INTRODUCTION Chronic Obstructive Pulmonary Disease (COPD) is a common disease that tends to occur worldwide and is a common cause of respiratory failure requiring mechanical ventilation and admission to the intensive care unit (ICU). The present study was carried out to investigate the efficacy of sildenafil in facilitating the weaning of COPD patients from the ventilator. METHODS This random...

BACKGROUND AND AIM Studies on weaning strategies have yielded conflicting results regarding the superiority of different methods. The aim of this RCT was to compare the efficacy of gradual pressure support (PS) reduction without an initial spontaneous breathing trial (SBT) with PS-supported SBT. METHODS Patients mechanically ventilated for >24h were randomized to weaning by gradual reduction ...

In the last 15 years, availability of beds in ICUs and new technologies, coupled with improved levels of care, have highlighted a new population of patients labeled as survivors of a catastrophic illness. These patients often require mechanical ventilation (MV) and long-term weaning procedures. Despite the fact that this group of patients represents 10% of all ICU admissions, they account for a...

BACKGROUND AND OBJECTIVE Weaning parameters are commonly measured through an endotracheal tube in mechanically ventilated patients recovering from acute respiratory failure, however this practice has rarely been evaluated in tracheostomized patients. This study aimed to investigate changes in weaning parameters measured before and after tracheostomy, and to explore whether the data measured aft...

Acute respiratory failure (ARF) is a leading indication for performing critical care ultrasonography (CCUS) which, in these patients, combines critical care echocardiography (CCE) and chest ultrasonography. CCE is ideally suited to guide the diagnostic work-up in patients presenting with ARF since it allows the assessment of left ventricular filling pressure and pulmonary artery pressure, and t...

Quality indicators are key elements of quality management. The quality indicators for intensive care medicine of the German Interdisciplinary Society of Intensive Care Medicine (DIVI) from the year 2010 were recently evaluated when their validity time expired after two years. Overall one indicator was replaced and further three were in part changed. The former indicator I "elevation of head of ...

OBJECTIVES To understand the role of patient-ventilator asynchrony in the etiology of sleep disruption and determine whether optimizing patient-ventilator interactions by using proportional assist ventilation improves sleep. DESIGN Randomized crossover clinical trial. SETTING A tertiary university medical-surgical intensive care unit. PATIENTS Thirteen patients during weaning from mechani...

OBJECTIVE To determine early predictors of outcomes of adult patients with severe acute respiratory failure. METHOD 100 consecutive adult patients with severe acute respiratory failure were evaluated in this retrospective study. Data including comorbidities, Sequential Organ Failure Assessment (SOFA) score, Acute Physiological Assessment and Chronic Health Evaluation II (APACHE II) score, PaO...

BACKGROUND Dexmedetomidine can be used for sedation of mechanically ventilated patients and has minor respiratory effects. The aim of this study was to compare the incidence of patient-ventilator dyssynchronies during sedation with dexmedetomidine or propofol. METHODS We conducted a multicentre, prospective, open-label, randomised clinical trial, comparing dexmedetomidine with standard propof...