Aust Crit Care
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Mechanical ventilation strategies for patients suffering from acute respiratory distress syndrome (ARDS) have traditionally relied on volume cycling. Due to the poor lung compliance characteristic of ARDS, these patients may be exposed to very high inspiratory pressures to achieve sufficient tidal volumes for adequate gas exchange. This greatly increases the risk of ventilator-induced lung injury associated with alveolar over-distention. The literature review explores the rationales behind alternative ventilation modes and strategies introduced to reduce the risk of ventilator-induced lung injury for the patient with ARDS.
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Despite the fact that tetanus is entirely preventable, mortality and morbidity as a result of this disease remain significant. The tetanus toxoid is one of the most potent poisons known. ⋯ Tetanus often leads to prolonged hospital stays and requires emergency and intensive care intervention and management. This case study illustrates a number of important points concerning the recognition, treatment, management and prevention of tetanus poisoning, and highlights the importance of considering the immunisation status of our elderly patients.