Chest
-
Comparative Study
Post-ICU mechanical ventilation: treatment of 1,123 patients at a regional weaning center.
To update our database, reporting changes in the results of weaning attempts and profile of patients transferred to us after prolonged mechanical ventilation (PMV) in the ICU. ⋯ Patients are being transferred from the ICU to our RWC for attempted weaning sooner in their course of PMV. Although more severely ill on arrival than in past years, mortality is unchanged, more than half of the patients continue to be successfully weaned, and survival after RWC discharge is improved.
-
Comparative Study
Human and financial costs of noninvasive mechanical ventilation in patients affected by COPD and acute respiratory failure.
It has been suggested that noninvasive mechanical ventilation (NIMV) may be a time-consuming procedure for medical and paramedical personnel. We carried out a prospective trial in 10 consecutive COPD patients aimed at assessing the human and economic resources needed to ventilate patients by NIMV and we compared these with those needed by a group of six patients receiving invasive mechanical ventilation (InMV). ⋯ We conclude that in the first 48 h of ventilation, daily NIMV is neither more expensive nor time-consuming and staff demanding than InMV. After the first few days of ventilation, NIMV was significantly less time-consuming than InMV, for MDs and Ns, so that medical and paramedical time expenditure seems not to be a major problem during NIMV.
-
Increasing evidence indicates that routine preoperative diagnostic spirometry (pulmonary function tests [PFTs]) before elective abdominal surgery does not predict individual risk of postoperative pulmonary complications and is overutilized. This economic evaluation estimates potential savings from reduced use of preoperative PFTs. ⋯ Reduced use of PFTs before elective abdominal surgery could generate substantial savings. Current evidence indicates reduced use would not compromise patients' outcomes.
-
To highlight the incidence of subglottic stenosis (SGS) as a complication of surgery for congenital heart disease and the role of single-stage laryngotracheoplasty in treating this complication. ⋯ SGS can complicate surgery for congenital heart disease in children. Single-stage LTR is an effective treatment modality for this problem.