STUDY OBJECTIVES This multicenter study was undertaken to characterize the population of ventilator-dependent patients admitted to long-term care hospitals (LTCHs) with weaning programs, and to report treatments, complications, weaning outcome, discharge disposition, and survival in these patients. DESIGN Observational study with concurrent data collection. SETTING Twenty-three LTCHs in the...

mission when he suddenly developed severe dyspnea and symptoms of congestive heart failure. Physical examination, ECG, x-ray examination and catheterization of the heart suggested severe mitral regurgitation with left and right heart failure. He was scheduled for operation with the diagnosis of ruptured chordae of the mitral valve with severe mitral incompetence. At operation, all chordae of th...

Patient-ventilator interaction is a key element in optimizing mechanical ventilation. The change from inspiration to expiration is a crucial point in the mechanically ventilated breath, and is termed "cycling." Patient-ventilator asynchrony may occur if the flow at which the ventilator cycles to exhalation does not coincide with the termination of neural inspiration. Ideally, the ventilator ter...

Chronic obstructive pulmonary disease (COPD) and heart failure (HF) both are global epidemics with substantial burden on morbidity and mortality. They present major challenges to healthcare providers and often coexsist. Multiple interactions exist between these conditions. COPD is often responsible for delayed diagnosis of HF and vice versa, since both conditions have similar symptoms such as d...

legal consequences for both the patient and the consulting cardiologist. Enabling the consulting cardiologist to receive as many objective and imaging data as possible, in real time, is the perfect scenario. In this issue of IMAJ, Birati and Roth [3] review the latest data on the usefulness of telecardiology in various cardiac conditions. Although they focus on the Israeli experience and data, ...

INTRODUCTION Although continuous or frequent stimuli in tracheostomized patients may cause tracheal granulomas, little is known about management of patients with translaryngeal intubation. CASE PRESENTATION A 1-month-old Japanese boy, weighing 3.5kg, was admitted to our hospital owing to cardiac failure caused by an atrial septal defect and intractable arrhythmia. To treat his unstable cardio...

The clinical usefulness of inspiratory flow pattern manipulation during mechanical ventilation remains unclear. The aim of this study was to investigate the effects of different inspiratory flow waveforms, i.e. constant, sinusoidal and decelerating, on arterial blood gases and respiratory mechanics, in mechanically ventilated patients. Eight patients recovering after open heart surgery for valv...

Background: Neonatal lupus erythematosus is an uncommon disease. Congenital complete heart block (CCHB) usually happens in neonates with maternal systemic lupus erythematosus. The most prevalent presentation of CCHBis bradycardiathatcanbediagnosed through an electrocardiogram. Case report: Here in, we present the case of a full-term male neonate with gestational age of 37 weeks and birth weigh...

We determined the effect of varying ventilator tidal volume (VT) and inspiratory flow (V) on the inspiratory muscle work (WI) during assist-mode mechanical ventilation (AMV) in four healthy subjects. In another four subjects, under constant chemoreceptor input, we determined the responses of neuromuscular output as assessed by the mouth occlusion pressure (P0.1) to alteration in WI. During AMV,...

OBJECTIVE Arteriovenous carbon dioxide removal (AVCO(2)R) uses a simple arteriovenous shunt for CO(2) removal to minimize barotrauma/volutrauma from mechanical ventilation. We performed a prospective randomized outcomes study of AVCO(2)R in our new, clinically relevant model of respiratory distress syndrome. METHODS Adult sheep (n = 18) received an LD(50) severe smoke inhalation and 40% third...