Minerva anestesiologica
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Minerva anestesiologica · May 2013
Editorial CommentEndotracheal cuffs and microaspiration. No guarantees.
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Minerva anestesiologica · Apr 2013
ReviewPatient-ventilator dyssynchrony during assisted invasive mechanical ventilation.
Patient-ventilator dyssynchrony is common during mechanical ventilation. Dyssynchrony decreases comfort, prolongs mechanical ventilation and intensive care unit stays, and might lead to worse outcome. Dyssynchrony can occur during the triggering of the ventilator, the inspiration period after triggering, the transition from inspiration to expiration, and the expiratory phase. ⋯ To date, technological complexity has made it impossible to evaluate patient-ventilator synchrony throughout the course of mechanical ventilation. Studies have shown that a high index of dyssynchrony may increase the duration of mechanical ventilation. Better training, better ventilatory modes, and/or computerized systems that permit better synchronization of patients' demands and ventilator outputs are necessary to improve patient-ventilator synchrony.
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Fever is a common symptom in intensive care unit (ICU) patients and is caused by a wide variety of infectious and noninfectious disorders. The presence of fever often results in the act of diagnostic tests and procedures that considerably increase medical costs and expose the patient to inappropriate use of antibiotics which eventually results in antibiotic resistance. ⋯ Currently, managing ICU patients with fever should be towards a more restrictive approach than simply starting antibiotic therapy. This review summarizes the common causes of fever in ICU patients and outlines a clinical approach to the management of these patients.