BACKGROUND Organizational factors associated with adoption and use of respiratory care protocols have received little attention. This study examines patterns of protocol use and features of a hospital and providers that are associated with respiratory care protocol use. METHODS Forty-four hospitals and their health-care providers responded to an online survey regarding perceived outcomes of p...

Long-term acute care hospitals (LTACHs) are health care facilities that admit complex patients with acute care needs (eg, mechanical ventilator weaning, administration of intravenous antibiotics, and complex wound care) for a mean duration of stay of 25 days. LTACHs are different than nursing homes and were initially created in the 1990s in an effort to decrease Medicare costs by facilitating p...

The management of invasive mechanical ventilation, and the regulation of sedation and analgesia during ventilation, constitutes a major part of the care of patients admitted to intensive care units. Both prolonged dependence on mechanical ventilation and premature extubation are associated with increased risk of complications and higher hospital costs, but clinical opinion on the best protocol ...

Methods Once removed the endotracheal tube from patients, who were extubated in our ICU after successful weaning trial, was connected to a filter (Hygrobac), and both were attached to ASL 5000 active servo lung (IngMar medical). The lung model was set with a compliance of 50 ml/ cmH2O and resistance of 10 cm H2O/L/s. The inspiratory effort included sinusoidal half-wave shape, muscular pressure ...

OBJECTIVE To evaluate the prevalence and magnitude of weakness in patients receiving chronic mechanical ventilation and the impact of providing aggressive whole-body rehabilitation on conventional weaning variables, muscle strength, and overall functional status. DESIGN Retrospective analysis of 49 consecutive patients. SETTING Multidisciplinary ventilatory rehabilitation unit in an academi...

OBJECTIVE Meaningful use of electronic health records (EHRs) is dependent on accurate clinical documentation. Documenting common goals in the intensive care unit (ICU), such as sedation and ventilator management plans, may increase collaboration and decrease patient length of stay. This study analyzed the degree to which goals stated were present in the EHR. DESIGN Descriptive correlational s...

OBJECTIVE To determine the prevalence of ventilator-associated pneumonia in an intensive care unit, as well as to identify related factors and characterize patient evolution. METHODS This study evaluated 278 patients on mechanical ventilation for more than 24 hours in a university hospital. RESULTS Ventilator-associated pneumonia developed in 38.1% of the patients, translating to 35.7 cases...

Ventilators functions and features have evolved with the advancement of technology along addition microprocessors. It is important to understand examine benefits risks associated these advanced automated modes. Adaptive Support Ventilation (ASV) a mode that unique Hamilton Medical ventilators, thereby limiting number clinicians who experience using this mode. ASV can make changes respiratory ra...

This paper summarizes the Part 3 of the proceedings of the 8 International Conference on Management and Rehabilitation of Chronic Respiratory Failure, held in Pescara, Italy, on 7 and 8 May, 2015. It summarizes the contributions from numerous experts in the field of chronic respiratory disease and chronic respiratory failure. The outline follows the temporal sequence of presentations. This pape...

Survival to hospital discharge of patients suffering exacerbations of COPD is better than other medical causes for ICU admission. Although non-invasive ventilation (NIV) may prevent progression to tracheal intubation, its failure in most cases should lead to a period of controlled mechanical ventilation aiming for early extubation, possibly supported by NIV and tracheostomy if this fails. A gre...