American journal of respiratory and critical care medicine
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Am. J. Respir. Crit. Care Med. · Nov 2024
Timing of Extubation in Adult Patients with Acute Brain Injury.
Whether extubation immediately after a successful spontaneous breathing trial is associated with clinical benefits in adult patients with acute brain injury is unknown. ⋯ Prompt extubation following a first successful spontaneous breathing trial was associated with more ventilator-free days (up to 28 days) among adults with acute brain injury receiving invasive mechanical ventilation.
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Am. J. Respir. Crit. Care Med. · Nov 2024
Randomized Trial of the Four Supports Intervention for Surrogate Decision Makers in Intensive Care Units.
Individuals acting as surrogate decision-makers for critically ill patients frequently struggle in this role and experience high levels of long-term psychological distress. Prior interventions designed solely to improve information sharing between clinicians and family members have been ineffective. ⋯ gov, ID: NCT01982877.
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Am. J. Respir. Crit. Care Med. · Nov 2024
Impact of Fluid Balance on the Development of Lung Injury.
The pathophysiological relationship between fluid administration, fluid balance, and mechanical ventilation in the development of lung injury is unclear. ⋯ In conclusion, our study did not detect a significant difference in lung injury between high and low mechanical power. Some damage is directly attributable to mechanical power, while additional injury appears to result indirectly from high fluid balance, which reduces end-expiratory lung gas volume, with ascites playing an important role in this process.