Search results for " Ventilation"

Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies …

2023

Background: There is insufficient evidence to guide ventilatory targets in acute brain injury (ABI). Recent studies have shown associations between mechanical power (MP) and mortality in critical care populations. We aimed to describe MP in ventilated patients with ABI, and evaluate associations between MP and clinical outcomes. Methods: In this preplanned, secondary analysis of a prospective, multi-center, observational cohort study (ENIO, NCT03400904), we included adult patients with ABI (Glasgow Coma Scale ≤ 12 before intubation) who required mechanical ventilation (MV) ≥ 24 h. Using multivariable log binomial regressions, we separately assessed associations between MP on hospital day (H…

Ventilación mecánica no invasiva en el postoperatorio. Revisión clínica

2015

Non-invasive ventilation (NIV) is a method of ventilatory support that is increasing in importance day by day in the management of postoperative respiratory failure. Its role in the prevention and treatment of atelectasis is particularly important in the in the period after thoracic and abdominal surgeries. Similarly, in the transplanted patient, NIV can shorten the time of invasive mechanical ventilation, reducing the risk of infectious complications in these high-risk patients. It has been performed A systematic review of the literature has been performed, including examining the technical, clinical experiences and recommendations concerning the application of NIV in the postoperative per…

A Randomized Controlled Trial Comparing Inhaled Isoflurane Via the Anaesthetic Conserving Device (Sedaconda <sup>®</sup> ACD) with Propof…

2021

Background: Small studies indicate that isoflurane may be useful for sedation during invasive ventilation of ICU patients. There are no published large prospective efficacy trials. Methods: This phase 3, non-inferiority trial evaluated the efficacy and safety of ≤54 hours of isoflurane via the anaesthetic conserving device (ACD) compared with propofol in invasively ventilated ICU patients (30-day follow-up). Primary endpoint was percentage of time in Richmond Agitation–Sedation Scale (RASS) range –1 to –4; the predefined non-inferiority margin was 15% below the propofol mean. Secondary endpoints: opioid requirements, spontaneous breathing during sedation, time to wake-up and extubation, adv…

An Experimental Investigation on the Air Permeability of Passive Ventilation Grilles

2015

Abstract The need of increasing both energy saving and acoustic insulation has leaded to the design of lowest air permeability frames resulting in the worsening of indoor air quality. Moreover, sometime in several civil-use existing buildings (i.e. schools or houses, historical buildings) mechanical ventilation systems cannot be installed due to non-removable constraints. In these cases, passive ventilation grilles are a cheap and effective solution for the ventilation. This work deals with an in-depth experimental analysis about the air permeability values measured over a set of passive ventilation grilles available on the market. Obtained results often showed performances very far to thos…

Ventilating the newborn and child

2010

Summary The mechanical ventilation of neonates and children in operating theatres has always posed a challenge for anaesthesiologists. Firstly, the extreme physiological features of neonatal lungs make them very difficult to ventilate with an anaesthesia ventilator. Gattinoni's "baby lung" concept to describe ARDS lungs in adults comes from the physiological features of neonatal lungs (low dynamic compliance, low pulmonary time constant, low FRC, high closing volume, proneness to atelectasis, high inspiratory airway resistance). Secondly, the performance and technology (peak flow, insufflation power, trigger sensitivity, ventilation modes, etc.) of anaesthesia ventilators is still less adva…

Tracheostomy mechanical ventilation in amyotrophic lateral sclerosis.

2013

Automated Weaning from Mechanical Ventilation after Off-Pump Coronary Artery Bypass Grafting

2017

Background The discontinuation of mechanical ventilation after coronary surgery may prolong and significantly increase the load on intensive care unit personnel. We hypothesized that automated mode using INTELLiVENT-ASV can decrease duration of postoperative mechanical ventilation, reduce workload on medical staff, and provide safe ventilation after off-pump coronary artery bypass grafting (OPCAB). The primary endpoint of our study was to assess the duration of postoperative mechanical ventilation during different modes of weaning from respiratory support (RS) after OPCAB. The secondary endpoint was to assess safety of the automated weaning mode and the number of manual interventions to the…

Quantifizierung von Atelektasen bei kontrollierter Beatmung: Spiral-CT versus dynamische Einzelschicht-CT

2004

Ziel: Dynamische CT-Untersuchungen (dCT) erlauben die Darstellung und Quantifizierung ventilierter Lungenflache und Atelektasenbildung wahrend kontinuierlicher Beatmung. Diese Studie ­vergleicht eine quantitative Auswertung einer infrakarinalen dCT-Einzelschicht mit der einer Spiral-CT der gesamten Lunge, um zu untersuchen, ob eine dynamisch gemessene Einzelschicht bezuglich der intrapulmonalen Atelektasenverteilung reprasentativ fur die Gesamtlunge ist. Material und Methoden: An 8 gesunden Schweinen erfolgte eine dCT (Schichtdicke 1 mm, zeitliches Inkrement 100 ms) wahrend kontinuierlicher Beatmung, gefolgt von einer Spiral-CT der gesamten Lunge (Schichtdicke 2 mm; Pitch 1,5; Inkrement 2 m…

Neuromuscular and Chest Wall Diseases in Pregnancy

2009

Patients with severe respiratory muscle impairment, in particular when vital capa-city is below 60% of the predicted normal values, are often discouraged frombecoming pregnant for fear of respiratory complications and the need for tra-cheostomy and invasive mechanical ventilation (1). A growing fetus can impairthe functioning of weak diaphragms resulting in lower vital capacity and respira-tory reserve and impair cough function. In addition, there is increased oxygenconsumption and ventilation requirement. Complications in pregnancy and theneed for analgesics and anesthesia during labor and delivery can also cause orexacerbate ventilatory failure.Neuromuscular DiseasesNeuromuscular diseases…

Indication and Timing

2016

Tracheostomy is performed in patients requiring prolonged mechanical ventilation aiming at avoiding the potential detrimental effect of a sustained translaryngeal intubation (e.g. laryngeal oedema, mucosal ulcerations). Potential benefits of tracheostomy in critically ill patients are improved comfort and reduced need for sedation, easier clearance of secretions and oral hygiene, and a possible faster weaning from mechanical ventilation. Controversy exists over optimal timing (early, tracheostomy placement compared with later time points) in patients with respiratory failure. Among the published randomised controlled trials, two large studies did not report a significant advantage of an ear…