitive outcomes. Mechanically ventilated children receive sedative and analgesic medications, often at high doses and for long durations, to improve comfort and synchrony with mechanical ventilation. ⋯ The heterogeneity in age and critical illness encountered in the PICU pose several challenges to research on sleep in this setting. The present article reviews the available evidence on sleep in critically ill children admitted to the PICU, with an emphasis on subjective and objective methods of sleep assessment used and special populations studied, including mechanically ventilated children and children with severe burns.
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Randomized Controlled Trial
Lung volume changes during cleaning of closed endotracheal suction catheters: a randomised crossover study using electrical impedance tomography.
Airway suctioning in mechanically ventilated patients is required to maintain airway patency. Closed suction catheters (CSCs) minimize lung volume loss during suctioning but require cleaning post-suction. Despite their widespread use, there is no published evidence examining lung volumes during CSC cleaning. The study objectives were to quantify lung volume changes during CSC cleaning and to determine whether these changes were preventable using a CSC with a valve in situ between the airway and catheter cleaning chamber. ⋯ When there is no valve between the airway and suction catheter, cleaning of the CSC results in significant derangements in lung volume. Therefore, the presence of such a valve should be considered essential in preserving lung volumes and uninterrupted ventilation in mechanically ventilated patients.