Articles: mechanical-ventilation.
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Am J Infect Control · Oct 2014
Observational StudySubglottic secretion drainage and continuous control of cuff pressure used together save health care costs.
Preventive strategies to reduce ventilator-associated respiratory infection (VARI) include the use of an endotracheal tube incorporating a lumen for subglottic secretion drainage (SSD) and a system for continuous control of endotracheal tube cuff pressure (CCCP). The health care costs associated with the combined use of these 2 measures aimed at preventing VARI are not known, however. The objective of this study was to determine whether the simultaneous use of these 2 preventive measures for VARI could save health care costs. ⋯ The combined use of SSD and CCCP reduced the incidence of VARI and saved health care costs.
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Acute respiratory distress syndrome (ARDS) can occur during the treatment of several diseases and in several interventional procedures as a complication. It is a difficult situation to handle and special care should be applied to the patients. ⋯ In our current work we will present definition and causes of pneumothorax in the setting of intensive care unit (ICU). We will identify differences and similarities of this situation and present treatment options.
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Aerosol delivery through mechanical ventilation is influenced by the type of aerosol generator, pattern of nebulization, and a patient's breathing pattern. This study compares the efficiency of pneumatic nebulization modes provided by a ventilator with adult and pediatric in vitro lung models. ⋯ Aerosol drug delivery with a jet nebulizer placed proximal to the ventilator was not dependent on nebulization mode during simulated pediatric and adult conventional mechanical ventilation. Use of expiratory intermittent mode and continuous nebulization should be considered to reduce treatment time.
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Observational Study
Head-of-Bed Elevation Improves End-Expiratory Lung Volumes in Mechanically Ventilated Subjects: A Prospective Observational Study.
Head-of-bed elevation (HOBE) has been shown to assist in reducing respiratory complications associated with mechanical ventilation; however, there is minimal research describing changes in end-expiratory lung volume. This study aims to investigate changes in end-expiratory lung volume in a supine position and 2 levels of HOBE. ⋯ HOBE significantly increases global and regional end-expiratory lung volume; therefore, unless contraindicated, all mechanically ventilated patients should be positioned with HOBE.
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Journal of critical care · Oct 2014
Management of severe community-acquired pneumonia: A survey on the attitudes of 468 physicians in Iberia and South America.
The purpose of this study is to characterize the practices of pulmonary, internal medicine, and critical care physicians toward the management of patients with severe community-acquired pneumonia (CAP). ⋯ Despite the recent advances of knowledge reflected in the present study in the management of severe CAP, several of them are still incompletely translated into clinical practice. Significant variation in practice is observed among physicians and represents a potential target for future research and educational interventions.