e recent systematic review by Paulus and colleagues provides an insight into manual lung hyperinfl ation (MHI) [1], but deserves further comment. MHI research has generally focused on surrogate measures of secretion clearance, such as lung/thorax compliance [2]. Investigation into the eff ects of MHI on airway secretion clearance is warranted to elucidate the mechanistic and hence potential the...

Sperber, J. 2016. Protective Mechanical Ventilation in Inflammatory and VentilatorAssociated Pneumonia Models. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1208. 84 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-554-9546-6. Severe infections, trauma or major surgery can each cause a state of systemic inflammation. These causes for systemic infl...

Results We found 58/83 (69.9%) patients developed VAEs. Of these, 32/83 (39.0%) had VAC, 27/83 (32.5%) had infection related ventilatorassociated conditions (IVACs) and 31/83 (38.3%) had probable VAP. At multivariate analysis, a high diastolic blood pressure (OR 0.78; 95% CI 0.64-0.95, p = 0.014), high GCS (OR 0.37; 95% CI 0.14-0.98, p = 0.045) and longer duration of ventilation (OR 0.32; 95% C...

In a recent issue of Critical Care, we read with interest the article by Trupka et al. [1], who investigated the utility of an enhanced antimicrobial de-escalation (EAD) program in mechanically ventilated patients with suspected pneumonia. They found that the EAD program did not affect the rate of antibiotic de-escalation or the duration of antibiotic therapy in intensive care units (ICUs). We ...

What should nurses do in caring for intubated patients to prevent ventilatorassociated pneumonia? What is the most effective way to suction patients who are ventilator dependent? Should patients experiencing acute coronary syndrome be given thrombolytics or just be whisked to the catheterization laboratory for a cardiac angiogram, angioplasty, and stent? Should all diabetic patients, regardless...

Pneumonia generally occurs following aspiration of microorganisms from the oral cavity or nasopharynx. Aspiration pneumonia is common in the nursing home population and is often associated with oropharyngeal dysphagia and regurgitation of gastric contents [1]. Dental plaque has been particularly studied as a source of bacteria that may cause respiratory infections. A study in Japan showed an as...

Methicillin-resistant Staphylococcus aureus (MRSA) emerged as a clinically relevant human pathogen more than five decades ago.1 The virulent bacterium was first detected in hospitals and other health care facilities where vulnerable hosts, frequent exposure to the selective pressure of intensive antimicrobial therapy, and the necessity for invasive procedures created a favorable environment for...

AJN t May 2005 t Vol. 105, No. 5 http://www.nursingcenter.com suspended because her gastric residual volumes have been greater than 100 mL per hour. She is lying flat in bed with a temperature of 103°F. Heavily sedated, she responds only to suctioning. What are the most important interventions to consider, and what are the best, evidence-based nursing practices to help Ms. Liston be liberated f...

The oropharyngeal region is one of the most complex niches of the human body being colonized by several species of bacteria and fungi. In the oral cavity, there are several species considered pathogenic and opportunistic colonizers that can cause various diseases. In addition, the ability to form biofilm presented by different bacterial and fungal genera is directly related to the virulence of ...