Anxiety during weaning was present in 0, 9 and 24% patients in the DEX, SOC and SOCDEX groups, respectively. Anxiety after extubation was present in 41, 20 and 34% in the DEX, SOC and SOCDEX groups, respectively. [ncbi.nlm.nih.gov]

• Fatigue

  Progressive exhaustion/fatigue with Altered Mental Status are the primary reasons. A cooperative patient, even if hypercapnic, may be managed with maximizing other therapies (see Noninvasive Ventilation and Magnesium ). [pedemmorsels.com]

  Once daily T-piece trials are preferable to multiple short trials, probably because fatigued respiratory muscles are given sufficient time to recover between trials. [aic.cuhk.edu.hk]

  Does respiratory muscle rest relieve fatigue or incipient fatigue? Am Rev Respir Dis 1988 ;138: 516 - 517 Citing Articles (658) Article Figures/Media [nejm.org]

  Sine Apnea alarm setting is 15-20 second delay FiO2 alarm set at +/- 5% set FiO2 Complications of mechanical vent include Barotrauma/Volutrauma, decrease in CO, BP; pulmonary infection, Tracheal damage, decreasedUO, resp muscle fatigue, poor nutrition [studystack.com]

  “The goal of the medical device manufacturer is to help reduce the number of nuisance alarms and alarm fatigue,” Rogers said. “This is a hot topic with AAMI and ECRI. We are trying to manage alarms with intelligence. [rtmagazine.com]

• Fever

  New onset of fever, purulent sputum, leucocytosis, and desaturation should prompt further investigation. [clinicaladvisor.com]

  Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N.Engl.J.Med 344 (7):481-487, 2001. MacIntyre N. Improving patient/ventilator interactions. In Vincent J-L. [aic.cuhk.edu.hk]

  VAP should be suspected when a new or changing pulmonary infiltrate in seen in conjunction with fever, leukocytosis, and purulent tracheobronchial secretions. However, many diseases can cause this clinical scenario. [emedicine.medscape.com]

• Stridor

  An 86-year-old man developed stridor and acute respiratory failure after being treated for a chronic obstructive pulmonary disease exacerbation and a urinary tract infection that required mechanical ventilation. [ncbi.nlm.nih.gov]

  Extubation Obese patients are particularly at risk of post‐extubation stridor [ 29 ]. [ccforum.biomedcentral.com]

  Difficulty weaning from mechanical ventilation CCC — Weaning from mechanical ventilation hot case CCC — Non-invasive ventilation for weaning CCC — Extubation assessment in ICU CCC — Extubation assessment hot case CCC — Cuff Leak Test CCC — Post-extubation stridor [lifeinthefastlane.com]

  Additionally, NIPPV may be an effective intermediary therapy for children experiencing post-extubation de-recruitment or stridor/stertor. [academic.oup.com]

• Nausea

  The drug's most common adverse reactions include hypotension, hypertension, nausea, bradycardia, and dry mouth. However, to our knowledge, no reports of dermatologic allergic reactions from dexmedetomidine use have been published. [ncbi.nlm.nih.gov]

• Fear

  And the fear is that false hopes will be raised. [nytimes.com]

  Summary: Failure to intubate following RSI in the emergency department is a feared complication. Practitioners must have a predetermined course of action to cope with this event. [emj.bmj.com]

• Confusion

  Its greatest strengths are its choice of material, its figures and tables, and its concise, understandable reviews of complex technical aspects of mechanical ventilation, pulmonary physiology, and the potentially confusing literature on clinical applications [amazon.com]

  Ventilation Physiologic effects of positive pressure ventilation Dynamic hyperinflation and auto-PEEP Barotrauma Other Introduction Although mechanical ventilation is a key component of intensive care, unfamiliar jargon and technical detail render it confusing [courses.washington.edu]

  […] a sign of airway obstruction Check plateau pressure (press and hold the inspiratory hold button) as below Set peak pressure alarm to trigger >80 cm H2O Aggressive Obstructive Lung Disease management with Bronchodilator s and steroids However, do not confuse [fpnotebook.com]

