artificial respiration

..Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in critically ill patients. The clinical and economic consequences of VAP are unclear, with a broad range of values reported in the literature..

..Further trials will be needed to clarify the optimal duration of treatment and the circumstances in which monotherapy can be safely used...

..Although management of patients with pulmonary contusion is supportive, pneumonia and adult respiratory distress syndrome with long-term disability occur frequently...

..Optimal fluid management in patients with acute lung injury is unknown. Diuresis or fluid restriction may improve lung function but could jeopardize extrapulmonary-organ perfusion...

..CONCLUSIONS: Superior vena cava measurement should be systematically performed during routine echocardiography in septic shock as it gives an accurate index of fluid responsiveness...

..To study VILI in healthy mice, the authors used a MV model with clinically relevant ventilator settings, avoiding massive damage of lung structures and shock, and preventing metabolic acidosis...

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..To determine the effects of low-dose prolonged methylprednisolone infusion on lung function in patients with early severe ARDS...

..The aim of this study was to investigate factors affecting clinical outcomes of adults hospitalised with severe seasonal influenza...

..Our findings support the hypothesis that antibodies targeted against these proteins may be useful as adjunctive therapy in intubated patients with P. aeruginosa colonization or infection...

..The objective of the present study was to examine if the echocardiographic evaluation of right ventricular function performed in ARDS may help to answer to this question...

..CONCLUSIONS: The regular administration of povidone-iodine may be an effective strategy for decreasing the prevalence of ventilator-associated pneumonia in patients with severe head trauma...

..25 +/- 0.09 to 0.08 +/- 0.08, p < 0.01). We conclude that cells of ventilator-injured lungs are subject to reversible plasma membrane stress failure...

..The authors sought to determine the effects of short-term mechanical ventilation on local inflammatory responses in patients without preexisting lung injury...

..However, little information exists on the outcomes following discharge. A study was undertaken to examine the rates of readmission, recurrent AHRF, and death following discharge and the risk factors associated with them...

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..Disclaimer: It is not intended that these guidelines should constitute a minimum standard of practice, nor are they to be regarded as a substitute for good clinical judgement...

..the effects of HV are cumulative; (2). specific patterns of gene activation and suppression precede lung injury; and (3). alteration of gene expression after mechanical stretch is pathogenic...

..Dexmedetomidine induces sedation via different central nervous system receptors than the benzodiazepine drugs and may lower the risk of acute brain dysfunction...

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..Differences between LVDI and HV suggest that an optimal frequency range of DI exists, within which the benefits of maintaining an open lung outweigh injury incurred from overdistention...

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..We assessed the physiologic response to varying levels of NAVA and pressure support ventilation (PSV)...

..In the present pilot study we tested the hypothesis that timely initiation of iLA using clear algorithms and an improved cannulation technique will positively influence complication rates and management of lung protective ventilation...

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..Many interventions have been studied to reduce the risk of VAP. We systematically reviewed the influence of airway management on VAP in critically ill patients...

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..Acute respiratory distress syndrome survivors treated with high and low tidal volumes have abnormal pulmonary function that was related to decreased health-related quality of life 1 year after hospital discharge...

..CONCLUSIONS: The present study found DeltaPEPKT and DeltaPEPPLET to be as accurate as DeltaPP in the prediction of fluid responsiveness in mechanically ventilated septic patients...

..The effect on mortality should be confirmed...

..CONCLUSION: FQ use and longer duration of antibiotic treatment are independently associated with MRB emergence. Reducing antimicrobial treatment duration and restricting FQ use could be suggested to control MRB spread in the ICU...

..It is not yet clear whether the open-lung approach will further reduce mortality in patients receiving volume- and pressure-limited ventilation support...

..The objectives of the current study were to investigate whether tidal volume or minute ventilation is the dominant factor for the accuracy, and the accuracy of the technique when spontaneous breathing effort is present...

