Articles: mechanical-ventilation.
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J Pediatr Rehabil Med · Jan 2015
Decreasing mechanical ventilator support in medically fragile children with bronchopulmonary dysplasia: A step-by-step weaning protocol at a pediatric long term extended care facility.
Prolonged mechanical ventilation (PMV) in medically fragile children is commonly used in pediatric long term extended care facilities (P-LTEC). Currently, PMV weaning is performed in an unstandardized fashion. Without an official protocol, patients are subjected to delayed weaning, infection, increased mortality, and difficulty obtaining placement at adult group homes. A step-wise approach may help these children wean from PMV effectively. ⋯ Using the data obtained in this case series an official protocol could be created to wean P-LTEC residents from PMV, with reasonable expectations of the process.
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The need for prolonged mechanical ventilation (PMV) after cardiac surgery is still a common problem. We hypothesized that subjects who required PMV after a single surgery (either coronary artery bypass grafting or valve surgery) would have better outcomes than those who had experienced both revascularization and valve surgery. ⋯ These results suggest that patients needing PMV after combined cardiac surgery may suffer worse outcomes than those needing PMV after simple cardiac surgery.
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The aim of this study was to clarify the distinctions in the clinical characteristics and outcomes between early- and late-onset severe pneumonia after renal transplantation requiring ICU admission. ⋯ Early-onset severe pneumonia in renal transplant recipients resulted in a more serious condition, higher rate of NIV failure, longer duration of mechanical ventilation, and increased length of ICU and hospital stays.
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J. Cardiothorac. Vasc. Anesth. · Jan 2015
Tracheal Ring Fracture Secondary to Percutaneous Tracheostomy: Is Tracheal Flaccidity a Risk Factor?
To evaluate the risk factors of tracheal ring fracture and whether previous tracheal ring flaccidity predisposes to it in consecutive, mechanically ventilated, intensive care unit patients undergoing different percutaneous dilatational tracheostomy procedures (Ciaglia Blue Rhino, PercuTwist, and Ciaglia BlueDolphin). ⋯ In addition to the PercuTwist technique and intubation>14 days before tracheostomy, tracheal flaccidity was a significant risk factor for tracheal ring fracture. In the presence of this finding, a less traumatic tracheostomy procedure should be applied.
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Respiratory dysfunction often persists in post intensive care unit (ICU) patients and intermediate care facilities have been established to ensure the continuous of appropriate care. ⋯ In their vast majority patients with chronic respiratory failure, who were admitted to RIU,were weaned from mechanical ventilation, although in a substantial percentage the maintenance of tracheostomy was mandatory after discharge. Hippokratia 2015, 19 (1): 37-40.