Articles: mechanical-ventilation.
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J Intensive Care Med · Jan 2015
Comparative Study Observational StudyEvaluation of a new index of mechanical ventilation weaning: the timed inspiratory effort.
The performance of most indices used to predict ventilator weaning outcomes remains below expectation. The purpose of this study was to evaluate a new weaning index, the timed inspiratory effort (TIE) index, which is based on the maximal inspiratory pressure and the occlusion time required to reach it. ⋯ The TIE index performed better than the best weaning indices used in clinical practice.
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Academic pediatrics · Jan 2015
Multicenter Study Observational StudyRisk factors for requiring intensive care among children admitted to ward with bronchiolitis.
To examine risk factors for transfer of bronchiolitis patients from the ward to the intensive care unit (ICU) and/or initiation of critical care interventions. ⋯ In this multicenter study of children hospitalized with bronchiolitis, low birth weight and tachypnea were significantly associated with subsequent transfer to the ICU and/or use of mechanical ventilation.
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Anaesthesiol Intensive Ther · Jan 2015
Case ReportsSwift recovery of severe acute hypoxemic respiratory failure under non-invasive ventilation.
In the setting of severe acute respiratory distress syndrome (ARDS; PaO2/FiO2 < 100), the cut-off point for switching from non-invasive ventilation to intubation combined to mechanical ventilation is poorly defined. ⋯ Given the complications associated with tracheal intubation and mechanical ventilation on the one hand and with delayed intubation on the other hand, high PEEP-NIV may warrant study in a restricted set of patients closely monitored in a critical care environment.
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The purpose of this pilot study was to explore the utility of the mammalian swine model under simulated intensive care unit (sICU) conditions and mechanical ventilation (MV) for assessment of the trajectory of circadian rhythms of sedation requirement, core body temperature (CBT), pulmonary mechanics (PM) and gas exchange (GE). Data were collected prospectively with an observational time-series design to describe and compare circadian rhythms of selected study variables in four swine mechanically ventilated for up to seven consecutive days. We derived the circadian (total variance explained by rhythms of τ between 20 and 28 h)/ultradian (total variance explained by rhythms of τ between 1 and <20 h) bandpower ratio to assess the robustness of circadian rhythms, and compare findings between the early (first 3 days) and late (subsequent days) sICU stay. ⋯ Individual subject observations were more informative than group data, and provided preliminary evidence that (a) circadian rhythms of multiple variables are lost or desynchronized in mechanically ventilated subjects, (b) robustness of circadian rhythm varies with subject morbidity and (c) healthier pigs develop more robust circadian rhythm profiles over time in the sICU. Comparison of biological rhythm profiles among sICU subjects with similar severity of illness is needed to determine if the results of this pilot study are reproducible. Identification of consistent patterns may provide insight into subject morbidity and timing of such therapeutic interventions as weaning from MV.