Articles: mechanical-ventilation.
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Observational Study
Long Term Acute Care Patients Weaning From Prolonged Mechanical Ventilation Maintain Circadian Rhythm.
Circadian rhythm regulates many physiologic and immunologic processes. Disruption of these processes has been demonstrated in acutely ill, mechanically ventilated patients in the ICU setting. Light has not been studied as an entraining stimulus in the chronically mechanically ventilated patient. The purpose of this study was to determine the association of naturally occurring ambient light levels in a long-term acute care (LTAC) hospital with circadian rhythm in patients recovering from critical illness and requiring prolonged mechanical ventilation (PMV). ⋯ Despite requiring continued high-level care and a prolonged stay in a medical facility, patients recovering from critical illness and actively weaning from PMV maintain their circadian rhythm in phase with normal diurnal variations of light.
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J Pediatr Intensive Care · Mar 2014
Utility of daily routine portable chest X-ray in mechanically ventilated patients in the pediatric intensive care unit.
The utility of daily routine chest X-rays (CXRs) in mechanically ventilated patients in intensive care units is still controversial. The present study compared the diagnostic, therapeutic and outcome efficacy between daily routine and non-routine (clinically indicated) CXRs in children patients in pediatric intensive care unit (PICU). A prospective randomized study conducted in tertiary center 18-bed PICU, Riyadh Military Hospital, Riyadh, Kingdom of Saudi Arabia. ⋯ Also, the percentage of CXRs with new findings that result in intervention was higher in non-routine group (78% vs. 69%; OR = 1.60; 95% CI = 0.50-5.70). The daily routine CXRs was not associated with a reduced effect on length of stay in PICU and hospital or mortality and it does not seem to add any advantages over non-routine CXRs in PICU. Large multicenter studies are needed to confirm these results.
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Trans. R. Soc. Trop. Med. Hyg. · Mar 2014
ReviewSpectrum and outcome predictors of central nervous system infections in a neurological critical care unit in India: a retrospective review.
There are few published studies on the spectrum and outcome of central nervous system (CNS) infection in the neurology intensive care unit (NICU). We report the spectrum of CNS infections in the NICU and the predictors of outcome. ⋯ Of patients admitted to the NICU during the study period, one-third had a CNS infection. Half of those with a CNS infection survived, and predictors of death were prolonged mechanical ventilation and prolonged hospital stay.
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Arch. Bronconeumol. · Mar 2014
ReviewWeaning from mechanical ventilation in paediatrics. State of the art.
Weaning from mechanical ventilation is one of the greatest volume and strength issues in evidence-based medicine in critically ill adults. In these patients, weaning protocols and daily interruption of sedation have been implemented, reducing the duration of mechanical ventilation and associated morbidity. ⋯ Several indices have been developed to predict the outcome of weaning. However, these have failed to replace clinical judgement, although some additional measurements could facilitate this decision.
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Journal of hepatology · Mar 2014
Outcome of patients with cirrhosis requiring mechanical ventilation in ICU.
Mortality rate of patients with cirrhosis admitted to the intensive care unit (ICU) and requiring mechanical ventilation varies between 60 and 91%. The aim of our study is to assess the prognosis of these patients, their 1-year outcome and to analyze predictive factors of long-term mortality. ⋯ Patients with cirrhosis admitted to the liver ICU and who required mechanical ventilation have a poor prognosis with a 1-year mortality of 89%. At ICU discharge, a total bilirubin level higher than 64.5 μmol/L and length of ventilation higher than 9 days could help the hepatologists to identify patients at risk of death in the year following the ICU discharge.