Articles: mechanical-ventilation.
-
Intensive care medicine · Sep 2016
Multicenter Study Observational StudyQuantifying unintended exposure to high tidal volumes from breath stacking dyssynchrony in ARDS: the BREATHE criteria.
Breath stacking dyssynchrony generates higher tidal volumes than intended, potentially increasing lung injury risk in acute respiratory distress syndrome (ARDS). Lack of validated criteria to quantify breath stacking dyssynchrony contributes to its under-recognition. This study evaluates performance of novel, objective criteria for quantifying breath stacking dyssynchrony (BREATHE criteria) compared to existing definitions and tests if neuromuscular blockade eliminates high-volume breath stacking dyssynchrony in ARDS. ⋯ The BREATHE criteria provide an objective definition of breath stacking dyssynchrony emphasizing occult exposure to high tidal volumes. BREATHE identified high-volume breaths missed by other methods for quantifying this dyssynchrony. Neuromuscular blockade prevented breath stacking dyssynchrony, assuring provision of the intended lung-protective strategy.
-
Pulmonary interstitial emphysema (PIE) primarily affects premature infants on positive pressure ventilation. PIE is rarely reported in infants and children in the absence of mechanical ventilation and/or associated respiratory infection. ⋯ The cystic lesions spontaneously resolved after conservative treatment. Based on the clinical course and the chronological changes on imaging, the cystic lung lesions were diagnosed as localized persistent PIE.
-
Communication is an integral part of nursing practice not just only for therapeutic reasons but also for sharing information. Nurses working in intensive care experience challenges when communicating with patients who are mechanically ventilated due to lack of knowledge and skill. These challenges infringe on the patients' rights to receive information and as such they may impact negatively on the patients' outcomes. ⋯ A greater understanding of communication dynamics with the intensive care unit with patients who are mechanically ventilated is crucial to enable nurses to improve their care and improve patients' comfort. Incorporating communication in the nursing standards would ensure that patients are treated with dignity which would help improve patient outcomes.
-
Med Klin Intensivmed Notfmed · Sep 2016
[Positioning therapy and early mobilization in intensive care units : Findings from the current 2015 guidelines].
The 2007 guidelines "Positioning for prophylaxis and therapy of pulmonary disorders" were completely revised in 2015 on behalf of the German Society of Anaesthesiology and Intensive Care Medicine. With regard to practical and scientific relevance, early mobilization of patients in critical care has been included in the guidelines for the first time. ⋯ As such, the flat supine position should only be used in cases of urgent medical or nursing needs. This underlines the importance of a moderately elevated head of bed position (20(o)-45(o)) in mechanically ventilated patients.