Articles: mechanical-ventilation.
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Observational Study
Diaphragm Excursion-Time Index: A New Parameter Using Ultrasonography to Predict Extubation Outcome.
The diaphragmatic response to increased mechanical load following withdrawal of mechanical ventilation is critical in determining the outcome of extubation. Using ultrasonography, we aimed to evaluate the performance of the excursion-time (E-T) index-a product of diaphragm excursion and inspiratory time, to predict the outcome of extubation. ⋯ Diaphragm E-T index measured during SBT may help predict the outcome of extubation. Maintenance or increase in diaphragm E-T index between A/C and SBT increases the likelihood of successful extubation.
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Intensive care medicine · May 2018
Randomized Controlled Trial Multicenter StudyOropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate in lung cancer surgery: a randomized clinical trial.
Respiratory complications are the leading causes of morbidity and mortality after lung cancer surgery. We hypothesized that oropharyngeal and nasopharyngeal decontamination with chlorhexidine gluconate (CHG) would be an effective method to reduce these complications as reported in cardiac surgery. ⋯ CHG decontamination decreased neither MV requirements nor respiratory infections after lung cancer surgery. Additionally, CHG did not change tracheal microbiota or postoperative antibiotic utilization.
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Multicenter Study Observational Study
Prolonged Mechanical Ventilation as a Predictor of Mortality After Cardiac Surgery.
Mortality among the small percentage of cardiac surgery patients receiving prolonged mechanical ventilation is high, but this issue appears to be inadequately addressed in guidelines. ⋯ Prolonged postoperative mechanical ventilation was required by 10-20% of cardiac surgery subjects, who constitute a specific group that represents most of the postoperative mortality, which is associated with multiple organ failure and sepsis.
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Indian J Crit Care Med · May 2018
Noninvasive Ventilation for Acute Respiratory Failure due to Noncystic Fibrosis Bronchiectasis.
Data regarding the use of noninvasive ventilation (NIV) for treatment of acute respiratory failure (ARF) among patients with noncystic fibrosis (CF) bronchiectasis are limited. We intend to describe our experience with NIV use in this setting. ⋯ NIV is feasible for management of ARF with non-CF bronchiectasis. High APACHE may predict NIV failure among these patients.
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Recent studies demonstrate that burn patients are undergoing unnecessary intubations. We sought to determine the clinical criteria that predict intubations with benefit. ⋯ Intubation should be considered for patients displaying the Denver criteria, which includes full thickness facial burns, stridor, respiratory distress, swelling on laryngoscopy, upper airway trauma, altered mentation, hypoxia/hypercarbia, hemodynamic instability, suspected smoke inhalation, and singed facial hair. Patients lacking these criteria should not be intubated.