Search results for "Mechanical Ventilation"
showing 10 items of 180 documents
The Impact of Venous Thromboembolism In Critically Ill Patients: A Meta-Analysis of Major Clinical outcomes
2010
Abstract Abstract 3327 Background: Critically ill patients are at high risk of developing venous thromboembolism (VTE) during their stay in the intensive care unit (ICU) because of premorbid medical and surgical conditions. The clinical consequences of Deep Vein Thrombosis (DVT) have the potential to be serious yet are frequently unrecognized in the Intensive Care Unit (ICU). In contrast to the extensive documentation on the short and long–term outcomes of patients with DVT evaluated in other clinical settings, little is known about the clinical course of this disease in the ICU setting. We hypothesized that both undetected and clinically evident VTE would affect the prognosis of critically…
Off-label tocilizumab and adjuvant iron chelator effectiveness in a group of severe COVID-19 pneumonia patients
2021
ABSTRACT: Tocilizumab (TCZ), a monoclonal recombinant antibody against IL-6 receptor, is currently used in managing the cytokine release syndrome (CRS) that occurred in coronavirus disease 2019 (COVID-19) selected cases. The primary objective of our study was to establish the effectiveness of TCZ in patients with severe or critical severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pneumonia.We retrospectively analyzed 25 consecutive patients, admitted in the Academic Emergency Hospital Sibiu, Romania from April 1, 2020 until May 25, 2020, all with confirmed SARS-CoV-2 infection and severe pneumonia. All patients were treated off-label with TCZ, beside their standard care. Adjuvan…
Supportive und adjunktive Therapiemaßnahmen bei akutem Lungenversagen
2008
Various supportive and adjunctive therapies to conventional mechanical ventilation have been evaluated in patients with acute lung injury and acute respiratory distress syndrome (e.g. nitric oxide, prone position, surfactant, glucocorticoids). Although some investigations have shown promising improvements in oxygenation and physiological variables, large randomized trials of adjunctive and supportive therapies showed no impact on survival.
Extubation strategies in neuro-intensive care unit patients and associations with outcomes
2020
Background Prolonged invasive ventilation is common in patients with severe brain injury. Information on optimal management of extubation and on the use of tracheostomy in these patients is scarce. International guidelines regarding the ventilator liberation and tracheostomy are currently lacking. Methods The aim of 'Extubation strategies in Neuro-Intensive care unit patients and associations with Outcomes' (ENIO) study is to describe current management of weaning from invasive ventilation, focusing on decisions on timing of tracheal extubation and tracheostomy in intensive care unit (ICU) patients with brain injury. We conducted a prospective, international, multi-centre observational stud…
Ventilation workshop - a new concept
2000
The use of simulator technology to practise crisis resource management or to train standardised procedures in anaesthesia is a proved concept, although its setup in clinical practice is still in progress. To get a better understanding of the complex pathophysiological and clinical relations in the pulmonary system and the kind of alterations that could be induced by changing the ventilation of an intensive care unit patient, we modified the current concept. We created a workshop, which employs more than just the simulator training in the classical sense. During this workshop the participants attend one patient from admission to an emergency room, until discharge from an intensive care unit …
Predicting critical illness on initial diagnosis of COVID-19 based on easily-obtained clinical variables: Development and validation of the PRIORITY …
2020
ABSTRACTObjectivesCurrently available COVID-19 prognostic models have focused on laboratory and radiological data obtained following admission. However, these tests are not available on initial assessment or in resource-limited settings. We aim to develop and validate a prediction model, based on clinical history and examination findings on initial diagnosis of COVID-19, to identify patients at risk of critical outcomes.MethodsWe used data from the SEMI-COVID-19 Registry, a nationwide multicenter cohort of consecutive patients hospitalized for COVID-19 from 132 centers in Spain. Clinical signs and symptoms, demographic variables, and medical history ascertained at hospital admission were sc…
Perioperative Adverse Events in Obstructive Sleep Apnea and Use of Noninvasive Mechanical Ventilation: Key Topics and Clinical Implications
2016
Obstructive sleep apnea (OSA) is a common public health care problem and, yet, the perioperative management of OSA remains inadequate. Patients affected by this condition are prone to early postoperative complications, in part due to the negative effects of sedative, analgesic, and anesthetic agents on pharyngeal tone and arousal responses to hypoxia, hypercapnia, and obstruction. The use of opioids may also contribute to late adverse events, mainly by suppressing the rapid eye movement phase of sleep. As a result, preoperative screening of patients at high risk of OSA, as well as the implementation of a perioperative strategy to reduce the risk of complications, should lead to early periop…
Specific Features of the Coagulopathy Signature in Severe COVID-19 Pneumonia
2021
Rationale: COVID-19 displays distinct characteristics that suggest a unique pathogenesis. The objective of this study was to compare biomarkers of coagulopathy and outcomes in COVID-19 and non-COVID-19 patients with severe pneumonia.Methods: Thirty-six non-COVID-19 and 27 COVID-19 non-immunocompromised patients with severe pneumonia were prospectively enrolled, most requiring intensive care. Clinical and biological characteristics (including plasma biomarkers of coagulopathy) were compared.Results: At similar baseline severity, COVID-19 patients required mechanical ventilation (MV) for significantly longer than non-COVID-19 patients (p = 0.0049) and more frequently developed venous thrombot…
Predictors of poor prognosis in healthy, young, individuals with SARS-CoV-2 infections.
2021
OBJECTIVES: To identify predictors of poor prognosis in previously healthy young individuals admitted with COVID-19. METHODS: We studied a cohort of patients hospitalized with COVID-19 disease. All patients without comorbidities, no usual treatments and =65years old were selected from an international registry (HOPE-COVID-19, NCT04334291). We focused on baseline variables-symptoms and signs at admission-to analyze risk factors for poor prognosis. The primary endpoint was a composite of major adverse clinical events during hospitalization including mortality, mechanical ventilation, high flow nasal oxygen therapy, prone, sepsis, SIRS, and embolic events. RESULTS: Overall, 773 healthy young p…
Progressive active mobilization with dose control and training load in critically ill patients (PROMOB): Protocol for a randomized controlled trial
2020
The dose of progressive active mobilization is still uncertain. The purpose of this study is to identify if the addition of a protocol of progressive active mobilization with dose and training load control to usual care is effective in reducing the length of stay in intensive care unit (ICU) and the improvement of the functioning, incidence of ICU-acquired weakness (ICUAW), mechanical ventilation duration and mortality rate in patients hospitalized in ICU. It is Double-blind randomised clinical trial. The setting for this trial will be medical and surgical ICU of a university hospital. The study participants will be 118 patients aged> 18 years admitted to ICU for less than 72 hours. Partici…