scholarly journals Correction to: The role of diaphragmatic ultrasound as a predictor of successful extubation from mechanical ventilation in respiratory intensive care unit

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Randa Salah Eldin Mohamed ◽  
Abeer Salah Eldin Mohamed ◽  
Waleed Fouad Fathalah ◽  
Mohamed Farouk Mohamed ◽  
Ahmed Aelgharib Ahmed
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Intensive Care Unit ◽  
Successful Extubation

An amendment to this paper has been published and can be accessed via the original article.

The possibility of reducing mortality in the neonatal intensive care unit

2016 ◽  
Vol 7 (2) ◽  
pp. 40-46
Author(s):  
Dar’ja V Asherova-Jushkova ◽  
Marina A Kovaljova ◽  
Tatjana V Chaparova ◽  
Anna A Shmeljova ◽  
Elena V Gorodova ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Study Group ◽  
Antibiotic Administration ◽  
Perinatal Center ◽  
Surfactant Administration ◽  
Related Mortality

The analysis of outcomes of various conditions of the premature neonates with extremely low (ELBW) and the very low body weight (VLBW), who were hospitalized for the last 3 years in the neonate intensive care unit (NICU) of the Yaroslavl regional perinatal center was carried out. Comparison of a lethality of premature with ELBW and VLBW depending on change of approaches to respiratory support, both in the delivery room, and at further stages of treatment, antibacterial strategy and infectious control in the department was performed. Was shown 2,5 fold decrease of mortality due to less invasive surfactant administration (LISA) in a combination with strategy of “the prolonged inspiration” and “open lungs”, the reduction of indications to mechanical ventilation. In study group, with use of LISA technique demonstrated the best survival (16,1 vs 53,0 %, р < 0,0002), smaller need for mechanical ventilation (38,7 vs 86,4 % р < 0,0037), reliable reduction of severe intraventricular hemorrhage (IVH) frequency: IVH3 - 12,9 vs 45,5 % (р < 0013), IVH4 - 6,5 vs 33,3 %(p < 0,0028). In the study group bronchopulmonary dysplasia rate was lower, but retinopathy of prematurity developed more often. The role of microbiological monitoring in NICU, restriction of antibiotic administration indications for reduction of intrahospital infection risks of was shown. Introduction of strict measures of infectious control allowed to reduce incidence of a necrotizing enterocolitis (NEK) from 1,5 to 0,4 % and the related mortality.

Collaborative Practice: Development, Implementation, and Evaluation of a Weaning Protocol for Patients Receiving Mechanical Ventilation

2003 ◽  
Vol 12 (5) ◽  
pp. 454-460 ◽  
Author(s):  
Mary Jo Grap ◽  
Dale Strickland ◽  
Laura Tormey ◽  
Kim Keane ◽  
Shannon Lubin ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Length Of Stay ◽  
Spontaneous Breathing Trial ◽  
Richmond Agitation Sedation Scale ◽  
Aggressive Approach ◽  
Respiratory Intensive Care Unit ◽  
Efficient Care ◽  
Practice Development

• Background Use of protocols to reduce weaning time for patients receiving mechanical ventilation helps reduce cost and length of stay. However, implementation of this type of protocol is not easy and requires a consistent collaborative effort.• Objective To provide a systematic approach to the weaning process by developing, implementing, and evaluating a protocol for weaning patients from mechanical ventilation in a medical respiratory intensive care unit.• Methods The weaning protocol used was a modification of a protocol developed by Ely et al. Modifications included a more aggressive approach in proceeding to the spontaneous breathing trial, inclusion of the Richmond Agitation-Sedation Scale, and documentation of the production of secretions.• Results Implementation of the protocol significantly reduced the duration of mechanical ventilation as measured by 8-hour shifts and ventilator days. Although length of stay in the intensive care unit was not significantly reduced (P = .29), a continuing downward trend occurred, from a mean of 8.6 days before the protocol was implemented to 7.9 days during the last 6 months of data collection (P = .07).• Conclusions The need to provide efficient care requires the collaboration of all disciplines involved in providing patients’ care. The weaning protocol introduced in this study demonstrates the benefits of using a collaborative team to identify best practices and implement them in a practice setting.

scholarly journals Study on effect of antenatal steroids on various outcomes in mechanical ventilated low birth weight neonates admitted to neonatal intensive care unit

2021 ◽  
Vol 8 (5) ◽  
pp. 808
Author(s):  
Madhu G. N. ◽  
Anil H.
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Low Birth Weight Infants ◽  
Antenatal Steroids ◽  
Successful Extubation

Background: There has been an increase in morbidity in low birth weight infants, since the advancement in field of neonatology. Mechanical ventilation is one of the important life saving intervention in these babies and if prolonged, it is known to cause various morbidities like bronchopulmonary dysplasia, retinopathy of prematurity, vocal cord injury. In this study we want to know effect of antenatal steroids on assisting in early extubation and in minimising duration of ventilation and prevention of reintubations.Methods: This study is a prospective observational study. The study was conducted in Kempegowda institute of medical sciences, Bangalore. Total of 60 low birth weight infants (<2500gm) who were admitted to the Neonatal Intensive Care Unit (NICU) and were on mechanical ventilator support were included in the study. The study was conducted for a duration of 18 months, between January 2019 to June 2020.Results: Out of 60 cases 49 of neonates underwent successful extubation and 11 had failed extubation and were reintubated. Out of 49 successful extubation cases 18 mothers were not given antenatal steroids and 7 of them received 1 dose and 24 received 2 doses of betamethasone respectively. Among failed extubation group 7 mothers had not received steroids and 2 had received one and 2 doses respectively.Conclusions: In this study, we were able to know the effect on antenatal steroids on duration of mechanical ventilation and also about their effect on extubation success. 

scholarly journals Indications and timing to perform tracheostomy in COVID-19 patients in intensive care unit: a review

2021 ◽  
Vol 8 (9) ◽  
pp. 1450
Author(s):  
Santosh Kumar Swain
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Health Care Professionals ◽  
Surgical Procedure ◽  
Proper Time ◽  
Invasive Mechanical Ventilation ◽  
Clear Cut

Coronavirus disease 2019 (COVID-19) is a fatal and evolving disease   and associated with more complication such as respiratory failure and requirement of mechanical ventilation in intensive care unit (ICU). Tracheostomy is a commonly performed surgical procedure done at ICU for prolonged ventilation of the COVID-19 patients. The indications and timing to do tracheostomy on COVID-19 patients are controversial. The requirement of prolonged invasive mechanical ventilation in COVID-19 patients is placing to increased request to perform tracheostomy. The role of performing tracheostomy in COVID-19 patients is exactly not known. Currently, there is no clear-cut evidence for improvement of the clinical course of COVID-19 patients. However, it is confirmed that tracheostomy decreases the ICU stay. Tracheostomy is usually suggested for avoiding potential tracheal injury within 7 to 14 days. Currently, there is uncertainty for timing of tracheotomy, prognosis of the patients and safety of health care professionals. Enhanced personal protective equipment and optimized tracheostomy can make the procedure safe and beneficial in COVID-19 patients. The need of tracheostomy is increasing in current COVID-19 pandemic. We have to perform this surgical procedure in proper time with safe manner for benefit of the patients and health care professionals. This review article focuses on the indications and optimum timing for performing tracheostomy on COVID-19 patients in ICU. 

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