Articles: mechanical-ventilation.
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Int J Chron Obstruct Pulmon Dis · Jan 2009
Can dead space fraction predict the length of mechanical ventilation in exacerbated COPD patients?
Chronic obstructive pulmonary disease (COPD) is a condition in which there is limited airflow during expiration (exhaling, or breathing out) that is not fully reversible and usually worsens over time. The disease is estimated to kill more than 100,000 Americans each year, and costs related to care of patients with COPD are significant. Physiologically, COPD represents a disruption in ventilation and in the exchange of gases in the lungs. Laboratory tests indicate elevated CO2 levels, gradual reduction of the levels of oxygen and pH in arterial blood, and a consequent rise in the dead space fraction (DSF) of the lungs. ⋯ Evaluation of DSF does not provide a factor in estimating the length of treatment for patients with acute respiratory failure due to COPD exacerbation.
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To evaluate and compare the efficiency of humidification in available heat and moisture exchanger models under conditions of varying tidal volume, respiratory rate, and flow rate. ⋯ Our data indicate that heat and moisture exchangers are more efficient when used with low tidal volume ventilation. The roles of flow and respiratory rate were of lesser importance, suggesting that their adjustment has a less significant effect on the performance of heat and moisture exchangers.
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Unplanned extubation is quite common in intensive care unit (ICU) patients receiving mechanical ventilatory support. The present study aimed to investigate the effectiveness of noninvasive positive pressure ventilation (NPPV) in patients with unplanned extubation. ⋯ Patients with unplanned extubation before the weaning criteria are met should be intubated immediately. On the other hand, when extubation develops during the weaning period, NPPV may be an alternative. The present study was conducted with a small number of patients, and larger studies on the effectiveness of NPPV in unplanned extubation are warranted for firm conclusions.
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To investigate the relationship between mechanical ventilation and mortality and the practice of mechanical ventilation applied in children admitted to a high-complexity pediatric intensive care unit in the city of São Paulo, Brazil. ⋯ Of the admitted children, 35.7% received mechanical ventilation for 24 h or more. Pressure ventilation modes were standard. Of the children studied, 91% had chronic functional status. There was a high incidence of Acute Respiratory Distress Syndrome, but a lung-protective strategy was not fully implemented. Inspiratory pressure at the beginning of mechanical ventilation was a predictor of mortality within 28 days and of a longer course of mechanical ventilation.
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Pediatr Crit Care Me · Oct 2008
WITHDRAWN: Reliability of displayed tidal volume in infants and children during dual controlled ventilation.
Previous studies have shown significant difference between ventilator-measured tidal volume and actual-delivered tidal volume. However, these studies utilized external methods for measurement of compression volume. Our objective was to determine whether tidal volume could be accurately measured at the expiratory valve of a conventional ventilator using internal computer software to compensate for circuit compliance, with a dual control mode of ventilation. DESIGN:: Clinical study during an 8-month period. SETTING:: Pediatric intensive care unit. PATIENTS:: All patients admitted to the pediatric intensive care unit during the enrollment period who were mechanically ventilated using the Servo i (Maquet, Bridgewater, NJ) were eligible for this study. INTERVENTIONS:: Patients were ventilated utilizing a dual control mode of ventilatory support and either an infant or adult circuit (with and without circuit compensation). MEASUREMENTS AND MAIN ⋯ There is an underestimation of delivered tidal volume when compensating for circuit volume loss measured at the ventilator. There is no improvement in measured tidal volume utilizing circuit compensation in small infants and children.