Tracheostomy is a well-established procedure which performed in critically ill adults requiring prolonged invasive ventilation. Transoral endotracheal tubes are poorly tolerated, have risk of dislodgement, require more sedation, and limits movement communication, while tracheostomy has been shown to improve patient comfort facilitate weaning better respiratory tract toilet. The common indicatio...

Total body oxygen uptake (VO2) increases during the transition from machine-assisted ventilation to spontaneous breathing. Since the volume of oxygen consumed by the respiratory muscles must contribute to the increase in VO2 (delta VO2), we explored whether delta VO2 and/or measurements of respiratory power output (Wresp) provide clinically useful information in the evaluation of disease state ...

Objetivo: Identificar os fatores preditores de sucesso no processo extubação paciente adulto, identificando quais do na adulto. Métodos: Revisão integrativa da literatura, com recorte temporal referente aos anos entre 2017 e 2021. Pesquisaram-se as bases dados MEDLINE, LILACS BDENF, por meio dos descritores “Desmame Respirador”, “Ventilator Weaning”, “Desconexión del Ventilador”, “Respiração Ar...

OBJECTIVE An endotracheal tube (ETT) imposes work of breathing on mechanically ventilated patients. Using a bellows-in-a-box model lung, we compared the tube compensation (TC) performances of the Nellcor Puritan-Bennett 840 ventilator and of the Dräger Evita 4 ventilator. MEASUREMENTS AND RESULTS Each ventilator was connected to the model lung. The respiratory rate of the model lung was set a...

BACKGROUND Mechanical ventilation is delivered to sedated patients during anesthesia, but also to nonsedated patients (ventilator weaning, noninvasive ventilation). In these circumstances, patient-ventilator asynchrony may occur, provoking discomfort and unduly increasing work of breathing. In certain cases, it is associated with an increased inspiratory load. Inspiratory loading in awake human...

Introduction
 A small number of children with repaired congenital heart defects may require a tracheostomy for ongoing ventilatory support. Congenital airway anomalies, laryngomalacia, postoperative complications and genetic syndromes associated facial such as DiGeorge Syndrome (22q11 deletion), can be counted among the reasons why patients are unable to weaned from ventilator. In this stu...

It is a pleasure and honor for me to give the 26th Annual Donald F Egan Scientific Lecture at the American Association for Respiratory Care. Much of my research career has focused on weaning from mechanical ventilation, and a major stimulus for my interest in this subject was an outstanding review article published in RESPIRATORY CARE by its current editor, Dave Pierson, in the early 1980s.1 In...

Weaning from mechanical ventilation represents one of the major challenges and concerns in intensive care units worldwide. The withdrawal time represents at least 40% of the overall mechanical ventilation period. Furthermore, in 30% of clinical cases some incidents will force the clinician to stop the attempt. Fortunately, there have been substantial improvements in mechanical ventilation weani...

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 mech...