..Currently, there are several theoretical and practical applications of LAV in the immature or mature lung at risk for acute respiratory distress and injury associated with mechanical ventilation...

..24-41.18) were independent predictors of mortality. CONCLUSIONS: This study confirms previous work showing that delirium is an independent predictor for increased mortality among mechanically ventilated patients...

..This study suggests that large Vt ventilation potentiates the predisposed, subclinical lung injury, such as nosocomial pneumonia or aspiration of gastric contents...

..Gamma-aminobutyric acid receptor agonist medications are the most commonly used sedatives for intensive care unit (ICU) patients, yet preliminary evidence indicates that the alpha(2) agonist dexmedetomidine may have distinct advantages...

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..To evaluate the clinical utility of bronchoscopy with protected brush catheter (PBC) and BAL for patients with ventilator-associated pneumonia (VAP)...

..05; C vs. A and B). CONCLUSION: Reducing left atrial pressure results in more severe ventilator-induced lung injury. These results suggest that lung blood volume modulates cyclic tidal lung stress...

..Performing TR late did not reduce pneumonia rates or ventilator, ICU, or hospital days. By identifying the at-risk population early TR could be performed in an attempt to decrease morbidity and length of stay...

..We advocate an approach to this common syndrome that identifies risk factors early in the hope of minimizing their impact...

..cross infection, prevention and control; respiration, artificial, adverse effects; antibiotics, administration and dosage infection control methods; pneumonia, etiology, prevention and control; intubation, intratracheal, adverse effects..

..Delirium is a common problem in the intensive care unit (ICU). Accurate diagnosis is limited by the difficulty of communicating with mechanically ventilated patients and by lack of a validated delirium instrument for use in the ICU...

..CONCLUSION: B-mode ultrasound may be proposed first-line in a ventilated patient with suspicion of maxillary sinusitis...

..Optimizing treatment focusing on this goal and new antimicrobials provide new opportunities to improve survival. (Crit Care Med 2001; 29[Suppl.]:N82-N86)..

..We conclude that cyclic RV afterloading necessitates multiple thermodilution measurements equally spaced in the ventilatory cycle for reliable assessment of RV performance during mechanical ventilation of patients...

..This study used an animal model simulating the critical care environment to investigate the effects of 5 days' mechanical ventilation and inactivity on diaphragm contractility and neurophysiologic function...

..We evaluated whether passing weaning parameters was associated with survival...

..Finally, after successful treatment and prior to discharge, a careful strategy for prevention of subsequent asthma attacks is imperative...

..The objective of the present systematic review is to assess the effect of exogenous pulmonary surfactant on all-cause mortality in children mechanically ventilated for acute respiratory failure...

..To study the effect of hemodialysis on intra-abdominal pressure...

..We hypothesized that mechanical ventilation (MV) augmented sepsis-induced myocardial CML deposition and inflammation...

..Additionally, the technique must be applied in the appropriate location by a trained team in order to avoid disappointing results...

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..Although RM may improve PaO2 in certain injury settings when traditional tidal volumes are used, sustained improvement depends on the post-RM positive end-expiratory pressure value...

..Protocolised weaning did not reduce the duration of mechanical ventilation and was not associated with an increased rate of re-intubation or intensive care unit mortality...

..VAP caused by HRM was not significantly associated with mortality. However, it was an independent risk factor, increasing length of ICU stay and hospital stay by seven days, and duration of MV by 10 days...

..We hypothesize that when atelectasis is minimized by OLC ventilation, cardiac function is not affected despite the higher mean airway pressure...

..The aim of this study was to investigate whether in-hospital mortality was associated with the administered fraction of oxygen in inspired air (FiO2) and achieved arterial partial pressure of oxygen (PaO2)...

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..Very few children receive prehospital airway management, ventilation or IV medications; consequently EMS personnel have little opportunity to maintain these pediatric skills in the field...

