Articles: mechanical-ventilation.
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Bedside monitors in the ICU routinely measure and collect patients' physiologic data in real time to continuously assess the health status of patients who are critically ill. With the advent of increased computational power and the ability to store and rapidly process big data sets in recent years, these physiologic data show promise in identifying specific outcomes and/or events during patients' ICU hospitalization. ⋯ Our proposed workflow may prove useful in the design of scalable approaches for real-time predictive systems in ICU environments, exploiting real-time vital sign information from bedside monitors. (ClinicalTrials.gov registration NCT02184208.).
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Nutrition and health · Sep 2020
Multicenter StudyValidation of the modified NUTRIC score on critically ill Jordanian patients: A retrospective study.
Nutritional status has been proven to be associated with poor outcomes in mechanically ventilated patients in intensive care units (ICU). Nutritional assessment has been assessed using different tools. Few data are available on the validity of the modified Nutrition Risk Assessment Tool for Critically Ill (mNUTRIC) score in ICU patients receiving mechanical ventilation (MV). ⋯ This study showed new evidence on the validity of the mNUTRIC as a tool for assessing nutritional risk in an ICU population in Jordan. The mNUTRIC score obtained from the current retrospective data suggests that the use of the tool can truly identify and diagnose critically ill patients with malnutrition.
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Zhonghua nei ke za zhi · Sep 2020
[A preliminary study on the evaluation of diaphragm function by ultrasound in patients with invasive mechanical ventilation].
Objectives: To study the feasibility of using ultrasound to evaluate diaphragm function in patients with invasive mechanical ventilation. Methods: From March to December 2017, 40 adult patients with acute respiratory distress syndrome who were admitted to the Department of Critical Care Medicine, Xiangya Hospital, Central South University for more than 48 hours were included. Diaphragmatic excursion and thickness of bilateral anterior, middle and posterior parts were measured by ultrasound for 5 consecutive days. ⋯ Bilateral anterior, middle and posterior diaphragmatic excursion recovered on day 5, and was higher than the baseline levels on day 1, with the left middle and posterior diaphragmatic excursion changing most significantly. (2) Compared with day 1, 2, 3, the thickening fraction of bilateral anterior, middle and posterior diaphragm were significantly decreased on day 4, with the left middle part [day 1: (33.87±14.34)%; day 2: (37.26±13.91)%; day 3: (30.56±14.27)%; day 4: (15.53±5.68)%] and the left posterior part [day 1: (35.50±15.69)%; day 2: (39.84±15.32)%; day 3: (29.06±14.96)%; day 4: (13.30±5.79)%] changing most significantly (P<0.05). The thickening fractions of left anterior, middle and posterior diaphragm recovered on day 5 compared with that on day 4, but still lower than those on day 1 (P<0.05). Conclusions: It is feasible to evaluate the diaphragm function in patients with invasive mechanical ventilation by ultrasound, which can provide guidance for preventing diaphragmatic atrophy and withdrawing from mechanical ventilation.
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To increase the understanding of the self-extubation phenomena, we assessed its rate in our medical ICU and aimed to identify the risk factors of self-extubation and the risk factors for re-intubation. ⋯ Results of our study showed that, in the era of reduced use of sedatives in the ICU, clinicians must be vigilant of the risk of self-extubation in the first 2 d of mechanical ventilation in patients who are agitated and with a longer endotracheal tube to carina distance on chest radiograph.
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Intra-abdominal compartment syndrome (ACS) is a devastating complication in burn patients with a high mortality. Apart from high-volume resuscitation as known risk factor, also mechanical ventilation seems to influence the development of ACS. The TIRIFIC trial is a retrospective, matched-pair analysis. ⋯ The TIRIFIC trial showed significantly increased ventilation pressures in the ACS group in general as a surrogate parameter to support early diagnostics. Especially, maximum PEEP levels and peak pressures are significantly increased in both, early- and late-onset ACS. As an addition to the actual WSACS guidelines we suggest IAP measurement in mechanically ventilated burn patients if ventilating pressures are rising continuously without a clear pulmonary or otherwise identifiable reason.