Mechanical Ventilation (51) Conventional Approaches (1) Patient-Ventilator Interaction (7) Nonconventional Modes (11) Protective Ventilation (4) Liquid Ventilation (5) Ventilator-Induced Lung Injury (8) Weaning (4) Patient Posture (1) Noninvasive Ventilation (9) Adjunctive Therapy (1) Acute Lung Injury and Acute Respiratory Distress Syndrome (24) Classification (1) Prediction (1) Physiologic an...

OBJECTIVE To report the use of a second-generation antipsychotic agent to assist weaning from prolonged mechanical ventilation in an anxious patient. DESIGN Case report. SETTING Medical intensive care unit at the Hospital of the University of Pennsylvania. PATIENT A 39-yr-old white female whose severe anxiety prohibited weaning from prolonged mechanical ventilation. INTERVENTIONS Initia...

No practice has changed more dramatically during my career than ventilator weaning. My training in the late 1980s and early 1990s was often spent at the bedside, debating whether to wean, when to do it, and which technique to use. Experts touted diverse modes and testing parameters, some rational, some not. Fortunately, critical care has evolved since then. The dangers of prolonged intubation a...

Although many studies show that the experience level of physicians is significantly associated with the outcomes of their patients, little evidence exists to show whether junior residents provide worse care than senior residents. This study was conducted to analyze whether the experience level of residents may affect the outcomes of patients cared for in a well-organized setting. We conducted a...

Although the majority of patients can be easily weaned from mechanical ventilation, a substantial minority pose considerable difficulty. These patients account for a disproportionate amount of health care costs, and they pose enormous clinical, economic, and ethical problems. The major determinants of weaning outcome include the adequacy of pulmonary gas exchange, respiratory muscle pump functi...

OBJECTIVE Early weaning from mechanical ventilation is one of the primary goals in managing critically ill patients. There are various techniques and measurement parameters for such weaning. The objective of this study was to describe the practices of ventilatory weaning in adult intensive care units in the city of Cali. METHODS A survey of 32 questions (some multiple choice) evaluating weani...

OBJECTIVE To test the hypothesis that standardizing the process of weaning from mechanical ventilation would decrease ventilation times and length of stay in a surgical intensive care unit. DESIGN Comparison of historic ventilation times with physician-directed weaning with those obtained with protocol-guided weaning by respiratory therapists. SETTING Urban, teaching surgical intensive care...

Mechanical ventilation is a life-saving intervention for patients in respiratory failure. Unfortunately, prolonged ventilator support results in diaphragmatic atrophy and contractile dysfunction leading to diaphragm weakness, which is predicted to contribute to problems in weaning patients from the ventilator. While it is established that ventilator-induced oxidative stress is required for the ...

BACKGROUND The rapid-shallow-breathing index (RSBI) is widely used to evaluate mechanically ventilated patients for weaning and extubation, but it is determined in different clinical centers in a variety of ways, under conditions that are not always comparable. We hypothesized that the value of RSBI may be significantly influenced by common variations in measurement conditions and technique. ...

Early mobilization and aggressive physical therapy are essential in patients who receive left ventricular assist devices (LVADs) due to long-term, end-stage heart failure. Some of these patients remain ventilator dependent for quite some time after device implantation. We report our regimen of mobilization with the aid of a portable ventilator, in patients with cardiac cachexia and LVAD implant...