Articles: mechanical-ventilation.
-
Comput Methods Programs Biomed · Apr 2018
Assessing mechanical ventilation asynchrony through iterative airway pressure reconstruction.
Respiratory mechanics estimation can be used to guide mechanical ventilation (MV) but is severely compromised when asynchronous breathing occurs. In addition, asynchrony during MV is often not monitored and little is known about the impact or magnitude of asynchronous breathing towards recovery. Thus, it is important to monitor and quantify asynchronous breathing over every breath in an automated fashion, enabling the ability to overcome the limitations of model-based respiratory mechanics estimation during asynchronous breathing ventilation. ⋯ The iterative pressure reconstruction method is capable of identifying asynchronous breaths and improving respiratory mechanics estimation consistency compared to conventional model-based methods. It provides an opportunity to automate real-time quantification of asynchronous breathing frequency and magnitude that was previously limited to invasively method only.
-
Journal of critical care · Apr 2018
Clinical features and outcomes of tetanus: Analysis using a National Inpatient Database in Japan.
This study was performed to elucidate the current clinical features and outcomes of tetanus using a national inpatient database in Japan. ⋯ The present study suggests that acute-care physicians should be ready to provide intensive care for patients with tetanus and cooperate with medical social workers and families for subsequent long-term nursing care.
-
Observational Study
Lack of Benefit of Heliox During Mechanical Ventilation of Subjects With Severe Air-Flow Obstruction.
The value of heliox (helium-oxygen mixture) for patients with severe air-flow obstruction is uncertain. The purpose of this study was to determine whether heliox could reduce the degree of hyperinflation and hypercapnia in mechanically ventilated patients with severe air-flow obstruction. ⋯ In mechanically ventilated subjects with severe air-flow obstruction, administration of heliox had no effect on indices of dynamic hyperinflation (plateau pressure and total PEEP) and resulted in only a small reduction in PaCO2 .
-
Acute medicine & surgery · Apr 2018
Risk factors for prolonged mechanical ventilation in patients with severe multiple injuries and blunt chest trauma: a single center retrospective case-control study.
Blunt chest trauma is common and is associated with morbidity and mortality in patients with multiple injuries, frequently requiring invasive mechanical ventilation. The aim of this study was to elucidate risk factors for prolonged mechanical ventilation (PMV). ⋯ Severe GCS (≤8), flail chest, or TTSS may be independent risk factors. Combining the three risk factors could provide high predictive performance for PMV.
-
Intraoperative use of positive end-expiratory pressure (PEEP) has a protective effect in patients with acute lung injury and is recommended during anesthesia to minimize postoperative pulmonary complications. However, high levels of pressure might also cause harm to the lung because of overdistension. This retrospective study was designed to compare the effect of low and high levels of PEEP on the risk of postoperative pulmonary complications in patients with normal lung function who were undergoing an elective craniotomy. ⋯ Low and high levels of PEEP show similar incidences of postoperative pneumonia and requirement of postoperative NIV or invasive MV in patients with normal function of the lungs undergoing elective craniotomy.