Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace / Fondazione clinica del lavoro, IRCCS [and] Istituto di clinica tisiologica e malattie apparato respiratorio, Università di Napoli, Secondo ateneo
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Every intubated and mechanically-ventilated patient should be clinically evaluated, at least on a daily basis, by a skilled team in order to speed up the weaning process as much as possible. Again, it should be emphasized that the adoption of an active clinical strategy when faced with "difficult" to wean patients is of paramount importance. In one study, performed in Spain, analysing the prevalence of mechanical ventilation in intensive care units [3], reported the mean number of days that patients spent on mechanical ventilation was 27. ⋯ These data suggest that there are still some patients being on mechanical ventilation for a longer than necessary period of time. Finally, very recent advances in technological areas such as artificial intelligence, are proving to be useful in the management of the weaning process. When such systems are applied to modern microprocessor-controlled mechanical ventilators they can significantly help in the process of weaning [42] by automatically reducing the ventilatory assistance and by indicating the optimal time to withdraw the patient from the ventilator and proceed with extubation.
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Monaldi Arch Chest Dis · Jun 1998
ReviewInvasive mechanical ventilation in exacerbations of chronic obstructive pulmonary disease.
Exacerbations of chronic obstructive pulmonary disease are appropriately treated when severe airflow obstruction does not respond to intensive therapy, including, at times, noninvasive mechanical ventilation. Ventilatory strategies include avoidance of the ventilatory complications of dynamic pulmonary hyperinflation with its resultant intrinsic positive end-expiratory pressure, thereby decreasing the risk of hypotension and barotrauma. ⋯ Further adjustments are made on the basis of gas exchange and pulmonary mechanics. Medical therapies include beta-agonists and corticosteroids.
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Monaldi Arch Chest Dis · Jun 1998
Randomized Controlled Trial Clinical TrialNoninvasive techniques of weaning from mechanical ventilation.