INTRODUCTION Reduction of automatic pressure support based on a target respiratory frequency or mandatory rate ventilation (MRV) is available in the Taema-Horus ventilator for the weaning process in the intensive care unit (ICU) setting. We hypothesised that MRV is as effective as manual weaning in post-operative ICU patients. METHODS There were 106 patients selected in the post-operative per...

BACKGROUND When to extubate the endotracheal tube is controversial in patients with depressed mental status. The use of the Glasgow Coma Scale (GCS) with score 8 or above as a criterion for extubation by many investigators is questionable. METHODS A total of 133 consecutive patients (M/F: 86/47; age: 71 ± 17 years) admitted to the respiratory care center (RCC) of the hospital were enrolled. T...

BACKGROUND Rehabilitation is a non-pharmacologic therapy that can restore health and reverse the patient's disability, but the efficacy of rehabilitation in critically ill patients is not well documented. METHODS In a prospective cohort study, we assessed whether the degree of change in functional status after comprehensive rehabilitation influenced clinical outcomes in 77 tracheotomized pati...

• BACKGROUND Use of protocols to reduce weaning time for patients receiving mechanical ventilation helps reduce cost and length of stay. However, implementation of this type of protocol is not easy and requires a consistent collaborative effort. • OBJECTIVE To provide a systematic approach to the weaning process by developing, implementing, and evaluating a protocol for weaning patients from me...

RATIONALE AND OBJECTIVES Duration of weaning from mechanical ventilation may be reduced by the use of a systematic approach. We assessed whether a closed-loop knowledge-based algorithm introduced in a ventilator to act as a computer-driven weaning protocol can improve patient outcomes as compared with usual care. METHODS AND MEASUREMENTS We conducted a multicenter randomized controlled study ...

Mechanical ventilation has, since its introduction into clinical practice, undergone a major evolution from controlled ventilation to various modes of assisted ventilation. Neurally adjusted ventilatory assist (NAVA) is the newest development. The implementation of NAVA requires the introduction of a catheter to measure the electrical activity of the diaphragm (EA(di)). NAVA relies, opposite to...

Two very low birthweight infants with severe clinical hyaline membrane disease requiring mechanical ventilation were dependent on slow-rate intermittent mandatory ventilation, without which they developed apnoea or hypopnoea and hypercarbia. Their ventilator dependence was apparently owing to inadequate ventilatory effort, and treatment with oral theophylline allowed easy weaning to continuous-...

Weaning from mechanical ventilation is usually straightforward but is occasionally challenging. Sedation must be used at the appropriate times and with appropriate dosing. A protocol that calls for a daily sedation holiday with a spontaneous breathing trial decreases time on the ventilator. Early tracheostomy is beneficial in traumatic brain injury patients. Noninvasive ventilation is most usef...

BACKGROUND Noninvasive ventilation has been studied as a means of reducing complications among patients being weaned from invasive mechanical ventilation. We sought to summarize evidence comparing noninvasive and invasive weaning and their effects on mortality. METHODS We identified relevant randomized and quasirandomized trials through searches of databases, conference proceedings and grey l...