Articles: mechanical-ventilation.
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In mechanically ventilated patients, Pulse Pressure Variation (PPV) has been shown to be a useful parameter to guide fluid management. We evaluated a real-time automated PPV-algorithm by comparing it to manually calculated PPV-values. In 10 critically ill patients, blood pressure was measured invasively (IBP) and non-invasively (CNAP(®) Monitor, CNSystems Medizintechnik, Austria). ⋯ PPVautoIBP was -0.19 ± 1.65% (mean bias ± standard deviation), PPVmanCNAP vs. PPVautoCNAP was -1.02 ± 2.03% and PPVautoCNAP vs. PPVmanIBP was -2.10 ± 3.14%, suggesting that the automated CNAP(®) PPV-algorithm works well on both blood pressure waveforms but needs further clinical evaluation.
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Enfermería intensiva · Oct 2013
Observational Study[Evolution in muscle strength in critical patients with invasive mechanical ventilation].
To assess the evolution of muscle strength in critically ill patients with mechanical ventilation (MV) from withdrawal of sedatives to hospital discharge. ⋯ The greatest muscle strength gain after withdrawing of the sedatives was achieved in the first week. Muscle strength loss was associated with a cardiovascular SOFA > 2 and costicosteroids. Patients with a MRC < 48 required more days with MV and a longer ICU stay.
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Randomized Controlled Trial
Adaptive support ventilation for complete ventilatory support in acute respiratory distress syndrome: a pilot, randomized controlled trial.
Low tidal volume ventilation has been shown to improve survival in acute respiratory distress syndrome (ARDS). Adaptive support ventilation (ASV), a closed-loop ventilatory mode, can minimize the work of breathing, and thus potentially improve the outcomes in ARDS. The aim of this pilot, randomized clinical trial was to compare the outcomes of ASV versus volume-cycled ventilation (VCV) in ARDS. ⋯ There was no significant difference in the outcomes of patients with ARDS ventilated with either VCV or ASV in this study.
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Enfermería intensiva · Oct 2013
Observational Study[Pain behaviour indicator scale (ESCID) application in severe non-communicative trauma patients receiving mechanical ventilation].
To assess pain in non-communicative patients with severe trauma undergoing mechanical ventilation prior to, during and after tracheal suctioning, mobilization and wound care. ⋯ An increase on the ESCID score was observed while performing the procedures.
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Patients with acute lung injury or acute respiratory distress syndrome (ARDS) admitted to the ICU present neuropsychological alterations, which in most cases extend beyond the acute phase and have an important adverse effect upon quality of life. The aim of this review is to deepen in the analysis of the complex interaction between lung and brain in critically ill patients subjected to mechanical ventilation. This update first describes the neuropsychological alterations occurring both during the acute phase of ICU stay and at discharge, followed by an analysis of lung-brain interactions during mechanical ventilation, and finally explores the etiology and mechanisms leading to the neurological disorders observed in these patients. The management of critical patients requires an integral approach focused on minimizing the deleterious effects over the short, middle or long term.