Articles: mechanical-ventilation.
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J. Cardiothorac. Vasc. Anesth. · Dec 2024
Effects of Neuraxial or General Anesthesia on the Incidence of Postoperative Pulmonary Complications in Patients Undergoing Peripheral Vascular Surgery: A Randomized Controlled Trial.
Postoperative complications after major surgery, especially in vascular procedures, are associated with a significant increase in costs and mortality. Postoperative pulmonary complications (PPCs) have a notable impact on morbidity and mortality. The primary aim of this present study was to evaluate the effects of spinal anesthesia compared with general anesthesia on the incidence of PPCs in patients undergoing lower extremity bypass surgery. ⋯ In this study, spinal anesthesia did not significantly reduce the incidence of PPCs in patients undergoing peripheral vascular surgery compared with general anesthesia. Neuraxial anesthesia may reduce the incidence of hypotension and the need for hemodynamic pharmacological support in patients undergoing peripheral arterial surgery, although further dedicated studies are required to validate these findings.
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The present study was designed to investigate the evolution and the impact of respiratory muscles function and limb muscles strength on weaning success in prolonged weaning of tracheotomized patients. The primary objective was to determine whether the change in respiratory muscles function and limb muscles strength over the time is or is not associated with weaning success. ⋯ Respiratory muscle function and limb muscles strength are severely impaired in patients with prolonged weaning from mechanical ventilation. Significant improvement of diaphragm ultrasound indices was associated with successful weaning from mechanical ventilation and ICU-acquired weakness upon admission was significantly associated with good outcome suggesting that it was an amendable determinant of weaning failure in this population.
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Am. J. Respir. Crit. Care Med. · Dec 2024
Air Hunger Far Exceeds Dyspnea Sense of Effort During Mechanical Ventilation and a Weaning Trial.
No systematic investigation into dyspnea in patients receiving prolonged ventilation (>21 days) after recovering from critical-illness has been published. ⋯ Patients developed increases in dyspnea and PtcCO2 but unchanged minute ventilation and work of breathing during an unassisted-breathing trial; patients selected air-hunger descriptors overwhelmingly over excessive effort; the observations support the belief that air hunger results from heightened respiratory-center stimulation combined with incapacity to increase minute ventilation.