Articles: mechanical-ventilation.
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To assess the risk of aspiration using a novel valve circuit that dynamically modulates endotracheal tube cuff pressure during the ventilatory cycle using bench and live animal models. ⋯ N/A.
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Although nutrition support is essential in intensive care units, optimal energy intake remains unclear. Here, we assessed the influence of energy intake on outcomes of critically ill, underweight patients. ⋯ Reduced energy intake during the first week in EICU was associated with a reduced MVD in clinically ill patients with BMI <20.0 kg/m(2).
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Mechanical ventilation is a fundamental treatment of acute respiratory distress syndrome (ARDS). Despite compliance with the recommendations of protective mechanical ventilation, it can results in serious complications including the pulmonary barotrauma. ⋯ This observation describes an unusual aspect of barotrauma which is pneumomediastinum. The authors also point out the role of chest imaging in the management of mechanical ventilation during ARDS.
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Ultrasound Med Biol · May 2014
Review Meta AnalysisUltrasonographic measurement of the respiratory variation in the inferior vena cava diameter is predictive of fluid responsiveness in critically ill patients: systematic review and meta-analysis.
Respiratory variation in the inferior vena cava (ΔIVC) has been extensively studied with respect to its value in predicting fluid responsiveness, but the results are conflicting. This systematic review was aimed at investigating the diagnostic accuracy of ΔIVC in predicting fluid responsiveness. Databases including Medline, Embase, Scopus and Web of Knowledge were searched from inception to May 2013. ⋯ The diagnostic performance of ΔIVC appeared to be better in patients on mechanical ventilation than in spontaneously breathing patients (DOR: 30.8 vs. 13.2). The pooled area under the receiver operating characteristic curve was 0.84 (95% CI: 0.79-0.89). Our study indicates that ΔIVC measured with point-of-care ultrasonography is of great value in predicting fluid responsiveness, particularly in patients on controlled mechanical ventilation and those resuscitated with colloids.
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Respir Physiol Neurobiol · May 2014
Comparative Study Clinical TrialPhysiological comparison of breathing patterns with neurally adjusted ventilatory assist (NAVA) and pressure-support ventilation to improve NAVA settings.
Neurally adjusted ventilator assist (NAVA) assists spontaneous breathing in proportion to diaphragmatic electrical activity (EAdi). Here, we evaluate the effects of various levels of NAVA and PSV on the breathing pattern and, thereby, on [Formula: see text] homeostasis in 10 healthy volunteers. For each ventilation mode, four levels of support (delivered pressure 0 i.e. baseline, 5, 8, and 10cmH2O) were tested in random order. ⋯ Diaphragmatic activity can decrease during NAVA without any change in VT and [Formula: see text]. This suggests that NAVA adjustment cannot be based solely on VT and [Formula: see text] criteria. Registered by Frédéric Lofaso and Nicolas Terzi on ClinicalTrials.gov, #NCT01614873.