Articles: mechanical-ventilation.
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Cardiac arrest is a critical event requiring adequate and timely response in order to increase a patient's chance of survival. In patients mechanically ventilated with advanced airways, cardiopulmonary resuscitation (CPR) maneuver may be simplified by keeping the ventilator on. This work assessed the response of an intensive care mechanical ventilator to CPR using a patient manikin ventilated in three conventional modes. ⋯ Volume and pressure ventilation modes responded differently to chest compressions. Yet, variation in delivered volume and the measured peak pressures were within the reported for the standard bag-valve-mask system.
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Assessment of the respiratory changes of the inferior vena cava (IVC) diameter have been investigated as a reliable tool to estimate the volume status in mechanically ventilated and spontaneously breathing patients. Our purpose was to compare the echocardiographic measurements the IVC diameter, stroke volume and cardiac output in different positive pressure ventilation parameters. ⋯ The results of our study suggest that IVC related parameters are not affected with different ventilatory settings. Further studies are needed to confirm the reliability of these parameters as a predictor of fluid assessment.
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Alveolar recruitment in acute respiratory distress syndrome (ARDS) is defined as the penetration of gas into previously unventilated areas or poorly ventilated areas. Alveolar recruitment during recruitment maneuvering (RM) depends on the duration of the maneuver, the recruitable lung tissue, and the balance between the recruitment of collapsed areas and over-insufflation of the ventilated areas. ⋯ Randomized studies on ARDS have shown no benefit or have even reflected an increase in mortality. The routine use of RM is therefore not recommended.