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..The proportion of patients successfully treated with NIV increased significantly over the 5-year period (13% vs. 9% of all patients receiving ventilatory support)...

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..Clinicians need to be aware of the limitations of P(vent) data and consider using ETTs that allow measurement of P(T), a more accurate reflection of pulmonary airway pressure...

..Six of these ethical questions have been presented to leading physicians and an ethicist, from a range of national, cultural and religious backgrounds, for their comment...

..There have been a number of recent reports describing improvements in arterial oxygenation with the use of recruitment maneuvers. However, the impact of recruitment maneuvers on patient-important outcomes such as survival is unknown...

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..To assess the effects of step-changes in tidal volume on work of breathing during lung-protective ventilation in patients with acute lung injury (ALI) or the acute respiratory distress syndrome (ARDS)...

..There is a nonsignificant trend of reduction in ICUs and hospital mortality together with fewer complications during ICU stay...

..These efforts involve the initiation of spontaneous-breathing trials, implementation of systematic weaning protocols, and optimization of individual patient interventions...

..It is also used for patients who develop acute respiratory distress after extubation, but there are no randomized controlled trials that address its effectiveness in this population...

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..Given the uncertainty of the benefits, calfactant cannot be routinely recommended in pediatric ALI/ARDS...

..Despite the theoretical advantages of physical therapy to address this problem, it has not been shown that physical therapy initiated in the intensive care unit offers benefit...

..To determine alterations in high-frequency oscillatory ventilation (HFOV) performance during clinical ventilator management...

..To describe and evaluate a new weaning and decision support system for mechanical ventilation...

..In a cohort of mechanically ventilated patients to compare the automatic tidal volume (VT)-respiratory rate (RR) combination generated by adaptive support ventilation (ASV) for various lung conditions...

..Failure of NIV was associated with a longer length of stay. In conclusion, NIV can be successful in selected patients, and is associated with a lower risk of pneumonia and death than is ETI...

..Unplanned endotracheal extubation (UE) is recognized as the most common airway adverse event in the intensive care unit (ICU)...

..Thanks to it, new ventilatory strategies and modalities have been developed. Finally, on-line monitoring of respiratory mechanics parameters is going to be more than a future perspective...

..We therefore compared the effects of Pao and Ptr regulated VAV on breathing pattern and inspiratory effort...

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..To compare the impact of assist-control ventilation (ACV) and pressure support ventilation with 6 cmH2O inspiratory pressure (low PSV) on sleep quality...

..Severe CAP requiring admission to the ICU is common, and the decision about which patients to admit often requires clinical judgment that in many cases appears at odds with various validated pneumonia severity scoring systems...

..Clinicians should be aware of the limitations of adaptive pressure control and understand when other breath delivery techniques are more suitable...

..We hope that as new data become available, the answer to this capnography question will become clear...

..To compare T-tube and pressure support ventilation (PSV) as two methods of mechanical ventilation weaning of patients with chronic obstructive pulmonary disease (COPD) after failed extubation...

..To examine the outcomes of morbidly obese patients with acute respiratory failure treated with mechanical ventilation...

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..Mortality rate, the possible factors affecting mortality and intubation in patients with acute exacerbation of chronic obstructive pulmonary diseases (COPD) and hypercapnic respiratory failure (RF) are yet unclear...

..5 +/- 0.4 vs. 6.7 +/- 1.2 mm, p <.001). CONCLUSIONS: Endotracheal tube intraluminal volume loss is common among patients with acute respiratory failure requiring mechanical ventilation and increases with prolonged tracheal intubation...

..This article reviews the rationale for using prone positioning in ARDS patients who require intubation and mechanical ventilation...

..on this preliminary experience in order to develop a microfluidic scale device capable of carrying out artificial respiration powered by photocatalysis...

..on this preliminary experience in order to develop a microfluidic scale device capable of carrying out artificial respiration powered by photocatalysis...

..These results will inform clinical trial outcomes measures as well as highlight targets for interventions designed to improve survivors' HRQL. ..

