Articles: mechanical-ventilation.
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Multicenter Study Comparative Study
Infants with severe respiratory syncytial virus needed less ventilator time with nasal continuous airways pressure then invasive mechanical ventilation.
Nasal continuous positive airway pressure (NCPAP) has been proposed as an early first-line support for infants with severe respiratory syncytial virus (RSV) infection. We hypothesised that infants <6 months with severe RSV would require shorter ventilator support on NCPAP than invasive mechanical ventilation (IMV). ⋯ Nasal continuous positive airway pressure was independently associated with a shorter duration of ventilatory support. Differences in baseline disease severity mandate a randomised trial before the routine use of NCPAP can be recommended.
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Journal of critical care · Dec 2013
Multicenter StudyFactors associated with timing of initiation of physical therapy in patients with acute lung injury.
Early initiation of physical therapy (PT) in mechanically ventilated patients is associated with improved outcomes. However, PT is frequently delayed until after extubation or discharge from the intensive care unit (ICU). We evaluated factors associated with the timing of initiation of PT in patients with acute lung injury (ALI) admitted to ICUs without an emphasis on early rehabilitation. ⋯ In 11 ICUs without emphasis on early rehabilitation, patients with ALI frequently received no PT. Severity of illness, mental status, sedation practices, and hospital site were significant barriers to initiating PT. Understanding these barriers may be important when introducing early ICU physical rehabilitation.
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Journal of critical care · Dec 2013
Randomized Controlled Trial Multicenter StudyThe relationship between positive end-expiratory pressure and cardiac index in patients with acute respiratory distress syndrome.
The purpose of the study is to evaluate the association between positive end-expiratory pressure (PEEP) and cardiac index in patients with acute respiratory distress syndrome (ARDS). ⋯ In patients with ARDS who are managed with liberal or conservative fluid management protocols, PEEP is not associated with lower cardiac index.
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Multicenter Study
High Resource Utilization Does Not Affect Mortality in Acute Respiratory Failure Patients Managed with Tracheostomy.
Tracheostomy practice in patients with acute respiratory failure (ARF) varies greatly among institutions. This variability has the potential to be reflected in the resources expended providing care. In various healthcare environments, increased resource expenditure has been associated with a favorable effect on outcome. ⋯ We were unable to demonstrate a positive relationship between resource expenditure and outcome in ARF patients managed with tracheostomy.
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Arch. Dis. Child. Fetal Neonatal Ed. · Jul 2013
Multicenter StudyIncidence of hypo- and hyper-capnia in a cross-sectional European cohort of ventilated newborn infants.
To determine the incidence of hypo- and hyper-capnia in a European cohort of ventilated newborn infants. ⋯ This study shows that hypocapnia is a relatively uncommon finding during neonatal ventilation. The higher incidence of hypercapnia may suggest that permissive hypercapnia has found its way into daily clinical practice.