Revista Brasileira de terapia intensiva
-
To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. ⋯ Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation.
-
Rev Bras Ter Intensiva · Jan 2017
Observational StudyPrognostic impact of the time of admission and discharge from the intensive care unit.
To determine the impact of the day and time of admission and discharge from the intensive care unit on mortality. ⋯ This study identified the time of discharge from the intensive care unit as a factor that was independently associated with hospital mortality.
-
Rev Bras Ter Intensiva · Jan 2017
Observational StudyPredictors and pattern of weaning and long-term outcome of patients with prolonged mechanical ventilation at an acute intensive care unit in North India.
This study aimed to examine the clinical characteristics, weaning pattern, and outcome of patients requiring prolonged mechanical ventilation in acute intensive care unit settings in a resource-limited country. ⋯ In acute intensive care units, more than one-fourth of patients with invasive ventilation required prolonged ventilation. Successful weaning was achieved in two-thirds of patients, and most survived at the 12-month follow-up.
-
Rev Bras Ter Intensiva · Jan 2017
Case ReportsUse of noninvasive ventilation in severe acute respiratory distress syndrome due to accidental chlorine inhalation: a case report.
Acute respiratory distress syndrome is characterized by diffuse inflammatory lung injury and is classified as mild, moderate, and severe. Clinically, hypoxemia, bilateral opacities in lung images, and decreased pulmonary compliance are observed. Sepsis is one of the most prevalent causes of this condition (30 - 50%). ⋯ The failure rate of noninvasive ventilation in cases of acute respiratory distress syndrome is approximately 52% and is associated with higher mortality. The possible complications of using noninvasive positive-pressure mechanical ventilation in cases of acute respiratory distress syndrome include delays in orotracheal intubation, which is performed in cases of poor clinical condition and with high support pressure levels, and deep inspiratory efforts, generating high tidal volumes and excessive transpulmonary pressures, which contribute to ventilation-related lung injury. Despite these complications, some studies have shown a decrease in the rates of orotracheal intubation in patients with acute respiratory distress syndrome with low severity scores, hemodynamic stability, and the absence of other organ dysfunctions.