Articles: mechanical-ventilation.
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Ventilator graphic monitoring is common in ICUs. The graphic information provides clinicians with immediate clues regarding patient-ventilator interaction and ventilator function. These display tools are aimed at reducing complications associated with mechanical ventilation, such as patient-ventilator asynchrony. ⋯ Ventilator graphics impact mechanical ventilation management through optimizing effectiveness of patient care and enhancing promptness of clinician response. Despite being a valuable asset in providing high-quality patient care, many bedside clinicians do not have a thorough understanding of ventilator graphics. Mastery of ventilator graphics interpretation is key in managing patients who are receiving ventilatory support.
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Clinical alarms, including those for mechanical ventilation, have been one of the leading causes of health technology hazards. It has been reported that < 15% of alarms studied rose to the level of being clinically relevant or actionable. Most alarms in health care, whether by default or intention, are set to a hypothetical average patient, which is essentially a one size fits most approach. ⋯ Observations of human response to stimuli suggest that response to alarms is closely matched to the perceived reliability and value of the alarm system. This paper provides a review examining vulnerabilities in the current management of mechanical ventilation alarms and summarizes best practices identified to help prevent patient injury. This review examines the factors that affect alarm utility and provides recommendations for applying research findings to improve safety for patients, clinician efficiency, and clinician well-being.
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Mechanical ventilation in critically ill patients must effectively unload inspiratory muscles and provide safe ventilation (ie, enhancing gas exchange, protect the lungs and the diaphragm). To do that, the ventilator should be in synchrony with patient's respiratory rhythm. The complexity of such interplay leads to several concerning issues that clinicians should be able to recognize. ⋯ Moreover, appropriate handling of asynchrony requires clinical skills, physiological knowledge, and suitable medication management. New technologies and devices are changing our daily practice, from automated real-time recognition of asynchronies and their distribution during mechanical ventilation, to smart alarms and artificial intelligence algorithms based on physiological big data and personalized medicine. Our goal as clinicians is to provide care of patients based on the most accurate and current knowledge, and to incorporate new technological methods to facilitate and improve the care of the critically ill.
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Intensive care medicine · Jun 2020
Pre-admission air pollution exposure prolongs the duration of ventilation in intensive care patients.
Air pollutant exposure constitutes a serious risk factor for the emergence or aggravation of (existing) pulmonary disease. The impact of pre-intensive care ambient air pollutant exposure on the duration of artificial ventilation was, however, not yet established. ⋯ Short-term ambient air pollution exposure prior to ICU admission represents an unrecognized environmental risk factor for the duration of artificial ventilation in the ICU.