OBJECTIVE Increased negative intrathoracic pressure during spontaneous inspiration through an impedance threshold device (ITD) causes elevated arterial blood pressure in humans. This study was performed to determine whether the acute increase in blood pressure induced by breathing through an ITD is associated with increased stroke volume and cardiac output. DESIGN Randomized, blinded, control...

BACKGROUND Prompt recognition of the reversal of respiratory failure may permit earlier discontinuation of mechanical ventilation, without harm to the patient. METHODS We conducted a randomized, controlled trial in 300 adult patients receiving mechanical ventilation in medical and coronary intensive care units. In the intervention group, patients underwent daily screening of respiratory funct...

Spontaneous breathing effort of a mechanically ventilated patient can seriously deteriorate the treatment outcome if it is not taken into account when choosing appropriate settings. This paper presents an improved spontaneous model that be used to develop mechanical ventilation algorithms. Through indicative experimental study shown this accurately describes healthy human test subject. In compa...

In this data-driven, evidence-based era of medicine, there remains a substantial portion of medical practice that lacks the ‘definitive’ clinical trial or other supporting science. This aspect of medicine is often referred to as the “art” of medicine and addresses that portion of disease management that is also referred to as clinical judgment or experience. There is probably an element of “art...

We identified 16 randomized controlled trials (RCTs) of methods for weaning patients from mechanical ventilation, 8 of which were trials of discontinuation assessment strategies, 5 of which were trials of stepwise reduction in mechanical ventilatory support, and 3 of which were trials comparing alternative ventilation modes for weaning periods lasting < 48 h. We found that different thresholds ...

PURPOSE This study aimed (1) to determine whether paced breathing (synchronization of the expiration phase with poling time) would reduce the metabolic rate and dictate a lower rate of perceived exertion (RPE) than does spontaneous breathing and (2) to analyze the effects of paced breathing on poling forces and stride-mechanics organization during roller-ski skating exercises. METHODS Thirtee...

The coupling patterns between the rhythm of a mechanical ventilator and the rhythm of spontaneous breathing were studied in enflurane-anesthetized adult human subjects. The spontaneous breathing pattern was altered in response to different frequencies and amplitudes of forced lung inflations. A 1:1 phase locking (the frequency of the mechanical ventilator is matched by the frequency of spontane...