Articles: ventilators.
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Semin Respir Crit Care Med · Jun 2022
Liberation from Mechanical Ventilation: Established and New Insights.
A substantial proportion of critically ill patients require ventilator support with the majority requiring invasive mechanical ventilation. Timely and safe liberation from invasive mechanical ventilation is a critical aspect of patient care in the intensive care unit (ICU) and is a top research priority for patients and clinicians. ⋯ We also discuss the roles for (4) extubation to noninvasive ventilation and (5) newer modes of mechanical ventilation during liberation from mechanical ventilation. We conclude that, though substantial progress has been made in identifying patients who are likely to be liberated (e.g., through the use of SBTs) and management strategies that speed liberation from the ventilator (e.g., protocolized SBTs, lighter sedation, and early mobilization), many important questions regarding liberation from mechanical ventilation in clinical practice remain unanswered.
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J Clin Monit Comput · Jun 2022
Continuous non-contact respiratory rate and tidal volume monitoring using a Depth Sensing Camera.
The monitoring of respiratory parameters is important across many areas of care within the hospital. Here we report on the performance of a depth-sensing camera system for the continuous non-contact monitoring of Respiratory Rate (RR) and Tidal Volume (TV), where these parameters were compared to a ventilator reference. Depth sensing data streams were acquired and processed over a series of runs on a single volunteer comprising a range of respiratory rates and tidal volumes to generate depth-based respiratory rate (RRdepth) and tidal volume (TVdepth) estimates. ⋯ In conclusion, a high degree of agreement was found between the depth-based respiration rate and its ventilator reference, indicating that RRdepth is a promising modality for the accurate non-contact respiratory rate monitoring in the clinical setting. In addition, a high degree of correlation between depth-based tidal volume and its ventilator reference was found, indicating that TVdepth may provide a useful monitor of tidal volume trending in practice. Future work should aim to further test these parameters in the clinical setting.
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Critical care medicine · May 2022
Ventilator-Associated Lower Respiratory Tract Bacterial Infections in COVID-19 Compared With Non-COVID-19 Patients.
Ventilator-associated lower respiratory tract infections (VA-LRTIs) are associated with prolonged length of stay and increased mortality. We aimed to investigate the occurrence of bacterial VA-LRTI among mechanically ventilated COVID-19 patients and compare these findings to non-COVID-19 cohorts throughout the first and second wave of the pandemic. ⋯ COVID-19 is associated with exceptionally long durations of mechanical ventilation treatment and high VA-LRTI occurrence proportions. The incidence rate of VA-LRTI was compared with the pooled non-COVID-19 cohort, however, not increased in COVID-19. Significant differences in the incidence of VA-LRTI occurred between the first and second wave of the COVID-19 pandemic.