Articles: mechanical-ventilation.
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Randomized Controlled Trial
Prophylactic Use of Nebulized Hypertonic Saline in Mechanically Ventilated Children: A Randomized Blinded Pilot Study.
Mucolytic agents, such as nebulized hypertonic saline, may improve airway clearance and shorten the duration of mechanical ventilation, but prospective blinded studies in children undergoing mechanical ventilation are lacking. ⋯ Administering prophylactic nebulized hypertonic saline to mechanically ventilated children did not improve clinically relevant outcomes, including duration of mechanical ventilation. Wheezing after hypertonic saline treatment was rare.
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Multicenter Study Observational Study
Impact of harmful use of alcohol on the sedation of critical patients on mechanical ventilation: A multicentre prospective, observational study in 8 Spanish intensive care units.
To evaluate the impact of a history of harmful use of alcohol (HUA) on sedoanalgesia practices and outcomes in patients on mechanical ventilation (MV). ⋯ HUA may be associated to a higher risk of SF and WS, and can prolong MV and the duration of stay in the ICU in critical patients. Early identification could allow the implementation of specific sedation strategies aimed at preventing these complications.
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Intensive care medicine · May 2016
Acute cor pulmonale during protective ventilation for acute respiratory distress syndrome: prevalence, predictors, and clinical impact.
Increased right ventricle (RV) afterload during acute respiratory distress syndrome (ARDS) may induce acute cor pulmonale (ACP). ⋯ We report a 22 % prevalence of ACP and a poor outcome of severe ACP. We propose a simple clinical risk score for early identification of ACP that could trigger specific therapeutic strategies to reduce RV afterload.
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Randomized Controlled Trial
Comparison of pressure and volume-controlled ventilation in laparoscopic cholecystectomy operations.
Laparoscopic cholecystectomy has many advantages such as shorter hospital stay of patients, minimal postoperative pain, rapid recovery after the operation; however, systemic disadvantages because intra-abdominal pressure, position and general anaesthesia may also appear. In this study, pressure-controlled ventilation (PCV) and volume-controlled ventilation (VCV) modes during laparoscopic cholecystectomy operations were compared in terms of their effects on haemodynamic, respiratory and blood gas parameters. ⋯ In this study, with volume-controlled ventilation anaesthesia in laparoscopic cholecystectomy, higher tidal volume and lower alveolar-arterial oxygen gradient were achieved after pneumoperitoneum. These findings indicated that VCV mode can provide a better alveolar ventilation than PCV mode in laparoscopic cholecystectomy operations.
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Intensive care medicine · May 2016
Diaphragmatic dysfunction in patients with ICU-acquired weakness and its impact on extubation failure.
Diaphragm function is rarely studied in intensive care patients with unit-acquired weakness (ICUAW) in whom weaning from mechanical ventilation is challenging. The aim of the present study was to evaluate the diaphragm function and the outcome using a multimodal approach in ICUAW patients. ⋯ Diaphragm dysfunction is frequent in patients with ICU-acquired weakness (80 %) but poorly correlated with the ICU-acquired weakness MRC score. Half of the patients with ICU-acquired weakness were successfully extubated. Half of the patients who failed the weaning process died during the ICU stay.