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Mechanical Ventilation

Mechanical Ventilations


Presentation

  • 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]
  • Gorham syndrome is a rare disease that presents as progressive osteolysis, and may affect any part of the skeleton.[ncbi.nlm.nih.gov]
  • A 41-year-old man presented to the emergency department with swelling of his lips a few days after starting lisinopril for hypertension.[ncbi.nlm.nih.gov]
  • At admission, dyspnoea was present in 46%, lipothymia in 23%, and abdominal discomfort in 38.4% of patients. A total of 53.8% of patients showed anasarca. Cardiogenic shock presentation was found in six patients (46%).[ncbi.nlm.nih.gov]
  • We present the successful use of perioperative non-invasive mechanical ventilation in a morbidly obese pregnant woman with bronchial asthma, severe preeclampsia and pulmonary edema undergoing an emergency cesarean delivery with spinal anesthesia.[ncbi.nlm.nih.gov]
Antipsychotic Agent
  • A second-generation antipsychotic agent was successfully used to facilitate weaning in a very anxious patient, possibly secondary to anxiolysis or direct effect on respiratory drive.[ncbi.nlm.nih.gov]
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]
  • 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]
  • […] 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]
  • […] patient to wake up- this is one of the advantages of using a propofol washout as you have a generally more predictable time of when your patient will awaken) Ensure everything is ready: (MSOAP)- Monitors and reintubation Meds (or meds for postextubation stridor[learnpicu.com]
  • Some patients can have post-extubation stridor and may need to be reintubated because of respiratory failure.[clinicaladvisor.com]
Diplopia
  • She had a history of febrile disease one month before, acute onset of paraplegia, diplopia, progressive arm weakness and dyspnea. Her consciousness was not impaired.[ncbi.nlm.nih.gov]
Ankylosis
  • This case demonstrates a rarely reported bilateral scapulohumeral bony ankylosis.[ncbi.nlm.nih.gov]
Unstable Gait
  • We report a 34-year-old male with Gorham syndrome presenting as progressive kyphosis, severe back pain, unstable gait, and exertional dyspnea. Pulmonary function testing revealed severe restrictive ventilatory impairment.[ncbi.nlm.nih.gov]

Workup

Pneumoperitoneum
  • This can manifest as pneumothorax, pneumoperitoneum, subcutaneous emphysema, pneumomediastinum and can sometimes progress to bronchopleural fistula or tension pneumothorax.[clinicaladvisor.com]
Hypercapnia
  • A subset of patients with ARDS has mixed hypercapnia and hypoxemia despite high-level ventilator support.[ncbi.nlm.nih.gov]
  • The purpose of this study was to determine whether heliox could reduce the degree of hyperinflation and hypercapnia in mechanically ventilated patients with severe air-flow obstruction.[ncbi.nlm.nih.gov]
  • 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]
  • […] due to decreased minute ventilation Increase Expiratory Time (e.g. shorter breaths or slower rate, decreases Auto-PEEP risk) Risk of hypercapnia Lung Injury Decrease Tidal Volume until plateau pressure Obstructive Lung (breath stacking) Decrease Respiratory[fpnotebook.com]

Treatment

  • Patient training, follow-up and reduction of side effects, largely delivered by trained nurses, contribute to achieve the main goal of the treatment-improved health-related quality of life. 2017 The Authors.[ncbi.nlm.nih.gov]
  • Monitoring the changes of serum BMP-7 and TGF-β1 is very important for treatment and prognosis assessment of the NRDS.[ncbi.nlm.nih.gov]
  • Various treatments for PIE have been proposed: high-frequency ventilation, postural therapy, selective bronchial intubation or surgery.[ncbi.nlm.nih.gov]
  • 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]
  • The use of advanced monitoring and the application of simple maneuvers at the bedside may assist clinicians to better individualize treatment and improve clinical outcomes.[ncbi.nlm.nih.gov]

Prognosis

  • PMX-DHP may improve the prognosis of severe respiratory failure in patients with AE-IPF.[ncbi.nlm.nih.gov]
  • Monitoring the changes of serum BMP-7 and TGF-β1 is very important for treatment and prognosis assessment of the NRDS.[ncbi.nlm.nih.gov]
  • Many experts recommend a "trial of therapy" to clarify both prognosis and quality of life. The key ethical question, then, is not whether to postpone a decision to forego mechanical ventilation. Instead, the key question is how long to wait.[ncbi.nlm.nih.gov]
  • We sought to describe clinical and genetic profiles and to determine prognosis of DMD and Becker muscular dystrophy (BMD) patients on home MV (HMV), hospitalized for AHF.[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]

Etiology

  • In children with rapidly progressive pneumonia and hypoxia refractory to mechanical ventilation, venovenous (VV) ECMO has been successfully used with survival ranging from 40-60% depending on the etiology.[ncbi.nlm.nih.gov]
  • The following variables were analyzed: age, gender, etiology, neurological level, ASIA (American Spinal Injury Association) grade, associated injuries, injury severity score (ISS), ASIA motor score (AMS) at admission and mortality.[ncbi.nlm.nih.gov]
  • 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[msdmanuals.com]

Epidemiology

  • 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]
  • 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]
  • […] and Policy Research University of British Colombia, Vancouver, BC, Canada. 8 Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, ON, Canada. 9 Department of Critical Care, Queen's University, Kingston, ON, Canada. 10 Department of Epidemiology[ncbi.nlm.nih.gov]
  • He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education.[lifeinthefastlane.com]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • There is little information regarding the pathophysiology of this illness. Important questions remain regarding this disease, including predisposing factors and management. Patients who require mechanical ventilation have poor outcomes.[ncbi.nlm.nih.gov]
  • Author information 1 Department of Pathophysiology and Transplantation, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy.[ncbi.nlm.nih.gov]
  • Pathophysiological changes involved in drug disposition in critically ill patients should be considered in order to optimize the dosing of vancomycin administered by continuous infusion, and certain strategies must be applied to reach therapeutic targets[ncbi.nlm.nih.gov]
  • This non-systematic review discusses the pathophysiology of fluid overload, its consequences, and the available therapeutic strategies.[ncbi.nlm.nih.gov]

Prevention

  • Currently, there are no agents approved by the Food and Drug Administration to target ACE inhibitor angioedema and to prevent intubation.[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]
  • In those patients tracheobronchial toilette is crucial in preventing or treating airways obstructed by secretions and deterioration of oxygenation.[ncbi.nlm.nih.gov]
  • Conservative approach should remain the first choice treatment of unilateral PIE in order to limit surgical procedures, while effort should be made to prevent this iatrogenic complication.[ncbi.nlm.nih.gov]
  • Afterwards, nonsteroidal anti-inflammatory drugs and/or radiation therapy can be possible treatment modalities to prevent recurrence of HOs.[ncbi.nlm.nih.gov]

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