Articles: mechanical-ventilation.
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To investigate the value of measuring the diaphragm thickness (DT) on thorax computed tomography (CT) at intensive care unit (ICU) admission for predicting intubation requirement and mortality among COVID-19 patients. ⋯ Mortality and MV requirements can be predicted from DT measurements. Diaphragm thickness can facilitate the identification of high-risk patients on CT evaluation at ICU admission.
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Pediatr Crit Care Me · Oct 2022
Long-Term Pulmonary Outcomes in Children Mechanically Ventilated for Severe Bronchiolitis.
Bronchiolitis is a common indication for mechanical ventilation in the PICU. Both bronchiolitis and invasive mechanical ventilation may cause adverse long-term pulmonary outcomes. This study investigates children with a history of invasive mechanical ventilation for bronchiolitis, addressing: 1) the extent, 2) potential explanatory factors, and 3) possible impact on daily life activities of adverse long-term pulmonary outcomes. ⋯ In this single-center cohort, one-quarter of the children attending follow-up with a history of invasive mechanical ventilation for bronchiolitis had adverse, mostly previously undetected, long-term pulmonary outcomes at 6-12 years. Atopic disease in family and longer duration of invasive mechanical ventilation were associated with presence of asthma. The presence of adverse pulmonary outcomes was associated with more frequent use of pulmonary medication after PICU discharge.
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The aim of this study was to define the level of peak inspiratory pressure (PIP) and mean airway pressure ([Formula: see text]) at which a pneumothorax is produced in an in vivo ARDS neonate model. In addition, we analyzed the hemodynamic response and cerebral parameters during the progressive increase of intrathoracic pressure. ⋯ A progressive increase of PEEP at a constant driving pressure did not increase severe adverse events at the range of pressures that we routinely use in neonates with ARDS. Asystole, pneumothorax, and cerebral compromise appeared at high intrathoracic ranges of pressure. Hemodynamics must be strictly monitored in all patients during the performance of lung recruitment maneuvers because hemodynamic deflections emerge early, at a range of pressures commonly used in ventilated neonates with ARDS.
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Pediatr Crit Care Me · Oct 2022
The Relevance of Airway Resistance in Children Requiring Mechanical Ventilatory Support.
To describe pulmonary resistance in children undergoing invasive mechanical ventilation (MV) for different causes. ⋯ Increased pulmonary resistance is prevalent in the pediatric population undergoing invasive MV. Especially in children less than 1 year old, this variable should be considered when defining a ventilatory strategy.