Resp Care
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We investigated whether decreasing ventilator circuit changes from every 2 days to every 7 days would impact ventilator-associated pneumonia rates at our institution. ⋯ A circuit change interval of 7 days had a lower risk of ventilator-associated pneumonia than a 2-day change interval. Therefore, ventilator circuits can be safely changed every 7 days in our setting.
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Measure the fraction of inspired oxygen (F(IO(2))) in infants receiving supplemental oxygen via nasal cannula and identify clinical variables that affect F(IO(2)). ⋯ Infants receiving oxygen via nasal cannula at > or = 2 L/min may be at risk for hyperoxic lung injury. Therefore, we recommend using the lowest possible oxygen flow needed to maintain normoxia in infants requiring prolonged oxygen therapy via nasal cannula.
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Sonography has inherent limitations for thoracic imaging because sound waves are reflected by bone and air space (such as in lung parenchyma). However, sonography is less expensive and more convenient than computed tomography (CT) or magnetic resonance imaging (MRI); it provides immediate information with real-time imaging; and it can provide information not available from a standard radiograph. This review describes the utility and limitations of sonography and compares sonography to radiography, CT, and MRI with regard to diagnosing pleural, pulmonary, and aortic diseases, including pneumothorax, pleural effusions and masses, hemothorax, empyema, consolidated lung, pneumonia, pulmonary abscess, pulmonary embolism, mediastinal masses, aortic dissection, aortic intramural hematoma, and penetrating aortic ulcers.
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Test whether a change in oxygen consumption produced by a reduction in level of mechanical ventilatory support predicts failure to tolerate the reduction in level of support. ⋯ Change in V(O(2)) following an incremental reduction in level of mechanical ventilatory support may be a useful predictor for determining which patients will rapidly fail to tolerate that level of reduction.