..This will permit the investigators to assess potential underlying mechanisms for the putative therapeutic effects of DHEA on mood, libido, and body composition. ..

..The long-term goal of our experiments is to provide the knowledge required to develop clinical strategies to oppose the deleterious effects of MV on respiratory muscles. ..

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..If effective, a proposal for using aerosolized PGE1 in neonatal PPHN as a multicenter study will be submitted to the NICHD Neonatal Network. ..

..The major aims concern modafinil efficacy for fatigue compared to placebo, safety in terms of effects on immunologic/virologic measures, and impact on depressive symptoms when present at baseline. ..

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..In addition, these data will inform future cohort studies and randomized controlled trials designed to improve outcomes for this growing patient population. ..

..Such information will provide for the first time solid scientific evidence to health care providers, and help them formulate objective guidelines for the management of patients being weaned at a LTAC facility. ..

..The data collected in the preliminary study will be used in the full-scale study. ..

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..Our long-term goal is to develop methods for the prevention of MV-induced diaphragmatic weakness based on an understanding of the cellular mechanisms responsible for MV-induced diaphragmatic atrophy and contractile dysfunction. ..

..End of Abstract) ..

..Because BPD is similar to emphysema, this research also may lead to better understanding and treatment of chronic obstructive pulmonary disease (COPD) in adults. ..

..Because BPD is similar to emphysema, this research also may lead to better understanding and treatment of chronic obstructive pulmonary disease (COPD) in adults. ..

..End of Abstract) ..

..Our long-term goal is to develop methods for the prevention of MV-induced diaphragmatic weakness based on an understanding of the cellular mechanisms responsible for MV-induced diaphragmatic atrophy and contractile dysfunction. ..

..End of Abstract) ..

..Because BPD is similar to emphysema, this research also may lead to better understanding and treatment of chronic obstructive pulmonary disease (COPD) in adults. ..

..The goal of the applicant is to become an independent researcher in the area of neurophysiology and neurotoxicology with the ability to run his own laboratory and write successful grant applications. ..

..The study will also identify the most important factors that make ICU patients thirsty so that future research studies can test how to relieve those factors and/or make interventions for thirst more readily available. ..

..The study will also identify the most important factors that make ICU patients thirsty so that future research studies can test how to relieve those factors and/or make interventions for thirst more readily available. ..

..We will test the hypothesis that the promoter regions of our 3 target genes are retinoid responsive. Thus, this project will provide novel mechanistic insights about alveolar formation and its dysregulation in CLD. ..

..Results will also contribute empirical data needed to generate and test hypotheses concerning appropriate symptom assessment and management interventions. ..

..Findings will assist in designing airway management interventions and technologies to improve the outcomes of critically ill patients, and inform the development of an intervention/technology package to reduce VAP. ..

..By evaluating the effect of oxygen exposure on oxidant stress and airway dysfunction this award will identify new therapeutic approaches to improve respiratory health of preterm infants in early childhood. ..

..This should provide novel insights into the regulation of cytokine expression during gram negative sepsis while identifying mechanistic therapies to ameliorate acute lung injury and multiple organ failure. ..

..If recommended therapy is beneficial but underutilized, these results will alert quality improvement officers and policy makers to an important opportunity to improve patient care for a common and deadly illness. ..

..The experiments also should help establish the molecular basis for the potentially therapeutic benefit of retinoids. ..

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..Alternatively, if nominal video-based approaches achieve comparable outcomes, training efforts can be streamlined at considerable cost savings with fewer impediments for distribution and dissemination. ..

..This will enable a synthesis integrating the signal transduction of peptide and non-peptide mediators with organ system interactions, and provide further insight into potential therapeutic interventions to ameliorate ARDS with MSOF...

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..Analyses will incorporate standard and novel approaches of genetic association to assess if and how genetic variation influences resuscitation outcome. ..