• Pneumoperitoneum

  This can manifest as pneumothorax, pneumoperitoneum, subcutaneous emphysema, pneumomediastinum and can sometimes progress to bronchopleural fistula or tension pneumothorax. [clinicaladvisor.com]

  In case of increase in airway resistance (bronchospasm, obstructed tube) or decrease in compliance of the respiratory system (obesity, atelectasis, selective intubation, surgical pneumoperitoneum, pneumothorax …), the tidal volume decreases, leading to [ccforum.biomedcentral.com]

• Hypercapnia

  A subset of patients with ARDS has mixed hypercapnia and hypoxemia despite high-level ventilator support. [ncbi.nlm.nih.gov]

  Hypercapnia and hypoxemia may coexist, although some disorders may affect gas exchange differentially. HYPERCAPNIA Hypercapnia usually is caused by hypoventilation or severe ventilation-perfusion mismatch. [pedsinreview.aappublications.org]

  Permissive Hypercapnia Permissive Hypercapnia in ARDS This single-minded focus on reducing plateau pressures derives from the likely survival benefit from low tidal volume ventilation and low plateau pressures observed in clinical trials (or if you prefer [pulmccm.org]

Asthma is a major cause of morbidity and mortality despite advances in outpatient treatment. Sometimes, children fail to respond to standard treatment and can potentially require mechanical ventilation. [ncbi.nlm.nih.gov]

PMX-DHP may improve the prognosis of severe respiratory failure in patients with AE-IPF. [ncbi.nlm.nih.gov]

Outlook (Prognosis) The outlook will depend on the reason the procedure needed to be done. References Driver BE, Reardon RF. Tracheal intubation. In: Roberts JR, Custalow CB, Thomsen TW, eds. [mountsinai.org]

Bronchiolitis due to respiratory syncytial virus was the main etiology (93.8%) and 31.3% had comorbidities. Measured respiratory pressures were PIP 29 (26-31), PPL 24 (20-26), tPEEP 9 [8-11] cmH2O. [ncbi.nlm.nih.gov]

To determine the etiology, the lower airway tract needs to be sampled. This can be done by endotracheal aspiration, bronchoalveolar lavage or by using a protected specimen brush (during bronchoscopy). [clinicaladvisor.com]

If there are no physical findings suggesting tension pneumothorax, and if ventilation-related causes of hypotension are a possible etiology, pending a portable chest x-ray, the patient may be disconnected from the ventilator and gently bagged manually [merckmanuals.com]

Crit Care Med 2010; 38:1947-1953 Mechanical ventilation : epidemiological insights into current practices. E Goligher, N Ferguson. Curr Opin Crit Care 15:44-51 Epidemiological insights into current practices. E Goligher, N Ferguson. [aast.org]

The epidemiologic characteristics and outcomes of severe trauma patients requiring prolonged mechanical ventilation (PMV) remain unclear. This retrospective study aims to investigate the outcomes of PMV in this specific group. [ncbi.nlm.nih.gov]

He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]

The use of fractional polynomials to model continuous risk variables in epidemiology. Int J Epidemiol 1999 ; 28 : 964 -74. ↵ Sauerbrei W, Meier-Hirmer C, Benner A, Royston P. [bmj.com]

OBJECTIVES: To provide a critical review of the experimental evidence surrounding the pathophysiology of ventilator-induced lung injury and to help clinicians apply the clinical recommendations to individual patients. [ncbi.nlm.nih.gov]

Moreover, it discusses practical approaches for detecting, correcting, and preventing asynchronies. Current evidence suggests that the best approach to managing asynchronies is by adjusting ventilator settings. [ncbi.nlm.nih.gov]

This prevents them from pulling out any tubes or intravenous catheters. This also prevents damage to their airway while the breathing tube is in place. [cincinnatichildrens.org]

The second is to prevent collapse of alveoli during expiration and hence preventing cyclic atelectasis. [clinicaladvisor.com]