Articles: mechanical-ventilation.
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J Paediatr Child Health · Jan 2014
Comparative StudyDräger VN500's oscillatory performance has a frequency-dependent threshold.
The aim of this study is to compare the high-frequency pressure amplitude (oscillatory change in pressure (ΔP)) and tidal volume (high-frequency tidal volume at the airway opening (VTHF )) delivered by the Dräger VN500 (Drägerwerk Ag & Co., Lübeck, Germany) and the Sensormedics 3100 (SM3100; CareFusion, San Diego, CA, USA) through a range of oscillatory frequencies. ⋯ The VN500 demonstrates a frequency-related reduction in ΔP not observed in the SM3100. Clinicians need to be aware of these differences in performance characteristics.
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Annals of intensive care · Jan 2014
A ventilator strategy combining low tidal volume ventilation, recruitment maneuvers, and high positive end-expiratory pressure does not increase sedative, opioid, or neuromuscular blocker use in adults with acute respiratory distress syndrome and may improve patient comfort.
The Lung Open Ventilation Study (LOV Study) compared a low tidal volume strategy with an experimental strategy combining low tidal volume, lung recruitment maneuvers, and higher plateau and positive end-expiratory pressures (PEEP) in adults with acute respiratory distress syndrome (ARDS). Herein, we compared sedative, opioid, and neuromuscular blocker (NMB) use among patients managed with the intervention and control strategies and clinicians' assessment of comfort in both groups. ⋯ In the LOV Study, high PEEP, low tidal volume ventilation did not increase sedative, opioid, or NMB doses in adults with ARDS, compared with a lower PEEP strategy, and appeared at least as comfortable for patients. NMB use may reflect worse lung injury, as these patients had more barotrauma, longer durations of ventilation, and higher mortality.
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Annals of intensive care · Jan 2014
Daily sedative interruption versus intermittent sedation in mechanically ventilated critically ill patients: a randomized trial.
Daily sedative interruption and intermittent sedation are effective in abbreviating the time on mechanical ventilation. Whether one is superior to the other has not yet been determined. Our aim was to compare daily interruption and intermittent sedation during the mechanical ventilation period in a low nurse staffing ICU. ⋯ There was no difference in the number of ventilator-free days in 28 days between both groups. Intermittent sedation was associated with lower sedative and opioid doses.
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Clin. Exp. Pharmacol. Physiol. · Jan 2014
Pulse pressure variation does not reflect stroke volume variation in mechanically ventilated rats with lipopolysaccharide-induced pneumonia.
1. The present study examined the relationship between centrally measured stroke volume variation (SVV) and peripherally derived pulse pressure variation (PPV) in the setting of increased total arterial compliance (CA rt ). 2. Ten male Wistar rats were anaesthetized, paralysed and mechanically ventilated before being randomized to receive intrapulmonary lipopolysaccharide (LPS) or no LPS. ⋯ There was no such correlation in LPS-treated rats either before (r = -0.08; P = 0.70) or during (r = 0.36; P = 0.08) vena cava occlusion. 4. In conclusion, under normovolaemic and hypovolaemic conditions, PPV does not reflect SVV during an increase in CA rt following LPS-induced pneumonia in mechanically ventilated rats. Our data caution against their interchangeability in human sepsis.
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Annals of intensive care · Jan 2014
Self-reported attitudes versus actual practice of oxygen therapy by ICU physicians and nurses.
High inspiratory oxygen concentrations are frequently administered in ventilated patients in the intensive care unit (ICU) but may induce lung injury and systemic toxicity. We compared beliefs and actual clinical practice regarding oxygen therapy in critically ill patients. ⋯ Most ICU clinicians acknowledge the potential adverse effects of prolonged exposure to hyperoxia and report a low tolerance for high oxygen levels. However, in actual clinical practice, a large proportion of their ICU patients was exposed to higher arterial oxygen levels than self-reported target ranges.