Articles: mechanical-ventilation.
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Randomized Controlled Trial Comparative Study
A randomized controlled trial of fentanyl in the pre-emptive treatment of pain associated with turning in patients under mechanical ventilation: research protocol.
To compare the effectiveness and safety of fentanyl with placebo as pre-emptive treatment for pain associated with turning in patients in intensive care units. ⋯ If pre-emptive fentanyl is more effective than placebo and reasonably safe, the results of the current study may change nursing attitude in managing turning in critically ill patients. As a consequence, pain may be decreased during this nursing procedure.
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Indirect calorimetry (IC) is the gold standard to measure energy expenditure (EE) in hospitalized patients. The popular 30 year-old Deltatrac II(®) (Datex) IC is no more commercialized, but other manufacturers have developed new devices. This study aims at comparing for the first time simultaneously, two new IC, the CCM express(®) (Medgraphics) and the Quark RMR(®) (Cosmed) with the Deltatrac II(®) to assess their potential use in intensive care unit (ICU) patients. ⋯ Quark RMR(®) compares better with Deltatrac II(®) than CCM express(®), but it suffers an EE variance of 441 kcal, which is not acceptable for clinical practice. New indirect IC should be further improved before recommending their clinical use in ICU.
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Randomized Controlled Trial
Bi-level Positive Airway Pressure (BiPAP) with standard exhalation valve does not improve maximum exercise capacity in patients with COPD.
Although BiPAP has been used as an adjunct to exercise, little is know about its effect on exercise in COPD. We aimed to evaluate the acute effect of BiPAP delivered with a standard valve (Vision, Respironics), compared to no assist, on exercise capacity in individuals with COPD. ⋯ Use of BiPAP with a standard exhalation valve during exercise increases VT and VE at the expense of augmenting VCO2 and dyspnea, which in turns reduces WLpeak in COPD patients.
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Comparative Study
Evaluation of an Automated Endotracheal Tube Cuff Controller During Simulated Mechanical Ventilation.
Maintaining endotracheal tube cuff pressure within a narrow range is an important factor in patient care. The goal of this study was to evaluate the IntelliCuff against the manual technique for maintaining cuff pressure during simulated mechanical ventilation with and without movement. ⋯ There was a clinically important drop in manually set cuff pressure during simulated mechanical ventilation in a stationary model and an even larger drop with movement, but this was significantly reduced by the IntelliCuff in both scenarios. Additionally, we observed that cuff pressure varied directly with inspiratory airway pressure for both techniques, leading to elevated average cuff pressures.
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Comparative Study Observational Study
The Timed Inspiratory Effort: A Promising Index of Mechanical Ventilation Weaning for Patients With Neurologic or Neuromuscular Diseases.
The aim of this study was to evaluate the performance of the recently described timed inspiratory effort (TIE) index in comparison with 4 other previously reported indices as to the weaning outcome in patients with neurologic or neuromuscular disorders. ⋯ In patients with neurologic or neuromuscular impairment, the TIE index had a better performance than the best weaning indices used in clinical practice.