Articles: mechanical-ventilation.
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Journal of critical care · Dec 2017
Decision support system facilitates rapid decreases in pressure support and appropriate inspiratory muscle workloads in adults with respiratory failure.
A commercially available decision support system (DSS) provides guidance for setting inspiratory pressure support (PS) to maintain work of breathing (WOB/min), breathing frequency (f), and tidal volume (VT) in proper clinical ranges (VentAssist™). If these values are outside the proper clinical range patients may suffer fatigue, atrophy, hypoventilation, hyperventilation, volutrauma, or VT deficiency. The purpose of our study was to evaluate the increase of the percentage of breaths in the targeted clinical ranges when the DSS guidance for setting the PS was followed. ⋯ The DSS is successful at assisting clinicians on how to set PS specific to a patient's individual demands (VT and f) while accounting for their breathing effort (WOB/min). The DSS appears to promote rapid weaning of PS to minimal ventilator settings when appropriate.
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Intensive Crit Care Nurs · Dec 2017
Development of the Nurses' Care Coordination Competency Scale for mechanically ventilated patients in critical care settings in Japan: Part 1 Development of a measuring instrument.
To develop a draft scale measuring nurses' care coordination competency for care of mechanically ventilated patients in critical care settings. ⋯ These findings could be utilised to educate and train nursesand establish the awareness that coordinating care is the nurses' responsibility. Future research focusing on its validity and reliability are needed.
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Journal of critical care · Dec 2017
A "Code ICU" expedited review of critically ill patients is associated with reduced emergency department length of stay and duration of mechanical ventilation.
To examine the effect of a system of expedited review of critically ill patients in the Emergency Department (ED) on ED length of stay (LOS) and Intensive Care Unit (ICU) outcomes. ⋯ A system of rapid review of critically ill patients in the ED was associated with reduced ED LOS and improved ICU outcomes.
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Intensive care medicine · Dec 2017
Recommendations for mechanical ventilation of critically ill children from the Paediatric Mechanical Ventilation Consensus Conference (PEMVECC).
Much of the common practice in paediatric mechanical ventilation is based on personal experiences and what paediatric critical care practitioners have adopted from adult and neonatal experience. This presents a barrier to planning and interpretation of clinical trials on the use of specific and targeted interventions. We aim to establish a European consensus guideline on mechanical ventilation of critically children. ⋯ These recommendations should help to harmonise the approach to paediatric mechanical ventilation and can be proposed as a standard-of-care applicable in daily clinical practice and clinical research.
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We aimed to test a novel method of delivery of chloral hydrate (CH) sedation in ventilated critically ill young children. ⋯ Delivering CH by continuous enteral infusion is feasible, effective, and may be associated with less positive fluid balance. Whether there is a risk of duodenal perforation requires further study.