Articles: mechanical-ventilation.
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Comparative Study
Differences in incidence and outcome of ventilator-associated pneumonia in surgical and medical ICUs in a tertiary hospital in China.
Ventilator-associated pneumonia (VAP) is a common hospital-acquired infection in intensive care units (ICUs). The incidences and outcomes of VAP in a medical ICU (MICU) and a surgical ICU (SICU) were compared. ⋯ These data indicate that VAP prolonged time on ventilator and ICU stay in our institute and increased the mortality in the MICU. There were no differences in incidence of or mortality from VAP in the MICU and SICU.
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To test the hypothesis that there would be better clinical outcomes following the treatment of patients with acute lung injury (ALI) using noninvasive positive-pressure mechanical ventilation (NIPPV) delivered via a complex critical care ventilator compared with a conventional mini-ventilator. ⋯ The findings of this present study suggest that there were more satisfactory clinical outcomes following the treatment of patients with ALI when NIPPV was delivered using a complex critical care ventilator compared with a conventional mini-ventilator.
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Management of the artificial airway includes securing the tube to prevent dislodgement or migration as well as removal of secretions. Preventive measures include adequate humidification and appropriate airway suctioning. ⋯ A number of new monitoring techniques have been introduced, and automated cuff pressure control is becoming more common. The respiratory therapist should be adept with all these devices and understand the appropriate application and management.
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Expert Rev Neurother · Jun 2014
EditorialNewly identified precipitating factors in mechanical ventilation-induced brain damage: implications for treating ICU delirium.
Delirium is 1.5 to 4.1 times as likely in intensive care unit patients when they are mechanically ventilated. While progress in treatment has occurred, delirium is still a major problem in mechanically ventilated patients. ⋯ This argues for minimizing the duration and tidal volumes of mechanical ventilation and for more effectively reducing sustained D2R signaling than achieved with haloperidol alone. The latter might be accomplished by reducing D2R cell surface expression and D2R-mediated Akt inhibition by elevating protein expression of dysbindin-1C.
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Preservation or restoration of normal alveolar epithelial barrier function is crucial for pulmonary oedema resolution. Keratinocyte growth factor-2 (KGF-2), a potent epithelial cell mitogen, may have a role in preventing ventilator-induced lung injury (VILI), which occurs frequently in mechanically ventilated patients. The aim of the study was to test the role of KGF-2 in VILI in rats. ⋯ Inflammatory cytokines (tumour necrosis factor-α, macrophage inflammatory protein 2), neutrophil and total protein levels in bronchoalveolar lavage fluid and surfactant protein mRNA expression in lung tissue were detected; the number of alveolar type II cells, lung water content and lung morphology were also evaluated. The results indicate that pre-treatment with KGF-2 showed dramatic improvement in lung oedema and inflammation compared with HVZP alone, together with increased surfactant protein mRNA and alveolar type II cells. Our results suggest that KGF-2 might be considered a promising prevention for human VILI or other acute lung injury diseases.